TREATISE ON HEADACHES:
INCLUDING
ACUTE, CHRONIC, NERVOUS, GASTRIC, DYSPEPTIC,
OR SICK-HEADACHES; ALSO, CONGESTIVE, RHEUMATIC, AND PERIODICAL HEADACHES.




NOTICE.
To obtain the most rapid yet thorough and practical knowledge of the contents of this
volume:
1st. Glance over the Preface and Introduction;
2d. Read carefully the remarks on the action of the different remedies against headache in
the Synopsis.
3d. Read the General Remarks before, and the Reviews and Notes, after the cases given in the
body of the work.
4th. Look over the Cases both in the body of the work, and in the Synopsis.
5th. Finally, make use of the General Review and Index.




A
COMPLETE TREATISE
ON
HEADACHES
AND
DISEASES OF THE HEAD.
1. THE NATURE AND TREATMENT OF HEADACHES.
2. THE NATURE AND TREATMENT OF APOPLEXY.
3. THE NATURE AND TREATMENT OF MENTAL DERANGEMENT.
4. THE NATURE AND TREATMENT OF IRRITATION, CONGESTION, INFLAMMATION AND DROPSY OF THE BRAIN AND ITS MEMBRANES.
BASED ON T. J. RUCKERT'S
CLINICAL EXPERIENCE IN HOMIEOPATHY.
WITH INTRODUCTIONS, APPENDICES, SYNOPSES, NOTES, DIRECTIONS FOR
DOSES AND MANY ADDITIONAL CASES.
BY JOHN C. PETERS, M.D.
NEW-YORK:
WILLIAM RADDE, 300 BROADWAY.
Philadelphia: RADEMACHER & SHEEK.-Boston: OTIS CLAPP.-St. Louis, Mo.:
D. R. LUYTIES, M.D.-London: BALLIERE, 219 Regent-st.-Manchester, Eng.:
TURNER, 97 Picadilly.
1 8 5 9.




Entered, according to Act of Congress, in the year 1853,
By WILLIAM RADDE,
In the Clerk's Office of the District Court of the Southern District of New-York.
H. LUDWIG, Printer and Stereotyper,
39 Centre-street.




AMERICAN ERDITOR'S PREFACE.
I HAVE undertaken the translation and elaboration of "Riickert's
Clinical Experience in Homceopathy, or a complete collection of all the
cures and practical remarks recorded in the literature of Homceopathy
from the year 1822 to 1850;" of which this little treatise on Headaches
forms the first part:
(1). Because it possesses much practical value, and will lead to the
better homceopathic treatment of the sick;
(2). Because it evinces in every line so much industry and honesty of
purpose, that it of itself furnishes strong proof that some homceopathic
physicians, at least, are both pains-taking and sincere;
(3). Because Riickert has recorded and compared the experience of
all classes of homeopathic physicians with the most wonderful faithfulness and impartiality, utterly regardless of his own preferences and
opinions, and without the least trace of a narrow, sectarian or bigoted
spirit;
(4). And finally, because I believe that the experience of the numerous physicians he has recorded is as real and true, as the majority, at
least, of all that is published in the general annals of medicine.




X]                           PREFACE.
One is strongly led to wish, that an equally complete collection of
allopathic cures, effected by a single remedy in each case, had beel
compiled faithfully and impartially by some one of the dominant school,
who is as honest, well educated, and liberal as Riickert.  In default of
this, I have occasionally alluded in various notes scattered through the
work to the best established old school curative and palliative treatment,
by way of contrast with the homneopathic, and for the information of
such medical students and young practitioners into whose hands this
treatise may fall.
I trust that no excuse will be necessary for enlarging the eighty-five
cases of Headache reported by iRickert into the present treatise. Riickert
truly says: " There are but few diseases to which the human frame is
liable, in which painful sensations about the head do not occur more or
less frequently; but few proximate or remote causes which are capable
of exciting disease at all, that do not frequently cause headaches; and
yet, there are but few monographs on the subject of Headaches; but
few works on the Theory and Practice of Medicine in which they arm
treated of fully and systematically.  On the other hand, how fre
quently is the practical physician called upon to relieve and cure headaches;" and how scanty have been the aids to cure, compared with the
frequent demands for cure! It is true that the admirable articles, of Dr.
Black, in the British Journal, and of Dr. Tietze, reprinted in the Boston
Quarterly Journal of Homceopathy, have lately done much towards
lightening the labours of physicians in the treatment of headaches; sill]
Riickert correctly judged that it could not prove an unnecessary task
to collect and arrange all the cases of cure to be found in the published
records of Homoeopathy.
As Riicklert confined himself to a bald and condensed statement'of
cases and their treatment, it was regarded as imperatively necessary to
add a few general introductory remarks upon the Nature and Causes of
the different varieties of Headache. (See page xi.)
As he limited his excerpts almost exclusively to the German Medical
Journals, it was felt incumbent to add the cases most easy of access,




PREFACE.                             Vii
published in the French, English and American works, and periodicals
(see cases, 2, 3, 5, 6, 7, 18, 19, 20, 40, 41, 47, 55, 56, 58, 59, 61 620
63, 71, 81, 82, 83, 84, 85, 89, 98, 111, 112 to 114, and 163.). As his remarks are almost entirely clinical, or drawn from bed-side
experience, it was suggested to fme to add other indications for the
selection and use of remedies a'gainst Headaches, to be drawn principally fromnt their well-known pathoenetic alld curative effects.  (See
Synopsis, patge 101, and numerous, iii:s scattered through the body of
the work.)
Althougth Riikert has been as minute in his directions about the size
and repetition   d loss ies as A strict adherelce to his authorities would
allow, still the ptublisher requested the addition of still more explicit
directions.  in the ott,s on doses, I have mainly foillowed the advice
and prIactice of my  Blamented f'iend Dr. Noack, late of the Leipzig
Homckeopathlic Hospital, arid of the celebrate d Fleischman, of the Vienna
Hospital. Personal oportunities of ohbservin- their practice have strongly
prejudiced me in its fiavour( corroborated as it then was, and now is, by
the successful resulbts of' rmaiv thoulsatid cases of every variety of disease.
I have also added short articles upon several remedies, viz.  Arumn,
Carb. veg., Glonoine, Gratiola, Hepar sulph. and Iris versicolor, and regret
that time and space would not permit me to allude to a few other well
established remedies against chtronic and nervous headaches.
Thus Riickert's valuable, but bahld compilation and condensation of
cured cases, has been gracdually enlarged and modified into a more or
less complete treatise on Headaches.
I feel constrained, however, to miake a flrw remarks upon the varieties
of pain, which have been met in the course of translation.  Every
English and American physician is necessarily surprised at the infinite
variety of pains, which the Germans describe so readily; we admit
aches and pains in general, make some distinction between constant and
intermitting pains, between dull and sharp pains, fixed and shooting
pains, &c., but we know little about the wonderfully numerous, and




Viii                         PREFACE.
minute distinctions of pain admitted by the Germans.  Still, these
trivialities, or profoundly accurate distinctions, whichever they may be,
are inherent in the German mind; I shall never forget my first surprise,
at hearing these minute distinctions admitted, and fluently spoken of, by
peasants and mechanics, not only in the Homceopathic Hospitals of
Leipzig and Vienna, but also in the large Allopathic Hospitals of
Dresden, Leipzig, Berlin, Vienna, Munich, and others.  In Riickert's
part of this work I have encountered the following kinds of pain, among
others: Klopfend-stechend, or throbbing-piercing; Klemmend, or compressing; Stechend-bohrend, or piercing-boring; Klopfend-reissend, or
throbbing-rending, or tearing; Drickend, or pressing, or aching; Betaubender, or stupefying; Glucksender, or clucking pain; Klopfender, or
throbbing, or beating; Reissencler, or rending, or tearing; Auseinanderpressender, or asunder-pressing pain; Pressender, or pressing; Zerspringender, or bursting pain; Wogender, or dashing-beating; Schwappender,
or undulating-dashing;  Ziehend, drawing; Spannend, tension-pain;
driickend-pressend, i. e. pressing-pressing, or pressing-squeezing, or
aching-pressing pain; Schraubender, screwing; Zwiingender, pinching;
Herauspressend, out-pressing; Zusammen-pressend, together-pressing;
Ziehend-wiihlend, drawing-rooting pain; and many others, some of
which have no real meaning, or are of no practical value to any except
a hair-splitting pedant, who doubtless would overlook the state of the
most important functions, neglect the most palpable and significant
physical signs, and think it of no importance to ferret out the exact
seat, or nature of any disease.
Still, to a certain degree, the character of the pain varies according to
the nature or seat of the disease, and in many instances is a sufficient guide'to a discrimination between some forms of disease, (and often enables
a homceopathic practitioner to select a curative remedy, which else had
been next to impossible. In a forthcoming work, I will take occasion
to enter fully into the signification of the principal varieties of pain, and
their appropriate treatment.
One great objection may be raised against this and similar works,




PREFACE.                           iX
viz.: that all the cases reported are successful ones. Malaise and Henderson have published several unsuccessful trials, and Dr. Black, in his
Article on Headache,* says that he had intended, if space permitted, to
report several cases in which treatment proved of no avail; but such
statements might merely afford an opportunity for some less honest
physician to insinuate that a wrong medicine had been given, or that a
better indicated one might easily have been selected.  Hence he contents himself with simply stating the fact, that several unsuccessful cases
had occurred in his own practice, as well as in that of other physicians,
in order that those just commencing homceopathic practice might not
suppose, from silence on this point, that all cases admit of at least temnporary relief; nor be too much disappointed when they meet with such
instances. He says it is advisable from the outset to make the patient
filly understand, that chronic headache of many years' standing cannot
reasonably be expected to be cured in a few months, and may not even
be alleviated in that time, but as a general rule, relief, if not a cure may
be looked for in most cases, after the lapse of some months, or one or
two years.  Of sixty-six cases of chronic and sick headache treated at
the New York Homceopathic Dispensary in 181, eleven were cured,
seventeen much relieved, and thirty-eight remained under treatment; in
1848, of eleven cases, seven were cured, one improved, two not improved, and one unknown.  In the General Homeopathic Hospital
Report,J of fifty-three cases of chronic headache, seventeen were cured,
and sixteen much relieved; of fifty-eight cases of nervous and sick headache,
fifty-six were cured and two not cured; of one hundred and thirty-eight
cases of rheumatic and gouty headache, one hundred and thirty-five were
cured, and three not cured. Of two hundred and nineteen cases reported
by Kiesselbach of Bremen, one hundred and ninety-nine were cured, and
twenty unknown.  Thus, of five hundred and forty-five cases of Headache, of all kinds, no less than four hundred and twenty-five were cured
under homoeopathic treatment, thuirty-four were relieved, and sixty-six
* See Brit. Jour. of IIom., vol 5.
-: See Annual Report of the New York Hommeopathic Dispensary for 1851.




X                            PREFA C(E.
cases were either not relieved, or the result was unknown.  Although
some of these reports are more favorable than the general practitioner
may always meet with in his own practice, still it will be impossible, after
consulting some of the cases given in this treatise, to deny that many
persons suffering with chronic headaches may obtain permanent 3relief
under homceopathic treatment; see cases 3, 5, G, 9, 10, 12, 14, 17, 21,
22, 27, 28, 29, 32, 34, 37, 40, 41, 43, 44, 46, 48, 49, 51, 52, 55, 56.
59, 63, 64, 65, 71, 74, 77, 78, 79, 80, 82, 86, 88, 89, 92, 95, 98, 1041-05, and others.
N.B.  A  volume on Apoplexy, Inflammations and Dropsy of the
Brain, similar in design and execution to the above, is in an advanced
state of preparation and will soon be published.
J. C. PETERS.
742 BRO:.Aw-.LY, N'iw YoaIx.




ON T'HE
NATURE AND CAUSES
HEADACHES.
IN order'to render this treatise rather more complete, it has
been regarded as imperatively necessary to make introductory,
remarks upon the different varieties of Headache, of which
cases of cure have been reported in the following pages.
Of the cases reported by Riickert, he has assumed that:
(a). Six cases, had a nzervous character; viz.: cases 9 and
16, cured by Bell.; 72 and 76, cured by Nux; and 96, by
Pulsatilla.
(b). That twenty-seven, were cases of fleqnicraniac, yJigainze
or One-sided headache, viz.: cases. 9 and 10, cured by Bell.;
29, by Calc.; 46, by China; 57, by Ignat.; 67, 69 and 70, by
Natrnm; 74, 76, 77, 78, 79 and 81, by iNux v.; 87, by Opium;
92 and 96, by Puls.; 101 and 102, by Sang.; 103, 104, 107,
108, 109 and 110, by Sepia; 112 and 118, by Spigelia.
(c). Eleven cases had a congestive character, viz.: cases 14,
15 and 16, cured by Bell.; 30, 34, 35 and 36, cured by Cale.
c.; 37, by Camph.; 68, by Natrultm; 94, by Puls.; and 104, by
Sepia.
(d). Nine cases had a arheumatic character; viz.: cases 23,
24 and 25, cured by Bryon.; 44, by Canstic-Lum; 154, by Dulc.;
61, by Merec.; 101, by Sang.; 108, by Sepia.
(e). Five cases, were of a gastric nature, or attended with
derangement of the stomach, viz.: case 14, cured by Bellad.;
33, cured by Calc.; 43, cured by Calusticumn; 95, by Puls. ~
119, by Sulph.




Xi1                     HEADACHES.
(1). With retching to vomit, in case 21, cured by Bryonia.
(2). With nausea and vomiting in general, in eleven cases,
viz.: case 4, cured by Arnica; 22, by 3Bryonia; 42, by Causticumn; 57, by Ignat.; 67 and 70, by Natrunm; 76, 78 and 80,
by Nux; 106, by Sepia; and 121, by Sulph.
(3). With vomiting of bitter substances in two cases, viz.:
case 12, cured by Bellad.; and 97, by Puls.
(4). With bilious vomiting in live cases, viz.: case 31, cured
by Calc.; 72, 74 and 77, by Nux; and 92, by Puls.
(f). Twenty-two cases bore a periociccal character, occurring in paroxysms, viz.: case 8, cured by Asarum; cases 9,
10, 12 and 16, by Bellad.; case 26, by Bryon.; case 45, by
Chain.; case 46, by China; 52, by Coloc.; 53, by Creosot.;
cases 65, 66 and 70, cured by Natrum; cases 72, 74, 77 and
79, by Nux; and cases 120, 122, 123 and 124, by Sulph.
(g). Fourteen cases were of an undcetermie ned character, viz.:
case 1, cured by Acon.; 11, 13 and 17, by Bellad.; 27, 28,
32, 35 and 36, by Cale.; 49 and 50, by Coloc.; 73, by Nux;
88, by Phosph.; and 91, by Puls.
1. NERVOUS HEADACHES.
These are generally understood to include periodical and
neuralgic headaches, Hemicranias, Migraines, one-sided, or
uni-lateral headaches, and some forms of so called sick-headachle, viz.: those in which no disturbance of the stomach has
bene evident before the headache set in, and nausea and
vomiting do not occur until after the pain in the head has
lasted some time, and become severe. The substances vomited
in an attack of trute nzeruvous headache are generally destitute of acid, bile or any acrid property; while in sick-headache,
previous derangement of the stomach, bowels or liver is
generally evident, and undigested food, bile, or some other
offending substance is always vomited up.
Nervous headaches occur muost frequently in delicate males,
and females of a highly nervous temperament, and are apt to
be reproduced by any unusual excitement, by joy, hope, fear,
excessive pleasure, anxiety, fasting, fatigue, &c. They are




NERVOUS HEADACHES.                Xiii
said, generally to depend upon a feeble, disturbed, or irritable
state of the nervous system; still, as the Great Sympathetic
nerve in some of its ramifications is the nmost common seat of
the disorder. and this nerve also presides over the circulation
of the blood, we are apt to have more or less of passive or
active congestion, attending the so-called nervous affection.
It has long been a stumbling-block in the way of pathologists
to explain why a weakened and debilitated state of a nerve
should be followed by pain, rather than of loss of sensation;
or by congestion, rather than aniemia; but late experiments
by Claude Bernard lhave apparently thrown much light upon
this point. He says it has been known for a long time that
cutting the medulla spinalis through, or certain other nervous
trunks, such as the par vagumn, the sciatic nerve and others,
will cause a general or partial, but decided diminution of the
warlmth of the body; but the reverse of this is the case when
the great sympathetic is cut through. Bernard noticed in
cutting through the cervical branch of the sympathetic nerve
which unites the cervical ganglions, that there followed immediately, an increase in the heat of the corresponding side of
the face, which could very easily be appreciated by the hand,
and which was found to be from 4~ to 6~ centigrade higher
by the thermometer. When the superior cervical ganglion of
the great sympathetic was entirely extirpated, Bernard found
the same effect produced with even greater intensity; and at
the same time that the heat was increased, the circulation of
the blood became more active. This new phenomenon of
increased calorification continued for a long time; Bernard
found it to last at times for several successive months, without
being attended with, or followed by any appearance of inflammation or cedema, or any other pathological change. If all
this be true, it is easy to understand why a feeble state of
the sympathetic nerve may be attended by heat and congestion to the head. The occurrence of pain is explained in
a similar way:
Bernard asserts, that when a nerve of sensation is cut, every
one knows a loss of feeling in the part to whieh it is distributed




Xiv                -  HEADACHES.
is produced; but the reverse is the case when the great sympa:
thetic is cut; if the superior cervical ganglion be extirpated,
the sensibility of the whole corresponding side of the face is
augmented; and it is particularly in the eye that this phenomienon canu be detected with most ease. Somewhat similar
experimlents by other physiologists, were cited by the translator
as early as 1841, in the second volume of the Homceopathic
Examiner, old series, p. 131. If these things be really true,
it is very easy to infer, that a debilitated condition of certain
parts of the great sympathetic nerve may be followed by heat
and congestion to the head, pain about one side of the head,
one temple or one eye; in fact, by all the phenomena of
nervous headache or hemicrania.
There is one form  of true ner~'vous headache, which
might very properly  be termed the nervous sick-hecadache, because it is attended with violent and long continued
nausea, retching and vomiting; it is frdecuently mistaken
for the true gastric, dyspeptic, or bilious sick-headache.
Although I am very far from denying that some derangemnent of the stomach or blood often causes headache, still
I feel convinced that the nausea, retching andcl vomiting
which attend: nervous sick-headache, are always sympathetic and secondary, to a primary disorder of the brain,
or nervous system. The true nervous sick-headache probably arises from an affection of the right Corpus Striatum;
at least experiments conducted by Budge seem  to prove
this almost conclusively; after killing a young dog, he removed
the skull rapidly, while an assistant laid open the abdomen
and exposed the bowels; the hemispheres of the brain were
then cut away, the Corpus callosum raised, and the Corpora
quadrigeinina and Corpus Striatum irritated with a sharp
needle, with the effect of producing marked perstaltic action
of the stomach and bowels; even when all perstaltic action of
the bowels had entirely ceased, it could at once be reproduced
by irritating the Corpora quadrigemina, and motions of the
stomach could always be excited by irritating the Corpus
Striatum, especially on thel rliht side. These experimients




NERaOUS AN-D SICK-HEADACIFS.           XV
throw  much light, not only on the vornmiting which attends
nervous sick-headache, but also explain the early occurrence,of vomiting in dropsy of the brain, the presence of obstinate
constipation, and we will soon see that they afford an explanation of the slowness of the pulse which attends the same
disorder. In fact, every careful observer must have noticed
that vomliting does not occur in nervous sick-headache, until
the pain has lasted some time and become cquite severe, proving
that the nausea and vomiting,'are secondary to the brainaffection. I have regarded it imperative to lay much stress
on these points, because all sick and nervous headaches have
imuch too generally been viewed in the light of secondary
affections, dependent upon derangement of the stomach and
liver, and thus their existence as primary disorders greatly
overlooked. Black truly says this error has no doubt rende'red the ordinary treatment so uncertain, and will also
confuse the homceopathic practitioner, if not sedulously
guarded against. Still, I have already willingly admiitted
that derangement of the digestive organs will often cause
headache or neuralgiat, which maV depend upon the nlere
presence of acid in the stomach; Dr. Rigby tells Us, that
having suffered in his own person an intense attack of Tic
doulonreux which OpiUnm would not assuage, he swallowed, at
the suggestion of a friend, some Carbonate of Soda dissolved
in water; the effect was almost imnnediate, carbonic acid was
soon eructated, and the pain at once abated. Again, the celebrated PROUT, from personal and other experience, concluded
that: excessive acidity of the ececumn is generally accompanied
by a deficient secretion of bile, and somletimles by a complete
temporary suppression of the biliary discharge, apparently
fi-om spasmodic constriction of the common gall duct; or, may
be, of the biliary ducts themselves. In this state of things, all
persons, he says, feel more or less of uneasiness; but the point
which he wishes to mention is, that certain individuals under
these circumstances, experience what is called nervous headache. This species of headache is frequently accompanied by
nausea,. is: confined to the forehead, and when severe produces




XV1                    HEADACHES.
complete intolerance of light and sounds, and a state of mind
bordering on delirium. After a greater or less period of time
the pain ceases, sometimes quite suddenly, and the remarkable
circumstances to be mentioned are, that this sudden termination is preceded by a peculiar sensation, sometimes accompanied by an audible clinking noise in the region of the gall
ducts, which immediately after is followed by a gurgling
sensation in the upper bowels, as if a fluid were passing
through them; in a few secoids after this fluid, which Prout
supposes to be bile, has reached the cnecum, the headache at
once vanishes like a dream. One of the greatest martyrs to,
this species of headache Prout has ever seen, invariably experiences the train of symptoms above described; and Prout has
witnessed it in a greater or less degree in many instances;
and indeed has experienced it in his own person. This variety
of headache is generally termed BILIOUS. These facts simply
prove, that irritation in the brain and nerves may be propa —
gated down, along the sympathetic nerve to the stomach; and
vice versa, that irritation in the stomach may travel up along
the same nerve to the brain or face, producing the so-called
dyspeptic or gastric headache.
The most superficial knowledge of the anatomy of the great
sympathetic nerve, will suffice to explain the readiness with
which irritation of the stomach, bowels, liver, urinary or
genital organs may be propagated to the brain, viz.: to those
parts of it supplied with filaments from the sympathetic nerve.
Thus, ist: the Pars  cephalica nervi syrpathetici, consists
principally of two filaments which proceed from the upper
part of the superior cervical ganglion; the larger and more
anterior being called the Carotid nerve, the smaller and posterior, the Jugular nerve. They effect the communications of
the sympathetic nerve with almost all the cerebral nerves.
(a). The Carotid nerve follows the course of the internal carotid artery, passes through the carotid canal into the skull, and
divides into an anterior and posterior branch, which, with their
twigs form the Internal Carotidplexus; from this plexus arise
the Inferior and Superior Carotico-tympanic nerves which go




NERVOUS AND SICK-HEADACHES.          XVii
to the internal ear, and explain the occurrence of noises in the
ears, sensitiveness to noises, &c., which attend many headaches. The Internal carotid plexus of the sympathetic nerve
gives off: (1) the deep and superficial Vidian nerves going to
the Spheno-palatine plexas; (2) three branches going to the
Ganglion of Gasser, situated in the orbit of the eye, and giving
off a twig to the Ophthalmic branch of the fifth pair of cerebral
nerves; (3) two twigs to the Oculo-motorius and abducens
nerves of the eye; (4) a twig which connects with the Ciliary
ganglion of the eye; (5) and finally, sends off branches which
accompany the Cerebral carotid artery, one of them sinking
into the Pituitary gland, and another reaching the interior of
the eye and retina, by following the course of the Central
artery of the retina. These intimate connections of the sympathetic nerve with the nerves and substance of the eye
sufficiently explain the intolerance of light, pain in the eye,
dimness of vision, motes, colors, and other phenomena of the
eye which so commonly attend nervous and sick-headaches;
and the readiness with which excessive use of the eyes will
excite headache in solme persons.
(b) The cervical ganglions of the sympathetic nerve give off
branches to the heart, throat, windpipe, to the temporal, maxillary and facial nerves, to the scalp, the vagus and recurrent
nerves, &c., sufficiently explaining the occurrence of palpitation of the heart, choking about the throat and windpipe,
pains about the temples, jaws and face, tenderness of the
scalp, and other sufferings which so often complicate and
aggravate nervous headaches.
We are now prepared to understand why such an immense
variety of exciting causes, and so many disturbances of distant
organs will produce attacks of headache; thus, the effects of
mental emotions and passions may be propagated from the
brain to the various branches of the sympathetic nerve in,
and about the head.  The same happens with the eye;
at least PIORRY has drawn particular attention to the frequency with which one-sided headache, or hemicrania arises
from irritation of the retina and iris, excited by excessive
B




XVi1                   HEADACHES.
use of the eye, bright light, or gorgeous spectacles; in short,
he regards hemicrania as originally a neurosis or neuralgia
of the retina and iris, confined at first to these parts,
but soon extending to the branches of the sympathetic and
cerebral nerves connected with them, and then marked by
disturbance of vision, pain in the eye, about the orbit and
temple, in the head, or on the surface of the skull, and finally
followed by nausea and vomiting. Affections of the ears, loud
or long continued noises will produce the same kind of headache in those predisposed. I have already referred to other
exciting and remote causes of headache; at present we will
confine our attention more particularly to some of the peculiarities and symptoms of Jligraine, JfegriT, fIemzicrania or
one-sided headache:
TISSOT says, when IMigraine is hereditary it often commences
as early as the seventh or eighth year, or even earlier, but
most commonly makes its appearance from the thirteenth to
the twentieth year of life, and continues in full force to the
fifty-fifth or sixtieth, then almost wholly ceases by the seventieth. If one is not attacked by it before the twenty-fifth year,
it is rare to become subject to it afterwards. I have seen boys
of three or four years, and girls of five or six years subject to
repeated attacks of sick-headache.
Some persons have only eight, or nine attacks a year; and
true Migraines, which occur more than three times a month.
or less than four times a year, are very rare. The paroxysms
have been known to occur with great regularity every fifteen
days, or every Monday, or Friday or Sunday, or some other
particular day of the week, for years, always at the same hour
of the day, and to last at least twenty-eight, and never more
than thirty hours; some of these cases are cured by travelling,
at least the celebrated FRANK: reports the case of a lady in
Milan, who was attacked every Wednesday with severe
headache; she was cured by going out into the country every
Tuesday, and not returning until Thursday. Still, susceptible
persons are generally liable to it at any time, and from a great
variety of causes; from breathing certain odors, from the influ



NERVOUS AND SICK-HEADACIHES.           Xix
ence of stormy weather, from moral emotions, from long continued studies, from an unaccustomed walk in the open air,
from the impression of cold on the bare head, from various
disturbances of the stomach, difficult digestion, hunger, the
use of certain articles of food, reading, studying, or pre-occupation directly after eating, &c. Hience it is evident, from
the great variety of the exciting causes which produce
headache, that the number of cases which occur at irregular
periods must be very much greater than those which re-occur
at regular and fixed periods of time. It is rare for a paroxysm of true hemicrania to last less than six hours, and it is
not common for it to be prolonged more than two days.
TISSOT thought, when an attack commenced with a slight
sensation of chilliness, the paroxysm was apt to be very
severe, and to be confined to the side on which the chill was
felt; and that in most attacks the same side of the head was
apt to be affected, although they have been known to affect
each side alternately, with great regilarity. He also thought
that those attacks which were preceded with sadness and
irritability for several days, were apt finally, to set in severely
on the going down of the sun, and to commence with a severe
chill. China, Arsenicum  and Nux, are said to be almost
specific in these cases. Other attacks may be preceded by a
degree of deafness for twenty-four hours. See Puls. and China.
PIoRiY thought that nervous and sick-headaches occurred
chiefly under one of two opposite conditions of the stomach,
viz.: either from a state of too great repletion, or of too great
abstinence. The so-called hungry headache is sufficiently
common in many young persons; it is apt to be preceded by,acid eructations, or by excessive hunger, or vomiting of acid
or acrid matters, and by an annoying sense of gnawing at
the pit of the stomach. Calcarea, Carb. veg., Veratrum, &c.,
deserve attention.
Some attacks are relieved by spontaneous vomiting;:- "in
others, the vomitings are a mere consequence of the seerity of
the pain, and do not afford relief; C. PISON first drew:attention
to the difference between the sympathetic and  ivusiie




XX                     HEADACHES.
vomitings, and the curative ones. Ipec., Puls., Cocculus,
Zinc., &c., are suitable.
Some attacks are much relieved by sleep; but others, in
which the disorder is seated primarily in the brain itself, and
extends to the sympathetic nerve secondarily, the more the
patient sleeps, the more the brain becomes congested, and
the worse he is; improvement only commences when he is
fairly aroused, and wide awake.  Opium, Hyosc., Coffea,
Thea, and other remedies are indicated.
Some paroxysms terminate by profuse sweats upon the
fore-arms and hands, and when these perspirations occur
regularly every morning the hemicrania will soon cease for
ever. Aconite, Arnica, Valerian, Sambucus, Ammon. acet.,.
Nux, and other remedies may be useful in bringing about
this desirable result.
Some cease after a slight bleeding of a few drops from the
nose. In such cases, Crocus, Carb. veg. and China, deserve
attention.
Sometimes an eruption of small pimples terminates the
attack, or a sweat on the affected side of the head and face,
or a profuse flow of tears, or free discharge of serosity from
the nostril. All these varieties of critical terminations doubtless require remedies suitable to aid and produce them, not to
check them. See Sulphur, iHepar sulph., Sepia, Gratiola, and
Arsenicum.
Although repose is necessary in most cases, some are only
relieved by riding in a carriage. Some are relieved in the
beginning of an attack by exposure to the fresh air, others are
made much worse. See Cocculus, Calcarea, 3Mere., Natrum,
and Hepar s.
In some cases the face of the sufferer is pale and shrunken,
in others red, hot and flushed, in others again, pale but bloated..
See China, Bellad., Ars., Verat. and Sepia.
When the pain follows the course of the external carotid
nerve the scalp becomes excessively sensitive to touch, and
the pains resemble those of rheumatism of the scalp; Wepfer
has even seen the hair to rise on end during the severity of




NERVOUS AID SICK-HEADACHES.             XXi
the paroxysm. See China, Colocynth, Bryonia, Carb. an.,
and others.
In other cases, the pains extend themselves violently
towards the teeth, and sometimes to all the parts supplied by
the fifth pair of nerves, so that the patient cannot open his
mouth, nor articulate a word; in other cases, the sufferings
extend to the neck, shoulder and arm, which remain painful
for some time afterwards. I have seen several cases which
always pass off when severe pain in the back, one knee, or
leg sets in. See Colocynth, Aconite, Aurum, Bryon., Causticum, Rhus, and others.
In other cases the disorder extends down along the sympathetic or pneumo-gastric nerve towards the stomach, liver, and
bowels; eructations occur, either inodorous, and without taste,
or of an insupportable mawkishness; abundant mucosities and
salivary fluid flow into the mouth, intermixed at times with
those of a bitter, bilious taste; there is extreme disgust for
food; the general malaise is increased by a fatiguing beating
of the heart, and by paroxysmal distensions of the stomach
with gas, followed by belchings, with transient relief; or
vomiting may occur, excited by the swallowing of the fluids
which collect in the mouth, and nmucus, or a little bile, and
much wind may be expelled. From time to time some alleviation may ensue, the distress in the epigastriumn. be less
great, the headache less severe, but occasional aggravations
also occur, followed again by intervals of relief, and finally one
or two easy loose stools set in, occasionally liquid and bilious,
and the whole attack subsides. See Colocynth, Cocculus,
Carbo animalis, Caps., Caust., Lachesis, Natrum, Creosote,
Pulsatilla, Sepia, and others.
Hence numerous varieties of iHemicrania have been admitted by PELLETAN.
1st. The Migraine stomacale.
2d.   "      "    Irienne, or of the Iris.
3d.   "      "    Uterine.
4th.   "     "    Plethorique, &c.




XXii                  HEADACHES.
These divisions are of importance to the homceopathist, as
they impress still more forcibly upon him the necessity of
selecting a remedy which acts, not only on the part of the
head involved by the Hemicrania, but which will also regu
late the variously disturbed functions of distant organs.
ayygienic treatment of Nervous Ileadaches.
A general invigorating mode of life, diet and exercise are
considered indispensable. Those who have brought them on
by sedentary habits, much mental exertion and loss of sleep,
must reform; they must exercise freely and regularly in the
open air, sleep sufficiently; and avoid the excessive worry
and perplexity of engrossing cares, or they may ultimately
be forced to take a journey into the country, or a long voyage,
to save their minds from becoming perfectly wrecked. If
the patient be in the habit of using strong tea, coffee or
tobacco habitually and excessively, he must try the effect of
abandoning them, for three or four weeks at least.
It is ordinarily thought sufficient to abstain from the use of
coffee and green tea, but WOOD had one striking instance
occur to himl  in which a patient, after suffering long and
severely with nervous headache, obtained an entire exemption
from it, by abstaining from the use of black tea, which was
his only indulgence. The shower-bath, and salt water bathing,
either at the sea-side, or in the house, are often useful adjuncts.
IBOERHAAVE advised persons who suffered from chronic headaches to use a warm bath frequently, and to rub their feet
briskly every morning with a piece of flannel, or cloth
dipped in cold water. OSIANDER says, if people would but
rise every morning, at 5 o'clock; and continue it during the
summer, or take an hour's walk before breakfast, they would
get rid of their headaches. He also affirms that simply
combing the hair carefully and constantly, just before going to
bed, relieved a lady from chronic headache.
Hard rubbing of the feet with rough cloths after a foot
bath is one of the best external remedies, according to BusHAN.
The meals of the patient should be taken regularly, and




NERVOUS AND CONGESTIVE-HEADACHES.       XXiii
when body and mind are refreshed, not wearied by exertion,
anxiety or needless worry.
It need scarcely be added that the bowels should be kept
regular, costiveness obviated, (and tendency to diarrhea
controlled), as far as possible by attention to diet. The
functions of the stomach and liver should be kept in as healthy
a state as practicable by the patient, by control of the appetite
and tastes in food and drinks; those of the kidneys and skin,
by attention to clothing, bathing, drinking of cold water, &c.;
and those of the uterus by great care at the monthly periods,
favoring the flow, if it be scanty, by avoidance of cold and
wet, excessive fatigue or mental emotion, the use of the warm,
or mustard foot or hip-bath, &c.; if the flow be excessive and
debilitating, absolute rest, cool drinks, cold-water injections,
&e., may be used.
Those who will indulge in the dissipations of excessive
pleasure, business, grief, or gormandizing, will needs retain
their headaches.
2. CONGESTIVE HEADACHES.
These may be active or passive, venous or arterial, arising
from too great and too rapid a flow of blood to, or too slow a
return of the blood from the head. They may occur singly,
or as complications of nervous or irritative headaches, the
congestion being secondary; or they may arise from irritation
of the brain or neighboring parts;] or the brain-trouble may
be entirely secondary to an irritated, or sluggish state of the
general circulation.
I have already alluded to the frequency with which nervous
headaches are attended with congestion, and have cited the
experiments of C. BERNARD as affording some explanation of
the manner in which congestion follows disorder of the Great
Sympathetic nerve. But TURENNE has lately advanced a new
theory of nervous headache or hemicrania; he decrees that
the pain in the head is caused by compression of the facial
nerve, especially of its ophthalmic branch, from accumulation
of blood in the sinuses at the base of the brain. He alludes,




XXiv                  HEADACHES.
in proof of this, to the fact, that the ophthalmic nerve and its
brBanches are spread on the external wall of the cavernous
sinus, and hence are necessarily compressed whenever this
reservoir is crowded with blood. The nausea and vomiting
of nervous headache are said to arise from compression of the
eighth pair of nerves, at the Foramen lacerum posterius, or
somewhere along the neck. The swelling, redness, pain, and
watery condition of the eyes, and disturbances of vision in
nervous headache, are said to arise from the difficulty with
which the ophthalmic vein empties itself into an already overfull cavernous sinus, and from consequent compression of those
fibres of the ophthalmic nerve which go to the eye, white of
the eye, lachrymal gland and eyelids. I-Iemicrania is also
decided to be most frequent on the left side, because the left
sinuses of the brain are larger and more distensible than
the right.
The more common varieties of congestive headaches are so
well understood, that it will only be necessary to say a few
words about the less common ibrms.
(a). Th/e Stupid hIeadache of Dl)r. Good
Is said to be marked by obtuse pain, sense of heaviness
extending over the whole head, and may arise from various
causes, especially from whatever prevents a fiee evacuation
of the right auricle and ventricle of the heart, and contributes
to retard the motion of the blood in the veins which discharge
their contents on this side of heart.  The congestion is
supposed to be secondary to nervous debility, or in other
words, to arise from the want of a proper and sufficient
supply of that nervous power, or may be fluid, on which the
feeling of organic comfort, refieshment, and vigor depends.
Hence this variety of headache has been decreed to be peculiarly marked by a sense of general disquiet and confusion,
rather than severe pain; by a general hebitude of sensorial
power which disqualifies the one laboring under it for a
continuance of mental labor; the sight is dim, the hearing
dull, the memory vacant, and hence it is most common in
feeble persons, and in hard students.




CONGESTIVE-HEADAC-rES.              XXV
The stupid headache from nervous exhaustion is closely
allied to that from venous congestion. See Opium, HIyosc.,
Bellad., Stramon., Coffea, Bryon.
(b).  llMienstrual Congestive Headache.
Another very frequent variety of congestive headache is
that which occurs near, before, during, or shortly after menstruation, especially when this is scanty, painful or difficult.
The state of system previous to the first establishment and
periodical recurrence of menstruation tends obviously to a
state of general plethora, which ought in due time to be fully
relieved by a means which nature adopts for the purpose.
But tendency to irritation of the brain, or some other organ,
or a loss of balance in the circulatory and nervous system, or
other causes, may allow the blood at such periods to rush
towards some distant organ; or want of proper and abundant
flow from the uterus may leave the system, or some particular
organ, oppressed and crowded with blood. Sabina and Stramonium are particularly suited for these menstrual congestions of the head, and many other organs. Almost every
variety of headache is aggravated about the menstrual period;
but when headache occurs just after the menstrual flow,
especially if this has been quite profuse, the headache is
probably not congestive, although it may be severe, for nervous
headache in excitable persons is apt to be brought on by
whatever directly, or indirectly debilitates, viz.: by bleeding,
purging, fatigue, loud noises, vivid lights, using the eyes too
much, or too closely, and other fatiguing or debilitating causes
or losses, such as diarrhzea, excessive perspiration, or profuse
menstruation.
(c). Hcemorrhoidal congestion.
Suppressed, or retarded piles are apt to be followed by
irregular hlemorrhoidal congestions to  the head, chest,
stomach, bowels, liver, spleen, kidneys, uterus, bladder, or
any other predisposed organ; hence may arise redness and
heat of face, illusions of vision, dizziness, threatening of
apoplexy; or constriction and anxiety about the chest, and




Xxvi                    HEADACHES.
even spitting of blood, or vicarious bleeding from tile lungs;
or throbbing and aching about the stomach, with or without
vomiting of blood; or aching in the liver and spleen with
threatening of dropsy; or venous congestion of bowels with
vicarious bleeding from them, or aching in the region of the
kidneys with scanty discharge of urine, or tenesmus of the
bladder from venous or halmorrhoidal congestion of it, and
bleeding from the kidneys or bladder, or congestion to the
womb with more or less profuse and vicarious hm-emorrhage
from it. In females, the vicarious menstrual and hmmorrhoidal
congestions and hemorrhages are so similar in their symptoms that superficial or careless physicians are very apt to
confound, and maltreat them. Sabina is the specific for the
former, Aloes for the latter. According  to  Schcenlein,
menstrual congestion of the headc is frequently marked by
stiffness of the neck; dull aching pain in the nape and occiput,
from congestion of the cerebellum; by rushing and roaring
noises in the ears, hardness of hearing, confusion of the head,
momentary loss of consciousness, followed by bleeding from
the nose, ears, or Caruncula lachrymalis. Still the symptoms
may differ widely fronm the above description, and very
frequently assume the appearance of a most perfect onesided nervous headache.
According to the same authority true hemorrhoidal congestion of the head is marked by great heaviness and confusion
of the head, the choroid coat is over-filled with blood, and
the sclerotica acquires a peculiar blue tinge, owing to a
varicose state of this membrane; there are also illusions of
the senses, appearances of sparks, figures, motes, flies, spider
webs and feet before the eyes, which often cause partial
blindness. From time to time violent vertigo sets in, throwing the patient into violent nervous agitation, as he supposes
that he is struck with apoplexy.
(d).  Throbbing H~eadache.'This is generally mistaken for the true congestive variety;:the pain is pulsatory, chiefly in the temples, often attended,with sleeplessness, and a sense of drumming in the ears; it




RHEUImATIC-IIEADACHES.           XXvii
depends upon an affection of an artery, or part of an artery,
without any dependence upon the regular systole of the
general circulation; thus, one or both temporal arteries are
often disturbed by this spastic irritation, and a pulsation is
produced nowise synchonous with the action of the heart,
but often half as rapid again. (See Camph., Valerian, &c.)
(e). Anwmic HTeadcache.
It is well known that excessive loss of blood will produce
all the signs of violent congestion to the head. (See China,
Ferrumn, Manganese, &c.)
3. RHEUMATIC AND GOUTY HEADACHES.
Rheumatic headache is described by some as a chronic
headache with vehement pain, but especially characterized
by a sense of tension of the whole head. If this form be not
always rheumatic, it is always dependent upon some local
irritation, of which rheumatism is the most frequent. As all
rheumatic affections, when they become chronic, have a
tendency to intermit and return periodically, we may easily
see why the disease before us should do so in many instances.
GooD says it may be distinguished from other varieties by its
being rather limited to some particular part of the head, by
its remissions and intermissions; by the acuteness of the pain
during the paroxysms, by an intolerance of all motion of the
head, far more than of light or sound, both of which, however,
are sometimes highly irksome; but especially by a peculiar
feeling of tenseness or constriction over the brain, as though
its membranes were muscles, and were spasmodically contracted. When the headache is entirely rheumatic, it ceases
as soon as another rheumatic pain sets in, in some other part
of the body. Frequently the disorder may be detected by
attention to its exciting causes; thus, Dr. PARR was for many
years a sufferer from irregularly returning paroxysms of
headache, for which he could assign no cause, but at last
noticed that they frequently returned after having his head
shaved; he suffered his hair to grow, and from that time the




Xxviii                 HEADACHES.
disease gradually lessened in frequency, duration and violence,
and from being a highly serious complaint, and one beginning to affect his memory, its returns became so rare and
slight as never to unfit him for any exertion of body or mind.
LINN~AUS is said to have cured himself of a severe and obstinate
rheumatic hernicrania, which returned every week and continued for twenty-four hours, by merely drinking a draught
of cold water early in the morning, and then walking himself
into a glowing heat. The majority of those so-called neuralgic
headaches which arise from decayed teeth are also rheumatic
in their nature, being excited by the frequent alternations of
heat and cold which reach the exposed nerve. But the secretions of the skin and kidneys afford the most decided
diagnostic signs of the presence of rheumatism; the perspirations and urine are intensely sour, even the secretions from
ulcers are unusually acid in rheumatism; the urine in rheumatic affections may seem nearly natural in color, and be
perfectly clear, and yet found to redden litmus paper very
much more decidedly than in any healthy condition. According to FRICKE the principal cause of rheumatism, as is well
known, is the action of cold upon the skin, by which its
exhalations are retained, and the lactic acid, instead of passing
off as lactate of ammonia, is retained in the blood, finally it
becomes oxydized, and is eliminated as carbonic acid and
water, but this conversion is produced at the expense of the
uric acid, which, thus unoxydized, is deposited about the
joints or other parts, causing pain, swelling and fever.
Until the pulse loses it hardness, the skin and urine their
intense acidity, rheumatic headache will persist, or relapse.
(See Aconite, Bryonia, Pulsat., Rhus, and other remedies.)




ON THE
HOM1EOPATHIC TREATMIENT
OF
HEADACHES.
The remedies used in the following cases of cure and re-,covery, were: Aconitum, Agaricus, Arnica, Arum, Belladonna, Bryonia, Calcarea, Camphor, Causticum, China, Cocculus, Colocynth, Creosote, Dualcamara, Gratiola, Ignatia,
Lachesis, Magnesia, Mercurius, Nux vomica, Opium, Phosphorus, Pulsatilla, Sanguinaria, Sepia, Spigelia, Silicea,
Sulphur, Zincum.
1. ACONITE.
GENERAL REcMARs. —(c6). It relieves the most violent headaches when the patient lies as if unconscious, retches to vomit
at times, whimpers and complains, fears to die, cannot endure
the slightest noise or motion, and in which the pulse is small,
or even intermitting; especially when the pain is throbbing
and piercing, or compressing, seated over the root of the nose,
aind the talking and the speaking of others aggravates it very
nuch. Aconite is also useful against headache fron taking
cold, attended with catarrh of the head, noises inz the ears,
and pains in the abdomlen, or by an annoying sensation as if
a ball rose up into the brain, spreading a cool wind around it.
Also in catarrhal headache when relieved in the open air,
and increased by talking.
Also in migrane, or one-sided headache, when muarked by a
violent, piercing, boring pain over the left eye, and attended
with nausea and vomiting, and aggravated by jarring. In
such cases Aeon. should be followed by Sulph.-DR. HtIEIuN,
p. 136-140.
1




a2                     HEAitMIDASCIxES.
(b). Aconite is indicated in hLeadaches of a congestive-inflammatory nature, when the patient has a feeling of fulness
and tension, as if a band were fastened around his head; in
this respect it resembles Bellad., Chlina, Mere., and Sulph.DR. BLACK.
CASE 1.-A woman, aged 54, of an irritable, complaining,
and vicious nature, readily breaking out into complaints and.
reproaches from slight causes, had suffered for 24 hours, after
taking cold, with severe but undefined headache, so violent as
almost to drive her distracted.  Aconite removed it -in 4
hours. Annals, vol. 1, p. 234.-xAsPAr, i.
[NoTE. —from J7lgeszing's Expeir'iments.-I infer that.Aconite is homceopathic to Headache when attended with numbness and tingling of -various parts, and with a sense of tightness and dragging.
Also for headache marked at first by a sense of warmth
diffused through the body,'with numbness and tingling, and asense of swelling of the lips and face, and tingling at the roots,
of the teeth, followed by a feeling of muscular weakness, by
slowness of breathing and of pulse, giddiness, confusion of sight,.
disinclination to be disturbed or to exert oneself, and attended
with much chilliness, particularly of the extremities, which
become cold to the touch.
Also in headaches attended with numbness of the flesh,
lancinating pains in the bones and joints, vertigo, dimness of
vision, moisture and coolness of the skin, silckness of stomach
and vomitincg, and by paleness and a sunken state of the face,
Also in headaches accompanied with a feeling of weight as
if a heavy load were resting oin the abdomen, bearing one
down to the bed; this peculiar symptom was present in five
cases, and seemed to resemble closely the feeling of oppression experienced in nightmare, which is said to be owing to
congestion of the right side of the heart, from accumulation of
blood in venous systemn/ in consequence of a weakened state
of the circulation.
In two cases it proved homceopathic to shivering, severe
pain in the head and eyeballs, constant lachrymation, intense




ACONITE.                       3
photophobia, heat of skin, quickness of pulse and general restlessness; to nausea, severe and constant vomiting, with pain
and tenderness of pit of stomach, numbrness and prickling of
the skin, dizziness, dimlness of vision, noises in the ears, sensations of weight and enlargement of various parts of the body,
but especially of tle face and ears, sinking feeling at pit-of
stomach, &c.
It is also hom copathic to general venous engorgement of the
brain and cerebral membranes, and considerable sub-arachnoid effusion.
It has been assurned! that the more nearly the headache approaches a neuralgic character, or rheumatic neuralgic, the
more readily Aconite will relieve. Still Fleming used it internally in fifteen cases of headache, with complete success in
ten; of the successful cases three were nervous headaches,
four were congestive or plethoric, and three were rheumatic.
Of the unsuccessful cases three were nervous, and two dyspeptic.  Relief was usually experienced after the first dose,
and a complete cure effected on the first or second day, or at
least there was no relapse for several weeks or months. IDrs.
Burgess and Radly announced to Fleming that they had seen
Aconite of incalculable service in relieving the agonizing pain
of nervous headache.  Profeissors Ifenderson and TMiller, of
Edinburgh, informed Fleming that they had employed it with
marked benefit in headache. Storck and Vogel recommend
it in rheumatic headache, nwhile Copland found it useful in
both nervous and rheumatic cases.
In two cases in which the internal use of Aconite did not
afford relief, the external was employed with much benefit;
in fact, Fleming, as a general rule, found the external application of the tincture -very effectual in the treatment of hemicrania, both when the pain affected a circumscribed portion
of the head, and when it extended along the course of a nerve.
Dr. Patterson, of the Royal Infirmary at Edinburgh, corroborates this assertion.-PETERS.]
CASE 2.-[E. W., aged 43, had suffered for three weeks
with a more or less constant pain extending over the temporal




HIIEADACIHES.
and frontal regions of the left side of the head; firml pressure
lessened the pain; exposure to cold, wet feet, or anxiety of
mind usually brought on an attack if it was absent, or increased its severity if present.  She had taken Opium with
but partial relief; was ordered to rub in a teaspoonful of
the Tincture of Aconite thrice daily.  Tile first application
affordecl mch relief, and in five days she was quite well; ten
weeks after, at last accounts, there had been no return of
pain. —Flemzing on Aconite. English edit., p. 139.-PETERS.]
Dosed-In acute cases, and for adults, in the beginning of an attack,
put from two to five drops of tincture of Aconite in a tumbler half full of
water, and give from a tea to a tablespoonful every one, two, or four
hours, according to the severity of the symptoms. If the paroxysm
becomes more severe, and is not owing to an aggravation by the
remedy, give a dose every quarter, half, or one hour, until some relief
ensues, Wand then lengthen the interval of time between the doses to
one, two, or more hours. Or six globules may be solved in a wineglassful of water, and one teaspoonfuil given as often as above directed.
Frequently, however, in sick headache, the stomach becomes so irritable
that it will not bear even a teaspoonful of water, then three or four
globuiles must be given dry upon the tongue, or one or two drops of
tincture of Aconite given per dose, upon a bit of sugar, as often as above
directed. One half, or one quarter the above quantities will suffice for
children. A dose of Aconite may also be given regularly, night and
morning, in appropriate chronic cougestive cases, and in those with a
chronic inflammatory tendency, for three or four days in succession;
then a dose of four globules may be given at night, dry, for three days
more; then every other night, until three doses more have been taken;
then, every third night, for three doses, and so on, until the case is
entirely cured, or it becomes evident that Aconite will not relieve it.PETERS.
2. AGARICUS MUSCARIUS.
GENERAL REmARS.-Agariclus is indicated in nervous and
congestive headaches, in which fulness, sleepiness, frequent
and irresistible inclination to yawn are present, attended by
relaxation and soreness of the whole body, pain in the back,
and a feeling as if the joints were dislocated.-Genl. Hom.
Journal, vol. 26, p. 223.-Dr. BLACK.
[NOTE.-It is hoimceopathic to congestion of the head, with
pulsation in all the vessels, redness and heat of the face, and
eliriumn; also to catarrhal headache, with aching in the fore



AGARIOUS AND ARNICAA.
head over the eyes, drawing pain in the forehead extending to,
the root of the nose, rending pain in the forehead above the
root of the nose as if the brain were lacerated, with burning'
pain in the nose and eyes, great dryness of nose, profuse
bleeding of the nose, and abundant discharge of thick, viscid
nasal mucus, followed by firecquent dropping of water fi'om
nose.-P PETEUs.]
[CASE 3.-D. C., aged twenty-five, had been subject to
headache every six weeks f~or seven years. The attacks comienced with acute pain over the eyes and sense of fulness,
gradually extendinlg thrlough the Ileacl, but most severe in the
forehead, soon becomling oppressive and violent, when the
eyelids drooped, pulse rose, face flushed, tongue became dry
and brown, the skin dryl and hot. The attacks lasted from
two to four days, and after the first or second day copious
vomiting, principally of a bitter, bilious fluid, took placeurine was scanty and high colored. After a day or two the
pain extended from the head down the spine, the neck often
became stiff; he felt bruised all over, and his joints painful;
the whole being followed by great exhaustion, wakeful nights,
and tendency to delirium..Treatnme2nt. —Lach. 6 and Nr-s. 6 effected some improvement during the whole of six mlonths; then a severe attack
was promptly relieved by Agaricus 6, and a continued use of
Agar. 3 kept the paroxysms off. entirely for five months.
Finally Agar., aided by Sulph. and Stramou., cured him effectually at last accounts, three years after.
Dr. Ker says the symptoms which led him to select Agaricus were the violent oppressive pains, principally in the forehead, often attended with delirium, the sense of languor, feeling as if the body were bruised and the joints dislocated, and
the sense of uneasiness and weakness all down the spine.
These he thought so characteristic of Agaricus, that he selected and gave it with the most happy results.-ID). KEr,, Brit.
Jour. Hom., vol. 5, p. 436.-PETEUS.]
Dose —Same as directed for Aconite.-P.




6  HEADAOHFS.
3. ARNICA MONTANA.
CASE 4.-A  man, aged thirty-five, after receiving blows.
upon the head, was attacked with the following sufferings,
which daily increased in severity.
Symrftonis.-Pressing pain in the forehead; painful but
dull aching upon the edge of the right orbit; heat in the head,
with coolness of the rest of the body; pain in the head, increased after eating; heat in the face, noises in the ears, contracted pupils, nausea every morning; disgust for tobacco
smoking; tenesrmus, with constipation; anxious dreams; evident fever every evening; irritable and conmplaining disposition.
Treatment. — After taking Arnica 6, all the above disorders
disappeared in the course of two days. —Archiv., vol. 5, part
1, p. 68. —DI. BAUDIS.
[NOTm. — AccordCing to A. T. Tho. Ilosol the flowers of Arnica
contain Iglasauures St'1rychinion, and somie of the tfull effects of
Arnica are similr  to th tose of Nux  vomnica; thus it not unfrequently causes a sensation of formication, and a prickling,
piercing, spasmodic feeling, which mnAy be compared with
that produced by slight electric shocks.
It is holmleopathic to disorder of the chest mnarked by
anxiety', oppression, palpitation, dry irritating cough, with
symptomatic headache and vertigo.
Also in the headaches, flushings and perspirations which
attend the change of life in women.
It deserves attention in the headaches which precede or
follow attacks of apoplexy.  Schneider did wonders with it
in such cases. —PETER'S.
Dose.-Compamratively larger doses of Arnica may be given than of
most other remedies, except Camphor; to adults one or two drops of
tincture of Arnica may be given in a teaspoonful of water, or on a bit of
sugar, every one, two, four, or more hours, in acute cases; or two or
three times a day in chronic cases.  For children, or very sensitive and
delicate adults, frolm three to six globules may be put in a wineglassful
of water and given, a teaspoonful as above directed.-PETERS.




ARSENICUM.
4. ARSENICUM  ALBUM.
G-ENERlAL }REMAliKs.-(a,.) Tietze says it is indicated in persons who suffer with the signs of abdominal plethora or fldness, in which the -whole appearance of the patient1: n reminds
-one of liver complaint  and it which bilio s colics often occur
inl alternation with lenicrani
Thhe pain itself in these cases a s oLf a'\Ciry indefinite clharacter, so that the patient canmluot describe it accurately; but
throbbing' and rending pains, Or pre si lg, or stuTpif-Ving ones,
ra'e the -nost comonmou g,,nenaIly oisot,sev ere  in the ganterior
portion of tLheC hoet, d h lich is inllIS;uiy sensitive to the fresh
air. The pat:uint cannot find any ecs. ucmu  -nove his head
to and firo, even toss his fe'  abut,  iannmna'e   he receives
relief fro'm  these restless,movementsu    xtei n 1a warmnth also
affords relief; he is very wea, ii thaiLk   tte  iut (die seems
to be bloated, is,. chilly, a-nd selies the wuanrntil_ ocf the fire, and
finds relief froom  covering and compressing   the bead with
varm cloths.-Genl. Hon. Journal 7o. 34,  1i.
(b.) According to Black it s u se it  iT thie hteadaches of:emaciated persons, who suffer w-ith disease of the heart, or of
-the digestive organs.  1ie saw the mnost marlked curative ef-!ects in a lady who had suffered ifor twenty years with attacks
of the most violent Hemicraniia, lasting for the most part at
least three days, during all of which time the patient generally
lay almost unconscious, and tortured by- the most violent
vomitings. —G-eln. H-lom. Jour., vol. 36, p. 223, and Brit. Jour.,of HI011m.
(c.) IIering recoimmends it in throbbing, rending pains in
the head, when increased in the warm room and relieved in
the open air.
[NTOTE.-In tlhe second number of t-he AN.. -omn. Jour.,
Dr. 1Marcy has given two cases of periodical- headache successfully treated with Arsenic; but it seems to have been used
much more successfully in old schlool practice than in the
honceopathic.  Watson (see P1ractice of Physic, p. 391) says:
" Arsenic is considered by mlany to have a specific power




8                        HIEADACHES.
over the complaint, and believes that four to six drops of
Fowler's solution, given three or four times a day, will be almost sure to remove Iemicrania in nine cases of ten in
which it occurs."  Still it is very certain that the majority of
patients will not bear such doses, and that much smaller ones
will suffice.
Arsenicumn  is homeeopathic when the eyes are inflamed
during the attacks of headache, when the lids are swollen and
face bloated, when a pricking sensation is experienced in the
tarsi, the eyes are suffused with tears, and the conjunctiva
is inflamed.
It is also particularlly suited to those patients who have
liver spots, and pityriasis, in many of whom those parts of the
skin protected from the light also acctiLire a brownish, dingy,
unwashed appearance. Dr. IXunt. cured many such cases
with one-fourth of a drop of Fowler's solution three times
a dayr.
It is also useful in headaches attended with chronic diarrhcea, or gastric irritation.
In headaches from suppressed eruptions, especially of the
scaly kind.
In those dependent upon or attended. with scanty urine, or
with dropsy; or arising from the incautious healing of ulcers,
It has also been found specific against the headaches which
attend an irritable state of the uterus and ovaries, marked by
constant pain, with heat, varying in severity, in the lower part
of the sacrumn, in the left groin and under the pubes, and by
bearing down pain, much increased by walking, standing or
sitting upright, allllost forcing the patient to stay in bed, or
recline upon a sofa, the uterus being tumid ancld tender. Such
cases may be cured radically byT Arsenic, without any local
treatment applied to the uterus.
Scheonlein says, in the worst cases of chronic headache we
must have resort to Arsenicum, which often cures the disease,
even when of years' standing, better than any other remedy.
Bright says that the periodicity of Helicrania has suggested
some similarity between its nature and that of genuine inter



ARSENICUTM. 
-mittents; however this may be, he says it is certain that
Bark, Iron, and Fowler's Solution, remedies which are mostsuccessful in ague, are equally efficacious here.
Chapman says so many cases of cure of periodical
headache occur to homceopathic physicians, that it may be
superfluous for hiln to cite any, but two may be briefly stated:
CASE 5.-A gentleman had for many years been subject
to periodical headaches, always occurring once a week, sometimes twice, and lasting several hours.  The headache was
stunninlg, rendering him incapable of all movement, or ot
attention to any subject; he could only rest his head on something, and bear the pain as best he could.
Treatmnent.-Arsen. was given him, and during  many
months he had only one or two slight paroxysms, and has,
had none lately.-CHAPImAN, Brit. Jour., vol. 7, p. 398.
CASE 6. —The wife of a physician was subject to distressing
periodical headache, with boring, circumscribed pressure on a
small spot in one temple.
Treatrntet.-A few doses of Arsen., of 12th and 30th dcliltion, cured her as if by mlagic, and five years have passed
without a return of the headache.-CHAPI-TAN, Ibid, P. 399.
CASE 7. —A  weak, thin, poor woman, who had nmu'sed z
child for eleven months, had had headaches for six months;
the pain conmmenced over the left eyebrow  and temple,
and lasted, without intermission, for twelve hours, after which
she generally vomited a quantity of yellow, bitter, or tough
matter; during the headache, and for some days after, she
could not touch food on account of irritability of stomach; as
soon as she recovered from  one attack, another came on,
periodically, every ten days; bowels regular, but loose and
bilious after a headache.
Treatinzet.-Child to be weaned.  Arsen. 30 and 18 was
given with most decided improvement in three weeks, and
entire cure in a month.-MinLDN:, Brit. Jour., vol. 5, p. 438.
-PETERS.]
Dose. —This powerful remedy must be given- with the precautions
due to its great power for good or evil. NVoack advises for adults one or




[0                        IAHEMA.CHES.
two drops per dose, of the second, third, fourth, sixth, or twelfth dilutions, to be repeated every two, four, six,ieight, twelve or more hours
in acute cases; or, as much of the powder as will go on the point of a
penknife may be taken as often as above directed.  Children and delicate adults may take, of a solution of three or six globules in a wineglassful of water, one teaspoonful every two, four, six, eight or more
hours.  In chronic cases, one close may be taken every twelve hours, or
night and morning until six doses have been tlaken; then every night
only, for six nights in succession; then every second, third, fourth, or
-sixth day.-PETERxs.
5. ASARUMI EUROPAjUMfU.
CASE  S.-A  youlg lady of good  constitution, but plethorie  had suffered  fbr several -years with the tfllowing
head-affection.
Symptomns. —Shlarp painl over the left eye with lachrymation; could not read with that eye; bright light; increased the
pain; the left side of the head was sensitive to touch, and the
hair would not bear combing; in violent attacks, both eyes
became painful, and nausea was su.peradded;  constipation;
imenses regular, still the attacks were apt to coinei on just before or after menstri,.uation.
J reatment.-Asaruin europ. 2 —  given during the interval
of relief, removed the whole disease. —N'ew  Archliv., vol. 2,
part 1, p. 49.-DIn. Gr,oss.
D0Se, — oackc advises one or two drops per dose of the pure tincture,
or first or second dilution, every two or more hours, in acute, or one or
two times a day in chronic cases.-P.
6. ARUM.
Bergius asserts that when Artnun is taken in doses of half
scruple of the cormpound powder, he has never known it fail
(of giving relief in nervous headache, even after the most celebrated remedies had proved useless or injurious.  Nloack advises it in headache fronm weakness of the stomnach.-PLErrE.S.
7.  AURU.I.
GEN-ERATL ThE.Mt7S.-GOId has frequently relieved the sense
Of rushing and roarinog in the head, such as occurs at times in
hysterical fdemales fiomn disorder of the uterine systemn; it not




ASARUMT, AnRUM, AURT,  AND BELLADONNA.           11
only relieves this permanently, but often improves the whole
general disorder connectecl with it. —Dn. tAlRITMANN, by Ruckert, p. 1132.
NorE.-It is suited to that form  of headache which, commnencing early in the morning, is increased by meditation and
reading, but especially by talking and writing, to' an extreme
degree of violence, and attended with perfect confusion of
nind,
It is also usef-l against congestion to, with rushing and
roaring in the head, bloating, glowing and shining of the
face, with protrusion of the e'yes, especially when Ibllowed by
a feelinr as if all the blood passed suddenl frlom the head to
the legs. When'there is great heat of the Ilead and face, with
coldness of the hands and feet; heat, pain, fiiilness of the head,
sleeplessness and anxious dreaims; congestion of' the head increasing to deliriur; throbbing of the carotid, and temporal
arteries.  It is also indicated  as,ainst a twisting, boring,
acutely throbbing, one-sided 1Lea(lache, commencing immtediately after wakling in the morning, inreeased byi coug:hing and
bending11 the head bacikwards.
It is particularly useful against hIemorrlhoidil andc  menstrual headaches.-PETmE1s.
Dose.-One or two grains of the first, second, or thirud trituration,
dry upon the tongue; or, for children and delicate adults, from three to
six globules in a wineglassful of water, one teaspoonful every two, four,
six, or eight hours, in acute attacks, or every two or three days in chroic cases.-P.
8. BELLADONNA.
G:ENLERAL  E..RIArns.-(a.) It is iindicated against. headaches
attended with pressure, fulness and heat of the head, transient redness of the fice, roaring in the ears, dulness of hearing, dilated pupils, &c.  It; is suitable for persons predisposed
to active congestions; for plethoric persons of sa-nguine temperament, with great irritability of the uterine system; in the
headaches of scrofulous children who learn to walk with difficulty, and are inclined to convulsions.-Genl. IHon. Jour.,
vol. 36, p. 223.-DR. Br3xcK.




12                     HIEADACHES.
(b). Ifeichelheim  says that several forms of headache may
be cured by Bellad.: 1, those occurring after taking cold, attended with visible congestion of blood to the head, red,
bloated face, hard beating of the carotids, violent pain, as if
the head would burst; 2, in other cases, in which the face is
pale and cold, the pain resembling a dull, insupportable pressure in the brain, as if the latter had not sufficient room in the
skull, often attended with vomiting.-IHygea, vol. 5, p. 209.
(c). According to Tietze, Bellad. is indicated in Ilemicrania
under the following circumstances: when there is a charact'eristic one-sided pain over the eye-brow, extending down into the
ball of the eve and into the bones of the nose, and attended
with increased secretion of tearsu; the pain is apt to be severely pressing in the forehead and upon the eye; at times it
seems as if the affected parts were forced or pressed outwards.
Every motion of the head or eyes increases the pain to an insupportable degree, especially when light also falls upon the
eyes; every noise or movement of others in the sick-room has
a like effect; the affected eye is often reddened, and waters.
Sympathetic affections of the stomach, such as pressure in
stomach, nansea, eructations, or even vomiting may be
present; but when dyspepsia is the primary affection, and the
head affection a secondary affair, Bellad. will never afford certain relief, but generally merely palliates. —Genl. HIom. Jour.,
vol. 34, p. 7.
(cd). Dn. ScHiwInzE says that be has treated several imijranes, some not very severe, and some of not very long standing, occurring in not very robust or plethoric males, and cured
them all, without exception, with BELL,,D.
(e). Griesselich has found it useful, when the scalp was
very tender, the veins of the head and hands much distended,
with sense of rushing in the head, roaring in the ears and
darkness be-fore the eyes; also against the most violent pains
in one half of the head, extending to the eye and nose, with a
sense of pushing, bursting, rushing and beating, increased by
every motion, by moving the eyes, by every noise or jarring,
and by the moving about of others; and attended by a sense




BELLADONNA.                    13
of moving and beating in the head and forehead at every
step, especially when going up stairs.
It is also useful against those pains in the head which set in
every afternoon, last till midnight, and are aggravated by the
warmth of the bed. Also in pains which commence suddenly, change into a sharp stitch, which seems to penetrate so
deep into the brain that one almost loses consciousness.TEygea, vol. 5, p. 136.
CASE 9.-A young, slender man, aged twenty-six, suffered with attacks of I-Ieicrania on the right side for fifteen
years; commencing in the morning, increasing until midday,
and subsiding in the evening; the pain being drawing and
pressing, beginning about the right orbit and extending to the
ball of the eye, to the forehead and temples; increased by
stooping, reading and writing.
Treatmzent. —Bellad. 30, 1 drop, every founr or five days for
foir weeks cured himT perfectly.-ScwAn.izZEF, p. 7.
CASE 10.-A gentleman, aged fifty-six, of medium stature
and phlegmatic temperament, suffered twenty years with attacks of headache, occurring every Friday. The pain was
always on the right side, attended with sense of pressing outwards, bursting and tension, with dizziness and loss of memory; the paroxysms lasted twenty-four hours, the face was hot,
red and bloated; there were stitches of pain in the eye, with
acrid tears and sensitiveness to light.
Treatment. —Old school remedies had been used in vain;
ATarx voqn. was given without effect; then he was cured by
Bellad. 30, given every Thursday for some timue.-Practical
Observations, vol. 1, p. 183.-Diu. SCIIUunEmT.
CASE 11.-A lady, aged forty, suffered two weeks with
severe headache of indefinite character; she could not keep
still an instant, but moved her head and the upper part of her
body to and fro constantly.
Belclad. 24 cured her on the first clay it was used.-Genl.
iom. Jour., vol. 17, p. 242.-Dnr. FIELIZ.
CASE 12. —A  maiden, aged seventeen, suffered several
years with attacks of neri-nus headache, commencing early in




14                    HIEAD1ACHES.
the morning. in:- easing till midday, and ceasing in the evening; often atten1ded with bitter or bilious vomits, with violent
pressure upon thle vertex and temples, with dizziness frtom raising or moving' the head, with coldness of the hands and feet,
rush of blood t;o the head, heat and redness of the iface. Was
cured by two doses of Bellad. 30.-Genl. I1onm. Jour., vol. 5.
p. 65. —DP. KNOuRE.
CASE 13.-A  young lady, aged nineteen, suffered with.
throbbing pains in the forehead, of which she was cured by
Bellad. 400 and 800. —Genl. i-lom. Jour., vol. 29, p. 275.
-D R. I-[INUPT3IMANN.
CASE 14.-A plethoric, sanguine, young iman, aged nineteen, swffered three tears with spasmodic twitchings, and latterly had kept his bed for four weeks, on account of violent throbbing, piercing pains in the forehead and occiput, great heat
in the head, and vertigo increased by motion; accompanied
by noises in the ears, heaviness of the arms, and swelling of
the veins; his eyes were fixed, his pupils very movable, and
he had various gastric derangements.
Treatment. —3BeIlad. 2, one drop every two houes,, cured
him quickly, after previous aggravation.-Genl. Iemon. Jonr,,
vol. 21, p. (6. —DP. Nioxcu.
CASE 15. —A woman, aged fifty, otherwise healthy, sutfered
four years with headache, marked by rending pain in forehead
to the right temple, with transient pains in the whole head,
with heat therein, worst in the morning, with sleepiness during
the attacks, rush of blood to, and heat in the face, and chilliness over the whole body.  She also had leucorrhea, especially when walking.
Treatment.  Bellad. 300, in solution, one spoonfulf a day,
cured her in sixteen days; the leucorrhia was relieved by
Sepia, 18.-Genl. Hom. Jour., vol. 35, p. 222. —DR. PERRY
CASE 16.- A young lady, aged twenty-five, suffcred eight
years with periodical headaches, generally occurring every
eight days, commencing with chilliness over the back and
shoulders, soon attended with violent nausea, disgust and
vomiting, with violent aching, pressing and rending pains in




BELLADONNA.                     15 
the whole head, especially in the forehead, increased to an
insupportable degree by the slightest motion of the head oreyes; the softest bed seemed too hard, and only the greatest
rest and quiet brought the slightest relief. Finally the pain
extended to the whole front headl, a glowing hot spot was to
be felt in the forehead, and the bones of the nose became
painful; she was obliged to lie in a dark place, as even a ray
of light irritated the eyes and increased the headache; her
limbs felt as if bruised, and she had palpitation to such a
degree that every pulsation jarred the head.:Bellad. 24 followed by Bell. 30 cured her.-Archiv., vol. 6?.
part 3, p. 84.-Do. HARTIMANN.
CASE IT.-A young lady, aged 24, of sanguine temperament and regular menstruation, had suffered for three years,
almost uninterruptedly, with the following
Syrniptomns.-IBIurning and pricking in the gunms, which
soon swelled up and became blanched; in a quarter of an hour
the upper lip and right side of t.ce commenced to swell, withtwitching, pricking  and drawing therein, then followed
screwing, boring, rending, pinching and piercing pain in the
right ear, with noises therein; piercing and drawing pain behind the ear; piercing and rending pain in the occiput, and
feeling as if it were screwed or pressed apart; boring and
piercing pain in the right temple; extreme painfulness of the
scalp.  These attacks occurred in the afternoon, lasted until
three in the morning, were increased by the warmth of thebed and by laying the head down.  She often seemed almost unconscious; the sub-naxillary glands were somewhat
swollen; she had great despondency.
Treatme'nt.-Bellad. 30, one drop per dose, moderated the,
attacks up to the fifth day; from the fifth to tenth day she
was quite well; a slight attack on the eleventh was treated
with Pulsat. 15, after which she remained well for four'
months. Subsequent slight returns were treated with Bellad.
30, and she was perfectly cured.-Archiv., vol. 3, part 1,.
p. 85.-DrP. A. SCHUBERIT.
Besides the above cases, Bellad. was often used as an inter



16                    HIIEADACIIES..current remledy in other and in the following additional
case.-PETERS.
CASE 18. —A gentleman, aged 50, very subject to attacks
of headache and blindness, lasting the greater part of the day,
and headache generally for two days, was relieved by iBellad.
18, in a quarter of an hour, and almost entirely cured of one
attack in half an hour.-IIENDERSoIN AiD FORBES, P. 70.
CASE 19.-A married lady, aged 37, had suffered for six
hours with severe pain across the top and middle of her head,,extending to both temples; the pain was heavy and crushing;
there was a sense of tightness across the eyes and root of nose,
with constant pain; the eyes were painful to motion and to
light, which produced frequent flashes in them; she also had
ringing in the ears.
7reabtzet.-IBellad. 6, two doses at intervals of twenty
xlinutes, almost entirely removed the attack.-HImEND)Erso N.
CASE 20.-A spinster, aged 40, subject to severe attacks,of headache, comning on gradually, lasting all day, keeping her
awake a great part of the night, and not usually ceasing till
the day after, and often not for several days, had been suffering for six hours with severe headache on right side of forehead and in right eye, with great increase of pain on moving
the eye.
[Treatment.-B-3ellad. 6, affordecd no relief in twenty-five
minutes; twenty minutes after a dose of Lachesis 6, was taken,
nlot a trace of uneasiness remained. —IENDERsoN.
Hendersonl reports several other brilliant cures in which
Bellad. and other remedies were used.-PETERs.]
REvIEw. — Of the nine cases reported by Riickert, three
were in males and six in females, their ages varying from
18 to 56 years. Schwarze found Bellad. most useful in males.
[Of the three additional cases, tw o were females and one
was a rmale, their ages varying fro1m 37 to 50 years. —PrETEs.}
The teumperament of thle patients was phlegmatic in one
case, sallguine in two, and Dr. Black found Bell. most useful
in those of a plethoric, sanguiine temperament, while Schwarze
cured many migranes in males who were not robust or plethoric.




BELLADONNA.                     17
Tietze noticed that the pains which Bellad. relieved most
rapidly were those seated in the ophthalmic branch of the fifth
pair of nerves.
The pains were one-sided in cases 9, 10, 15'and 17, and in
~ c, d, e; they involved the whole head in case 17; the back
of the head in cases 14 and 17; the forehead in cases 9, 13
and 16; the orbit, brow, and root of the nose in ~ c and e,
and cases 9 and 16; the temples in cases 9, 15 and 17; the
vertex in case 12.
As regards the kind of pains, they are described as a dull,
insupportable aching, pressing out and pressing asunder in
~ b, c, and e, and cases 10 and 16; as drawing and aching in
cases 9 and 12; piercing and boring in cases 14 and 17; as
stretching and throbbing in case 13; beating in ~ e; beginning
suddenly and becoming piercing in ~ e.
Among the accompanying complaints we find vertigo, heat
of the head, redness and heat of face, redness of the eyes;
noises in the ears, beating of the carotids, and all the signs of
congestion to the head. On the other hand, Heichelheim saw
the face pale and cold, with dull pressure and vomiting.
Miany gastric derangements are apt to be present, such as
coated tongue, bitter taste, inclination to vomit, vomiting of
bitter substances, oppression of the stomach; still Tietze remarks, when the dyspeptic symptoms are primary, and the
headache secondary, that Bell. will rarely cure, but at most
only alleviate transiently. Further, the pains may be attended with loss of memory, soreness of the scalp, distension of the
veins of the head and hands, coldness of the limbs, and chills.
The majority of the cases belonged to the chronic forms of
headache; the disease had lasted for at least several years in
six cases, in the others several weeks.
The cures in some cases were effected very soon, in others,
after three or four weeks.
Of the nine cases, Bellad. effected a cure, unaided by anly
other remedy, in eight; the dose was 24th or 30th dilution in
six cases; the 2d dilution was repeated in one case; the high
potencies in solution and repeated, were used in two cases.
2




18                         EItEADACH ES
)}OS, —Th e lmost fficient dcses are sufic'ntlty pointed ot.l in -the
above pa-ragraphsl   Wh'en the high dilutions are used, five or six
globuiles lay be dissolv;ed in a wineglassful of water and one teaspoonful takern every half, one or two hours in severe cases, or only every
two, fourL, six or eihlt ihours in nmilcder ones.  WVhen tine lower dilutiens are preferred one or two drops of 1iClNid Belladonna n-y be given
every two,- three, far, six, eight or twelve hours in mild attacks, or
every quarter, half Onef Or two hours in sevcra ca-ses, and in such as are
otA relievecd by doses given at loingetr interval.  In c'hronzic cases'from
vtwo to five globules, or ore or +t-wo drops msay be taklen every' morning,
or every  second, third or fourlth Ilmoing', as Belladonren is apt'o cause
aggr-t ow io ns he    n gi'en   in the afternoon, evenin o or  nig'ht. izlch dre
may tat^kef one g;lobule pe-r dose., or one drop of th1- seeiond, ti-l'rd, sixth
or twelfth licquid dJluN io v at th saLs naterva s i.1  t Le  o a o  ve dire cted.
[NoE.P-One e   o t   P'o- s 1 —t  arLbouev ntO'sf  of v':0  -, 94ache is a dCll, he1aYy i:'ontal l    pain-   hepvey r  uig0ar ])Ln ovr
the whole'orehena  ~ a geeralu drul fao._!~  d.sg'ere;-,l d:; uallTy
ushered in by a.. ons  of dryness in the mboih rnmid hJleeoat
dimness of Vision and slight dizziness atte-ade!- v-it^i   enlargemerint of the pupils.
It is homceopathic  to head0rches Mfolwed.  by delirium, especially if it be of a  extravagant or pleasnnt eharacter, ac-,cormpaanied with uncontrollable laughter or incessant loquacity,,and the face be gushed and the eyes glistening.
It is also payti-icularly suited for hysterical headache with
excessive irritation of the bladder9 strangury, bloody micturition, followed by an excessive flow  of urine.
Piorry has rendered himself celebrated by his bold use of
Belladonna in hemnicrania: he assumes the disease to be a
neurosis or neuralgia of the iris, or, more properly speaking,
of the nerves of the iris9 and that it is most frequently brought
on by exposure to bright light, or dazzling, spectacles, and
excessive reading.  From  thence he assumanes that the disorder
spreads to the great sympathetic ierve,  soon involving the
stomach, and to various branches of the fifth pair, causing
pains about the head and fgce.   On account of the specific
action of Belladonna up3on the iris, and its well establ~shed
reputation against neuralgia, he selected it as the principal
remedy in hemicrdoanioa, and applied it locally about the eye,




I nLADOiNnA AND BYONIoA.                 19
using fol  one0 to  oonu: grarins  oC t.he extra~c moistened with
ai ttli waLer'n   n"d - i t'he te  pes  do
a ~     ac lifl-  pe d  up o   n..... and lids. Piorry
avers t!ial he Jhaiai y ever -fz,l's to cheic the paroxysIs if
the 3e'a'ndo beo ea iie t-aia  i;he onevrnt o' their corn'mren.emreIt,
or soon ain.o 0ne d      oro)p of a s'onh~:mn of Attopine imay also
be a pi-cJ-d, ae7ordi-.~1  to P0 ji-ory9, to the eye it-self, or:a small
qu antity  a Ub ed onR  i Pd'-.  b!i w ovr, ndl t enm-p ]lews   iL a-v3 h    witnoessefd Czav e'  Casa-s Ic? i, Whi'h aPa-~ e- s had foi d ti s mode of
t1reatmint    o  no  s     e  ca,  t..a.'ks- subscai, g in a
tGninnM, —~z~,maeO. ~(he r,ep3 Padwy-sy m"..; msI   caused by
1ryon.    when viewed in  con e cion with tne physiological
phenonPa nb w     it exriteso in oether organs and systems- of
the lh-a  boo) PoLo -o JI-r-at1ons -ind distnubances in thea
nerves of sesat i -oni d in t.he operat;ons of seaverali eerebral
nerves, vizo of to  " frIo1al. and tnva or'l3 boaoi ies o]f the. tnifacial in fE'At it causes an actual hemicrania _I inthis respect
its action is nearly allied to a-11t a     ColocynilJH and N-u1x vom.;
Colocynth1, however, does not affect tlhe motor nerves of the
face, whiile Bryon. often attacks the temporal and maxillary
twigs of the superior facial branch.-Ausltrian IHom. Jour.,
vol. 3, p. 118.
(6). Bryon., according to Knorre, relieves headaches affecting
the forehead, brows and' temp-les, the pain being achuilg and
pressing out as if "the head w otld burst; attended with penetrating stitches so violent, as to fqrce one to cry out; arising
from congestion of blood to the head, and increased by stooping, moving the head, coughing' or sneezing.-Genl. Iom.
Jour., vol. 5, p.  8.
(c). According' to BlackT it is indicated wlhen the pain is on
one side of the IObrehead and extends to the neck, arins and
face, and is inoe throbbing in its character the more severe
it becomes.  It may be given with advantage in alternation
-with Almina.-Genl. Ion.  o0111or., vol. 369 p. 224.
(d). Griesselich thought it was most useful in burning and




20                    HEB tIFAI)CHES.
pressing pains, with the feeling when stooping, as if everything would fall out of the forehead; especially when they
are increased by walking, and relieved by pressing upon the
head, or tying something tight around it. He also advises it
against superficial rending pains extending to the face and
temlples; in aching, boring and rending pains in small spots,
occurring in persons of an irritable, angry disposition, and
subject to rheumatism.-~Iygea, vol. 14, p. 228.
CASE 21.-A lady, aged 30, of relaxed constitution, very
irritable and timid, formerly irregular, generally too profuse,
but now regular in her menstruation, had sufferecl or years
with violent headaches, occurring especially after depressing
mental emotions..ymptoms. —The paroxysms commlenced early in the morning, increased during the whole day, and were so intense by
evening that she lay almost senseless. The pain was compressing, and involved the whole brain; her eyes were dull,
glassy, contracted, and she could scarcely open them from
pain; she could not bear the least noise or light; was irritable,
inclined to find fault and scold. During the afternoon palpitation of heart, oppression of chest, nausea and retching to
vomit generally set in. If she got some sleep during the
night she was generally better the next clay, but if fever and
wakefulness set in, she was often obliged to keep her bed for
several days in succession.
ff~eatmrent.-Bryon.  3, one drop, was soon followed by
sleep; the next day she was quite well, although a fiesh attack occurred seven days after from the reception of distressing news; still IBryon. again brought on sleep, and she
remained permanently cured. —Archiv., vol. 1, part 2, p. 104.
-DR. M/OtITZ:~]ULLER.
CASE 22. —A young lady, aged 20, irritable and inclined
to anger and vexation, had suffered for a year with attacks of
headache commencing in the morning, marked by drawing,
boring-aching in the forehead, and by piercing, rending and
burning in the whole head, gradually decreasing after vomitmng set mn.




BRYONIA.                    21
Treatment.-Nux vorn. 9 lessened the attacks, and two
doses of Bryonia then cured her entirely.-Archiv., vol. 6,
part 3, p. 100.-DR. SCHULER.
CASE 23. —Mrs. P., aged 34, suffered frequently and
periodically with one-sided headaches. After taking cold she
was attacked, June 2d, with violent headache in the left temple, the pain being pressing and outward-pressing.
Treatment.-Nux 6, two doses, was given without benefit;
then Mere. 3, two doses; in the afternoon a violent aggravation set in, the pain shifted from the left to the right side,
became piercing and drawing, and so severe that the patient
cried out from the slightest touch or motion of the head. At
2 o'clock Bryon. 200 was given, and at eight o'clock the
patient was almost beside herself with suffering; then Bryon.
6, four drops in solution, was given every two hours; at 12
o'clock she was relieved, and the next day was perfectly well.
-Genl. Hom. Jour., vol. 33, p. 101. —DR. KALLENBACH.
CASE 24. —A tailor, aged 44, slenderly built, with the
signs of abdominal disease, had suffered from his youth, after
a severe fall, with periodical attacks of pain on the right side
of his head. The paroxysms were generally excited by
changes in the weather, and often were so violent that he
fainted away.
Symptoms. —Violent, piercing headache fixed in a small
spot on the vertex, with the feeling as if the coronal suture
were forced apart and a cool air passed through the brain;
vertigo; illusions of visions; lachrymation; sensitiveness to
light; loss of appetite; white coated tongue; feeling of heaviness in abdomen; constipation; turbid urine; drawing pains
in the joints, without swelling or redness; emaciation; paleness; dejection; loss of hope; his pulse was generally slow
and soft, but became frequent and hard during the attacks.
Treatment. —He had taken every conceivable remedy, in
the old way, for six weeks, he then received four grains of
Rad. Bryon., divided into six powders with sugar, one dose to
be taken morning and evening; after the second dose the pain
became so violent that he became unconscious, but the next




22                       1MADACES.
day it was gone and never retned.- Aust:    IIom. Jour.,
vol. 3, part 1, p. 119.
CASE 25. —A  powerfll man, aged 50, was attacked with
violent pains in his head after a severe cold; the pains in-volred the right sidle, and were rending and drawing; the
temporal veins were unusually distended, and his eyes glistening; ihe was exceedingly restless, his tongue coated, he
had. oppression at the epig.astrium, cn-.stipation, dryness of
the slkin and hard, quick pulse.
Trecattent.-After a great variety of allopathie remnedies,
among others leeching and bleeding, head been used without
avail, he received one grain iof  ad. sryon., nmorning and
evening, and was cured in a -ew days after a violent aggravation.llIbidl, p. 120.
CASE 26.- A serviant g i, a' r age d 2., of ir'bust'ame, sutffering at times with epileptic attacs,'as swazeeod almost without exception at every menstrunal pe-riodi with pains in the
head, always commencinl in thele night, and lastirg for several
days; the pains were mvci  -ind  piercing,  corined to the
right side) antd dedpri ved her of Kil s 1 p) h    — ye   -ee 3 bioodshot antl protruatdig m; hei-r  N MFIrs..i.'. a.~.d c verenr  with cold
sweat; her to Inueo cka.d;,:.z. o, e      c. U.ipat.ion
had lasted forn day; w;~ hcL  pulse }i d;  Vi-  dy;  urine scanty
and turbid.   She had o-reat at nity,  and c-     ~ o2-i)a d of
crvmwing anud piricking pain  zi  eathee wnojoints
Treatctt.-After six Sdiv*ayis alo'i c   treatmen t    without
relief she received Bryon. one grain,    e ties a dy,'with
relief thie same day and perfct%  cure, in a few days.-Ibid.,
p. 120.
REVT'rE.-Of the six cases, two were in male.s and four in
females, atll middle aged,
In two cases ttaking  cold was the exciting cause; in one case
changes of weather; in one case the time of menstruation; in
another depressing  mental emotions; while, according to
Hering, Bryonia is useful in the headaches of rheumatic subjects, and those of an irritable, timid disposition and inclined
to anger and vexation.




ienYL~iTIA~ o23
In t     wo coans the pain was on the'right side, in the te  ples,
ioireiliea;!  nt:.d vertex  in one cafse it was on the left.
In two case3s'f.b- pain colm.menceda early in the morning and
increased  "'1 ~vTI.igo
-Drawin       ls OC cecurred in thrlee cases; piercing pains as
often; besides, we meet wiltvh pe-ni;tti g9 compressing, outpressing, rending, boriing, btnmg, mad t   arobbinct pains, especially when the attacks beeo'ne s-ec. Tv sevr al cases the
paroxysims occurred  periodic 1y1.
Among the attendini   ecttle ts e  iand congestion to the
head in, casoe 24; vertigo' in cas  24; dSisteension of te~mporal
veins in ciese 25; rlnes% proteusio,  ane I, li'.ening of t1he eyes
in cases 25 and 2o  dkimneoss, g'assr ems  and inability to open
the eyes'n cases 24 and  6   llunsio ns cf " visi on in case 21;
paleness of the fae in ceases 24 a-d  6;   i       Ace co 0 ed with cold
sweat in case 26-; coated tci-e,.-,     retgin, to vomit,
Tvoniitig, 7lcstinpg onstipation and  t'bid uidi) e Ja caes  24 and 26;
hardish  i hm'd and q-1cla;A eple       in ce  s 4 -r d  6; d"rawing
pa-ins i  the yoiil4s in-1 U csn   2 o; ehrs.i.,n oIf the"S  pains to the
nape, arms and iL~ace in
The condc ion     of';. invse,:,  c h 5  msi were: il.novin  the
"headq, or toobwin5L,n r......i?  0   ng, stoo piug, walking,
noise  n- ight; te pis,ll                 i1enced early in  he
morningand wrxe worst at nit,.
Bryon e'ured: Ponr  cases:,   i.t honat aid:fiom  other remedies,
viz.: cases 521, 215,: f.. 2   In two cases Nux,2  vom. was given
previonsl y without ae-jct.
Black generally     n?r 4 Alumain iasefI'  in alternation with
Bryon.
The m.ost of the cases wer   of a chronic nature, and the
cures set in quickly.
The doses were of CBryon. 3d aid 61th dilution.  In case 23,
the high potencies merely  excited, while the 6th relieved
quickly.  The doses given by Allopaths were grain doses of
the Root; they cured but caused severe aggravations in two
cases.




24                      HEADACHES.
Dose. —The lower or stronger dilutions seem to be most useful.
Noack says one or two drops of the pure tincture, or of the 1st, 2d or
3d dilution may be given as directed for Bellad. in acute, or once or
twice a day in chronic cases. When the globules are preferred two or
three may be given per dose, every ~, 1, 2 or 4 hours in severe cases;
and every 6, 8 or 12 hours in slighter attacks; or five or six globules
may be solved in a wineglassful of water, and one or two teaspoonfuls
given as often as above directed.-PETERS.
10. CALCAREA CARBONICA.
GENERAL REMAmKs.-(a). According to Hahnemann it is
most suited when there is heaviness and aching in the forehead,
forcing one to close his eyes; in headaches from excessive
reading and writing; boring in the forehead, as if the head
would burst; throbbing pain in the occiput; pushing in the
middle of the brain; hammering headache after walking in
the open air, forcing one to lie down; headache and buzzing
in the head, with heat of the face, icy coldness of the right
side of the head, and sweat on the head at night.-Chronic
diseases, vol. 2, p. 308.
(b). Black says Calc. may be used in some cases in which
Bellad. seems indicated, viz.: in those with heaviness, fulness,
aching and heat in the face. It mnay also be given when there
is a violent aching pain over the eyes with trembling of the
lower lids, especially when the patient is dull and confused in
the morning, awakes from sleep unrefreshed, and suffers with
nervous debility.  Genl. iom. Jour., vol. 36, p. 224.
(c). According to Tietze, Calc. is next to Sepia the most
important remedy in chronic migrane, especially in persons
who have had to contend much with dyscratic diseases, and in
whom a scrofulous predisposition is still evident. The pains
which it relieves most readily, are dull aching pains in the
vertex, extending towards the forehead; or drawing pains and
coldness in the forehead attended with nausea, and arising or
being increased by exposure to the free air; or rending pains
in the right side of the forehead, with great soreness to touch;
or throbbing and pushing in the middle of the brain; or headache generally confined to the right side, from which it radi



CALCAREA CARBONICA.              25
ates to other parts. These headaches may be attended with
eructations, inclination to vomit and vomiting; or the menses
may appear too early and flow too freely. —Gnl. Hom. Jour.,
vol. 34, p. 19.
CASE 27.-A young lady, aged 23, had suffered for two
years with headaches; she had been scrofulous when a child;
commenced to menstruate scantily when 12 years old, often
with an interval of six weeks.
Symptoms.-Dulness of the head, boring in the forehead
as if the head would burst; hammering headache when in the
free air, forcing her to return and lie down; buzzing in the
head with heat of the face, and falling out of the hair; webs
before the eyes, dimness of sight especially when reading;
inclination to diarrhoea; during menstruation cutting pains in
abdomen, and grasping pain in the sacrum; frequent awaking
at night, with weeping and unhappiness. Calc. 30 effected a
cure.-Annals, vol. 1, p. 74.-Du. Sci-noTER.
CASE 28. —A woman whose menses occurred too frequently
and freely, and who felt worst early in the morning, had
suffered for 15 years, with:
Feeling of coldness in the whole head; with vesicles or
aphthse in mouth constantly going and coming; acrid eructations from the stomach, without thirst; drawing pains in the
legs, extending up to the back, and pricking in the anklejoints.
Treatment.-Sulph. 30 merely relieved the pains in the
limbs, but Calc. 30 removed the whole trouble permanently.Archiv., vol. 17, part 1, p. 9.-D. 13. in D.
CASE 29.-Miss G., aged 19, had suffered almost daily for
7 years with headache, sometimes affecting one side only, at
others the whole head. She had frequent nausea and vomiting,
and her menses were rather profuse.
Treatment.-Sepia and Carb. veg. were given without avail,
except the pain became more limited to the right side; Cale.
carb. 500, was also given without relief; then Tinct. sulph.,
four doses of two drops each, one dose daily; then Cale. carb.
4th dilut., six doses, two every week, with improvement after




26                     ZIHLEADACHES.
2d dose, so that she had no return of headache for four months;
then a slight attack was immediately relieved by one dose of
Calc. c. 4th, and she remained permanently cured.-GenL
Hom., Jour., vol. 33, p. 106.- I ALLENBACH.:
CASE 30.-liss J. had suffered for a long time with
violent pressing pain over lthe left friontal protuberance, wlxhich
prevented her friom attending to any household duties;  it was
increased by over-heating and by fright; relieved by binding
up the head and by lying edown; it commuenced early in the
morning, persisted the whole day, and then returned again in
a few deys; she had heat aind rush of blood to the head, pain
in her eyes, diumness of silght re1,  dull spots on her cheeks;
also so-re throat frot-zn every cold, constant pain in her back
and stitches in tuhe sacrurn; slie was.nnoyed with:falling
aslceep Of her feet, nro   constant dorowosmness; her menses were
very pofuse avnd asttended. with oainsin the hips. Caic. c,
repeated every 8 days i curod herp entiirely.   Practical Observations, vol 2, p. 5.-Dr. D S2CID Tra.
CASE 31- A  roebust woMan,  aged 5,I  ad  an attaIk of
headacer,  contlng on witl every rain-storn  and lastinag 24hours; consisting, of constalnt drteiung and pnrickingm in the
head1,, atU.e nded with i much drowsiness, and vominting of bile.
if5 eaio:me 6.-i-  LTp. 30 did f1ot reieve; biut sl'-r t.aking
Cale. c. 30 she had no attack subsequenetu to the first 8 days of
treatmeunto. — Aiiv9 VOl. 17, p. 1, page 8.-oDu. D. OF D.
CASE 82. — ar. J.,'ged 40, of sanguine teiLperaiuent, had
suffered when a child with scdid-hl ed, afterwards with worm
eomrplaints, and finally for many years with the following
constaintly increasing malady.
Synzm  toms.-Tearing  pain, eL;tending  froin the temnples
towards the vertex, which then became hot; when the pain
increased much,, throbbing set in, and was aggravated by
mental exertion and spirituous drinks. These attacks were
worse every four weeks; and if he ate rather freely in the
evening he was generally attacked with spasms of the stomach
and vomiting of food. Ile had burning in the eyes, and
puriulent discharge from the,.ears; when reading his head




CALOAEA CARBONICA.                   27
became confused, and painful on one side, with sweat on that
side; his hair fell out freely;.]is inose was filled with offensive
pus; he hawked up ph].egnm fi-ij. the throat; was constipated 
hadcpierciing pan in tilhe leCt side from motion; shortness of
breath froiom stoopi.ng and going up stairs; nocturnal pains in
the back and armitis; loss of strength;  talking weakened him
very much; he fell asleep early in the evening, awoke frecTuently dmuring the night; was irritable and easily excited to anger.
_Teatnent.- As he had been in the hIbiA of being bled
every year, for four years, he first received Aconite; then
Nux veOi. 30, Bollowed by some relief from headacehe; then
Cale. c. 30, for five weeks) when he was fully relieved of all
his complaint.-Annals, vol. 1, p. 2836 —Dm' ScHroTEm.
CASE 33.-Chronic headache occurrin:  after suppression
of itch; af'ecting, the forehead,  most violent in the forenoon,
increased or excited by mental occ-upation  attended with
pleness of the, face disordered digeotion, an.d. WOiesE, eispecially in tIhe in'ring.'6earzen.-TJTx vom. onlOy afforded pialative re lief, but
several doses of Ca0e. c. 3, given at,lon  intervals, cured the
Case 3permanently. —}y'ea  voJ.o 20, p. 35_5.-PD.  rI ALY,
CA>SE 3I4.,-A1 youmng aay, aged 21, of sleonde r m2ake, and
taciturn, butl irritcrale dispositibon, whose Imenstinul ati0on occurred
profusely every three weeks and was pre3ecded by swelling
and painfullness of the breasts and ie.leucorrhoean had su-fered for
several weeks:
With throbbing pain in the forehead, internal heat in the
head and sensaticn as if it would burst, setbt;ing in evey afternoon and increasing till evening; during the attacks the blood
flew to her face, her cheeks became very red and spotted, and
her sleep was, heavy with loud, almost snoring breathing.
Cale. c. 30 effected a permanent cure. —Archiv., vol. 17, p. 1,
page 8. —DRi. B. OF D.
CASE 35.-A lady, aged 43, of choleric temperament, had
suffered since the suppression. of a chronic catarrh of the nose
with:




.28                    HEADACHES.
Violent one-sided headache in the forehead over the left eye,:attended with feeling of coldness, with stitches in tile epigas-trium, and pain in the back.
Treatment.-Calc. c. 30, followed in eight days by Sulph.
30, and after eight days more by Cale., cured her entirely in
three weeks.-Archiv., vol. 17, p. 1, page 10. —Dn. B. OF D.
CASE 36.-A single woman, aged 25, of violent temper
and bilious constitution, who had suffered formerly with discharge from the left ear, was troubled with an internal sense
of coldness and numbness on the left side of head near the
back, accompanied by rending pain, shooting through the left:arm down to the hand, and often extending to the left leg,
with swelling of the knee, most severe in the evening, and
while at rest.
lTreatmenrt. -Cale. 30 for four weeks, followed by Nux 30,
for eight'days, and again by Calc. c. 30, effected a perfect
cure.-Ibid.
REVIEW.-Of the ten cases, two occurred in males, eight in
females, their ages varying from 19 to 51 years. The temperament is given as sanguine in one case; choleric in one case;
venous or bilious in one case; delicate in one case.
The most common exciting causes were previous scrofulous
affections, scald-head, suppressed discharges from ears or nose,
or suppressed itch. In case 31, the attacks always occurred
during rain storms.
In four of the female cases, the menses occurred too soon.and too profusely; in one case only, in a scrofulous person
were the menses too late and scanty.
The ohearacter of the pains varied very much; most frequently they were of a hammering, throbbing or pushing
nature, as in ~ a, c, and cases 32 and 33; pressing and dull in
~ a, b, c; boring with sense of bursting in ~ a, and cases 27
and 34; pricking in case 31; rending in ~ c; stretching in
case 32; piercing in case 31; radiating in ~ e.
Quite peculiar to Cale. is the sensation of coldness in the
head, the icy coldness of the right side of the head, mentioned
in ~ a, c, and cases 28, 35 and 36; and the night-sweats, ~ a.




CALCAREA CARBONICA.                29
As regards the locality of the pains, the majority were
seated in the forehead over the eyes, see ~ a, b, c, and cases
30, 33, 343, 35; next in the middle of the brain ~ a, c; then in
vertex, see ~ c; occasionally in the occiput, see ~ a; or in the
side of the forehead, ~ c; or on one side, see case 33, viz.: on
the right side in ~ c, and case 29; on the left side in cases 30,
35 and 36.
As regards the time of day in which the pains commence
or increase, we find early in the morning in cases 30 and 38;
in the forenoon in cases 33 and 34.
Among the accompanying disorders, we find congetion to
the head and iace in ~ a, and. cases 30 and 34; red slots npon
the cheeks in cases 30 and 34; dimness of vision in cases 27
and 30; paleness of face in case 33. Dr. Black mentions
quivering of the lower eye-lid. Among the gastric derangements we find nausea, eructations, hot risings from  the
stomach, vomiting of bile or food, inclination to diarrhcea;
also aphthbe in the mouth; and sleepiness.
Among the causes of the commencement or increase of the
Cale. headaches, we find mental labor, reading and writing
in ~ a, and cases 32 and 33; household occupations in case 30;
speaking in case 32; exposure to free air and walking in ~ a,
c, and case 27; touch in ~ e; fright and over-heating in case
30; use of spirituous liquors in case 32. Among the causes
which alleviate the pain, we find, closing the eyes in ~ a;.
binding up the head in case 30; lying down in ~ a, and cases,
27 and 30.
Calc. effected four cures unaided by any other remedy; in
several cases Sulph. was given with little or no effect; in one
case Cale. was given in alternation with Sulph.; and in one
case with Nux.
All the cases were old chronic ones, and the cures were
effected in a few weeks.
As regards the dose, Cale. 30 was given in seven cases;
Calc. 3 in one case; Cale. 4 in one case. Generally one dose
sufficed to effect a cure. In case 29, Cale. 500 was given
without avail, while four doses of Cale. 4 effected a cure.




30                        ULADA-CGES. 
Bos,80-In chkroznic cases, two or three,grains of the si, 2d or 3d
tritluration, or as mluch as will cover a sixpence, or the top of the cork of
the vial, may be taken once or twice a day, or every 2d, 4th or 6th
day. Or from three to five globules may be taken as often as above.
it is not often used in acute cases.-PETFRas.
11. CAtIP0HRA.
CAgSE 8Y~ A wroman, aged 36,'i th unu-sual deveLibpimat
of the erebae'li —n  hacId sn-eflered for s-/veimal m-A)oths wi-'cl
Throbbing` ad ieavy beat-ing ii 1iJne cereh lnm;  pu lse irri*table an d'sy-,?nm',oosg W-'  me Da i;mg w1h', tim,  bra; grieat
redness iand'....l i   he fn.i 
recia~,>2 —.S2im   qir iits ofC ag-mpo_-P'    o   0 to  3 i of wl-ch one
or two drops v1ere I  iVni  oCei        mininuOS, 1' or e  -moved the
whO  e ae ttach., in t he cou rse of an nee. S ivE -- SSE   13   L
CASE 308.      yoing ~a s1Y   mc, 9   ~fred wLLh Piaroxysms
of headache of the i 1cilcmog' characte.r
Throbbing' in'clh  crehulinih    syn chr oonous   with. the pulise
be as.  Camlplior l-th, one drop per dose, evey en mte   inutes
relieved the attack in a few hours.-GRiEssuLCH-r
CASE 39. —A man, agen   39, was attacked with throbsing
headcach e in the cerebelTamn, wlhich he himself described as
synchronous with the pulse.
Spirits of Camphor, fo r or five drops per dose were given.
every fifteen minutes, and sufficed to remove the difficdty ia
the course of two hours. -lygea, vol. 13, p. 456.
REvrIEw.- Campchor is the only rem  edy which produces and
promptly cures throbbing pains in the cerebellum synchronous
with the pulse.
[NOT,.-Judging from  Christison's records, Camphor is
homceopathic to some varieties of nervous and congestive
headaches, when the patient is languid, listless, giddy and confused; when all objects cluiver, and sparks appear before his
eyes, and his bodly feels so light that he seems to skim alo-ig
the floor almost without touchilng it  when the patient is pale
and chilly and his head feels numb; followed by a strange
feeling of anxiety, so that without thinkl-ung himself in danger
he sheds tears, but cannot tell why.  These symptomis may be




followed by somne heat of skin, paipitlion, herried l pulse sense
of intoxie{atloni moisture of the skil, and per0ofounlid  5seep for
sorme hours, attended with excessive sweatin g. —PvETEns]
Do0s,-Thbe proper dose is sufi iently iiiCatd indiat    1 trhe   ireatment o~f
the above casesa  It s a matter of' -re' at thaothr lil remect es, sucL
as Chamomia  CoffTea, Borax, Feirrum,  Ipecac., LTycopoclidnm,   x
moscheate, and many others are not given as freely as above recomi
mended for Canmphor instead of'beinm adnministered cin doses  as infnitesimrn  as i these remiadies w-re; as powerfil as ilsenic., Bellad. or
Mer0c. corrosi v.-PTE S.
12.  CARDO  tI  Llao   C>cjs.
in neIIoLYYLs arod c0P'25giwvg   K  *Cw. jSO), ii-li 13 S'C
soccip rit so..i S o-:for, 6 Y9 I 1;1 XV1SiI SO *esL:. o   the scasp,
and  y         a~ssH T iom.,.o' a1oction  of  oe  si gestiv
organs, $  o  efelO'i@.,  w  -, e, o ce Gel.    e     vol. 36,
page 2243.
as. CARBO VEJGETABJILS.
CASE 40. — A young gentleman, aged 8S ha(d been subjees
for two years to attoncks of excrucicating headache, comnluencing
wih giddiness and sense of f-Cullness, ending in most acut;e pain.
Carb. vg.  relieved hi-m entirelye-DuIsFoe D, 1p 10o.
CASE 41.-A. g'ardner, aged 40, became subject to headaches after a Mll upon the head; the paroxysnis camne on two
or three times a day, lasted an hour and were followed by
great weakness and palpitation.
Treatment-B]ellad. kept off the attacks for three weeks.
Carb. veg. was then given and the pain did not return for six
months; it was repeated and the malady was overcome, slight
pain only being experienced on sudden changes in weather.
-Ibid.-PETESRS.
Dosoe-Carb. anim. and vegetab. may be given in the same doses as
recomme~nded for Calcarea.-PETERS.
14. CAPSiCU]M.;
GENERAL REAi S.-(Ks.  (). According to IHering, Capsicum
is often usef-d against throbbing headaches,  or those marked




32                      EADACHEES.
by distending, bursting or out-pressing pains, increased by
motion or walking; or against piercing-rending pains, occurring while one is at rest, or when moving the head or eyes, or
stooping; when exposure to the free air or cold aggravates the
pain; and the attacks occur in phlegmatic, dull, or irritable
people, or in children who are very contrary, apt to be chilly,
especially after drinking, and are afraid of the free air and of
active exercise.
(b). Tietze uses Caps. when the pains are throbbing, or
aching and piercing and attended with nausea to the point of
vomiting; when they are aggravated by moving and bending
the head, by moving the eyes, and the patient is very sensitive to the cold air.-Genl. HIom. Jour., vol. 34, p. 32.
Dose.-Capsicum may be given at the rate of one or two drops of
the 1st, 2d or 3d dilution, every two, four, six or more hours, according
to the severity of the symptoms. Children and delicate females may
take one or two globules as often.-PETERS.
15. CAUSTICUM.
GENERAL RIEMAiKs. —According to HIahnemann it is indicated againist dull, stupifying aching in the brain; piercing
in the head; stitches in the temples; burning piercing in the
vertex.-Chronic Diseases, vol. 3, p. 86.
CASE 42.-A delicate seamstress, aged 37, had suffered
for a long time with an affection of the head.
It began with stitches in the scalp, shot to the temples,
where it also became piercing, and was attended with nausea;
the pain was most severe in the morning, soon extended
through the whole body, which became chilly and covered
with goose-skin, whilst the head and face became burning hot.
Her menses were very irregular, at times too early, at others
too late.
Treatnment.-Bellad. not only did not relieve, but the paroxysms became more severe in the evening. Causticum 30,
removed the whole difficulty.-Archiv., vol. 17, p. 1, page 10.
-DR. 13. OF D.




CAUSTICUM AND CHAMOMILLA.               33
CASE 43.-A  merchant, aged 52, of robust constitution,
had suffered for several years with the following complaints:
Violent stitches of pain in the right temple, most severe in
the evening when he came out of the open air into a warm
room, and attended with giddiness. Irregular appetite, at
times poor, at others ravenous; fulness in the abdomen,
constipation for several days at a time; at night when in bed
he had drawing pains in all his limbs, persisting severely
until midnight; chills during the evening, with dejection of
mind, and gloomy anticipations about the future; frequent
sorrow and care.
TreatSment.-Pulsat. afforded but little relief, but Caust. 30,
removed the whole difficulty. —Ibid.
CASE 44.-An old lady, aged 75, a great coffee drinker,
had suffered several years with:
Nocturnal pains of a rending and digging character, attended
with constant roaring and rushing in the head; formnication
in the arms and rending in all the limbs, increased by motion.
T'recatment.-Sulph. 30, one dose every fourteen days for
five doses, with the continued use of coffee, removed the pains
in the limbs, and Caust. 30, five doses at the same intervals of
time cured those in the head.-Ibid.
REVIEW.-All three cases were chronic; the pains affected
the temples in particular; they were piercing and connected
with rending and drawing in the limbs.
]D0se — Causticum is regarded by many physicians as a very mild
or almost inert remedy, still it seems to have been exceedingly useful
in the above three chronic cases, and that in the high dilutions. Two
or three globules may be given two or three times a day at first; then
every two, four or six days; if this does not suffice, one or two drops
of the first, third or sixth dilution may be used in chronic cases once or
twice a day, or at the longer intervals above directed. It is rarely given
in acute cases.-PETERs.
16. CHAMOMILLA.
GENEnAL REMARKS.-According to Hering, Chamomilla is
useful in pains from taking cold and from excessive use of
coffee; especially when there is rending and drawing in one;
side of the head extending down into the jaws; stitches in the,
3




34                      IAIEA)ACIES.
temples; heaviness, or very annoying throbbing over the nose;
especially when one cheek is red and the other pale, or the
whole face is swollen, and the patient has a bitter putrid taste
in the mouth. It is often suitable for children and for persons who become ill-natured from pain.
CASE 45. —Mrs. P., aged 34, suffered periodically with
one-sided headache.
Synmptoms.-Violent piercing pains in the left side of the
head, extending from the occiput to the upper jaw of the same
side; at times she had rending pains in the left ear, the left
cheek became red and hot, and frequent slight chills were
followed by stitches in the region of the liver.:treatment.-Chanmoiilla 200, afforded no relief from early
in the morning until 10 o'clock at night; then Chamnom. 3,
three drops in solution, one teaspoonful every hour was given
with relief in the course of an hour, and the next day she was
well.-Genl. Hom. Jour., vol. 33, p. 101. —KALLENBAC11.
DoSe0 —Chamn. is rarely or never suitable in the cure of chronic
headaches. It is such a very mild remedy that in acute attacks several
drops of the pure tincture may be given every half, one, two or more
hours; or the same quantities of the first, second or third dilutions may
be used for children or very sensitive adults. In the very rare cases in
which these doses do not suffice, the higher potencies may be tried, viz.:
six globules in a wineglass of water, one teaspoonful per dose, as often
as above directed.-PETERS.
17. CHINA.
GENEnAL REMARKRS. —(a.) According to Hering, China is
often useful in the headaches of sensitive persons when the
pain is pressing and prevents sleep at night, or causes such
tearing in the temples that it seems as if they would burst;
also against boring pain in the vertex, with feeling as if the
brain were bruised; or jerking, rending, sense of fluctuation
and bursting pain, aggravated by stepping, walking, by every
movement, and by opening the eyes, and relieved by lying
-down and by quiet. It is also indicated when the scalp is'v ery tender to touch; and for the headaches of discontented
and irritable persons, and those of disobedient and obstinate
children, who are fond of stuffing themselves with all kinds of




CHINA.                        35
imp'roper food, have pale faces, who are only occasionally red
and warm, and then become very talkative, or are restless the
whole night. Often suitable after Coffea.
(b). Tietze thinks China most suitable when the pain is a
pressing rending, or tearing pressing, especially when most
severe in the temples, worst at night, preventing sleep, the
pain being aggravated by the slightest touch, by stepping,
draughts of air or wind. Also when there is excitement of
the mind and imagination, and the patient is wayward, abusive
and angry.-Genl. Hom. Jour., vol. 34, p. 22.
(c). According to Black, China is indicated in drawing,
rending, pressing headaches, which abate from  quiet, but
increase from the slightest motion and do not remain fixed in
one spot; also against the passive congestions of the head
which follow great losses of blood, violent purgings, and loss
of semen; when there is a feeling of emptiness in the head,
ringing in the ears, weakness of sight, with rending, drawing
and squeezing pains.-Genl. ionm. Jour., vol. 36, p. 232.
CASE 46.-A  girl, aged 15, not yet menstruated, had
suffered for six months, with longer or shorter intervals of
relief, from headache.
Symptonzs. —Very painful movement and beating of the
brain against the skull; she could not keep her head still, but,shook it up and down; severe pain on the left side; feeling as
if the upper part of skull would burst off, the pain being
increased by motion and steplping; the left eye was affected;
the left side of neck was painful and stiff; and she was
lachrymose and dejected.
Treatmet.-R-thus did not help; but China 12, half a drop,
removed the pain in four hours; it returned in six hours more,
and was then removed entirely by a second dose of China. —
Annals, vol. 10, p. 414. Dr. HARTLATUB.
CASE 47. —Mrs. D., suffered with severe pain on the top of
her head, with a flushed face, but not a freq-uent' ulse; conse-.quent upon immense losses of blood after miscarriage, and:at other times.
Treatment.-Bellad. 3 was given without relief, and the




36                    tHEADACHES.
pain became distracting. Nux 3 was also given without
benefit, as she was worse if possible on the third day; then
China 6, one dose, cured her promptly and completely.-Dr.
SHARP. —Brit. Jour. HIom., vol. 9, p. 585.-PETERS.
REvIEw.-The pains relieved by China consisted of rending
or pressing, or of both combined, attended by a feeling of
fluctuation and of beating in the brain as if the head would
burst; they were worst at night, aggravated by the slightest
touch, by moving or stepping and by currents of air, and
relieved by rest and lying down. The mind was excited,
irrit-able, or inclined to scolding and anger. It was also found
useful against passive congestions from loss of fluids.
[NOTE.-China and Quinine have been used much more
freely in old school practice than in the homceopathic. Wood
says: " In relation to the permanent cure of headache, sulphate of quinine should always be employed in intermittent
and periodical cases and may be tried with the hope of good
in others. In hemicrania he has found Quinine in connexion
with Oil of Valerian almost uniformly successful; he gives
from ten to thirty grains of the Sulphate and about twenty drops
of the Oil daily, divided into six or eight doses, and persisted
in, if necessary, for a week or more; and thinks that enough
quinine should be given to induce its peculiar effects upon the
brain, such as buzzing in the ears, &c."  Dr. W. tells us that
"it very often happens that the pain is increased for the first
day or two, after which it gradually subsides;" and perhaps
takes the patient along with it. JohnsOn says Quinine and
Arsenic are the most potent of all remedies in this disease;
they seldom fail to put a stop to the complaint.-PETERs.]
DoSe. —Noack advises one, two or several drops of the pure tincture
of China per dose; or like quantities of the first, second or third dilution, repeated every half, one or two hours in severe cases, or every two,
four or six hours in milder attacks. Children and delicate adults may
take from one or two, to three or five globules as often.-PETERS.
18. COCCULUS.
GENERAL REMAIRKS.-(a). Hartmann relieved several headaches by it, which were increased after eating and drinking,




cocCULUS.                    37
attended by a sense of emptiness and hollowness in the head,
and by pains which the patient could not describe accurately.
(b).,According to Black, Cocculus is most suitable for hypochondriacal and melancholic persons, inclined to anxiety and
-fright; for nervous gastric headaches attended with nausea or
actual vomiting; for headaches during menstruation, especially
when that occurs too soon. Black also says he has had frequent occasion to observe in chronic headache with vomiting,
that the remedies first check the latter, and then the headaches
become less severe and diminish in frequency. When the
headache is severe and attended with vomiting, he has found
Cocc. the most useful intercurrent remedy in checking the
vomiting; also Ignat. and Eugenia.-PETERS.-Genl. iom.
Jour., vol. 36, p. 232.
The only case recorded by Ruckert in which Cocculus was
-used, is case 60, in which it was given in daily alternation
with Phosphor.
As the English physicians have used it more frequently and
successfully I subjoin the following additional case.-PETERS.
CASE 48.-Mliss HI., aged 35, of full habit, had been subject
to headaches for 15 years; they came on shortly after menses
first set in and have regularly appeared at that time ever
since; the pain was violent and dull, affecting the whole head;
she was obliged to lie on her side, and could not rest for a
moment on the back of her head, nor bear the least light;
while the slightest noise excited nausea and vomiting; the
attacks lasted from 36 to 48 hours, generally commencing on
the third or fourth day of menstruation; menses were abundant but not painful.
_Tecatment..-Cocculus 6, from every half to every six hours
during the paroxysms, almost freed her from her headaches in
three months. Then Bellad. 6 and Cocc. 18 were given and
she had no return of pain for twenty months.
The principal indication in this case for the selection of
Cocculus was the marked tendency to nausea resembling sea:sickness, as if the stomach heaved up and down. So great was




38                      HEADACHES.
this peculiarity that travelling in a carriage made the patient
feel ill, and nausea had often been brought on by looking at a
vessel pitching up and down on the sea. —3BLacK.-Brit. Jour.
Hom., vol. 5, p. 430. —PETERS.
bDose~ —One or two drops of the first, second or third dilution of
Cocculus may be given every half, one or two hours in severe cases; or
every two, four or eight hours in milder attacks. When the stomach
is exceedingly irritable the doses should not be given in water, but on
a bit of sugar, or granules should be prepared and given dry upon the
tongue, from one to three per dose, as often as above directed.-PETERs.
19. COFFEA.
GENERAL REMARxs. —(Ct). According to Hering, Coffea is
useful in violent one-sided, drawing, pressing pains, as if a
nail were driven into the side of the head; or as if the brain
were crushed, torn or. bruised; arising from  slight exciting
causes, such as thinking, vexation, taking cold, eating too much,
&c., attended with disgust for accustomed coffee, with sensitiveness to noise and music; the pains seeming quite insupportable, forcing the patient to weep; or the patient gets
quite beside himself, screams, cries, tosses about, is extremely
anxious, fearful of the cold air, and chilly.
The remedy may be frequently repeated, and followed by
Nux v. or China, or at times by Ignat. or Puls.
(b). According to Tietze, Coffea is useful in migrane when
the pain is drawing and pressing as if from a nail driven into
one side of the brain, or as if the whole brain were bruised or
crushed; when the pains drive one to distraction, force one to
walk around the room, and are attended with great sensitiveness to noise, and fresh air, with chilliness; and are increased
after eating. If such a headache has been produced by mental
exertion in a person who seldom or never takes coffee, then
Coffea will almost certainly relieve. —Gen. I-Iom. Jour., vol.
34, page 21.
(c). When the above state of mental irritability is present
with headache, Coffea often relieves with wonderful celerity.
[NOTE.-Coffee and tea are also used miuch more largely for
the relief of headaches in the old practice than in the new;




COFFEA.                       39
Wood says:'" on the whole, he has found nothing more effeetual for the relief of severe headache than two or three cups
of strong tea; but when the disease depends upon the use of
tea or coffee (there is some homeopathy here), they act simply
like ardent spirit in relieving the horrors of intemperance, and.
then should not be employed, as they aggravate the evil in the,
end."  Trousseau (see Trcwai' de T/cercpezutize) says, common.
usage has sanctioned the efficacy of coffee in headaches, especially in that form which sets in after eating, in nervous persons; slight attacks of migrane almost always are removed by
it. Sandras (see Trcaitej'pratique des nalcddies nerveuses, vol.
1, p. 354) says that the only remedies that he has used with
any success in migrane are: tea, morphine and emeticocathartics. Tea, he says, if taken in very strong doses dunring
the first few hours of the attack, will sometimes dissipate it, as
if by enchantment; but to obtain this result one must drink
several cups of strong tea, with but very little sugar, and no
milk or alcohol. Valleix (see Guide dae 2Jiddecin practieiei
vol. 4, p. 766) says: In some cases a cup of the infusion of
coffee will drive away an attack. Formney recommends an
infusion of crude coffee as follows: coffee, finely ground but
not roasted, and perfectly dry, 15 grammes; boiling water,
sufficient for a cup; make an infusion and drink at once. The
regular daily use of the Tinct. of Crude Coffee and the Tinct.
of Green Tea, deserve a much more extended trial than they
have yet received.  Good says, as a general palliative strong
coffee has often proved serviceable, and where its own sedative
virtues are not sufficient, it forms one of the best vehicles for
the administration of Opium; it diminishes in some measure
the hypnotic power of Opiumn and counteracts its secondary
disturbing effects; still if Opium be given mixed with strong
coffee for the cure of many modifications of headache, tranquillity and ease will often be produced though no sleep
follows; but when Opium is taken alone, sleep will perhap
follow, but it is mostly succeeded by nausea and a return of
pain. For similar reasons the Turks and Arabs make coffee
their common vehicle for taking Opinm.-PETERs.]




40                      HEADACHES.
DoSe, —Noack advises one, two, or four or more drops of the pure
tincture of raw coffee per dose at short intervals of time; in some
rare cases the first, second or third dilution may be used, or several
globules per dose, either dry upon the tongue or dissolved in a tea-:spoonful of water.-PETERs.
20. COLOCYNTH.
(a). According to IHering, Colocynth will help the most
severe and raging rending pains; or one-sided, drawing,
pressing, squeezing pains; or aching in the forehead, increased
by stooping and by lying upon the back; and, finally those
attacks which set in every afternoon or evening, affecting the
left side, attended with great restlessness and anxiety, especially when the sweat of the patient has a nrinous smell; when
but little urine is made, and that which is passed at first is
very offensive, but becomes very abundant and clear during
the severity of the pains.
(b). Tietze thinks that Coloc. is most indicated when the
one-sided pains are aching and pressing, or else drawing, and
attended with nausea and vomiting; when they affect the
forehead and left side of head, and the attacks generally set
in in the evening, the pain being increased by stooping, moving, shaking the head, moving the eyelids; also by mental
emotions, such as indignation, bitter feelings, or mortification
about unworthy treatment. Great restlessness and anxiety
often attend the pain. —Genl. I-Iom. Jour., vol. 34, p. 22.
(c). According to the Austrian provers, the forms of hemicrania curable by Colocynth depend upon an increase of sensibility, aroused by rheumatic, arthritic or gastric irritations.
It cannot cure megrims arising from thickening of the arachnoid, adhesion of the membranes, or other organic changes.
Generally, the hemnicrania which Colocynth cures most readily
is seated in the course of the frontal nerve, is attended with
violent pain in the eye, and alternates with neuralgia of the
cceliac plexus.-Austrian Jour., vol. 1, p. 148.
CASE 49.-Coloc. 30, cured a violent, piercing pain in the
forehead and eyes, shooting from without inwards, and
which had lasted for 90 hours, both by day and night; the




COLOCYNTH.                     41
pulse was hard, thirst excessive, there was a bitter taste of all
food, general dry heat and constipation. Entire relief followed
in six hours.-Gen. I-Iom. Jour., vol. 4, p. 13.-AwTTORY.
CASE 50.-A young lady, aged 24, of delicate constitution,
formerly scrofulous, was attacked with intensely violent,
pressing, rending, headache; she could not lie still, was constantly getting up, bent herself together, wept and screamed.
When the headache abated attacks of suffocation set in, with
oppression of chest, gasping for breath, clenching of the hands,
&c. The paroxysms recurred every half or one hour. Coloc.,
six doses, relieved the whole suffering.-Practical Observations, vol. 2, p. 9. —DI. SCHINDLER.
CASE 51.-An old lady, aged 50, had suffered for several
years with headache on the left side, occurring periodically
in the afternoon about five o'clock.  She had been treated
allopathically without relief.
Treatrnenrt.-Asarum afforded some relief, but Colocynth
cured her in a few days permanently. —Archiv., vol. 11,
part 2, p. 114.
CASE 52. —nlr. W., aged 29, of robust frame and choleric,
phlegmatic temperament, suffered with:
Periodical headache, recurring every morning about half
an hour after awaking, being rending, piercing and jerking
in its character, and affecting the right temple in particular,
but extending from thence over the whole right side of the
forehead. He also had dulness of the head; turning out of
the right eye, which was red and watery, and seemed smaller
than the other; flimmering before and dimness of the same
eye. The pains extended to the teeth, where they became
raging, aching, and jerking, attended with sensitiveness of the
right side of the head, especially about the eye, with soreness
to touch; he also had loss of smell; flowing catarrh; cough, with
greenish expectoration and increase of headache; white coated
tongue; inclination to vomit; contraction of the stomach, with
soreness to touch; heaviness of the limbs; coldness and thirst.
The attacks lasted from  6 A. AM. to 3 P. M., attended with
great anxiety and restlessness, so that he walked about the
room in agony.




42                     HEADACHES.
ireatment.-Nux v., Bell., Bryon., China, Chamin. and Sulphur were given without much benefit; then Coloc. 2 was
given and rendered the next attack lighter, and seven more
doses effected a perfect cure. —Genl. Hom. Jour., vol. 27,
p. 293.-D-. HIAUSTEIN.
REvrtEW.-The above cases presented the following striking
peculiarities: the pains occurred in paroxysms, generally lasting
from morning till afternoon; they were violent, rending, compressing, drawing, pressing, piercing and jerking. In three
cases they were on the left side of the head, in one case on the
right, in others more in the front-head and forehead, and
were attended with nausea, vomiting, great restlessness and
anxiety; with perspiration of urinous smell, with scanty and
offensive urine; the attacks were excited by vexation and
mortification, increased by stooping and lying on the back,
by moving, especially of the eyelids, by shaking the head and
by touching it.
[NOTE.-The use of Colocynth as specific to some forms of
neuralgia of the head, hip and other parts, has long been
known to the homceopathists, but Watson tells us that Sir
Charles Bell, drawing a bow at a venture, achieved a cure of
a patient upon whom much previous treatment had been expended in vain, by some pills composed of Extract of Colocynth, Croton Oil and Galbanum.  He mixes one or two
drops of the Oleumn Tiglii, with a drachm of the compound
extract of Colocynth, and gives five grains of this mass, with
ten grains of the compound Galbanum  pill at bed-time.
Watson says he mentions the exact proportions and dose because other cases have been since reported, both by Sir
Charles and others, in which the same prescription was followed by the same success. The small quantity of Colocynth
in the above farrago would probably have been equally useful. — PETERS.]
The DOSes were Coloc., 2d dilution, 6th and 30th; the cures took
place quickly. [Noack advises one or two drops of the 1st, 2d, or 3d
dilution, repeated at longer or shorter intervals, according to the severity of the headache.] —PETERs.




CREOSOTE-CROCUS.                  43
21. CREOSOTE.
CASE 53.-A  man, aged 40, strong and plethoric, was
attacked three weeks after having the influenza, with:
Violent pain in the whole back head, extending to the
nape, and most severe on the right side; the pain commenced
at five o'clock, A. M., with great severity, increased for several hours, then lessened, and finally ceased about eleven,
A. M. These paroxysms occurred daily, bnt anticipated and
postponed somewhat. Every movement of the head increased
the pain; the sexual desire was much lessened, and the
attacks were more severe after gratification of it. Every kind
of cure, together with Bark and Quinine, had been tried in
vain.
Tlreagment.-Creosote 3d, one close per day, for ten days,
produced a marked alleviation, then it ceased to cause inmprovement, and finally the disorder commenced again to increase in severity. Creosote 2d was given, and after being
continued, one dose daily, for some time, the patient was
entirely cured.-Vehsemeyer's Journal, vol. 2, p. 228. —REIsIG.
[DBse,-Noack advises one or two drops of the 1st, 2d, or 3d dilution every two, four, six, eight, twelve or twenty-four hours, according
to the acuteness or severity of the attack.-PETERS.]
22. CROCUS.
GENERAL REMAnrS. -The pains in the head so frequently
occurring during the change of life in women, may often be
relieved by Crocus, especially when they are of a pushing,
throbbing character, with pressure upon the eyes, attacking
first one spot, then another, with distension of the bloodvessels, not confined to the head only, but spreading to other
parts of the body; also when the pains are most severe at the
times when the menses used to occur, and persist uninterruptedly for two or three days, having but few intermissions
even during the night, sufficiently long to allow of sleep; becoming less severe and continuous after the menstrual period
has passed. Dose. Crocus 3d, repeated two or three times a
day, and resumed again at each monthly period.-Genl.
Hiom. Jour., vol. 18, p. 111.




44                       HEADACHES.
[Dose.S-Noacl advises one drop of the pure tincture, or of the 1st
or 2d dilution, every half, one, two or three hours in severe attacks, and
two or three times a dayv only, in mild cases. —PErERS.]
23. DULCAMARA.
CASE 54.-A healthy woman, aged 40, was attacked with
headache on coming to, after suddenly falling senseless to the
floor.
Symptoms. —Violent boring burning in the forehead and
vertex, with digging in the brain from  within outwards;
sensation as if a board before the forehead pressed back the
brain; increase of pain from every motion, even from speaking; heaviness of the head; accumulation of saliva in the mouth;
dryness of the tongue and thirst; hard, tense pulse; great
weakness and bruised feeling of limbs; attacks of siclkness
during damp, rainy weather.
Treatmezt.-Ten minutes after Dulc. 8, increase of pain set
in and lasted an hour, followed by sleep for three hours, from
which she awoke well.
See Mat. Med. Pur., Symptoms 11, 16, 23, 27, 34, 37, 59,
95, 97.-Annals, vol. 1, p. 234.-Dn. GAsPARY.
DoSe,-Dulcamara is one of the milder remedies, of which Noack
advises one or two drops of the pure tincture, or of the first or second
dilution every one, two, four or six hours. In appropriate cases the
higher dilutions may be used, or three globules solved in a wineglassful
of water, one teaspoonful to be taken per dose as often as above directed.
-PETERS.
24. GRATIOLA OFFICINALIS.
[Chapman has used it in sick headache with benefit when
there is nausea, disgust for food, giddiness relieved by being
in the open air, heaviness of head and constriction of forehead. A drop of the second or third dilution will sometimes
cut the attack short, but its effects are generally merely palliative; one patient has frequently succeeded in breaking up
the attacks during the course of several years, but still
remains subject to them.-JBrit. Jour. Hom., vol. 8, p. 226. —
PETERS.]
[D0se0-Gratiola is an acrid remedy, and apt to cause aggravations,
hence Noack advises but one drop per dose, of the 2d, 4th or 6th dilu



DULCAMARA —GRATIOLA-IEPA/R SULPHURIS.           45
tion, once or twice a day, or only every two days in chronic cases. In
acute and severe attacks, two or three drops of liquid Gratiola may be
put in a wineglassful of water, and one teaspoonful given per dose
every half, one or two hours, until relief ensues, and then only every
two, four, six or eight hours. For children aud delicate adults, as
many globules may be put in the same quantity of water, and one teaspoonful given as often as above directed.-PETERS.]
25. HEPAR SULPHURIS.
CASE 55.-Miss J., aged 17, had suffered with headache
almost constantly for three months; she had dull, pressive pain
over the root of the nose, and a little over the eye, worst in the
morning, increased by reading and mental exercise, generally
relieved by rest; also weakness of back  and occasional
derangement of stomach.
Treatment.-Ilepar. 6 caused an aggravation for seven
days, then Hepar 15 caused a relief for a month, and Hepar
18 effected a complete cure.-BLACK, iBrit. Jour., vol. 5,
p. 428.
CASE 56. —Lady A., highly nervous, had suffered more
than eight years with severe headache, consisting first of a dull
pain in forehead, then becoming acute and extending to the
whole head.
TreatMent. —lepar for six weeks, when decided improvement commenced, followed by extreme languor and weakness, which lasted fully more than a month-when this carative weakness, denoting a great change taking place in the
organism, disappeared, the headaches were also gone.-BLACK,
Ibid, p. 429.-PETERs.
[Dose. —Hepar sulph. is generally given dry upon the tongue, one
dose of the 1st or 2d trituration every hour or two, in severe attacks; or one
or two grains or granules of the 3d, 6th or 12th dilution every one or two
days in chronic cases.-PETERS.]
26. IGNATIA.
GmuENRAL REMARKS.-(a).  According to Tietze, Ignatia is
suitable in hemicrania as a purely spinal remedy; also for
sensitive, irritable, hysterical persons of a sanguine nervous




46         -           HEADACHES.
temperament; for delicate persons, where there is an inclination for visionary dreaming; when grief is borne silently;
when slight clonic cramps are apt to occur after fright and
vexation; when the pain is pressing, piercing, from within
outwards, especially in the forehead and root of nose, or as if
a nail was pressed into the temples or sides of the head.Genl. IIom. Jour., vol. 34, p. 11.
(b). Dr. Black says it is a good remedy in the nervous
headaches of hysterical women, when they set in and subside
suddenly. —Genl. IHom. Jour., vol. 36, p. 233.
(c). According to IHering it cures pressing pain over the
nose, when relieved by stooping; pressing from within outwards; jerking and throbbing; rending in the forehead as if
a nail were driven into the head; piercing and boring deep
into the head with nausea, darkness before the eyes, and
dislike for light; paleness of the face, much watery urine; the
pains ceasing for a while when one changes his position,
returning frequently after eating, coming on again in the
evening after lying down, and in the morning soon after
rising; rendering the patient very timid and changeable, or
silent and dejected.-P. 140.
CASE 57. —A young lady, aged 24, blond, pregnant for the
fourth time in seven years, had suffered with migrane before
her pregnancy, and been troubled for four weeks with the
following:
Symptoms.-Pain beginning in the middle of the forehead,
extending down to half of the nose, upwards to the middle of
the vertex, where it presses like a weight, followed by nausea
and inclination to vomit; most severe from early morning to
mid-day, then remitting but at times persisting till night; every
noise and loud speaking irritated her very much; she was pale,
had a suffering appearance, and great lassitude of the limbs.
Ignat. 6, repeated every four or five days, removed the whole
difficulty. —Dr. ScuIWARZE, p. 9, see case 90.
REvIEw.-The sphere of action of the remedy is sufficiently
given in ~ a and e; it is especially suitable for nervous hysterical persons, other circumstances not forbidding.




IGNATIA — RIS VERSICOLOPu-LACHESIS.          47
DSOe. —Ignatia is a powerful remedy, of which one or two drops of
the second, third or sixth dilution may be given every one, two or four
hours in severe attacks, or every six, eight or twelve hours in milder
cases. Or one, two or three globules may be given dry upon the
tongue. In chronic cases the dose should be repeated once or twice a
day, or only once every two, four or more days.-PETERS.
27. IRIS VERSICOLOR.
Dr. Tames Kitchen says it is the most prompt and effectual
remedy against sick headache that he has ever given in this
truly annoying disorder. The first dose will arrest the trouble
in some patients, as he has witnessed in several cases. IIe has
made comparative trials with it and other remedies, telling
his patient to observe which medicine would relieve them
most speedily; they have invariably, on the return of the
attack, pointed out the Iris. This he conceives conclusive
respecting this complaint, so that he need not comment on it
further than to recommend it very highly so far as his experience goes. —North Am. Hoom. Jour., vol. 1, p. 464.
DIBSe, —Dr. Kitchen recommends an alcoholic tincture of the root,
diluted as required from the first to the sixth dilution, a few drops in a
tumbler half full of water, a teaspoonful. per dose. It is particularly
useful in allaying the nausea and vomiting. —PETERs.
28. LACHESIS.
GENERAL REMARIKS.-According to Black it is indicated
in one-sided tense headaches extending from the occiput to
the eyes, with vomiting, stiffness of the neck and soreness of
the scalp.-Genl. Ibom. Jour., vol. 26, p. 233.
NOTE.-In British Jour. of Homceopathy, vol. 5, p. 404,
Black reports several severe chronic headaches mainly cured
with Lachesis and Sepia.
Henderson, Ker and Russell, also  report favorably of
Lachesis in chronic headaches.
CASE  58.-C. B. has suffered severely with headaches
after a bilious attack; they commence with dimness of vision,
which continued for an hour, then go off, leaving a dullish
pain over the eye, causing him  to feel exhausted and disinclined for any occupation. Bowels rather costive.




48                     HEADACHES.
Treatment.-Lachesis 15; had one headache only in a week,
leaving deafness, twitching of the lids and lips and. twitching
and throbbing under one eye. Lachesis relieved his head for
a week more, but the twitching still remained. Bellad. 12 and
Lach. 15 quickly removed the rest.-RUSSELL, Brit. Jour.
Hom., vol. 5, p. 433.
In another similar case Russell found the headaches to
disappear entirely under the use of Lachesis for one year, but
then they returned again and Lachesis was useful for a few
months longer in arresting the vomiting, which attended severe
attacks, but the headaches remained. Drysdale found Cannabis useful in such cases.-Ibid.
CASE 59.-Miss B., aged 24, had suffered with headaches
for four months, with a general feeling of numbness and
faintishness, great giddiness and paleness; the pain was generally shooting and throbbing over one eye, frequently
attended with nausea, increased by motion and always worst
in the morning; is seldom a day free from headache, and when
she is, giddiness takes its place; acid taste in mouth, everything turns sour, fulness and weight in stomach after eating;
tongue clean and bowels regular. Menses regular, but attended
with pain in back and lower part of abdomen, and more severe
headache than common. Lach. 15, almost entirely effected a
cure in six weeks. The indications for its use were the onesided headache, often attended with sickness, the vertigo with
paleness, the tendency to faint and general sensation of numbness.-Dr. KER, Brit. Jour. Hom., vol. 5, p. 434.-PETERs.
D0e, —The credit of introducing this powerful remedy into practice is entirely due to the veteran Dr. Hering of Philadelphia; he advises
one dose of the 6th, 15th and 30th dilution once or twice a day in
acute cases, every two, four, eight, ten or more days in chronic cases.
29. MAGNET. SOUTH POLE.
GENERAL REMARKS.-,After the use of Nux vom. (see case
80) the following state remained.
CASE 60.-Confusion of the head, dizziness, tottering and
staggering while walking, with rush of blood to the head;
formication in the brain, about the root of the nose and in left




MAGNET. SOUTH POLE. —MERCUR. SOLUB.      49
temple; at 12 o'clock violent but transient stitches set in, with
smarting and dryness of the eye-lids, and watering of the
eyes.
Treatment.-After stroking the painful part for two minutes
with the South Pole of the Magnet the whole was relieved in
twenty-four hours. —Archiv., vol. 5, part 1, p. 89.
30. MERCURIUS SOLUBILIS.
GENERAL REMARKs.-(a). According to Hering, Mferc. is
indicated when the head seems so full that it feels as if it would
burst, or as if it were pressed together with a band; worse at
night, the pains being rending, burning, boring or piercing.
(b). Black says it may, be used against rending and drawing
pains in the head, seated in the pericranium and bones of the
face; also in rheumatic headaches, with vertigo, pain in.the
forehead, and derangement of liver. —Genl. IHom. Jour.,
vol. 36, page 233.
(c). Schelling recommends it in headaches and toothaches
of a peculiar kind, especially when accompanied with an
affection of the mouth; with jerking, throbbing pain in the
forehead, temples and vertex; with digging in the head,
rending and piercing in the teeth, which become loose; the
pains extending over the cheek, behind the ear into the occiput,
and attended with:
Vertigo, chilliness, shuddering with flushes of heat, thirst,
congestions, and inclination to perspire; with moist skin and
great sensitiveness to every change of temperature; with
yellow color of the face, and blue rings about the eyes, rumbling in the bowels, oppression of the stomach, &c.; the symptoms being most severe in the evening or at night. It cures
in from two to seven days.-H-ygea, vol. 17, p. 359.
(d). Rademacher points out the following kinds of headrheumatism which Mercury will cure. In general, he remarks,
the affection is always periodical, at first perhaps almost as
regular as a fever and ague, and the aggravations occur more
4




50                    HEADACHES.
frequently in the forenoon, than afternoon. When the disorder
becomes chronic the paroxysms become irregular, or even
continued.
The different forms are:
(1). When the pain has its seat under the skull, and shoots.
from the region of the eye-brows into the back of the head..
When the pain lessens, the scalp becomes tender.
(2). When the pain involves the region of the supraciliary
arch of one side and the temporal bone, extending to the eye
of the same side, which becomes fiery red and lachrymates
during the paroxysms.
(3). Against dull rheumatic pain over the orbits of the eyes.
In one case the patient had a dull pressing pain over the
eye-brows, lost his sight entirely, and the pupils became
sluggish and immovable; he was also weak minded, and
repeated one thing very frequently.
Merc. solub. given to the point of salivation restored him
entirely.
CASE 61.-Mrs. N. had suffered for nine days with:
Violent rending in the left side of the head, extending to
the teeth and muscles of the neck of that side, with piercing
pain in the left ear; either cold or warm things taken into the
mouth, or the slightest touch, aroused the pains; she had three
severe paroxysms per day, followed by chills without heat or
thirst; was relieved by lying down, and she staggered when she
attempted to walk. On the eighth and ninth days delirium
set in during the attacks, with perspiration in the palms of the
hands, and fits of partial unconsciousness; she had no appetite, got no sleep, and her mood was irritable and lachrymose.
Treatment.-After an evening attack Bryon. 30 was given,
and only a few slight attacks occurred, always in the morning; after the lapse of fourteen days more severe attacks
again set in, in the evening, marked by rending pains in the
forehead, shooting with the speed of lightning into the teeth,
forcing her to get up and walk about. Profuse salivation set
in, but she was able to hold both warm and cold things in




MERoURIT  SOLUBILIS.             51
her mouth; violent chills occurred after the paroxysms, and
she became very weak, irritable, and inclined to anger. Mere.
12 was given with rapid relief to all the pains.-Annals,
vol. 1, p. 235.
[CASE 62.-Lady J. D., aged 30, when weakened by nursing, was attacked with pain on left side of the face, from decay
and filling of a tooth; she had severe pain in the lobe of her right
ear, extending down into the jaws, over the side of her head,
and into one eye; it commenced with slight jagging, and
then became severe and shooting; it generally came on at
night and left a sense of throbbing. Cured by Merc. 6, 15
and 3d in about 6 weeks. —RussELL. —Brit. Jour., vol. 5,
p. 431.
CASE 63.-T. F. had suffered with rheumatic pains in the
head and gums for six weeks, also with slight pains in the
legs. He generally awoke at 7 A. M., with pain in the head,
followed by soreness of the gums when it ceased; the pains
were most severe in the back and top of the head, and in the
right side of upper jaw; aggravated in the morning and when
in bed, relieved by getting up and by pressure. Merc. 6,
three or four doses, removed the pains entirely for five
months. —MAIDDEN.-Brit. Jour., vol. 5, p. 438.
CASE 64.-A spinster, aged 30, had suffered for seven or
eight months with severe pain in her head, arising from
inflammation of the bone or periosteum; the pain was dull
and constant over both occipital prominences, but on the left
side it extended along the side of the head as far as the eye;
she was unable to turn her head to the left side; the pain was
worst in bed, aggravated by motion, and attended with great
tenderness to pressure, and occasional throbbing. Merc. 3
and Ruta 3 effected a cure in two months. —MADDEN.-Ibid,
p. 438.-PETERS.]
REvIEw.-The headache for which Merc. is most suitable
is generally of a rending character, although at times it
may be piercing, boring, burning or drawing; with feelings
as if the head would burst, or as if it were bound with a
band; involving the pericraniumn, bones of the face, region of




52                       HEADACHES.
the eyebrows and temples, and from thence extending to the
back of the head, or into the teeth, or muscles of the neck;
occurring periodically at times, attended with flushes of heat
intermixed with chills, inclination to perspire, with bilious
derangement, yellowness of the face, dark rings around the
eyes; being worst at night, and relieved at times by lying
down. The bilious and rheumatic character of the whole
disorder is not to be mistaken at times.
Dose.-This should always be comparatively small; I have noticed
several times, even in headaches which were evidently connected with
decided bilious derangement, that a dose of Mercurius sufficiently large
to act on the liver and bowels would always be followed by more frequent and severe attacks of headache. One or two grains of the 2d or
3d dilution of Mere. viv., Mere. solub., or Mere. corros., or from two to
four globules may be given night and morning in chronic cases. In
acute cases the same quantities of Mere. solub. or Mere. corros. may be
put in a wineglassful of water and one teaspoonful given every half, one
or two hours until relief ensues, and then every two, four, six or eight
hours. For children or delicate adults the same quantities of the medicine may be put in a tumbler half or quite full of water, and from a
teaspoonful to a tablespoonful given per dose.-PETERS.
31. NATRUM MURIATICUM.
GENERAL  REMARKE.-According  to  HIahnemann, this
remedy comes in play against daily headaches, especially
when seated in the back of the head and forcing one to close
his eyes; also when there is a pressing in the whole head and
temples; in headaches with feeling as if the head would burst,
commencing early after awaking in the morning; against
rending, piercing pains in the head, forcing one to lie down;
against stitches and pressing over the eyes, and beating,
hammering and throbbing in the head.-Chronic Diseases,
vol. 4, p. 349.
CASE 65.-Miss L., aged 30, of delicate frame and inclined to sorrow and melancholy, had suffered for many
years with periodical headaches, especially after taking cold
about the head.
Syqmptoms.-Violent stretching, drawing, rending pain,
extending from the top of the head towards the temples and
cheeks, and persisting without cessation for several days,




NATRUM MURTATICTJM.               53
although not always equally severe; always attended with
toothache and violent salivation, the spittle often gushed violently out of her mouth, her gunas were reddened, the whole
cavity of the mouth sore, and her teeth painful, especially the
front ones. She often had stretching pains in the whole of
her face, the scalp was sore to the touch, as if ulcerated,
especially when she was dejected and sorrowful. Her menses
returned somewhat too soon; she complained of continued
excessive lassitude and a certain nneasiness in the whole
body, as if everything within her were in motion, and
trembled so that she could not sit quietly in one place.
These attacks had become more frequent during the last
eight months, and arose from the slightest cold.
Tkreatment.-Cham., Bell. and Merc. were given without
relief; then Natrum InMuriaticum, 22, one dose, night and
morning, sufficed to cure the disease in a short time. Three
weeks after, a slight return of the old trouble occurred from a
violent cold, but disappeared rapidly and permanently under
the use of the same remedy.-Austrian Hom. Jour., vol. 4,
p. 1, p. 169.
Here belong also the following interesting cases cured by
the so-called " Sool," or Saline Baths.
CASE 66.-A lady, aged 28, in whose family head affections with congestions were hereditary, received an accidental blow three years before, upon the left temporal bone;
this spot remained sore and sensitive, and the slightest
touch of it caused trembling of the whole body; the pains
persisted night and day, and were attended with general
cramps of the limbs.
After the use of twelve general, and daily foot baths at the
"Sool" baths of Ischl, in Austria, she was entirely cured.
-Austrian HIom. Jour., vol. 10, p. 1, p. 173.
CASE 6T.-A lady, aged 32, without children, of a mild
but irritable disposition, and disposed to melancholy, suffered
with paroxysms of one-sided headache, attended with sudden
distension of the abdomen, rumbling in bowels, inclination to
vomit, fainting fits, and cramps of the limbs.




54                    BLEADACEmsIo.
Thirty " Sool" baths relieved her considerably, and a repetition of the baths the next year cured her entirely. —Austrian
Hom. Jour., vol. 10, p. 1, p. 174.
CASE 68.-A spinster, aged 34, had suffered with daily
attacks of headache, ever since she had got rid of a tape
worm, by heroic means, several years before.
Symptoms.-Violent pains with congestion of the head, to
which were added cramps, pains in the breast and limbs,
and distension of the abdomen.  During the intervals of
relief she had great nervous weakness, and constipation.
The use of the Ischl'" Sool" baths for six weeks restored her
entirely. —Austrian Hom. Jour., vol. 10, p. 1, p. 174.
CASE 69.-A young married lady was attacked with vario3oid after confinement, followed by necrosis of the leg, after the
cure of which she was visited with one-sided headaches,
recurring frequently with increased severity.
Symptoms.-She had suffered for thirteen years with these
headaches; for ten years with very profuse leucorrhea of bad
appearance, attended with pain in the region of the ovaries,
in the loins and thighs; her menses had been suppressed for
several months; the os uteri was beset with ulcers with a grayish
base. Her appetite was poor, digestion slow, she had desire
for acids and farinaceous food; her abdomen was distended,
the mesenteric glands were evidently enlarged and indurated,
and she had obstinate constipation.
Trleatment.-She took two or three glasses of Wildegger
water per day, with meat diet, and in a few weeks all the'morbid symptoms and appearances ceased, and she recovered
perfectly.-Austrian Hoom. Jour., vol. 4, p. 1, p. 175.
CASE 70.-A forester, aged 40, was attacked with violent
headache after a severe cold, which headache continued to
return periodically every eight or fourteen days, for five months,
with such severity that the previously robust man was reduced
to a skeleton.
The pain extended from the middle of the left temporal
bone over the left eye-brow, and from thence to the cheek, so
violently and suddenly that he often fainted away; in the




NATRUM MURIATIU.                  55
course of a few hours with the increasing severity of the headache, violent retching and vomiting usually set in, and a
slimy, watery fluid was ejected from the stomach, after which
-the pains diminished.
The use of twenty-eight baths at Kissingen, in the course,of four weeks did not produce much relief; in the sixth week
-of this treatment improvement commenced, in the seventh
week he was almost, and in the eighth week, quite restored.
— Ibid, vol. 4, p. 1, p. 172.
[CASE 71.-A young lady had been subject to headache for
eight years. The pain generally commenced in the morning
on getting up, was incessant, dull, wearing and aching, seated
in the forehead over the eyes, and attended with intolerance
of light, tenderness of the scalp, and such trembling of the
hands that she could not lift a cup without spilling some of
the contents.  She was seldom free from the pain at any
time, although a walk in the open air often relieved it somewhat. Her menses were irregular and painful; she always
had much thirst.
Treatment.-Pulsat. and Graph. restored the menses to a
natural state, but left the headaches unabated in severity.
After using Natrum IMiur. she was so completely relieved, that
-with one or two exceptions she had remained free fromn headache, for six years, at last accounts.-Dunsford's Practical
Advantages, p. 103. —PETERS.]
REvIEw.- In the above cases we find old chronic headaches, some of them hemicranias, cured by Katrum Mur.
in the form of " Sool" baths; in two cases only, a homoeopathic preparation, the 22d dilution, was used.
[NoTE.-The experiments of M. Plouviez throw some light
upon the action of Natrum Muriaticum when taken in large
quantities. From careful chemical analysis it seems to di-:minish the quantity of the water or serum of the blood quite'decidedly, thus rendering the blood thicker; it also increases
the quantity of blood globules in a marked degree, viz.: from
130.08 to 143.00; and these effects were always most decided
in feeble and lymphatic subjects. It increases the quantity of




56                      HEADACHES.
fibrin in the blood in a slight degree, and diminishes the quantity
of albumen in about an equal proportion; i. e. it tends to
cause a fibrinous dyscrasia rather than an albuminous. Finally,
it slightly increases the quantity of fat and iron in the blood.
It is said to increase the appetite, but its most frequent and
certain effect is increase of strength, while the heat of the
body is more readily generated, and exposure to cold is better
borne. M. Plouviez increased in weight under its use to the
amount of 13~ lbs. Troy in about two months, and repeatedly
became so plethoric, with fulness about the head, that he felt
himself obliged to be bled. —PETER.]
Dose.-One or two grains of the 2d, 3d or 6th dilution may be
taken night and morning; in appropriate cases the higher dilutions may
be tried. When salt baths are used in conjunction with the internal
use of the remedy, more massive doses must be given, viz.: from two
or three, to five grains of the 1st, or decimal dilution. Children and
very delicate adults may take from two to five globules per dose, every
one, two or four hours in acute attacks; or once or twice a day in
chronic cases.-PETERS.
32. NUX VOMICA.
G4ENERAL REMARKS. —(a). Schrden says as follows about
the use of Nux vomica in general:
Youths and maidens who have weakened themselves by
masturbation often suffer with headache of the following
kind:
Suddenly that part only of an object on which their sight
is directly fixed appears steady, while all the rest of it
seems to move and float around the fixed part: thus, of
a hand they will see only a finger, of a chair only one leg;
they can spell printed letters with some exertion, but cannot
see a whole word at a time; they often see luminous appearances like a fire-wheel, reaching from the external angle of the
eye towards the pupil. Watering of the eyes often precedes
the commencement of a frightful, gradually increasing headache, lasting for 24 hours and attended with vomiting.
Nux v. 12, a few drops per dose, will soon lessen and finally
cure this disorder. —Hygea, vol. 5, p. 197.




NUJX VOMIC.                   5
Nux v. will also often cure the headaches of hysterical
women, when taking the form of boring Clavus hystericus, or
of a dreadful pressure upon the temporal region, forcing one
to lie down, and attended with retching to vomit.-Ibid.
Nux will also help, or cure the headaches of men in the
prime of life, arising from sedentary pursuits, or great mental
exertion, especially when there is an aching in the forehead
and temples, commencing soon after awaking in the morning,
attended with noises in the ears when they sit up, and
synchonous with the pulse; it is most useful in those who have
weak digestion, sluggish bowels and an irritable temper.
D0ose.-Nux v., 6th or 12th, a few drops repeated every three or
four days.-Ibid.
(b). Knorre found it useful in headaches from congestion of
blood to the head, attended with pressing and squeezing in
the forehead, especially over the eyes; with dulness and
heaviness of the head, vertigo when walking or stooping, heat
and redness of the face, and vomiting of tasteless substances,
night and morning.-Genl. Horn. Jour., vol. 5, p. 274.
(c). Knorre also found Nux useful in periodical headaches,
beginning every morning soon after rising, increasing till
mid-day, and then diminishing; the pain being aching and
rending, attended or not with pain in the region of the liver,
with nausea, inclination to vomit, bitter eructations and
vomiting, constipation and choleric disposition. —Ibid.
(d). According to Tietze, Kux is most useful in males, when
the headache or hemicrania proceeds from an affection of the
ganglionic system, especially if the patient be subject to
hmemorrhoids, is of a choleric temperament, apt to indulge in
drinking, or is studious and sedentary in his habits.
The pain is most frequently of a drawing, aching character,
with the feeling as if a nail were driven into one half of the
head, on which side the brain seems bruised or jarred. It is
also useful in the headaches of women who are apt to have
their menses too frequently and profusely, especially when the
attacks set in early in the morning, or immediately after eating, or after mental exertion.-Genl. Hom. Jour., vol. 34, p. 11I




58                    M3ABDAMnECH S.
(e). Lobethal thinks Nux most useful against headaches
from excessive drinking, and from mental exertion when
attended with congestion to the head; especially when they
occur in sanguine, excitable persons and consist in a dull
confusion of the head, and are complicated with aching in the
pit of the stomach, or pain in the hypochondria, with nausea,
eructations and constipation.
Nlux v. also relieves more readily than any other remedy,
those congestions to the head, dependent or not upon habitual constipation, which arise from a plethoric state of the
abdominal blood-vessels.  Such conditions are most apt to
occur in men who lead a sedentary life, and who by constantly
renewed mental efforts, induce repeated congestions to the head.
-Genl. Hom. Jour., vol. 13, p. 274.
(f). According to Hering, Nux is useful in headaches from
constipation and excessive use of coffee; also against pains as
if from a nail driven into the brain, or consisting of a succession of piercing throbs, attended with nausea and sour vomiting; or of stitches and pressing on one side of the head, commencing early in the morning and increasing in severity
until the patient becomes unconscious or half delirious; or of
pains which increase until the head feels as if it would burst
whenever one attempts to think; also when the brain aches as
if it were lacerated, the face being pale and distorted, the
head heavy with noises therein, attended with dizziness or
trembling when walking; the pains being increased by motion,
even of the eyes, in the open air, early in the morning, after
eating, or from stooping; and finally when the head is sore to
the touch, increased by cold.
CASE'2.-An active woman, aged 40, had suffered for
nine years with hysteric headaches, occurring paroxysmally
every ten or fourteen days, and had been treated allopathically
for five years, without benefit.
Symrptoms.-The attacks commenced with dull, aching
pain in the whole head, but most severe in the vertex and
forehead; attended with vertigo, dulness of the head, violent




NUX VOMICA.                   59
pressure over the eyes, sensitiveness of them to light, and increased secretion of tears; followed by paleness of the face,
with distortion; nausea, bitter-sour taste in the mouth, vomiting of bile, asthma, palpitation of heart; finally, when the pain
became most intense, a heavy sleep set in, from which she
could hardly be aroused.
During the intervals of the paroxysms she had frequent,
but endurable headaches, constant feeling of coldness in the
head, and gastric derangements; but mental emotions, and the
neighborhood of disliked persons, would bring on an attack
immediately. Nux effected a cure. —Genl. iom. Jour., vol. 5,
p. 274. DR. KNORRE.
CASE 73.-A lady, aged 27, of sanguine temperament, apt
to be violent, and excessively irritable, had the following:
Symptoms.-Sensation of wavering in the brain, dulness of
the head, as after a debauch; pressing pain in the occiput,
almost as soon as she awoke in the morning; pressing, pushing
headache from the slightest exertion of the mind, increased by
the use of coffee and wine. After eating she had drawing pains
in the teeth and temples; looseness of the teeth; bitter taste in
the mouth. Nux v. 24 effected a cure in 6 days. —Annals,
vol. 1, p. 73. Do. SCHROTER.
CASE 74.-A blooming maiden, aged 11, had suffered for
half a year with headaches, recurring periodically, every four
or five days, affecting one side, being pressing and boring,
commencing early in the morning, forcing her to lie down,
and attended with bilious vomiting. Nux v. 18, two doses,
effected a cure. DR. DIEz, p. 180.
CASE 75.-A powerful man, aged 52, had suffered for ten
days with severe headache on the left side. KNux v. 24, one
dose cured him in two days.-Ibid.
CASE 76. —A delicate man, aged 48, had s-uffered for
twelve years with intermitting nervous headache, occurring
every four or six months, lasting from three to four weeks,
and persisting every day from 7 to 12 A. M. It affected the
left side of the forehead, and left eye, in particular; was
attended with much eructation, nausea, and vomiting.  Nux




60                    HEADACHES.
v. 18, two doses, broke up one attack entirely; a later attack
was cured by Nux v. 9, and he remained well subsequently.
DIEZ, p. 181.
CASE 77. —A man of powerful constitution and choleric
temperament, had suffered for years with periodical headaches,
affecting the left side, recurring every ten or twelve weeks,
lasting from sixteen to twenty days, commencing early in the
morning, increasing gradually to an almost insupportable
degree, then ceasing about 2 or 3 P. M., but returning on the
following morning with renewed violence.
They were preceded by oppression of the chest, anxiety,
and palpitations. The pain was boring and rending; it extended over the left side of the head and eye, concentrating
itself in the region of the left orbit, in a spot about the size of
a sixpence which became slightly reddened, swollen, and sore
to the touch. The headache was attended with nausea, bitter
eructations, vomiting of bile, and by constipation. Nux v.i
24th, given on the fourth day of the attack, removed it in
twenty-four hours, and it never returned again.-DIEz, p. 180.
CASE 78. —A  man, aged 30, of healthy but irritable
constitution and sedentary life, had suffered for five years with
periodical headaches.
Symptoms. The attacks came on daily, very early in the
morning, forcing him to lie down; increased in severity till
mid-day, and often were so violent that the patient was in the
greatest despair. He had a piercing pain over the left orbit,
at times also a pressing pain which shot into the eye, and was
increased by pressure; contraction of the eyelids from sensitiveness to light, and lachrymation; heat about the whole
of the eye, obstruction of the nose; the attacks were relieved
by sneezing, which it was hard to provoke; he also had an
inclination to vomit; confusion of thoughts from the severity
of the pain; great irritability, and dislike for all noise. Nux
v. 24, two doses effected a cure.-Archiv., vol. 2, part 1,
p. 146. DR. WISLICINUS.
CASE 79.-A woman, aged 35, of choleric, irritable and
vexatious disposition, had suffered for three years with vertigo
and periodical headache on the left side.




NUX VOMICA.                   61
Symptoms. The pain involved the left side of the forehead,
as if from an ulcer, or a wedge pressed into the head, or as if
the left side would press asunder, or burst; it always set in
suddenly, early in the morning, continued until 1 P. M., and
then ceased quickly; it was most violent in bad weather, and
attended with constipation.
Treatment.-Nux v. 9, effected a speedy cure, after a
previous aggravation.-Archiv., vol. 5, part 3, p. 31. DR.
H. in Z.
CASE 80.-A lad, aged 14, had suffered with headache
from his fourth year, after a fall.
Symptoms.-Almost every day, and sometimes several
times a day, he was attacked with an undefined pain, or a
heavy, dull pressure, extending from the back of the head to
the top, and attended with nausea, obliging him to keep very
quiet; the pain set in almost every morning, just after rising,
and was also brought on by mental exertion.
Treatment. —Nux vom., 1st, one dose every other day,
effected an improvement in fourteen days, and twenty-two
doses in all, effected a cure.-lHygea, vol. 6, p. 499. GRmIEssF
LICH.
CASE 81. —A powerful man, aged 40, of fiery, angry disposition, had suffered for eight days with violent headache,
on the right side.
Symptoms.-The pain was pressing and piercing; it commenced every morning early, about 7 A. M., above the root of
the nose, and extended from thence over the right eyebrow
into the right temple; it increased in severity from 9 A.M. to
12 M., to such a degree that the patient tossed about frantically in the bed; his face became pale and covered with cold
sweat; when he stooped forward it seemed as if a ball
would fall out of the root of the nose; the scalp was painful,
and he had a dry catarrh of the head.
Treatment. —Nux v., 15, one dose removed the majority of
the sufferings in four days, and the south pole of the magnet
removed the rest.-(See case 59.) Archiv., vol. 5, pt. 1, p. 89.
DR. PLEYEL.




62                      "AnDsacEms.
[CASE 82.-A pale little boy, aged 6, had suffered for six
months after an attack of hooping cough, with frequent attacks
of the most violent pain in the forehead, coming on suddenly, and lasting ten or fifteen minutes. He took Nux in
the evening and had an attack at night, which had never occurred before; in less than a week the headache had entirely
ceased, and did not return for two years.-DUNSFORD, p. 104.
CASE 83.-Professor Fourdrin was attacked suddenly with
severe pressing pain in the eye and brow, attended with
nausea, and straining to vomit; his pulse was feeble and
quick, his agitation extreme; he was forced to move his
head about from side to side; his eyes were weak and
fatigued. Prolonged study was the exciting cause.'Treatment.-Nux 30, three globules; the next day he was
well. A similar attack, three months after, was relieved by
the same remedy in ten hours. After great fatigue he had
alternate chills and heat, severe pain in left temple, heaviness
of the eyelids, and heavy pain over the brows; nausea and
vomiting.-MALAISE, p. 11.
CASE 84. —A young lady had suffered for four years with
great heat in the forehead, tearing and lancinating pains in
the skull, occurring at short intervals, and attended with
beating in the forehead and temples; the pains were always
most severe after dinner and after mental exertion; she also
had pain in the loins, palpitations and sleeplessness.
kTreatment.-Nux vom., 30, effected a cure in a month.MALAISE, P. 14.
CASE 85. —Baroness L. had suffered for five days with
pain, pri- cipally in the forehead, increased after dinner, with
painful commotion in the nape when walking, and her face
and eyes were slightly bloated.
Treatment.-Nux effected a cure in three days. —MALAIsE,
p. 17.
CASE 86.-Miss C., aged 11, languid, sallow and tall, had
suffered almost every day for four years with severe headaches, causing great prostration, with inability for physical or
mental exertion; the pain was chiefly over the eyes, causing




NUX vOMrcA.                    63
her to frown, and producing dimness of vision; her eyes were
dull; head, heavy and aching; she was relieved by lying
down and by pressure; her pains were aggravated by motion
and intellectual exertion; her tongue was pale and slightly
coated, bowels costive, abdomen swelled, but not painful;
sleep heavy, with dreams and starts, her pulse slow, feet very
cold, and appetite capricious.
]Treatment. —Nux 30; on the second day after commencing
treatment the headache left her, and did not return for three
months, at last report. —KER, Brit. Jour. Eom., vol. 5, p. 434.
-PETERS.]
REVIEw.-Of the ten cases, byRiickert, six were in males and
four in females, all of different ages; with one exception all the
patients were of robust constitution; or sanguine, see ~ e, or
choleric temperament, ~ c & d; they were active, irritable,
and inclined to anger.
According to Schroen, see ~ a, Nux cures the faulty vision,
with pains in the head and vomiting, which are apt to occur
in both sexes, when weakened by masturbation. Schroen
says it cures clavus hystericus, see ~ a, also Hering, see ~ f;
and the headaches of women with too frequent and copious
menses, see ~ d; also of men who sit much, study hard, see ~
a, d & e; after the abuse of coffee and spirituous liquors, see
~ d, e & f; headaches of haemorrhoidal subjects, see ~ d & e;
from constipation, disorders of the ganglionic system, and
consequent congestions of the head, see ~ d, e & f.
As regards the locality of the pain, we find it affecting the
back of the head and extending to the top; but most frequently
it attacks the forehead, temples, the parts over the eyes, and
the root of the nose. Of the ten cases cured, no less than
seven were one-sided headaches, and of the seven, no less than
five were on the left side, see ~ a and f.
The paroxysms occurred periodically in six cases; were
intermitting in one case, and returned in longer or shorter
paroxyms.
The pains were generally pressing, violent or dull; aching
and pushing; aching and boring; aching and piercing; but




,64                     EMADACEMS.
the piercing pains were the least frequent; besides, in a few
cases they were boring and rending, involving a small spot
which became red; or felt as if a wedge was pressed
into the head, or like an ulcer, or as if the brain was torn, or
pressed outwards.
In the majority of the cases the attacks commenced early in
the morning, increased during the day, and lessened towards
evening.
The pains were excited by mental emotions, from  the
approach of disliked persons, from  mental exertion, by bad
weather, and were increased by bright light and noise, by
exposure to the free air, and after eating.
The accompanying disorders, were: confusion of thought,
intolerance of light, dimness of vision, flow of hot tears, dry
catarrh of head, toothache, paleness of face, bitter-sour taste
in the mouth, eructations, nausea, vomiting, especially of bile,
constipation, asthma with palpitation, chilliness and coldness
of the body, and finally perspiration at the end of the attacks.
In two cases the disease had lasted only eight or ten days;
in eight cases it had persisted for a half, five, or twelve years.
The cures took place rapidly in most cases, and decidedly.
As regards the dose:
1 dose sufficed to effect a cure in 5 cases.
2 doses    "       "        "    4   "
22  "       "        "       "    1   "
The 1st, 9th and 15th potencies were used each in 1 case.
18th              potency was    "          "2  "
24th                    "          cc       cc 4  "c
30th                    "          "        " 2  "
DoSe — The proper dose is sufficiently indicated in the above cases
and review. It seems that cures have been effected with the every
dilution from 1st to the 30th. No cures have as yet been reported from
the exceedingly high dilutions. One or two drops of the 1st, 2d or 3d
dilution may be taken by adults every one, two, four or more hours in
acute and severe cases until relief ensues; then every six, eight or twelve
hours until a perfect cure follows. Delicate adults and children may
take like quantities of the 6th, 12th or 30th dilution, or one or two
granules, as often as above directed. In chronic cases, one dose may be
taken night and morning, or every second or fourth day. —PETERS.




OPIUM.                      65
33. OPIUM.
GENERAL REMARCS.-The headaches which can be relieved
by Opium, are both those which have their seat solely in the
brain, and those which are essentially connected with other
disturbances of the body; the latter is the case in the socalled migranes.
CASE 86.-A lady had suffered with headaches for many
years, occurring at uncertaimnperiods of time. Many remedies
had been used in vain, but the severity of the attacks and the
length of time which they continued (generally several days)
always obliged her to seek fresh relief from medicine../Sylnptons?-The pain occupied the left supra-orbital region,
and was pressing, stitching or piercing; motion, noise or fresh
air increased it, hence she always sought rest,. solitude and
darkness; her pulse was feverish, she had chills, yawnings,
loss of appetite, and an irritable state of mind, both previous
to and during the paroxysms of headache; also nausea and
vomiting.  IlTer urine was at first clear and spasmodic,
afterwards it became darker, with a sediment. The temperature of her skin alternated at first, then became moderately
and permanently increased, and finally a gentle, general perspiration set in with evident relief to all the symptoms. The
attacks occurred at irregular periods of time, and the menses
had less influence upon them, than the state of the weather.
The intervals were characterized by an uninterrupted state of
good health.
After trying almost all other means, the patient finally took
nothing but Opium during the attacks, which then ceased in
a few hours, and became mich less frequent in their occurrence. —Iygea, vol. 14, p. 147.-Dr. SCHIMD.
CASE 87.-Dr. Schmid himself had suffered Bor several
years with attacks of headache, which were violent, and if left
to themselves lasted from four to eight days; they incapacitated him for any unusual exertion, and at one time verged
closely upon a decided affection of the brain, when he finally
concluded to use Opium. Among all the remedies which he
5




66                    HEADACHES.
had used, Opium was the only one which relieved him, not
only certainly, but quickly.
It is to be regretted that Dr. S. did not describe the character of his headache, but he seems to have thought more
about the dose than the peculiarities of his case. Whenever
the attacks reached a considerable degree of severity, he took
from five to ten drops of the concentrated tincture; one or two
doses sufficing to relieve the attack rapidly. But after the
cessation of the headache, constantly recurring disturbances
of the abdominal organs always set in. —ScHMD.
[NOTE. —Opium is of course used far more frequently and
freely in the ordinary practice, than in the hoinceopathic.
SANDRAS (see.aladies nerveuses, vol. 1, p. 355) advises the
use of from -j th to - th of a grain of the Muriate of Morphine,
to be taken every quarter of an hour, at the commencement of
an attack of nervous or sick headache; and says, that he has
not only frequently noticed a very decided relief from present
suffering, but that subsequent attacks would be less frequent
and severe. He always expects relief to follow by the time that
the third or fourth dose has been taken, and never pushes the
remedy beyond the fifth or sixth dose. IVIAGISTEL asserts that
he has succeeded in more than fifty cases by the endemic use
of Morphine about the brow and temples. Others. speak
highly of the regular use of two or three drops of Morphine,
night and morning, between the intervals of the attacks; also
of giving a larger dose, say, from five.to six, or more drops,
immediately at the beginning of a severe paroxysm, and
smaller ones occasionally, during the first few hours of suffering. I have heard of several cases in which this treatment
was apparently very useful, and others in which the suppression of the disorder plunged the patient into a profoundly melancholic, or some other nervous state.
Still Morphine and its Acetate exert a remarkable and
specific action upon the rigit side of the head. According to
the experiments of Chevallier and Beraud it is holnceopathic,
when there is an intolerable pain on the rigit side of the
head, with redness and perspiration of the face, heavy and




OPIUM.-PHOSPHOR.                 67
dull expression of the countenance, and excessive itching of
the skin. Also, when there is a violent burning in the occiput, redness of the eyes, heaviness and fulness of the head as
if it would burst, increased by reading and mental exertion,
attended by coldness of the extremities and back, sour eructations and acid vomiting; all followed by hot perspiration
and excessive itching of the skin.
Opium and China are both homceopathic to congestive
headaches, but Opium is specific against passive congestive,
or venous headaches, China to the active or arterial congestive
form. Again, China and Quinine exert as decided an action
upon the left side of the head, forehead and left temple, as
Opium and Morphine do upon the right side and occiput.
China and Quinine are honceopathic to violent semi-lateral,
periodical and intermitting headaches, particularly when
involving the left side of the head, and attended with throbbing of the temporal arteries, ringing in the ears, partial
deafness, with excessive hunger and thirst, followed by eructations, nausea, great flatulency upwards and downwards, and
excessive debility, similar to that which succeeds a long fit
of illness. — PETERS.]
34. PHOSPHOR.
GENERAL REMAIKS. —(C&). According to Dr. Lobethal,
Phosph. is often very useful against stormy congestions of
blood to the head, especially of the vessels of the eye and ear,
when they are either too obstinate to give way before the use
of Acon., Bellad. and Nux v., or depend upon a general
erethism of the system.-Genl. IHom. Jour., vol. 13, p. 291.
(b). Hahnemann recommends it in stupefying headaches,
congestions of the head, morning headaches, and against
piercing pains externally on the side of the head.-See Hahnemann's Chronic Diseases, translated by Dr. Chs. J. Hempel.
CASE 88.-A  man, aged 30, several weeks after falling
from a scaffolding, was attacked with the following sufferings,
shortly after being thoroughly wet through.




68                     HEADACHES.
Synptoms. —Burning in the nape of the neck, and between
the shoulder-blades, but most severely in the back and top of
the head. Throbbing, raging and pressing forwards towards
the foreheadc, as if the head would burst and the eyes be forced
out; the eyes then becoming fixed and staring; every motion
increased the pain, so that he was obliged to hold his head
perfectly stiff and creep about gently; when eating he only
dared to move his jaws very gently; changes of weather also
aggravated the suffering; pressure upon the second cervical
vertebra increased the pains and the fornlication, which was
almost constantly present in the arms; he was feverish, with
profuse night sweats.
Tqiecatmentz.-Arnica, Bryon., Silex and HIepar. were given
without benefit. Rust's inunction cure was then tried for a
time, with relief at first, soon followed by an increase of the
whole disorder. Phosphor. 1st was now given, two drops per
dose, in alternation with Cocculus 1st, two drops per dose, one
remedy only each day, and continued for three months. In
fourteen days signs of improvement commenced, which
gradually increased, so that at the end of three months a
perfect cure was effected, and the patient could return to his
work. —Hygea, vol. 20, part 2, p. 160.-Dr. BoscH.
[NOTE.-Phosphor. is also one of the best remedies against
the headaches which attend the so-called irrictative cy8spepsic;
especially when there is a periodical twitching, beating pain
in the forehead and about the root of the nose, for many days
in succession; commencing every morning about 9 o'clock,
becoming most violent towards noon, and followed by vomiting.  In many morning-headaches, particularly when the
patient has a capricious appetite, sense of weight and fulness
in the stomach after meals, irregular bowels, severe lancinating pains darting between the shoulder-blades from the pit
of the stomach, and much flatulence; white tongue, often with
red points on its tip and edges, quick and irritable pulse, dull
heavy aching pain over the loins, excessive depression of spirits,
and despondelncy so intense as to excite the most painful
ideas. Phosphorus enters so largely into the composition of




PHOSPHOR.-PLATMTA.                   69
the brain and nervous system, and exerts so specific an action
upon the sexual and urinary organs, that it deserves particular
attention in nervous headaches and in those arising from, or
connected with derangements of the kidneys, ovaries, &c.PETERS.]
Dose. —Noack advises one or two drops of the tincture, or ethereal
solution of Phosphor., or of the 1st, 2d or 3d dilution in severe cases
every half, one, two or four hours; or the same quantities of the 6th or
12th dilution, in milder cases, every six, eight, twelve or twenty-four
hours. Very sensitive males, delicate females or children, may take
two or three globules as often, or solve from three to five pellets in a
wineglassful of water, and take one or two teaspoonfuls per dose as often
as above directed. —PETERS.
35. PLATINA.
GENERAL REMARKS. —(a). Dr. Seidel recommends it in
violent compressing pain in the forehead, especially over the
root of the nose, attended with heat and redness of the face,
lachrymose disposition, too frequent and profuse menstruation.
-Archiv., vol. 12, part 3, page 148.
(b). According to Black, Platina is suitable for headaches,
connected with excessive leucorrhcea, the pains being nervous,.
stretching and spasmodic, and involving the forehead and
eyebrows.-Genl. IHom. Jour., vol. 36, p. 234.
[CASE 89.-Miss C., aged 18, had been suffering for about
seven or eight months, with severe but dull pain, commencing
behind the ear, extending to the side of the face, lips, forehead
and crown of the head; it was increased by light and touch;
was preceded by coldness of the feet; commenced on waking
in the morning, gradually increased in severity until about
noon, then became sharp, and continued so for two or three
hours, when it gradually declined till evening; her tongue
was apt to get red and dry, she had oppression of the stomach,
her bowels were costive, appetite poor, with dislike for animal
food; her menses regular and natural, and the pains always
ceased during them.
Treaetment.-Platina 6, was followed by increase of pain
for seven days; then Plat. 12, produced almost entire relief;
still her bowels remained costive and passages clay-colored,




70                      HEADACHES.
or white. Digitalis quickly corrected the state of the bowels,
and she had no return of pain for more than one year.RUSSELL. Brit. Jour. of oem., vol. 5, p. 432.-PETERS.]
Dose —Noack recommends one or two grains per dose, of the 1st,
2d or 3d dilution in severe cases, every two, four or six hours; or of the
6th or 12th dilution every eight, twelve or more hours in milder
attacks. Delicate adults or children may take two or three pellets as
often as above mentioned; or night and morning only in chronic cases.
-PETERS.
36. PULSATILLA.
GENERAL REMARXs.-(a). According to HIering, Puls. is
useful against rending pains, which become worse in the
evening; or throbbing, piercing pains soon after rising in the
morning, and in the evening after lying down; against pushing, piercing and rending in the temples, especially when the
pains are confined to one side; or are attended with vertigo,
inclination to vomit, heaviness of the head, darkness before
the eyes, and great sensitiveness to light; by roaring in the
ears, or pricking, jerking and tearing pains in them; or by
pale and tearful face, no appetite or thirst, but with chilliness,
anxiety, bleeding of the nose, and palpitation of the heart.
Also, when all the above complaints are worst when quiet or
sitting, are relieved in the open air, and the headache is lessened by pressing on the head, or tying something around it.
It is most useful in the headaches of' slow, good-natured people.
(6). According to Tietze, Pulsat. is especially indicated
when the pains are rending, throbbing, piercing or jerking,
affect the temples and back of the head most severely, and
are accompanied by the well-known general indications for
the remedy. —Genl. Hom. Jour., vol. 34, p. 21.
CASE 90.-A puerperal woman, aged 24, was attacked
with headache after taking cold; her gentle nature, inclination
to weep and pale appearance indicated Puls. After the
fruitless use of Bellad., she was relieved by Puls. 30 —Revue
Hom. MIar. 1846.-Dr. SOLLIER.
CASE 91.-An obstinate, censorious and irritable woman,
aged 30, who menstruated profusely, always suffered with




PULSATILLA.                   1
severe headaches, both before and after menstruation; the
pain was on the very top of the head, pressing, boring and
digging there until she was almost driven to distraction; she
could not bear anything upon the head, which seemed as if
festered, still she could not avoid carrying her hand involuntarily to the painful part. Bowels not constipated, but difficult to move; her sleep was full of dreams; she was chilly,
but not thirsty. Puls. 200, relieved the pain in half an hour.
— New Archiv. vol. 1, part 3, p. 59. —Guoss.
CASE 92.-A girl, aged 8, of gentle lachrymose disposition,
had suffered for six months with headache on the left side.
The pain involved the left side of the forehead, was throbbing
and piercing; occurred alternately either early in the morning, or in the evening soon after lying down; was relieved by
external pressure and by the open air; increased in the warm
room, by lying down, by stooping and by moving the eyes;
it lasted several hours, and then increased t6 an almost insupportable degree, so that the little patient tossed about in:agony. When the pain lessened severe stomach-ache set in,
followed by sour and bilious vomiting; which was succeeded
by griping, pressing and squeezing pain in the bowels. At
times these three varieties of pain occurred in alternation, and.at other times, on successive days. After the use of Puls. 3,
the whole disorder ceased on the fifth day of treatment, for,ever. —Archiv., vol. 5, part 1, p. 93.-Dr. PLEYEL.
CASE 93.-A lady, aged 43 years, troubled with irregular
menstruation, thin, pale and of a gentle disposition, was;attacked with permanent headache after using mercurial
-ointment for the cure of sore throat.
Symptoms.-Persistent headache, increasing towards evening, relieved at night, but not allowing of sleep; the pain:seemed to rise up from  the nape of the neck, and extend to
both temples, leaving the neck cramped; the attacks were
violent, forcing her to lie down, were attended with noises in
the ears, dizziness when walking, and appearance of black.gauze before the eyes; the pains were boring and piercing,,occasionally slightly tearing, and extended at times between




r'2                   HEADACHES.
the shoulder blades; or were attended with twitching of the
left eye-lid, by smarting, aching and weeping of the left eye,
with piercing pains in the limbs, with chilliness, and constipation. Bryon. did not afford relief; Puls. 6, one drop per
dose, effected a cure in eight days.-Archiv., vol. 3, part 2,
p. 115.-Dr. SCHNIEBEE.
CASE 94. —A young lady, aged 24, of strong constitution
but gentle disposition, and subject to irregular menstruation,
was attacked with headache; at first it affected the forehead and then the whole head, which finally seemed as if
screwed up into a vice; she also had vertigo, and heaviness of
the head when she attempted to sit up in bed; the pain was
increased by thinking and reading; lassitude, trembling and
shaking of the limbs were present, with alternating paleness
and redness of the face, nausea, sense of crawling in the pit
of the stomach, dryness of the mouth without thirst, disgust
for food, tightness of the chest, transient shivering, weak,
scarcely perceptible pulse, excessive sensitiveness, weeping,
&c. Pulsat. 12, one drop, cured her in twenty-four hours.Archiv., vol. 2, part 2, page 135. —Dr. HARTxxNN.
CASE 95.-A man, aged 25, had suffered for two months,
in consequence of taking cold, with piercing, boring headache,
extending from the right temple to the back of the head;
increasing to a frightful degree in the evening and at night,
and shooting into the ear and towards the side of the neck.
-Iis head seemed numb, his mind as if paralyzed and unfit for
any occupation. Pulsat. 24 in solution, one dose every morning, cured him entirely in eight days.-Genl. Hom. Jour.,
vol. 37, p. 96.-Dr. RAMPAL.
CASE 96.-A lady, aged 30, eight days after confinement
was attacked with chills, heat and headache fiom taking cold.
She had an insupportable tearing pain in both temples,
attended with vomiting of bitter substances; vertigo and
constant nausea, compelling her to maintain a half sitting,
half recumbent posture, with closed eyes and the greatest
quiet. Every movement, even opening the eyes, increased
the pain, as if the head would burst; her pulse was frequent,




PULSATILLA.                   73
and full, skin hot but slightly moist, and the lochia were not
suppressed. Bryon. 200, caused improvement up to the
fourth day; then the pains returned again, and were so much
relieved by Puls. 200, that she was quite well on the fifth day.
CASE 97.-A lady, aged 30, of healthy constitution, but
suffering for several years with attacks of cramp in the
stomach, and used to being bled, had been nursing a child for
three months, when she was attacked with headache persisting for several weeks, and for which she had already been
bled without relief.
XSymptoms.-Violent one-sided headache consisting of piercing pain in the forehead, temples and right ear, extending
into the teeth, and attended with general throbbing in the
head, as if from the beating of the pulse. The pain lasted
the whole day, and became especially violent in the evening,
and at night after lying down. She had thirst, constipation,
chills, and evident loss of strength.
Treatment.-Puls. 6, removed the headache -and chills
entirely; but transient gnawing pain in the stomach and constipation, required Nux v. 12, for their removal. She then
continued to nurse her babe in health and comfort.-Annals,
vol. 1, p. 85.-Dr. RUCxERT.
[CASE 98.-A woman, aged 54, had suffered with headache
for three weeks; she had tearing pains in the forehead, worst
in the evening and at night; it seemed to her as if her head
must burst if she did not tie something around it; the
pains were so violent as to force her to cry out; she had
various strange noises in the head, also photophobia, bruised
and tired feeling in the limbs, sleeplessness and despondency.
Treatment.-Bellad. was given for one day, without benefit;
then Pulsat. effected a cure in twenty-four hours.-Malaise
Clinique, p. 9.-PETERs.]
[NOTE. — Pulsatilla acts especially upon the eye, like Bell.,
but on quite different parts; it acts primarily upon the mucous
membranes of the lids and ball, and upon the nerves and
bloodvessels which supply them; while Bellad. acts upon the
Iris and Retina and the nerves and bloodvessels which supply




Y74 A:HEADACIES.
them; to be more precise, Pulsat. acts upon the ophthalmic
branch of the fifth pair of nerves, Bellad. upon the optic, or
second pair of nerves. Pulsat. has been found almost specific
by Herz and iHufeland against nervous headache when:attended with the following very peculiar affection of the eye,
viz.: when there is a spasmodic affection of the eyelids, commencing at the external angle of the eye, and attended with
a peculiar flimmering, so that all objects whose rays fall upon
the eye from that side, seem to be in a very rapid and waving
motion; or the patient seems to look through very rapidly
moving water, or through rapidly vibrating air, which appears
heated to an intense glow; accompanied with a number of
light colored, circular, serpentine, or zig-zagged appearances,
especially about the external angle of the eyes. The above
mentioned authorities say that this peculiar disorder will yield
rapidly, to a few grains of Extract of Pulsatilla, although it
will obstinately withstand even massive and heroic doses of
Bellad., Hyosycam. or Opium. Again, while Bellad. is specific against the purely nervous and congestive headache,
Pulsat. is a principal remedy against the sick headache,
strictly so-called. We have already seen that in the Belladonna headache sympathetic affections of the stomach may
arise, but when indigestion, or irritation of the stomach, or
dyspepsia, is the primary affection and the head disorder a
secondary affair, Bellad. will never afford certain relief.
Exactly the converse of this holds true with regard to Pulsatilla. The headache which Pulsatilla most readily relieves, is
one which has its starting point in the stomach, brought
on by the use of indigestible, rich, or fat food, or from excess
in eating or drinking, or from indigestion produced by great
bodily fatigue, loss of rest, extraordinary mental inquietude,
or exertion just before or after meals. The pathological state
of the stomach, is irritation of the mucous membrane induced
eitheir by an excess of acid, by undigested food or regurgitated
bile, or by venous congestion arising from a sluggish state of
the liver. Under all these circumstances the affection of the
brain is secondary; the predisposition is said to consist for the




PULSATILLA.                    75
most part in debility of the stomach, and in a peculiar state of
the nervous system which renders the brain especially sensitive to gastric irritation.-PETERS.]
REVIEW.-Of the eight cases reported by Riickert, seven
were in females of gentle, delicate and yielding dispositions,
and most of them were middle aged.
In two cases, taking cold was the exciting cause of the
headaches; in case 92, the pain attended a profuse flow of the
menses.
The pains occupied the forehead and temples, as well as the
top, a whole side, or the back of the head; in one case it was
confined to the right side; and in one, to the left.
The pains were generally pressing, piercing or boring; at
times slightly tearing, or throbbing and digging, with the
feeling as if the head were festered, or screwed up.
The attacks were especially violent in the evening and at
night, but in one case they occurred early in the morning, as
well as in the evening; the sufferings were increased by being
in a close room, by lying down, by stooping, by moving
the eyes; in one case also by thinking and reading; while
they were relieved by pressing on the head, and by the
free air.
In case 92, the paroxysms appeared on the setting in, and
also towards the end of menstruation.
As accompanying complaints, we notice disinclination for
food, absence of thirst, presence of nausea, sour, bitter and
bilious vomiting; straining at stool, which is not hard;
oppression of the chest and chilliness.
In two cases Bell. and Bryon. had been previously used
without benefit, and in one case Bryon. had materially relieved
the patient before Puls. was given.
The cures took place rapidly in all the cases.
The doses were Pulsat. 3, 6, 12, 24, 30 and 200. In the
majority of cases one dose sufficed to cure; still Puls. 24, was
given repeatedly in solution, one dose per day.




76                       HEADACHES.
Doseo-Noack prefers the 2d dilution, which he asserts has proved
more serviceable than any other preparation; still he advises one or two
drop doses of the pure tincture, or of the 1st, 2d, 3d, 6th or 12th dilution, to be repeated once or twice a day, in chronic cases; or every quarter,
half, one, two or more hours in severe attacks; or every two, four, six or
eight hours, in milder ones. Delicate adults and children may take
two or three globules as often; or three, five or more globules may be
solved in a wineglassful of water, and one or two teaspoonfuls given per
dose.-PETERS.
37. RHUS TOXICODENDRON.
GENERAL REMARIKS.-According to Schelling, in 1849, when
the whole epidemic constitution of the period frequently called
for Rhus, violent headaches also occurred frequently; they
were one-sided, attacked the forehead, temples, ears and teeth
in particular, and recurred periodically; the pains were
drawing and tearing, as if a sharp knife were run through the
affected parts, or as if the eyes, ear or forehead were being
cut out; they were severe enough to make the stoutest persons complain loudly, and even to cause cramps in others.
In one such case, Arsen. produced relief immediately, but
only transiently; in many other cases Rhus afforded relief
effectually.-Hygea, vol. 17, part 3, p. 274.
CASE 99.-A  young man was attacked suddenly, after
suffering for some time with pain in the back and loins, with
a piercing pain in the forehead soon after rising in the morning; followed by a sense of creeping, dashing and digging in
the brain, also by a stupefying dizziness and an indescribable
aching and pain in the left temple, forehead and eye, so that
he fell back fainting upon his bed again; he also had oppression of the chest, sore-throat and thirst; his tongue and left
side seemed partially paralysed; he could scarcely speak intelligibly, and could move the limbs of the left side imperfectly.
Treatment. —Rhus 1st, restored him in 2 days. —Dr. SCHELLING. —Ibid.
Dose.-Noack advises one or two drops of the pure tincture, or of
the 1st, 2d, 3d or 6th dilution, repeated frequently in acute and severe
cases, but to be given only once or twice a day in slighter attacks.
Schelling, it will be seen above, also used the low dilutions. Still Rhus




RHUS TOXICODENDRON.-SANGUINARIA.            77
is an acrid remedy, and apt to cause aggravations in delicate persons and
children, who should use from one to three granules per dose, or for
whom from three to five globules may be solved in six tablespoonfuls of
water, and one teaspoonful given per dose.-PETERS.
38. SANGUINARIA.
GENERAL REMARKS.-According to HERING, Scanguinarica
is the best remedy against most cases of Mligrane, or sick
headache; still it will prove most useful when the attacks
occur paroxysmally, viz., every week or at longer intervals; or
when the pains begin in the morning, increase during the day
and last till evening; when the head seems so full that it must
burst, or as if the eyes would be pressed out; or when the
pains are digging, attended with sudden piercing, throbbing
lancinations through the brain, involving the forehead and
top of the head in particular, and being most severe on the
right side; followed by chills, nausea, vomiting of food or
bile, forcing the patient to lie down and preserve the greatest
quiet, as every motion aggravates the sufferings, which are
only relieved by sleep. —New Archiv., vol 2, part 2, p. 132.
CASE 100.-A man was attacked with frightfully severe
headache; the only relief he could obtain, was from pressing
the back of his head against the head-board of the bed.
Treatment.-An infusion of Rad. Sanguinar. removed the
headaches permanently.
CASE 101.-A lady suffered with frequent and severe
attacks of headache, with such sensitiveness during the paroxysms, that no one dared to walk across the room.
reatrnent.-The first dose of Sang. 6, produced such an
aggravation that the patient became almost beside herself;
after the second dose, she fell into a pleasant sleep from which
she awoke refreshed. Dr. HI-elfrig always gave Acon. and
B3ellad. during the paroxysms of sick-headache, and used
Sanguinar. 30, during the interval, unless some other remedy
was more indicated. -HERING.  Ibi.
Dose. —The proper dose is sufficiently indicated in the above cases.
-PETERS.




78                    HEADACHES.
39. SEPIA.
GENERAL REMARKS.-(a). According to Ilahnemann, it is
indicated when there is dulness of the head, and inability for
mental occupation; in attacks of sick headache, attended with
boring pains forcing one to cry out with agony, and with
vomiting; against throbbing headaches most severe in the
back of the head; congestion to the head while stooping;
coldness on the top of the head.-See Hahnemann's Chronic
Diseases, translated by Chas. J. Hempel.
(b). Hlering assumes that Sepia is suitable against piercing,
boring, or throbbing headaches, most severe in one temple,
or under one frontal protuberance, which is often sensitive to
the slightest touch; especially when the paroxysms are so
severe as to force one to cry out, and are attended with
nausea and vomiting; also when the slightest motion increases
the sufferings and the patient is obliged to remain very quietly
in a darkened room, with his eyes closed; sleep then being
easily induced and the whole attack passing off after a long
slumber.-P. 143.
(c). Dr. KREUSSLER found Sepia most useful in the following
kinds of headach'e:
In aching, piercing, drawing, and rending pains, affecting
all parts of the head, and attended with heat in the face,
noises in the ears, nausea and vomiting, vertigo, and great
weakness; all the sufferings being generally greatly aggravated by warmth. The piercing pains, however, were not so
severe as those which Acon., Rhus, or Pulsat. relieve so
readily, and were not constant, but occurred in paroxysms of
longer or shorter duration. The aching or pressing pains
were most frequent and severe in the back of the head.
-Genl. Ibom. Jour., vol. 29, p. 172.
(d). According to Dr. Tietze, Sepia acts upon the nervous
and vascular system, wherever it finds a passive congestion
connected with a dyscrasial suffering; and all diseases to be
cured by Sepia must be traced to some such source. In
general, we should bear in mind that both Bellad. and Sepia,
if they are to cure hemicrania, pre-suppose the existence of




SEPIA.                      79
congestion of blood to the brain; but for Bellad. the congestion
must be decided and active; for Sepia, rather passive; for
Bellad. to afford help, there need be no dyscrasia present;
for Sepia, a dyscrasia should never be absent. Tietze found
Sepia most useful in the headaches of females, especially of
hysterical patients; in obstinate and deeply-seated cases, in
which derangement of the nervous system had already lasted
for a long time; when the pains were piercing and confined
to one side; and when leucorrhcea was present during the
intervals of the paroxysms. He found it almost specific in
cases attended with Sudor hystericu8s, or a peculiarly sweetish
smelling perspiration of the arm-pits and soles of the feet.
He assumes that it is most indicated against those hemicranias
which arise slowly out of an affection of the assimilation, and
the whole bearing of the patient expresses the presence of a
deep-seated affection; his skin being pale, dingy or sallow,
the frame delicate, and the features marked with traces of
fiequent and severe suffering.
The pains it most readily relieves are piercing or pressing,
or aching and piercing, boring, rending, and pricking, and
attended with passive congestion to the head.-Genl. Hom.
Journal, vol. 34, p. 10.
(e). Black contents himself with asserting that it is mostsuitable against nervous, rheumatic and arthritic headaches,
especially when they occur in delicate and sensitive women.
-Genl. Hom. Jour., vol. 36, p. 234.
CASE 102. —Mrs. B., aged 21, of venous constitution, suffered in the middle of pregnancy, with frequently recurring
rending, piercing pains on the right side of the head.
Treatrbent.-Sepia 30, removed the pains in 2 hours, permanently.-General Homceopathic Journal, vol. 29, p. 72.
- Dr. IKREUSSLER.
CASE 103.-M- rs. M., aged 25, of bilious constitution, suffered with drawing, rending pains on the right side of the
head, intermingled with sharp stitches; the attacks being most
severe every morning and evening, and much relieved during
middle of the day. Her menses had commenced to become
rather scanty.




80                     HEADACHES.
Treatment.-Aconit., Pulsat., and Rhlus were given without benefit, but Sepia removed the whole disorder rapidly
and permanently.-Genl. Homr. Jour., vol. 29, p. 191. —Dr.
KfREUSSLER.
CASE  104. —Miss H., of venous temperament, had suffered for some time with headaches, which were becoming
more and more severe. She had violent pressing or aching
pains in the back of the head, attended with heat and redness
of the face, painfulness of the eyes, lassitude and weakness of
the limbs, lachrymose disposition, and disinclination to any
occupation.
Treatnzent.-Two doses of Sepia 15, removed her sufferings
permanently, although the first dose produced an aggravation. —Ib id. p. 1 72. —Dr. IK[REUSSLER.
CASE 105.-A stout girl had suffered for several months
with constant headache, frequently attended with nausea; her
-face was flushed, but her pulse small and weak, and menses
regular.
Treatent.-Sepia 30, in solution, cured her perfectly in a
week.-Archiv., vol. 20, part 3, p. 5S. —Dr. GOULLON.
CASE 106.-A lady, aged 32, who had suffered for many
years with cramps, and congestions of the head and chest, had
had violent headache for 14 days.
Synmptoyns.-Soreness and pain in the left eye and temple;
throbbing, rending, and piercing in the left temple; pricking
as if from an ulcer in the left zygoma and in the molar
teeth; soreness of the scalp to touch; aggravation of the
pains at various times of the day, followed by fainting fits.
She also had shivering, coldness of the feet, flushes of heat,
thirst, anxiety and despair of recovery.
recttnent.-Seven doses of Sepia 2, were given, one dose
every night and morning; she was entirely restored on the
4th day.-Genl. IlonL. Jour., vol. 33, p. 23.-Dr. IHAUSTEIN.
CASE 107. —A young lady, aged 19, a brunette of sanguine
temperament, who had been rheumatic for several years, had
now suffered for several months, generally after a slight cold,
with violent pains in her head.




SEPIA.                    81
Symptoms. —Tearing and boring, intermingled with acute
stitches, more frequently on the right side, than the left;
when the pain was very severe, she was obliged to keep very
quiet, close her eyes, and press her hand upon the painful
part; chilly weather increased the pains, which were scarcely
ever present at night, but occurred at almost any time during
the day; she had disinclination for food, her passages were
rather loose, her menses occurred too frequently and lasted
5 or 6 days.
Treatment. —Sepia 30, produced a decided improvement
about and after the 12th day; she relapsed slightly at the end
of 5 weeks, and then was cured entirely by repeated doses of
Sepia 30, in solution.-Dr. HImRscm.-Genl. Horu. Jour., vol. 7,
page 132.
CASE 109.-A lady, aged 40, and of an hysterical habit,
had suffered since her fourteenth year with headaches recurring every 2 or 4 weeks, affecting the left side, commencing
early in the morning, with rending and drawing pain under
the left temporal bone, passing over into aching and throbbing
in the back of the head, and followed by nausea and vomiting;
she could not open her eyes or bear light, and had obstinate
constipation.
treatment.-Sepia, several doses, repeated every 8 days,
removed the disorder.-Practical Observations, vol. 2, p. 10.
-.Dr. SCHINDLER.
CASE 110.-A man aged 30, of medium stature, and with
blackish brown hair, had been speedily cured of an ulcer up n
the leg, by external applications. Since then, he had suffered
with headache on the left side, extending to the left ear and
eye, commencing with violent stitches in the forehead, recurrinlg every five minutes, day and night, with such violence that
his face became distorted, and he screamed out with pain;
his scalp became exceedingly sore, he knew not where to lay
his head; every noise, even the speaking of others, increased
the pain; his tongue was white and he had a bitter taste in
the mouth.
6




82                     HEADACHES.
Treatnment.-Sepia 6, relieved the pains in two hours, and
he was cured in four days.-Genl. HIom. Jour., vol. 10, page
220.-Dr. S.
[CASE 111. —A nursing mother had suffered with headache for three weeks, characterised by acute pain in the
forehead, attended with throbbings which occasioned pain in
the teeth, and eyes; with noises in the ears; constipation,
nausea, and sometimes vomiting.
Jreatment.-Sepia (two doses) was followed by a severe aggravation; the pains changed to one side, and the disorder
assumed the form  of megrim; but in two days almost all
traces of the disorder were removed. A few doses of N1ux
subsequently removed the constipation.-3MALAIsE, p. 12.
CASE 112.-Miss V., aged 17, had had headache more or
less for eighteen months; the right side of the. head was principally affected with violent pulsations, especially severe in
the right side of the back of the head, attended with dimness
of vision, itching of the nose, dilatation of the pupils, and
frequent nausea; her tongue was coated, she had a bad taste
in the mouth, and irregular appetite; her sufferings were
more severe in the morning than in the evening; scarcely:a day passed by without some pain, ordinarily commencing in,the occiput. Her menses were regular.
Treatment.-Nux, Bellad., Aconit., Spigelia, China, and
Cina, were used for twenty days without benefit; then Sepia
30, (several doses) was given, and effected a perfect cure
in fifteen days, which lasted for at least two years and a half.
-Ibid.]-PETERS.
REvIEw.-Among eight patients, reported by  Riickert,
seven were females; of these, three were said to be of a venous
constitution, and one of sanguine temperament; two had
dark hair, and all were middle-aged.
Among the causes of the headache, we find: taking cold in
one case; and suppressed ulcer in one case.
Of the eight cases, six had the pains confined to one side
of the head; three times on the right side, and three times
on the left.




SEPIA.                      83
Among the localities involved by the pain, we find: the
forehead, extending to the eye, mentioned most frequently,
then the sides of the head, next the temples, top and back of
the head.
As to the character of the pain, we find it most frequently
rending or tearing, frequently attended with stitches; less
frequently we find drawing, aching or throbbing; boring pain
occurred only once.
As regards the time when the pains appear, we do not find
them confined to any particular period.
The pains were increased by rough weather, by moving or
opening the eyes, by noise, or the speaking of others, by the
slightest touch, by every movement, and by warmth. They
were relieved in one case by external pressure, by rest in a
dark place, by closing the eyes, and by a long sleep.
As accompaniments of the pain, we find: soreness of the
scalp, in case 105; heat and redness of the face, in cases 103
and 104; disgust for food, in case 106; white tongue and
bitter taste, in case 108; nausea and vomiting, in cases 104 and
107; constipation, in case 107; too frequent menstruation, in
case 106; scanty menstruation, in case 102; fainting fits, in
case 105; shivering and coldness of the feet, in case 105;
anxiety, in case 105; disinclination to work, in case 103; and
inclination to weep, in case 103.
Among the indications for the use of Sepia, we find:
hysteria, with long-continued derangement of the nervous
system, in ~ d and e; leucorrhcea between the paroxysms, in
~ d; sudor hystericus in ~ d; chronic expression of suffering
in the features, in ~ d; pale, sallow, dingy complexion in ~ d;
congestions in ~ b and d; passive congestions in ~ d; delicacy
of frame in ~ d and e; and return of pains at intervals, in ~ c.
Almost all the cases were chronic, and the cures followed
very quickly.
Sepia effected a cure in all eight cases without the aid of
any other remedy; in three cases, but one dose was used; in
two cases, two doses; in one case, nine doses; in one case
Sepia in solution was given, in repeated doses.




84                      HEADACHES.
The 2d, 6th and 15th potency were used each in one case;
the 30th, in four cases.
Dose. —Noack prefers one-grain doses of the 2d or 3d trituration, to
be given once or twice a day in sub-acute and chronic cases; more frequently in acute attacks. In the above cases the use of the 2d and 6th
dilutions was not followed by aggravations, but by speedy recoveries;
while the higher potencies, such as the 15th or 30th, sometimes either
caused aggravations, or more probably allowed the disorder to progress
unchecked to an extreme degree of suffering. Delicate and nervous
adults, and children may use the granules or high dilutions, either in
solution, or by drops or globules.-PETERS.
40. SILICEA.
GENERAL REMIARKS.-(a).  According to Hering, Silex is
useful against pushing, throbbing pains, with heat and rush
of blood to the head, especially when they are excited by
exertion, speaking, or stooping; in nocturnal pains, extending
from the nape, up to the top of the head; against rending
pains setting in every forenoon; when it seems as if the forehead would be pushed out; when lumps arise upon the head,
the hair falls out, and the scalp is very sensitive to touch;
also against tearing pains in the head, p. 142.
(b). HIahnemann advises it against headache ascending
from the nape to the top of the head, and preventing sleep
at night; for daily headache in the forenoon, with tearing
pains and heat in the forehead; for heaviness in the forehead
from  noon till evening; for pain as if the head would burst;
sweating of the head at night. —Chronic Diseases, vol. 5.
(c). Black advises it against headaches fiom organic disease,
excessive study, or nervous relaxation arising from any other
cause, when vertigo and weakness of memory are present, &c.
— Genl. Hom. Jour., vol. 36, p. 235.
CASE 113. —A young lady, aged 28, a brunette, of middling stature, had suffered for a long time  with  violent
headaches.
Symwptoms. —The pain involved either the vertex, back of
the head, or forehead; at other times when it extended over onehalf of the head, the one-sided pain consisted in a bruised feeling, so that even external pressure caused pain; in the forehead




SILICEA. —SPIGELIA.                85
the pain was of a pushing character, attended with great weakness of the eyes; when the pain became very violent, nausea
and vomiting set in; touching the head, walking about, and
exposure to the free air caused aggravation; the paroxysms
came on every two or three days or weeks, sometimes lasting
only a few hours, at others several weeks. At times, all food
tasted like clay; bits of tape-worm were discharged; she had
trembling of the limbs, and general feeling of weakness.
Treatment.-Silicea 30, in two drachms of diluted alcohol,
ten drops to be taken daily, from July 24 to the middle of
September.  Result. —The first four doses always caused
aggravations; afterwards a perfect cure was effected. —Genl.
HIom. Jour., vol. 22, p. 11.-DR. TIETZE.
Dse. —Trinks says in obstinate and chronic cases he has always
used the 2d or 3d dilution, one or two grains per dose, night and
morning, for weeks and months together, not only without producing
any unpleasant or stormy aggravations, but always with the most
gratifying curative results. Those who prefer them may use the higher
dilutions and globules, at long intervals.-PETERS.
41.  SPIGELIA.
GENERAL REMARScs.-(a). Spigelia, according to Tietze; is
indicated in hemicrania of the left side, the pain often involving the whole of that side of the head, and extending to
the face and teeth. Also:
When the pains consist in a digging-tearing, or in an aching-pressing; are increased by stooping, the slightest movement in the free air, and by every loud noise. It is especially useful when gouty affections in various parts of the
body are also present. —Genl. Hom. Jour., vol. 34, p. 21.
(b). According to Black, Spigelia is suitable against nervous
rheumatic headaches, when the pains are aching and
piercing, extend to the nape and face, and are increased by
touch, motion, and noise.
(c). Dr. Nehrer says, in the winter of 1845, he cured six
cases of one-sided headache, involving one or the other eyebrow, the pain being violent and throbbing, or else throbbing




86                     READACHES.
and piercing, or tearing, and attended with redness and
lachrymation of the affected eye; the paroxysms followed a
perfectly regular twenty-four hour type; the weather at the
time was icy-cold and rainy.-Spigelia 20, afforded relief
quickly and certainly.-New Archiv., vol. 3, part 1, p. 63.
(d). According to Hering, the typical character of the pains
relieved by Spigelia, is remarkable; the head, eyes, face, or
teeth may be affected; the paroxysms occur generally in the
morning or forenoon, before twelve o'clock; and motion,
especially stoopintg, causes an aggravation.  Among the
other indications for the remedy, are noted: aggravation
from stooping; aching and pressing in the head; sensation
as if the brain would be forced out through the forehead, &c.
The latter symptom occurs in fifteen or twenty other remedies; the first symptoms in many remedies also, especially
Ign., Pulsat., Coloc., Bryon., Bell., &c; but in no other remedy
do we find so many pains increased by the same causes, and
hence this possesses a peculiar significance for Spigelia. In
Spigelia-headaches, the face is often pale.-CorrespondenzBlatt, vol. 6, p. 80.
CASE 114. —A man, aged 25, of choleric sanguine temperament, and powerful constitution, had had violent headaches, off and on, for three years.
Symptoms.-Constant, violent and partly jerking or rending
pain; partly sawing pain, as if the nerves were lacerated
with fine instruments, involving the right side of head and
temples, and extending over the eye into the cheek-bones.
The right eye was much affected, and wept fieely; it pressed
and pushed itself forward, and was very sensitive to light;
there was a burning heat in the affected part, and in the face;
the veins of the temples were distended and pulsating;
there was coryza and disturbed sleep.
Treatment.-Bellad. and other remedies were given without
benefit, as the pain increased to an extreme degree, and
extended to the teeth. Then Spigelia 30, was given, followed by profuse sweat in half an hour, lasting all night, and
the patient awoke well after a sound sleep. —CorrespondenzBlatt, 6. —ROMIG.




SPIGELIA.                    87
CASE 115.-A  woman, whose menses recurred'too frequently, preceded by weakness of the chest with fainting, and
with great weakness from  the slightest exertion; also complained of violent stitches in the left temple, worse when
moving about. A few doses of Spigelia 30, cured her entirely.
-Ibid.
CASE 116.-A boy, aged 7, had suffered for several weeks
with headache; first here, then there, but especially in the
forehead and back part of the head; increased by motion,
by running, jumping, even by walking, but especially by
stooping, or shaking the head,'by coughing, and every concussion of the body, even by noise, and the warmth of a
stove. He frequently became pallid in the face, with blue
about the eyes, and sometimes became so sick as to vomit.Spigelia 30, effected a cure.-Ibid.
CASE 117.-It also cured a case in which pains in the
eyes occurred every morning, followed by piercing in the
head, face, teeth, and throat. In a week after were added,
chilliness and heat every night, without thirst; the headache
became throbbing on one side, so that he could not stoop,
and it seemed as if his head would fall off. There was
throbbing over the left eye, burning and piercing therein,
commencing early in the morning behind the eye, and finally
extending forwards; the eye seemed smaller, but was
swollen (Dulcam. and Scilla cause the same); the patient had
fever the whole day, with dryness of lips, and whiteness of
the tongue. The whole disorder, after lasting three weeks,
was cured in a few hours by Spigelia 30.-Ibid.
CASE 118.-Beating and throbbing in the vertex and
under the eyes, especially the left, increased by the slightest
motion. There was a discharge of thin green mucus from
the posterior nares; the gums were swollen, and there was
pain in the teeth. Spigelia 30 effected a cure.-Ibid.
CASE 119.-Chronic catarrh of head, violent headache,
with feeling as if the head would burst when stooping, worse
on the right side, and increased every morning till twelve
o'clock, after which it diminished; there was such tearing




88                    HEADACHES.
pain when stooping, that he was obliged to support his head.
Cured by Spigelia 30.-HERING.
CASE 120.-A widow, aged 56 (born in the East Indies),
of choleric and irritable temperament, with dark hair and
complexion, and of large stature, received a blow upon the head
many years before, and frequently suffered with headaches
since then. After a severe cold, taken at the end of June,
1850, the headache set in, and persisted with greater or less
violence, until the last of October. The disorder remained
about the same, for, if single symptoms ceased awhile, they
were sure to return again.
Symptoms.-Pain, especially in the forehead, where she
had received the injury; feeling as if from an internal ulcer
on the left side above the eyebrow, extending to the temples,
and occasionally to the back of the head; the pain often shot
into the eye, rendering it so painful that it could not be
moved; it consisted of a sore feeling, or of a boring or heaviness, more rarely of throbbing, especially on laying the head
down; it was increased every night and forenoon, also from
every movement, especially from stooping, which she could
not do without pain, even when free fromn headache. The
pains were also increased by every concussion, by noise, by the
loud speaking of others, with nausea from the same causes.
The only relief she obtained was from absolute quiet, and
from resting the head against something. Otherwise, she
was generally well, with the exception of being costive.
Tlreatment.-She used many remedies, among them Sulph.
30, twice with benefit; still, the increase of pain from stooping remained.  Merc. and China produced transient relief.
July 13th she received Spigelia 22, with relief for several
days; on the 16th, she took Coffea without benefit; the relief
afforded by Spigelia was thus neutralised, and the old disorder returned in full force. In August, several doses of China
27, and Bellad. 15, produced some relief, and in September,
Merc. 15; but October 21st, the old disorder again returned
severely, and she received Spigelia 200, in solution, one
dose, soon followed by slight aggravation with toothache, and




SPIGsLI:A.                    89
bleeding of the gums;- a repetition of the same dose was foElowed by a frightful aggravation, more severe than ever
before experienced, and attended with chills, shivering of the
whole body, and walking round the room in agony. After
using Camphor the aggravation subsided, and on the following day the pain was all gone, so that she could even stoop
without re-producing it. She then remained free from all
pain until March, 1851, when she took'Staphysagria 15, in
solution, for gum boils; after using Staphysag. for two days,
a violent aggravation again set in, followed by severe headache, feeling of ulceration, and as if the eyes would fall out,
from every motion or touch; with chills and spasmodic shivering from the severity of the pain; she was again obliged to use
Camphor as an antidote; in a few days she was restored, and
remains well to the present time, December, 1851. —R cKERT.
REvIEw.-This peculiar and important remedy was used
in thirteen cases; two, are described as occurring in those of
powerful constitution, and choleric, or choleric-sanguine temperament.
The character of the pains relieved by it differed very
widely; in some cases it was boring, ulcerating, or throbbing,
see ~ c, e, and g, and case 112; in others it was aching or
pressing, tearing or digging, or jerking and rending, see
~ c and a, and case 112; or finally sawing and piercing.
Hering calls particular attention to the fact that no other
remedy relieves such a variety of pains arising under the
same circumstances. Finally, it also relieves a feeling as if
the eyes were pressed, or turned out.
The situation of the pains relieved, was generally in the
fore part of the head. In eight cases the pains were confined
to one side, viz., in two cases to the right, and in five cases
to the left. In several instances the region of the eyes, and
the eyes themselves, were attacked with pain; they even
became inflamed and watery.
The regular, typical recurrence of the pains was peculiarly
marked, generally in the night or in the forenoon; the pains
spread not only to the eyes, but also to the whole side of the




90                      HEADACHES.
face and to the teeth, in ~ a and case 112; to the nape of the
neck in ~ b; and are apt to be associated, according to TIETZE,
with arthritic pains in various parts of the body. Dr. Nehrer
effected cures with Spigelia when the weather was damp,
cold and rainy, and Black thinks it cures nervo-rheumatic
pains most readily.
Among the causes of aggravation, stooping is the most
prominent; then every motion, concussion, loud noise, the
speaking of others, straining at stool, &c., see case 112,
and ~ g.
Among the accompanying symptoms, Hering draws attention to a peculiar paleness of the face, see ~ d and case 114.
The doses were Spigelia 30 and 200 in repeated doses.
The cures occurred speedily and decidedly, in cases more
or less chronic or rez~ent.
Dose.-Noack and Trinks as usual prefer comparatively large doses,
such as two or three drops of the 2d or 3d dilution, repeated at short
intervals, in acute attacks; at longer intervals in chronic and milder
cases. Still the high dilutions seem to have been decidedly useful in
the above cases, and we can only regret that Romig, Hering and
Riickert did not note more carefully the intervals of time allowed to
elapse between each dose. The same doses as those recommended for
Rhus., may be used.-PETERas.
42. SULPHUR.
GENERAL  REMARKS.-(a).  Hahnemann  recommends it
against night-headaches, which arise from the slightest movement in bed; against heaviness of the head, especially in the
occiput; daily drawing headaches, with sense of bursting;
piercing headaches with buzzing; throbbing pains in the
vertex; coldness, and cold spots on the head.-See Chronic
Diseases, translated by Dr. Chas. J. Hempel.
(b). IIering advises Sulph. against throbbing and rending
pains, with fever heat, occurring early in the morning, or in
the evening, attended with nausea, aggravated in the open
air, and relieved by being in a warm room; also against rending, stupefying pains and aching, occurring every week,
followed by falling out of the hair, and occurring after the
suppression of eruptions, or ulcers.-Page 142.




SULPHUR.                     91
(c). According to Black, Sulphur is indicated against headaches affecting the forehead and vertex, in which the patient
complains of heat of the head and coldness of the feet, and
has a sense of compression of the head, with noises in the
ears and hammering; also, against the congestive headaches
of persons who lead a sedentary life, saffer with constipation
or piles, or in whom old ulcers or eruptions, or hemorrhoidal
fluxes have been suppressed.-Genl. Hom. Jour., vol. 36,
page 235.
CASE 121.-A robust woman, aged 62, was attacked with
the following:
Symptoms.-Vertigo, crawling and pricking in the vertex,
rushing and noises in the ears, aching in the forehead, tightness around the head as if from a band, piercing pain in the
temples and cheeks, mucous state of the mouth, oppression
of the stomach, heaviness and anxiety in the praecordia;
with irritable disposition, great weakness and emaciation.
2Treatment. —Pulsat. occasioned very little relief, which,
however, followed quickly when Sulphur was used, and she
was cured in 10 days.-Hygea, vol. 15, page 512. —Dr.
SCHELLING.
CASE  122.-A  lady, shortly after confinement, was
attacked with violent tearing pain in tile forehead and upper
half of brain, especially about the eyes and nose, with the
greatest sensitiveness of the affected parts to touch, and feeling as if they were blistered; her head and body felt cold,
although the external air was warm, and her pulse was quick;
these attacks came on several times a day, and also at night;
they were preceded by tickling in the nose, like that which
precedes sneezing, by coughing and yawning; and were
followed by perspiration.
Treatment.-She was cured by four doses of Sulphur, at
intervals of from nine to twelve days.-Annals, vol. 4, page
258.-Dr. HIARTLAUB.
CASE 123.-A young man who had formerly suffered
with herpes rodens on the legs before he was attacked with
headaches, had complained for thirteen years with:




92                   HEADACHES.
Throbbing, tearing headache in the occiput, extending
forwards, and attended with nausea, vomiting, and aching
of the eyes; the attacks were preceded by flatulence, and
the headaches lessened somewhat at the end of two or three
days, when fever set in, and canker-sore mouth, followed by
sore throat; they recurred every three or four weeks.
Treatment.-Bellad., Merc., Nux, and Pulsat., were given
without benefit; but after taking several doses of Sulphur,
itching of the legs and perspiration of the feet set in, followed
by a diminution of the headaches, and in the course of a few
months he was perfectly restored.-Genl. Hom. Jour., vol.
10, p. 136.-DR. BERNSTEIN.
CASE 124.-A robust youth, aged 18, was attacked, one
year after the suppression of itch, every morning about nine
o'clock, with violent aching pain in the forehead, fever, rushing and roaring in the head, gradually increasing until noon,
and then entirely subsiding by four o'clock in the afternoon.
IHe had already suffered for several months in this way.
Treatrrent.-Sulph. 30, cured him entirely in ten days.Genl. IHFom. Jour., vol. 4, p. 305. —DR. HIRscH.
CASE 125.-A girl, aged 11 years, had already suffered
for two years with headaches, which had been of daily occurrence for the last three months.
Symnptoms. —Aching pain in the forehead and whole front
head, commencing immediately upon waking in the morning,
and persisting the whole day. She was unfit for thought or
study, and much debilitated.
1rTeatmnent.-Tinct. Sulph. effected a perfect cure in three
weeks. —Annals, p. 271.-DR. HARTLAUB.
CASE 126.-Captain R. had suffered for a long time with
headaches; shortly before they set in he had suppressed an
attack of itch, with ointments.
Symptoms.-Violent throbbing, pressing pains in the head,
especially after partaking of warm food, when in a warm
room, or exposed to the heat of the sun; congestion of blood




SULPHUR.-THUYA.                    93
to the head, with vertigo, relieved by the application of
cold water.  He was troubled with itching about the rectum,
with flatulence and derangement of the bowels.
Treatment. —After the use of Sulphur, at first in alternation with Nux, and then of Sulphur alone, one dose every fifth
day, he was seized with more troublesome itching and pricking about the arms, and finally with itching of the legs,
when his other troubles ceased entirely.-Genl. I-Tom. Jour.,
vol. 10, p. 138. —)R. BERNSTEIN.
REvIEw.-Of the six cases one-half were males; in three
cases the exciting cause of the headaches was suppression of
itch or herpes, see ~ b and c; inclination to constipation,
and hemorrhoids were also present, see ~ c.
The pains were most frequently seated in the forehead 
their character was generally aching and tearing, or as if
there were a band around the head; in one case there was
throbbing, pressing, rushing, and roaring. They occurred
either daily, at a particular hour, or in paroxysms several
tines a day, also at night; were increased by warm  things;
they were also attended by various disorders of the stomach,
flatulence, nausea, or vomiting.
Of the six cases, Sulprhur cured four, without aid from any
other remedy.
The size of the doses is unfortunately not mentioned in
most of the cases, although we learn that they were firequently
repeated.
Dose. —Noack advises one or two grains of the 1st or 3d trituration,
or frorn otle to three drops of carefully prepared tinct. of Sulphur, once
or twice a day in subacute or chronic cases; more frequently in severe
attacks. -P'E1its.
43. THUYA.
GENERAL REMARKS.-Tietze uses Thuya against hemicrania
when he finds that it has been preceded by sycosis. It is
most serviceable when the pains involve the left side, extend
from thence in rays, and become tearing in their character in
the forehead and face, as far as the zygoma. It is especially




94                      HEADACHES.
indicated when a peculiar sensation is present, as if a convex
button were pressed upon the head, particularly in the neighborhood of the sutures of the skull, or as if a nail were thrust
into the head.
If such pains are present, and we have reason to suspect
sycosis; if the disorder has become chronic and inveterate;
if the pains are increased by rest and warmth, especially that
of the bed, and are relieved by looking upwards and bending
the head backwards; and if they have been preceded by rheumatic or arthritic affections, with nocturnal exacerbations,
then Thuya will assuredly prove the only curative remedy.G(enl. I-Iom. Jour., vol. 34, p. 19.
DoSe. —Noack recommends one or two drop doses of the 1st, 2d or
3d dilution, every one, two or four hours in severe attacks; every six,
eight, twelve or more hours in milder paroxysms; and once or twice a
day in chronic cases. It is thought to be most useful by some physiians, in cases attended with the most obstinate constipation, with
ieucorrhoea or other uterine, or urinary trouble. —PETERS.
44. VERATRUIM.
G-ENERAL 1REMARiKS.-(a). Lobethal says that Veratrum  is
very useful against the nervous headaches of young maidens
and hysterical women, when they are attended with nausea
and vomiting, and the face is pale and cadaverous.-Genl.
Hi-om. Jour., vol. 13, p. 371.
(b). Black recoimmends it against aching, throbbing, nervous
headaches, affecting one side of the head, attended with stiffness of the neck, feeling as if the head would burst, and
with vomiting.-Ibid., vol. 36, p. 235.
(c). Hering asserts that Veratrum is useful when the scalp
is very sensitive to touch, when diarrhcea is present, and the
pains become so severe that the patient is rendered quite
delirious, or at least very weak and inclined to faint; when
the pains are increased by rising up, or lying down, and are
accompanied with cold sweat, coldness and thirst.  Also,
when long continued constipation has produced congestion of
blood to the head, with unilateral pains, and aching-throbbing
feeling as if the brain were bruised or compressed; with




VERATRUM.-ZINCUM.                    95
choking in the throat, or pain in the stomach, stiffness of the
neck, profuse flow of urine, nausea and voiniting. —Pp. 137
and 140.
Dose,-Noack advises one or two drop doses of the 2d, 3d, 6th or
12th dilution every few hours in severe cases; once or twice a day in
chronic attacks. —PETERS.
45. ZINCUM.
CASE 127.-A young lady, aged 24, of robust frame and
regular menstruation, had suffered for four years with:
Aching, tearing pain in the back of the head, piercing in
the right eye, rending and piercing in the ears, and occasionally in the teeth. These attacks had increased yearly in
severity, until they had begun to affect her mental powers.
Treatment.-Bellad. 30, relieved the pain in the eye, but
merely lessened the other sufferings; then Zinc. 30, cured her
entirely in thirteen days. —Practical Observations, vol. 2,
p. 187.-Dr. SCHULZ.
Dose, —Noack advises one or two grain doses of the 1st, 2d or 3d
trituration every two or three hours in acute attacks, once or twice a
day in chronic cases.-PETERS.
GENERAL REVIEW.
It must be expressly understood that this general review
applies mainly to the forty articles and eighty-five cases,
supplied by Riickert; a general review of the forty additional cases, numerous additional articles and notes, will be
given at some other place.-PETERS.
Spigelia was used successfully in thirteen cases; Bellad., in
twelve cases; Cale., Nux, Puls. and Sepia, each in ten cases;
Bryonia and Sulph., each in six cases; Arsenic., in five cases;
Colocynth, in four cases; Camphor and Causticurn, each in
three cases; Aconite, Opium, Sanguinaria, China, Cocculus,
Carb. v. and Hepar sulph., each in two cases; Agaricus, Arnica,
Asarum, Creosot., Dule., Ignat., Magnet., Mlere., Phosph.,




96                     HEADACHES.
Silex, and Zinc., each in one or more cases. Although no cases
have been reported in detail, still Aurumn, Arum, Coffea. Carb.
an., Caps., Chamomilla, Crocus, Lach., Plat., and Iris versicolor, have been found useful by various observers.
According to Riickert, these forty remedies were used
against the following groups of symptoms, and under the
following circumstances.
(1). Against NERvous headaches in general: Agaricus,
Aurum, Carb. an., Cocc., Ign., Plat., Sep., Silex, and Verat.
Against ONE-SIDED headaches, or 2gjyranes in particular:
Aeon., Ars., Bell., Calc., Caps., China, Coffea, Coloc., Ign.,
Nux, Opium, Puls., Sepia, Spigel., and Thlluya.
(2). Against CONGESTIVE headaches: Aecon., Belladonna,
Bryon., Calc., Carb. an., Nux, Phosph., Sepia, Sulph., and
Veratrum; against passive congestions, Opium, China, Sepia.
(3). Against CATARRIAL headaches, Aconit., Chain., Coffea.
[Pulsat., Agaricus, and Arsen.-PETELs.]
(4). Against RnIEUMATIC headaches: BryOn., Acon., Merc.,
Chain., Nux, Sepia, and Spigelia.
(5). Against ARIR'ITIc headaches: Sepia and Spigelia.
(6). Against headaches attended with GAs'treI disturbances:
Bellad., Nux, and Pulsat.; with nausea and vomiting in particular: Aeon., Am., Asar., Bellad., Bryon., Cale., Caps., Caunst.,
Coloc., Ign., Lachesis, Pulsat., Nux, Sanguinaria, Sepia,
Sulph. and Veratruni; with violent vomiting: Ars., Ipec.,
Tart. ermet., Sulph., Zinc., Cuprurn and Veratrum; with
retching, Acon. and Nux; with vomiting of bitter substances:
Bell., and Puls.; with vomiting of bile: Cale., Nux, Puls.,
Sanguinaria; with soaUr vomiting: Nux vomn. [Dr. Black
prefers Cocculus when the nausea is very great; others advise
Creosote; D1r. Chapman prefers Gratiola; D1. Kitchen, Iris
versicolor; while I have given CuprumI acet., with the most
marked benefit.-PETERS.]'
(7). Against PERIODICAL headaches: Bellad., Bryon., Cham.,
Coloc., Nux, Sanguinaria, Sepia, C/dna and Arsen.
(S). Principally against ACUTrE attacks: Aconite, Agaricus,
Arnica, Bellad., Bryon., Camphor, China, Cocculus, Coloc.,




GENERAL REVIEW.                   97
OCreosot., Dulc., Ignat., Magnet., Merc., Nux, Op., Phosph.,
Puls., Sanguinaria, Arum, Gratiola, and Iris versicolor.
(9). Principally against CHRONIC and inveterate cases:
Arsenicum, Calcarea, Causticum, Carb. animalis, Hepar
sulph., Phosphor., Sepia, Silex, Sulphur, Thuya, and Zinc.
(10). Principally according to the LOCALITY of the pains.
(a). When the pains involved the whole of the head: Bryon.,
Caust., Natr., Nux, Pulsat. and Sepia. (b). When they seem
to be seated in the brain: Arn., Bry., Cale., China, Dulc. and
Ignat. (c). When they affected the forehead in particular:
Arn., Bell., 7Bry., GCle., Coloc., Ign rc.Mere., J/tax, Puls., Plat.,
Silex, Sullph. and Thuya. (d). When the pains were principally
over the eye-brows: Bellad. Over the root of the nose: Acon.,
Ignat. and Plat. (e). On the vertex, or top of the head: Bell.,
Bry., Calc., Dulc., Nux, Natrum m. and Sulph. (fV). In the
temples: Bell., Caust., Chamin., China, Ign., Nux and Puls. (g).
In the occifpt, or the back of the head: Cale., Camph., Carb.
an., Creos., Natr., Nux, Puls., Sepia and Su2ph. (h). When
the pains were confined to one side in general: Bell., Cale.,.Chain., Coffea, Coloc., Lach., Natrumr m., Nux, Puls., Rhus,
Sepia, Silex, Spigelia. When limited to the right side: Bell.,
Bryon., Calc., Coloc., Nux, Puls., Rhus, Sanguinaria, Sepia,
and especially Opium. To the left side: Acon., Asarum,
Bryon., Cale., Charn., Coloc., Mere., Natrum, Nux, Puls.,
Sepia, Spigelia, Thuya, and especially China.
(11). According to the CHARACTER of the pains.
Against sore or festering pains, Puls. and Sep.; boring pains,
Calc., Pals., Sep. and Spigelia; boring pains, as if in the brain
itself, Ignat.; burning pains, Bryon.; boring-burning, Dulc.
Against aching pains; Ars., Bell., Bryon., Cale., China, Coffea,
Coloc., Natrum, Nux, Sepia, Sulph. and Veratrum.
Against aching fioln within outwardss: Ign., Caps.
stupefying  aching: Arsen.
dull aching: Cale.
digging aching: Bryon.
7




98                   EIEADACHES.
Drawing-asunder pains: Bryon., Caps. Throbbing, pushing
and hammering pains: Bell., Calc., Camph., Caps., Cham.,
Croc., Natrum m., Pulsat., Sanguin., Sepia, Silex, Spigelia,
Sulph., Verat.
Squeezing pains: over the nose, Aconit.; compressing pain,
Plat.; aching and compressing, Coloc. Feeling of emptiness,
Coco. Pain, as if from a nail driven into the brain, or the
true hysterical pain: Coffea, Ignatia, Nux, Evon., Hell.
and Thuya.
Pressing pain: Bell., Bryon. and Natrum; pressing-asunder, Arsen., Bell. and Bryon.; aching-pressing, Spigelia;
out-pressing, Bryon. and Ignat.; throbbing-pressing, Sulphur;
pressing together, Bryon.
Rending, tearing or drawing pains: Bell., Cham., China,
Coloc., Ignat., Mere., Nux, Pulsat., Sepia, Spigelia, Sulphur,
Thuya; boring-rending pains, Nux; aching-rending, China;
throbbing-rending, Arsen. and Spigelia; piercing-rending,
Natrum; rooting or digging and rending, Spigelia; rending
in small spots, Bryon.; drawing and rending, Rhus.
Stretching or tensive pains: Puls. Piercing, or pricking
or sticking pains: Bryon., Caust., Cham., Coloc., Nux, Puls.,
Sanguin., Sep. and Sulphur; outwards, Ignat.; inwards,
Coloc.; as if in the brain, Ignat; like needle-stitches or lancinating or pricking, Sepia; boring, Acon., Bellad. and Puls.;
aching or pressing and piercing, Pulsat.; throbbing, Acon.,
Bellad. and Spigelia; rending and piercing, Caps.
Sensation of rocking to and fro in the brain, Nux; of
wavering, Bellad.; of digging, Dulc. and Sanguin.; drawing,
Calc., Cham., China, Coffea, Coloc., lSIerc. and Sepia; achingdrawing, Nux; twitching or jerking, Coloc.; throbbing-jerking, Ignat.; as if compressed together by a band, Mere. and
Sulph.; screwed together, Pulsat. and Verat.; as if torn or
comminuted, Coffea, Nux and Verat.; as if the head would
burst, Cale., Merc. and Natrum; forcing one to cry out,
Acon., Coff., Cham. and Veratruml.
When the scalp was tender, Bellad., Carb. an., China and
Natrum m., were found the best remedies; when the hair




GENERAL REVIEW.                 99
was sensitive, Verat.; when there were hot spots upon the
head, Bellad.; coldness of the head, Calc. and Sulph.; sweat
upon the head in the evening, Cale.; rushing and roaring in
the head, Aurum, Bellad. and Cale.
(12). The following remedies were found most serviceable
when the headaches were EXCITED OR AGGRAVATED BY:
Touching the head, Bry., Cale., China, Coloc., Sep., Sulph.
Miovement in general, Acon., Bellad., Bry., Caps., China,
Creos., Nux, Sanguin., Sep. and Spigel.; at night, when in
bed, Sulph.; of the head and eyes, Bellad., Bryon., Coloc.,
Puls., Sepia; from opening the eyes, Sepia; when rising,
Veratrum; from stooping, Bellad., Bryon., Caps., Coloc.,
Nux, Puls., Sepia, Silex., Spigel.; when walking, Bryon. and
Caps.; when walking in the free air, Spigel.; after walking
in the open air, Cale.; while talking, Cale., Dulc., Ign.
From concussion, or jarring: Aeon., Bell., China; from
the talking of others, Acon., Bellad., Sepia, Spigel.; from the
walking about of others, Bell.; from every pulsation, Bell.;
from every step, or going up steps, Bellad.
From noise: Aeon., Bellad., Coff., Sepia and Spigel.; from
music, Coffea.
From  mental emotions in gevneral: Coloc. and Nux;
depressing emotions, Bryon.; from  vexation, Coff.; from
fright, Cale.; from mental exertion, Cale., Coffea, Nux.
After partaking of food: Arn., Coffea, Cocc., Nux; of
coffee or wine, Nux; of warm food, Sulph.
From bright light: Asarum, Bryon. and Nux; from rays
of light upon the eyes, Bellad.
From the influence of air: In the open air, Calc., Nux,
Spigel. and Sulph.; particular sensitiveness to the free air,
Caps., China, Coffea; sensitiveness of the head to air, Ars.;
draught of air or wind, China; air of a room, Ars., Puls. and
Sulph.; warm air in particular, Caust.
At the time of menstruation: Bryon., Coccul., Spigel.
From rest, or quiet or sitting: Pulsatilla.
From lying on the back: Coloc. and Verat.
From taking cold: Aeon., Bryon., Coffea, Nux v.




100                    HEADACHES.
(13). The following remedies were useful when the headaches were RELIEVED by:
Closing the eyes, Cale.; binding up the head, and external
pressure, Cale., Puls. and Sepia; by vomiting, Bryon.; the
free air, Acon., Ars. and Puls.; moving the limbs to and fro,
Ars. and Bellad.; the arms, Bellad.; by lying still, Cale.,
China and Mere.; the pains forcing one to lie still, Calc.,
Coloc., Nux and Sanguin.; by rest, China, Sepia and Spigel.;
by bending forwards, Ignat.; by external warmth, Arsen.
(14). When the pains and aches occurred early in the morning, Bellad., Bryon., Cale., Ignat., Natrum  m., Nux and
Sanguin., were found most useful; in the forenoon, Spigelia;
in the afternoon, Bell., Coloc.; in the evening, Bryon., Caust.,
Coloc., Pulsat. and Ignat.; at night, China, Mere., Silex and
Sulphur.
Riickert reports eighty-five cases of cure of headache,
effected by fifty-one different physicians; in eighty-four cases
the exact dose used is mentioned.
Strobng doses were used, viz.: from the pure tincture to the
3d dilution, in twenty-one cases; one dose sufficed to cure
"in five instances; one dose in solution was repeated in one
instance; repeated doses were required in fifteen cases.
The higher dilutions, viz.: from the 4th to 30th potency
were used in fifty cases; one dose sufficed to effect a cure in
thirty instances; one dose in solution and repeated in three
instances; repeated doses were required in seventeen instances.
The very high potencies were used in thirteen cases; single
doses in ten instances; in solution, repeatedly in three
instances.
Olfaction of the remedies was used in a few cases only.
Two-thirds of the cases were cured by the higher dilutions;
one-third, by the lower potencies.




SYNOPSIS
AND
ADDITIONAL CASES.
TnE original intention of this chapter was simply to furnish a
condensed statement of the principal indications, both clinical
and theoretical, for the selection of remedies against the
different varieties of headache. This had been accomplished,
when it was discovered that among the sixty-three cases of
headache collected by BEAUVAIS in his Clinique ffomxoopathique, no less than thirty-seven were not to be found in
Riickert's; hence, it was regarded as imperative to sacrifice
somewhat of the symmetry and methodical arrangement of
the present treatise, rather than have it go forth incomplete,
or less than it pretends to be, viz.: "' A complete collection of
all the cures and practical remarks upon the Homceopathic
treatment of Headaches, which have been published since
the year 1822." A few of the cases collected by Beauvais
have been rejected as unfit for republication here, as they
required the use of from four to five, or even six or seven
different remedies to effect a cure; but ten cases, translated
from  ATTrOMRm'S Primordie  einer Natur-geschichte der
Kranlkheiten, have also been added, and eight cases, cured by
Glonoine, reported by Dr. CoXE, of Philadelphia.
Of these additional cases, eight were cured by Sepia; eight,
by Glonoine; four, by Bell.; three cases, each by Ars., Nux,
Puls., Rhus, and Sulph.; one, by Staphysag.; and one, by
Sulph. and Sepia.




102                     SYNOPSIS.
ACONITUM NAPELLUS.
It has been recommended in headaches from suppressed
perspiration, and to induce those critical perspirations which
-sometimes cure chronic headache;
In severe rheumatic headaches, when attended with pains
in the fibrous sheaths of the nerves; in other fibrous tissues,
such as the dura mater, falx cerebri and cerebelli, in the
fibrous tissue of the scalp, in the periosteum of the skull and
bones of the face; especially when severe pains in the back,
bones and joints are also present, the urine and perspiration
having the well known rheumatic characters.  (See Merc.,
MIezereum, Iod. pot. and Bryon.)
In headaches attended with great and peculiar numbness
and tingling in various parts, and tending to falling asleep
of the limbs, and night-mare.
In severe one-sided headaches, especially on the left
side.
In violent congestive and sub-inflammatory headaches, with
fever, heat and redness of the face, some contraction of the
pupil, and wuithout active delirium.
In  the most violent nervous or neuralgic headaches,
when the patient is utterly prostrate and exhausted from the
severity of the pain, is cold and almost pulseless, with a
sinking feeling and great irritability of the stomach, and
coldness of the limbs, with tendency to livor, or blueness of various parts.
AGARICUS MUSCARIUS.
In the headaches of persons subject to nervous twitchings
and St. Vitus' dance, with spinal irritation, feeling of great
uneasiness and weakness down the spine, especially in those
unusually subject to frost-bites, and suffering with derangement, or enlargement of the liver.
In the headaches of those who become delirious whenever
they are feverish or in pain, attended with twitchings, startings, grimaces, and a state resembling pleasant intoxication.
(See Bellad., Stramon., &c.)




ACONITUM, AGARICUS, ARNICA, ARSENICUM.   103
In the headaches of persons suffering with softening of the
brain, or spinal marrow. (See Nux, and Iodide of Baryta.)
ARNICA MONTANA.
Against headaches arising from mechanical injuries; those
of persons subject or liable to apoplexy; and of women during the change of life.
Against headaches similar to those relieved by Nux, Ignat.,
Strychnine, the Magnet, and the alternate use of electrical
remedies, such as Zinc and Cuprum, Zinc and Argentum,
Zinc and Platina, especially when there is heat and burning
in the head, with coolness of the rest of the body, pain over
the eyes and temples, with feeling as if the integuments of
the forehead were spasmodically contracted.
Against aching with lancinating and tearing in the left
half of the head, left temple, or left frontal protuberance.
In headaches attended with a feeling of formication or
creeping in the limbs, with prickling, piercing sensations
somewhat similar to slight electric shocks, and a peculiar feeling of coolness over the body, followed by perspiration which
sometimes assumes a reddish hue upon the chest, with scanty
urine, and great increase of pain from walking about.
ARSENICUM ALBUM.
Against the headaches of persons inclined to dropsy,
or bloating of the face or feet, with scanty and albuminous urine, especially if the eyelids be red, swollen and
itchy, the tongue white as if rubbed over with chalk or
covered with cream, although the appetite may be ravenous,
and tendency to diarrhcea be present. (See Mere. Corrosiv.,
Camph., and Apis Mell.)
Also when the face is pale and sunken, with blue circles about the eyes and blueness of the lips, dingy appearance of the skin, tendency to boils and eruptions. (See
Carb. an. and Hepar s.)
In the headaches of those subject to catarrh of the head, short
dry cough, and tightness of the chest. (See Acon. and Antim.)




104                    SYNOPSIS.
In the headaches of persons with irritable bowels and subject to frequent diarrhea; or with sub-inflammatory irritation
of the uterus or ovaries, and having a pale or bloated, cachectic,
suffering or dyscratic appearance.
In regularly intermitting or periodical headaches, affecting
the forehead and right side of the head. (See China.)
CASE 128.-A lady had suffered for two years with neuralgic headache, and under allopathic treatment had been
bled, leeched, blistered, used opium  and had the actual
cautery applied three times before she was relieved. The
attacks commenced at 7 A.M. and lasted until 2 P.M., and were
so severe that the patient was obliged to give up and lie down;
she wept and screamed from the severity of the pain.
Treatment. —China was given without relief; four globules
of Arsen. produced relief in one hour, the next day she was
much better, and on the third day she was well. —Bibliotheque
IHom., vol. 3, p. 133. —D. CoNvERs.-Beauvais Clinique,
vol. 2, p. 23.
CASE 129.-A gentleman had suffered for two months
with violent migraine, commencing every morning at 8 o'clock
and lasting till 1 P.M.
Symptoms.-Severe pains, cutting and lancinating in the
left temple and forehead; they soon became so violent that
he wept and despaired like a child; the left eye became
sensitive to light, red and tearful; a corrosive fluid ran from
the left nostril during the paroxysms; during the interval of
relief he had loss of appetite, debility and great sensitiveness
to the fresh air.
lTreatment.-He had been leeched and blistered without
relief, also had taken anti-spasmodics and anti-arthritic remedies. China 3, and B3ellad. 12, were given without much
benefit; Arsenic. 30, was followed by suppuration in the
nostril, discharge ot a hard polypus, and entire cure in five
weeks.-Ibid., vol. 1, p. 569.-DR. HERMANN.
CASE 130.-A maiden, aged 15, suffered with pain in the
left forehead and temple, so severe that she wept and whimpered, and could not bear to be touched. Near the left temple




ASARUM, ARUM, AURUM.              105
there was a small, round, brownish red spot, with a black
point in the centre, painful to the touch.
Treatment. —Arsen. 30, three doses per day, cured the headache; but chills and spasms of the arms and legs, which set in
afterwards, were removed by Ignat. 12.-ATTOMYR., vol. 1,
page 474.
ASARUM EUROP.oUM.
Against headaches which come on just before or after
menstruation, with painful weight, tightness and dulness of the
head, and throbbing in the occiput. (See Pulsat., Sabina,
Crocus.)
ARUM MACULATUM.
In dyspeptic headaches, or those connected with debility
of the stomach.
AURUM MURIATICUM.
In the most violent congestive headaches, which will not
yield to Acon., Bell., Stramon., or Phosphor., attended with
great redness of the face, hald throbbing of the carotid and
temporal arteries, great rushing and roaring in the ears,
especially when owing to sudden suppression of piles, or
of the menses, and when the attacks are apt to pass off with
the feeling as if all the blood in the head rushed down into
the legs.
It is the great rival of M1ercurius in the treatment of headaches connected with disease of the periosteum, or bones of
the nose, ears and skull, arising from secondary syphilis,
although iHydriodate of Potash and Mezereum will often be
required in alternation with it.
In headaches arising from such derangements of the stomach
as are always followed by nettle-rash, especially when there
is a chronic tendency to congestion of the head, with great
despondency.
In headaches which commence in the morning, last all day,
and are increased to an extreme degree of violence by reflecting, reading, talking, or writing.  Headaches of literary persons, especially when their urine is rather profuse, thick, and.




106                     SYNOPSIS.
has a peculiarly offensive smell, while the perspiration is
copious and peculiar in its odor. (See Nux and Agar.)
BELLADONNA.
In headaches which always commence in the afternoon or
evening; being dull and heavy, affecting the forehead in particular, attended with active delirium, dilatation of the pupils,
partial blindness, and ceasing suddenly on the occurence
of a profuse flow  of limpid urine.  In headache from
diabetes.
In the headaches of persons affected with active febrile, or
florid scrofula, and having unusually large pupils; especially
if there be great irritability of the uterine system.   (See
Baryta and Stramon.)
Against headaches which always commence about, or in
one or the other eye, attended with great disturbance of
vision, and excessive dilatation of the pupils, being seated in
the retina, optic nerve, or ophthalmic branch of the fifth
pair. (See Stramon., Pulsat.)
Some remedies are peculiarly suited to headaches which
attack one small spot, as if a nail were driven into the brain,
or as if a small part were festered or ulcerated; Bell., on the
contrary is most suited for headaches extending over large
surfaces of the brain. Nux vom. is most indicated when the
pupils are contracted, and the various sphincters in a state of
spasm, the headaches commencing early in the morning and
subsiding towards evening; Bellad. is most suitable against
the exact reverse of all this, although in cases 9, 12, and 15
cured by Bellad. the pains commenced and were most severe
in the morning. It is perhaps most useful against headaches
affecting the right side, especially when the face of the patient
has a mottled appearance, from the presence of large red
spots.
CASE 131.-A lady, aged 36, had suffered for several
years with periodical headache, especially at the time of
menstruation; she had been treated without success by a
number of physicians.




BELLADONNA.                  107
Syrmptoms.-Severe pain in the head, with great heat and
redness of face, burning heat and throbbing in the head,
followed by delirium.
Treatrnent.-Bellad. 30, caused relief in six hours, and
although she continued to have periodical attacks, they were
much less severe. —Beauvais' Clinique, vol. 1, p. 514. —DR.
HERMANN.
CASE 132.-A pregnant lady, aged 35, had suffered for
four days with headache, concentrated especially in the bones
and skin of the left side of the forehead; the pains occurred
in paroxysms, which were at times exceedingly severe; they
were drawing, jerking and rending in their character, and the
skin and hair of the affected part became very sensitive; there
were noises in the left ear, almost entire loss of hearing; mist
before the left eye; the upper lid was sunken, as if paralyzed;
the white of the eye was reddened; there was loss of smell
and taste; also cough, with some expectoration of blood,
tickling in the larynx, and pain in the chest; the throat was
red, painful and swollen; the left arm was numb; there was
no fever.
Treatment. —Four doses of Bellad. 2, effected a cure.Attomyr's Primordien, vol. 1, p. 451.
CASE 133. —A student, aged 23, had suffered from his
eighth year with headache, which had ceased for awhile,
when he was suffering with fever and ague, but had returned
again.
Symptoms.-He generally had pain in a small spot, on the
left side of the forehead, on the evening before an attack of
headache; early the next morning the headache set in, and
the above mentioned spot became raised and red; occasionally
the attacks affected the right side. During the early part of
the night he had unusual wakefulness, and only fell asleep
towards 5 o'clock in the morning.
Treatment. —He was cured by Bell. 3, one dose night and
morning.-Attomyr, ibid.-ID. GRoss.
CASE 134.-A lady, aged 36, had suffered for two years,
with pain commencing over the forehead, extending down the




108                     SYNOPSIS.
right side towards the nose and jaw, and into the neck; the
pain was drawing, throbbing and rending; it generally cornmmenced at 4 A.M., and lasted for half or one hour, and was
attended with itching in the eyelids, some swelling of the
affected side of the face, with aching and pinching pain in the
ear, and with perspiration. At times spots came out on
the face.
Treatmnent.-Bellad. 30, effected a perfect cure.-Attomyr,
ibid.-DR. KIRSCH.
BRYONIA ALBA.
Bellad. and other remedies are indicated when the head is
heavy from great fulness of blood; Bryonia is the best remedy
against heaviness of the head from simple debility, or loss of
energy in the brain, similar to that heaviness which is felt in
an arm or leg that is wearied; just as a debilitated stomach
will feel the least weight put in it, or the bowels feel heavy
from their own weight, will a weakened brain rest heavily
against the skull.  It is most indicated in severe headache,
the brain feeling very heavy, as if it would incline to all sides
of the skull, with pressure in the brain from within outwards,
and great desire to lie down. Headache when stooping as if
all the contents of the skull would fall out of the forehead;
giddiness, and weight in the head.
Also against morning-headaches from debility of the brain
and nervous system. In this form, the patient wakes unrefreshed from sleep, is languid and weary, but not very drowsy,
scarcely able to dress himself, or to exert himself sufficiently
to get his breakfast; shortly after this meal, however, he
becomes revived and active. Bryonia is indicated when the
patient's head aches, and he feels gloomy in the morning, as if
he had over-exerted himself; with gloomy compression in the
forehead, over the eyes; compressive pain early in the morning, with heaviness, intermingled with stitches so violent that
the patient can scarcely open his eyes. Headache early in
the morning, on waking, in the occiput, extending as far as
the shoulders, resembling a weight pressing on a sore spot.




BRYONIA, CALCAREA.               109
Tearing and drawing pain in the cheek and jaw-bones, early in
the morning, just after rising. Beating and heat in the head,
early in the morning. Headaches which set in principally in
the morning, on waking; and those which are aggravated by
walking in the open air. (See Nux.)
Also against rheumatic headaches, when the disorder is
seated, not so much in the fibrous as in the true muscular
tissue, involving the nerves and bloodvessels which preside
over the nutrition of the muscles, rather than their motions; while Nux and Ignatia are more indicated when
the motor nerves are principally involved. Bryonia is also
useful in nervo-neuralgic and rheumatic headaches, in which
the pains spread to the frontal and temporal branches of the
trifacial nerve, and to the temporal and maxillary twigs of the
superior facial nerve; also when the pains extend to the muscles of the face, neck or arms; and are much increased by
every motion of these parts. When the paroxysms arise in
rheumatic weather, in cold, raw, and wet seasons, and are
attended with pains or swelling of the joints.
CASE 135.-Bryon. 9, relieved: vertigo in the morning,
throbbing in the head, especially after walking, or being overheated; pain in the teeth and dryness of the throat after
swallowing cold food, or drink; constipation; occasional pain
and tension in the right side. —Beauvais' Clinique, vol. 1,
p. 563.-DR. ReCKERT.
CALCAREA CARBONICA.
It is principally used in chronic and obstinate headaches,
attended with great sluggishness and somle drowsiness, oc-,curring in torpid, scrofulous persons, with a pale and
rather fair complexion, and a marked predisposition towards
corpulency.
Against headaches which instead of being relieved by a
walk or drive in the open air, are very much aggravated
by it. In chronic morning headaches, somewhat resembling
the stupid headache of Dr. Good.  In those attended with
coldness of the head in spots, and laruge dull red blotches upon




110                     SYNOPSIS.
the cheeks; and in females with profuse and frequent flow of
the menses, tendency to sour stomach and canker sore mouth.
CAMPHOR.
In sudden and acute headaches from excessive fatigue
or debility, especially when attended with throbbing in
the back of the head; it is supposed to exert a specific
action upon the cerebellum and medulla oblongata.
In headaches from suppressed perspiration, or those attended with warmth of the skin, hot perspiration, congestion
to the head, redness of the face, sparkling of the eyes, feeling of intoxication, noises in the ears, great anxiety about the
heart, chest, and pit of the stomach, and with nausea and
vomiting.
In apoplectic headaches, with wandering of the mind,,
sleepiness, even soporose sleep, with coldness of the skin,
paleness of the face, stertorous respiration, twitching, &c.
CARBO ANIMALIS.
This remedy, or animal carbon, is closely allied in its
action to Carbo vegetabilis, or vegetable carbon; to Graphites, or
mineral carbon; and to Sepia, or Jis9h carbon. A careful
study of these four remedies in connection with each otherwill lead to a better application of each of them to the
diseases in which they are severally indicated.
It should be remembered in the headaches of some dyscratic
subjects, as Wurm regards it as the best remedy to improve
the blood, especially in cancerous and bilious subjects, and
those with indurations and swellings of glandular organs,
especially if they are also subject to boils, or copper-colored
exanthems. (See Conium.)
In headaches arising from enlarged parotid, or cervical
glands pressing upon the bloodvessels of the neck; and in
women who suffer with enlargement of the ovaries. (See
Graphit. and Staphysag.
But more especially in dyspeptic headaches, when the
patient is incommoded by everything he eats, when the




CAMPHOR, CARBO AN., CARBO VEG., CAPSICUM.    111
occiput and left side of the head are most affected, the
left side of the scalp is sore to the touch, and the pains
are decidedly lancinating, and cutting. It is well known that
shooting or lancinating pains, and sharp, darting and pricking
pains, are chiefly met with in neuralgia and rheumatism, when
owing to some acrid humor in the blood, and in cancer; these
pains either follow the course of the nerves, or the fibres of
the muscular or fibrous parts affected.
CARBO VEGETABILIS.
Especially in headaches connected with indigestion and
great flatulence; some persons find prompt relief from the
most violent headaches by taking an ordinary dose of charcoal. SANDRAS knew of a case of headache, attended with
profuse accumulation of wind in the stomach, always relieved
by exposing the epigastrium to the cool fresh air, aided by
gentle frictions to expel the gas. Against headache connected
with obstinate and chronic fever and ague, of years' standing.
CASE 136.-J. K., aged 32, corpulent, sanguine and
swarthy, had been in poor health for some time, and consulted
several physicians without relief.
Symptoms. —Painful throbbing from the nape up into the
head, commencing before noon with stiffness in the nape, and
cold sweat; becoming worse after mid-day, especially after
eating, but the pain gradually ceased if he would lie down.
He had noises in the ears, dimness before the eyes, slight
constipation, smarting pain in the urethra before urinating;
rheumatic pains in the muscles of the abdomen, coldness of
the knees, fetid sweat of the feet, and frequent crops of boils.
Treatment. — Carb. veg. 18; in two months he was almost
well.-Beauvaisj vol. 2, p. 22. —DR. TIETZE.
CAPSICUM ANNUUM.
Against headaches connected with neuralgia, or with
derangement of the stomach, such as a chronic mucous state,
with heartburn, flatulence, flatulent colic, cramps of the
stomach, diarrhcea and haemarrhoids, especially when occurring in persons long afflicted with chronic gonorrhoea.




112                    SYNOPSIS.
CAUSTICUM.
In the chronic headaches of scrofulous and weakly persons,
who have become still more debilitated by long continued
grief; when attended with nausea, irregular appetite, chronic
constipation, menstrual irregularity, and pain in the back,
provided the headaches are most frequent and severe at night,
and attended with pains in the limbs. We have already seen
that the chronic dyscratic headaches most readily relieved by
Calcarea, are such as are most frequent and severe in the
morning.
CASE 137.-A boy, aged 12, after the suppression of itch,
was attacked with St. Vitus' dance, from which he was relieved
in a month under allopathic treatment, but left with: shooting
pains in the forehead, drawing pain in the right arm and
elbow, painful tension in the knee, and vertigo.
Treatment. —Three doses of Sulphur and two of Causticum
cured him entirely in six weeks. —Beauvais, vol. 1, p. 572.DR. HARTLAUB.
MATRICARIA CHAMOMILLA.
It is best suited as a palliative remedy against the sudden
and acute headaches of hysterical subjects, especially when
attended with bilious derangement, bitter taste in the mouth,
stitches in the region of the liver, a peculiar feeling of anxiety,
nausea, vomiting and bilious diarrhcea, with more or less flatulence, and menstrual derangement, viz., menstrual colic
with frequent discharge of coagule.
CHINA (CINCHONA).
It causes active congestion of the head; as it increases
the whole quantity of the blood  and favors an unusual
flow of it to the head more than any other remedy, except
Iron;it is easy to understand how it may relieve passive
stagnations of blood in the head, and those headaches dependent upon a deficiency of blood in the whole system, owing
to excessive bloodletting, helinorrhages, or great loss of any of
the fluids of the body.




CAUSTICUM) CHAMOMILLA, CHINA, COCCULUS.     113
It is most homceopathic to headaches attended with great
restlessness, much chilliness, trembling of the limbs, noises in
the ears, some deafness, decided hunger, constipation, frequent
pulse, heat of skin, and redness of the face.
CASE 138.-A robust and very active pastor, had suffered
for several years with an affection of the head, so violent that
he had lost all his former activity; there seemed to him to be
a place in his occiput as large as a closed fist, over which the
skin was as sore to touch, as if an abscess were beneath;
and what was most remarkable, the roots of the hair there
were sensitive to the slightest touch, while they would bear
hard pressure without pain. He also had pain and stiffness
in his loins, so that he was obliged to walk bent over, and
could only straighten himself with difficulty.
7recatment.-Tinct. China, in drop doses, removed the headdifficulty in thirty hours; Bryon. 3, cured the pain in the loins
in two days more.-Beauvais, vol. 1, p. 550.-DR. BETHMAN.
CASE 139. —Madam D., subject at all times to headache,
was seized in her forty-eighth year, after an extraordinarily
copious flow of the menses, with pain in the head, sickness,
inclination to vomit, chills, coldness of the feet, and great
debility.
reeatment.-China being indicated, -1-th of a grain doses of
quinine were given every two hours; in half an hour after the
first dose, relief commenced, and progressed so rapidly that
by the time she had taken six doses, she was restored to
health and strength.-Beauvais, vol. 1, p. 511. —DR. GRoss.
COCCULUS IN DICUS.
It is serviceable against the headaches which follow a
sudden suppression of the menses; those with excessive
dizziness; with an unusual degree of nausea, vomiting and
irritability of the stomach.
In headaches peculiarly marked by a feeling of emptiness and hollowness of the head; just the opposite of China,
Bellad., and other remedies, which cause a feeling of great
fulness, or distension.
8




114                    SYNOPSIS.
It is a main remedy against some forms of dyspeptic
headache, viz., when there is a bitter, salt, coppery, slimy
or bad taste in the mouth; want of appetite, disgust for
food, even for the smell of it; excessive nausea, with great
dizziness, and tendency to fainting.
CASE 140.-A lady, aged 28, suffered with frequent pains
in the forehead, accompanied with vomiting of bile and pressure in the stomach, as if from a stone; pain in the region of
the liver, which became acute when she stooped; constipation,
with scanty, painful and hard stools; painful menstruation,
lasting from eight to ten days, with flow of grumous blood;
followed by piles, great debility, sweats, and disturbed sleep.
Treatment.-Two doses of Cocculus 18, at intervals of eight
days, cured her entirely. —Beauvais, vol. 2, page 14.-DR.
SCHROEN.
COLOCYNTH.
In headaches which are very apt to pass off with diarrhcea,
Heckenberger noticed, when one drop of Tinct. Coloc. was
given every morning, fasting, for several weeks, that thin,
mush-like, and brownish stools would always follow.
Headaches connected with bilious derangement, profuse
menstruation, and frequent and violent colics; especially when
the pains are most severe in the left side of the head, forehead, left eye and upper teeth, occasionally extending to the
left shoulder, followed by soreness of the left side of the scalp.
In some respects this form of headache resembles that for which
Carbo-animalis is most suitable; in obstinate cases, Carbo-an.
may be given as a chronic remedy during the intervals
of relief, to break up the tendency to the attacks; while
Colocynth can be used to produce relief in severe and acute
paroxysms. In such cases, China may also be required.
CREOSOTE.
It has been advised in headaches attended with excessive
irritability of the stomach, severe nausea and vomiting,
although Acid. Ilydrocyan. may be required, or the Magnet.




COLOCYNTHI CREOSOTE) CROCUS, GLONOINE.   115
In headaches attended with profuse menstruation, chronic
inflammation of the labia and vagina, ulceration of the
os uteri, with whitish, yellow, serous or bloody leucorrhcea.
CROCUS.
Headaches of women during the change of life; those
which follow obstinate and fatiguing bleeding of the nose;
or profuse, and too freqluent menstruation.
In violent headaches which last three or four days at a
time, the pains being most frequent and severe on the left
side, attended with great drowsiness, confusion of the head,
feeling of intoxication, and dimness of vision.
GLONOINE.
This powerful remedy was introduced into practice by the
veteran Dr. Hering, to whose zeal and industry the MIateria
Medica owes so many contributions, both elaborate and
fragmentary. Dr. Vlnal has reported two cases of cure, of
headache; and Dr. J. Redman Coxe, four cases, with it.
SOBRERO says, a minute quantity of Glonoine held upon
the tongue produces a very violent headache for several hours.
It evidently exerts a peculiar and decided action upon the
head, and will prove hoinceopathic in certain forms of headache, especially in the highly congestive variety, when there
is a feeling of great heaviness and weight in the brain, rush
of blood, beating and throbbing, sense of soreness and swelling
of the head; particularly when the symptoms are most severe
at night.
CASE 141.-Mrs. E. T. C. had complained for several
weeks with: throbbing headache, dizziness, with flushes of
heat to the head and face, and feeling of soreness internally
when moving it.
Treatment. —She had taken various homieopathic remedies
without relief; then took Glonoine 9, two powders, with
relief in half an hour after the first dose, and no return of the
disease for six weeks, at last account. —Brit. Jour. of Hom.,
vol. 7, p. 421.-DR. VINAL.
CASE 142.-Miss Ann R. had suffered for several weeks




116                    SYNOPSIS.
with pulsating headache, and soreness on moving the head,
with dizziness and vertigo after stooping.
TrIeatment.-She had been treated homceopathically for
some weeks, without permanent benefit, when she finally took
Glonoine 6, four powders, one night and morning; she was,
relieved rapidly, and had no return of the disorder for a,
month, at last account. —Ibid.
CASE 143. —Mrs. M. J. C., aged 35, of bilious, sanguine
temperament, had suffered since her fifteenth year, with
repeated attacks of congestion to the head; had been treated
allopathically for five years without benefit; then was almost
cured by eight months homceopathic treatment, so that she
had no attacks for several years; and for seven years more,
had only slight paroxysms, which readily yielded to Aeon. 9,
and Bellad. 12. In 1848, she had two violent attacks; in
1849, prior to June, she had endured three violent paroxysms,
all of which yielded, but not very readily, to Aeon., and BellOn June 26th, 1849, she was attacked with the most violent
seizure she had ever experienced.
Symytoms. —Her face was nearly purple; the heat of her
forehead, and vertex exceedingly great; her eyes blood-shot.
and protruding, and the pain in her head most excruciating;,
her brain felt twice as heavy, and much larger than usual;,
she became perfectly delirious, knew no one, and repulsed her
husband and children; screamed violently, wished to escape
from the house, &c.
Treatment.-Glonoine 3, two pellets; followed by a violent
aggravation in five minutes, and an equally rapid improvement in five minutes more, so that in ten minutes after the
first dose, she was almost well; her head and face were cool,
pain gone, and she had no return of the disorder for five
months, when a slight attack yielded readily to Glonoine 3.
-Am. Jour. of Ibom., vol. 6, p. 76. —Dn. J. R. COXE, Jr.
CASE 144. —Deborah Gray, aged 40, a colored cook, had
been subject to violent headaches and congestions to-the head,
every twelve or fifteen days for many years, and from which
she was never relieved in less than twenty-four hours.




GLONOINE.                    117
Symptoms.-I1eadache and vertigo so severe that she was,obliged to hold her head with her hands; eyes very painful
and bloodshot; face and head very hot; she moaned much,
complained that her brain was being forced out of her forehead, and that it seemed too large.
Treatmetn.-Glonoine 3, one pellet; followed by evident
aggravation in six minutes, and entire relief in ten minutes;
she had no attack for fourteen weeks after, when a slight
attack was relieved in fifteen minutes, by one teaspoonful of
Glonoine 6, two pellets, solved in four ounces of water.-Ibid.
CASE 145.-Miss S. A. C., aged 8 years, of bilious, nervous
and choleric temperament, had been subject to bleeding of
the nose, pain and fulness in the head with vertigo, and slight
palpitation, three or four times a year for several years, when
she was suddenly attacked with violent headache, great heat
and flushing of the face, bloodshot state of the eyes, and full,
quick pulse.
Treatment.-Glonoine 9, one pellet, without any effect;
she then recovered in six hours under the use of Acon. and
Bellad. Three weeks after, for a similar attack, she took
Glonoine 12, two pellets; followed by an aggravation in seven
minutes, and a cure in twelve.-Ibid.
CASE 146.-Master L. S., aged 12 years, of bilious, nervous
and slightly lymphatic temperament, after being over-heated,
was seized with violent headache; his face was flushed, head
hot, pulse 106, full and strong; he had violent beating of the
arteries of the head, congestion and protrusion of the eyes,
feeling as if his head was larger than usual, and as if his eyes
were being pushed out, so that he could not sit upright, and
was obliged to keep his hand pressed upon his forehead.
Thqeatment.-Glonoine 12, one pellet; followed by a very
slight aggravation for eight minutes, and entire recovery in
seventeen.-Ibid.
CASE 147.-IVIr. - 13. }[I. S., aged 32, of large stature, and
bilious sanguine temperament, after taking a violent cold, was
seized with severe headache.
Symptors. —Severe pain in head; face much flushed, and




118                    SYNOPSIS.
very hot; whole head extremely hot; eyes very much bloodshot, and with a rather wild expression; trembling of the legs
and knees; slight quivering of the hands and wrists.
Treatment.-Glonoine 9, two pellets; followed by a slight
aggravation in nine minutes, and perfect recovery in twentysix.-Ibid.-DR. J. RI. COXE.
GRATIOLA OFFICINALIS.
In headaches attended with a peculiar biting-burning in
the face and other parts, great languor in the arms and legs,
often followed by an equally pecutliar coldness in, and on the
head, and in the stomach and bowels.
In the headaches which attend jaundice, bilious diarrhoea
or dysentery, with yellow, yellowish green and bilious stools,
discharge of brown, fetid and acrid mucus, with great smarting and burning in the rectum.
HEPAR SIPHURIS.
Especially in those headaches which commence early in
the morning, as soon as one wakes, and are relieved by
exposure to the open air. The Calcarea-headaches are also
morning-headaches, but they are very much aggravated by the
fresh air. Hepar is used even more frequently than Carbo-an. in
headaches arising from an unhealthy state of the system
marked by the frequent occurrence of pimples, boils, felons,
glandular indurations and suppurations.
IGNATIA AMAIA.
In the headaches of those who are a prey to long continued and deep-seated grief; although Arsenicum, Aurum,
or Causticum may be required in alternation.
In beating pains in the left side of the occiput, and
especially against those which are most severe over the root
of the nose.
LACHESIS.
From Hering's experiments it seems most suited to oppressive headaches, attended with nausea and giddiness;
those brought on by slight exposure to the sun, soon becoming violent and throbbing, with nausea, vomiting of green




GRAT. HEP.) IGN., LACI., LYCOP., MER0C. IAGNES.   119
bile, bad taste in the mouth, loss of appetite, flatulence, excessive restlessness, &c. In headaches which last three days,
become severe and congestive, with great drowsiness.  In
violent beating and throbbing headaches just before the
menses set in, with nausea, bad taste in the mouth, heartburn, and scanty menstruation.
LYCOPODIUMi.
CASE 148.-A lady, aged 50, had suffered for a long time
with painful and violent pressure on the left side of the top of
the head, attended with redness of the face, heat, agitation,
loss of sleep, aching and cramps in the stomach, periodical
vomiting, and constipation.
/Treatment.-She had been treated allopathically in vain;
Lycopod. 30, followed in twenty-one days by Nux 30, cured
her entirely in three months.-Beauvais, vol. 1, p. 574.DR. KRAMER.
MERCURIUS.
Especially in simple, recurring, and bilious headaches,
arising frequently from the slightest cold, and being decidedly most severe at night.
In pains about the head connected with irritation of the
fibrous tissues, although Iod. pot., and Aurum, or Katrum m.
may often be required in alternation.
Against rending and tearing pains, and especially against
burning on the top of the head.
MAGNESIA CARBONICA.
CASE 149.-A  lady, aged 23, had suffered for several
years with an affection of the head, marked by shooting pains
in the temples and forehead, coming on every morning, but
ceasing after mid-day. These pains were particularly violent
during the period of menstruation; then they forced her to lie
down, and were attended with vomiting. Her menses were
always scanty; she was constipated; and had a feeling of
anxiety, and palpitation of the heart almost every evening,
after lying down.




120                    SYNOPSIS.
Treatnent. —She took Magnes. carb. 30; her menses set in
sooner than usual, were more copious, and not attended with
headache or vomiting; followed by fiequent bleedings of the
nose, with relief fiom oppression of the chest; her stools
became regular. Very slight returns of headache, &c., were
removed by Lycopod. 30. —Beauvais, vol. 1, p. 553. —DR.
IIARTLAUB.
NATRUM MURIATICUM.
In headaches connected with obstinate and protracted
chlorosis; defective nutrition; dingy, flaccid, torpid skin; with
much nausea and tendency to fainting. Ferr., Calc. or Plumbum may also be required.
In daily headaches persisting for 20 days, relieved in the
open air, but increased by exercise. (See IHepar and Cale.)
Throbbing headaches every morning, especially during
menstruation, commencing in the nape and back of the head,
extending to the forehead, followed by eructations, nausea,
vertigo, and dimness of vision.
NUX VOMICA.
For the fullest information, and a most admirable resumen of
the action of this, and many other remedies, see Noack and
Trink's remarks, reported in Jahr's New Manual, or Symptomen-Codex, translated by Chas. J. Hempel, M.D.
CASE 150.-M. R., a teacher, had suffered for a long time
with severe pain in the head, frequent eructations, with inclination to vomit, and actual vomiting, sometimes of mucus, at
others of food, followed by more or less relief; his pains were
most violent in the morning, aggravated by smoking, and his
appetite was often poor.
Treatment.-N-ux 24, relieved him  entirely.-Beauvais,
vol. 1, p. 552.-DR. JUNGHANSEL.
CASE 151.-J. D., aged 52, a thick-set, healthy working
man was attacked suddenly, without known cause, with pain
on the left side of the head, attended with drawing and shootings; it returned every day at a certain hour, became more and
more violent, especially after dinner, and then lasted for about




NATRUM, NUX V., OPIUM, PHOSPIOR.       121
three hours; during the paroxysms he had an entire loss of
appetite, became feverish, with a quick and hard pulse, redness of the skin, and was obliged to lie down; towards the end
of the attack he perspired a little; he had a bitter taste in his
mouth, but little appetite, no thirst; his stools were regular
and urine normal. He had already been sick for ten days,
and was becoming irritable.
Tlireatment. —Nux 24, one drop; the next paroxysm was
lighter; the second very slight; and he had no subsequent
attack for at least six months.-B-ieauvais, vol. 1, p. 568.
CASE 152.-A lady, past the critical age, had suffered for
twenty years with severe headache, which changed its locality
frequently; it consisted in drawing and cutting pains, more or
less intense, with throbbing and aching in the temples; it often
commenced in the back of the head, then suddenly spread to
the whole head, attended with pain in the eyes; her head was
hot; urine pale and spasmodic, rarely of a natural color, but
often slightly red during the attacks. The paroxysms were
most severe when the weather was cold and wet, and most
frequent in winter; her hair was becoming gray, and fell out
in abundance after each attack.:Treatment.-One dose of Nux every six hours, followed by
some relief; then other remedies were used without benefit,
until Nux was again administered; when Nux was omitted
again, the attacks became more frequent and severe; when it
was resumed every two hours, relief again followed, and lasted
for two months.-Beauvais, vol. 2, p. 30.-DR. ScnMID.
OPIUM.
Has been fully treated of at page 66.
PHOSPHORUS.
Against obstinate tendency to congestion of the head,
which resists Acon., Bell. and Opium.
Chronic irritation of the brain-and headache from the
slightest vexation.
Headache in the forehead over the eyes, for two days in
succession, lasting from morning until evening.




122                    SYNOPSIS.
Headache every morning on awaking.
Periodical jerking-throbbing headache over the root of the
nose, for eight days in succession, always commencing about
nine o'clock in the morning, and most violent about noon,
when vomiting sets in.
Headache as if the head would burst, so severe as to force
one to cry out-lasting from 6 A. TI.~ until evening.
Headache in the forehead and over the left eye, every
morning for twenty-one days in succession, waking one from
sleep, and gradually ceasing after getting up and walking about.
CASE 153. —Miss K., aged 24 years, had suffered from
early youth with an affection of the head, marked by constant
slight pain; and by violent paroxysms several times a week,
lasting for a day and night, especially if she had been exposed
to a current of air; in the severe attacks the pain became
lancinating, commencing in the forehead, extending to the
right temple and occiput; her head became heavy, she was
obliged to lie down; the pain was increased by eating; she
was not able to stoop, as her sight became confused, and the
blood rushed to her head; she had but little appetite in general, and often none at all; her bowels were regular; menses
scanty, although they lasted eight days, during all of which
time the sufferings in her head were much increased.
_Treatment. —Sepia 30, was given without effect; Cale. c.
30, with partial relief; but after taking Phosphor. 30, she was
entirely cured. —Beauvais, vol 1, p. 566.-Dr. HARTLAUB.
PLATINA.
In headaches of females with an excitable vascular system,
too frequent and copious menstruation; especially when the
pains increase in severity up to 10 o'clock at night, and are
attended with great anguish, burning heat, bright redness of
the face, and violent thirst, followed by perspiration.
PULSATILLA. (See page'74.)
CASE 154.-A young lady, aged 23, had suffered with
headache for twelve days, after her second confinement.




PLATINA, PULSATILLA) RHUS.          123
Symptoms.-Extremely severe pain at intervals, every day,
lasting from six to ten hours, attended with cutting pains in
the top of the head, and burning in the eyes; nausea soon set
in, her mouth became dry and her face flushed; she was
obliged to keep the recumbent posture, and dared not make
the slightest movement; it seemed as if her head would burst;
her pains had increased in severity every day; at first they
had been relieved by tyinig a handkerchief around her head,
but now, only the most violent pressure by a stout person, with
both hands on her head, afforded her any comfort.
2Treatment. —She had been treated allopathically without
benefit, for twelve days; then one dose of Pulsat. was given;
the next day she only felt a little confusion and heaviness of
the head, and on the second day she was well.-Beauvais'
Clinique, vol. 1, p. 556. —DR. BETIIMIAN.
CASE 155.-A robust woman, aged 32, had suffered for
several months with a disagreeable drawing and twitching
pain in the left temple; it ceased during the day, but returned
regularly every evening and deprived her of rest at night; she
had constant noises in the ears and head, both by day and
night, both when at rest and when in motion, but more severe
in the evening, and then attended with a sensation as if the
left side of the vertex were lifted up, and off. This affection
of the head, and especially the accompanying sleeplessness, had
weakened her very much, and her memory in particular had
suffered. She also had twitchings in the left ear, dimness of
vision, and for six weeks had been annoyed by a discharge of
acrid blood from the vagina; her pulse was small; her temper
quiet and patient, but if she closed her eyes she fell into a
state of mournful reverie.
Treatment. —She had been bled without relief; then Pulsat.
3, was given, and in the course of six days she was almost
entirely well. A relapse, three weeks after, from taking cold,
was cured in nine days by Rhus.-Beauvais, vol. 1, p. 551.DR. BETiTMAN.
RHllUS TOXICODENDRON.
In headaches which set in after every meal, from the least
chagrin, or from exercise in the open air, lasting from 5 P. M.




124                    SYNOPSIS.
till bed-time, commencing in the occiput and nape, and
extending to the ears, nose, cheek-bones and teeth. Against
a peculiarly severe degree of heaviness in the head.
CASE 156.-M-rs. F., aged 37, always subject to headache,
had suffered almost constantly for two months, with throbbing,
aching, and tearing pains on the top of the head, and in the
temples, often accompanied with general trembling of the
body; the pains were more severe in the morning, than in the
evening; menses regular; general health good.
Treatment.-IBlryon. caused some relief, but Rhus cured her
entirely in five weeks, after an aggravation lasting several
days. —Beauvais, vol. 1, p. 573.
CASE 157.-Mrs. E. suffered with incessant pains in the
whole of the head, in the nape and shoulders, with excessive
debility, and entire loss of sleep.
reatrtment.-She had been treated in vain by an able allopath with anti-spasmodics, narcotics, vesicatories, &c.; one
dose of Rhus removed the pains in the head and nape,
and restored her sleep; several doses restored her to health.
— Beaunvais, vol. 2, p. 24. —DR. PESCHIER.
SANGUINARIA CANADENSIS.
In sick-headaches with excessive vomiting, water-brash,
vomiting of bitter substances; in throbbing headaches with
congestion to the head, noises in the ears and fever; in headaches attended with chills, nausea, rheumatic pains and stiffness in the nape and limbs, pain in the whole left side of the
head, and in the left foot.
SEPIA.
(See page 78.) In the headaches which attend scanty or
suppressed menstruation, watery, mucous, sanguineo-mucous,
whitish and milk-like, yellowish or purulent, and greenish-red
leucorrllcea, with induration of the neck of the uterus. (See
Arsen., Creosote, Platina, and other remedies.)
CASE 158.-Miss N., aged 25, blond and thin, had suffered
for five years with an affection of the head, which had become




SANGUINARIA, SEPIA.              125
especially severe during the last two. It commenced with
aching in the left supraorbital region, so that she was obliged
to press forcibly upon the eye with her hand; she also had a
feeling of dryness and roughness in the eye, and an indescribable pain in all the head. She had such an attack every
week, but the approach of her menses, or any unusual emotion,
rendered them  very severe. She generally waked in the
morning with pain, then had no appetite, and was obliged to
keep her bed if the sufferings were severe; the paroxysms
lasted five or six days, were attended with inclination to
vomit, and at times with sudden but transient vertigo, which
almost caused her to fall to the ground.
Treatment.-She took ten doses of Sepia 30, at intervals of
ten or fourteen days, and although she had two severe attacks
during the three months' treatment, she was then entirely
relieved of her headaches. —Beauvais, vol. 2, p. 8. —GmEsSELICH.
CASE 159.-Mrs. L., a delicate but healthy brunette, had
suffered for several years with attacks of migraine, generally
once a week or month, and lasting from twenty-four to thirtysix hours. The pain commenced in a small spot above the
right or left eye, extended to the back of the head, where the
scalp became very sore to the touch; she was obliged to lie
down and avoid the light, had inclination to vomit, and a bad
taste in the mouth, as if firom indigestion. She had had Tinea
capitis in her youth, and had been subject to pimples on the
face; her menses were frequent and copious; her sleep was
light and disturbed; she had a tendency to congestion to the
head; and the soles of her feet were inclined to burn.
Treatment. She took twelve doses of Sepia 30, at intervals
of seven or ten days, and was entirely cured of her headaches
in three months, although Sepia rather increased a leucorrhcea
with which she had been annoyed fbr a long time. —B3eauvais,
vol. 2, p. 9. —DE. GRIESSELICH.
CASE 160. Miss J. C., aged 10, had suffered for a long time
with attacks of headache, especially after active exercise, such as
running or jumping; the paroxysms came on at night, as often




126                    SYNOPSIS.
as every two or three weeks; they consisted of pain above one
eye, attended with copious vomiting of mucus.
Treatment.-Bellad. and Nux were given without much
benefit, but three doses of Sepia 30, cured her entirely. The
attacks at first became milder, and were not attended with
vomiting, then ceased entirely.-Ibid., p. 10.
CASE 161.-Mrs. P. R., aged 33, had suffered with headache since her youth, but more severely for the last six
months; the attacks came on every five or six weeks, always
commencing in the morning as soon as she rose; then the
pain became more and more severe, unless she lay down, when
it terminated in sleep; she had a pressure and heaviness in
the forehead, eyes and root of the nose, attended at times
with beating in the head, extending occasionally as-far as the
occiput. For two days after an attack she was so feeble that
she could scarcely rise. For the last six months the headaches
had been attended with retching to vomit, always occurring
about seven or eight o'clock in the evening. During the
intervals of relief, she had confusion of the head with pressure
upon the eyes, often attended with heat in and congestion to
the head; she had but little appetite, and drank but seldom;
had been constipated from her youth; her sleep was heavy,
often with troubled dreams, and a paroxysm was generally
preceded by a very deep sleep, and by very frightful dreams.
iHer menses were regular, but rather scanty, and she was often
troubled with leucorrhcea. She was becoming inclined to
melancholy; and was rather subject to coughs.
Treatment. —She took four doses of Sepia 30, one every
eight days; then two doses, one every fifteen days; at the end
of which time she seemed cured, as she had had no headache
for two months, her general health was improved, and her
spirits good. —Ibid., p. 11.
CASE 162. — rs. K. R. N., aged 46, stout and strong, had
been subject to attacks of headache every three months, ever
since she became regular for the first time, but they were
becoming more violent, and her physician had announced
that he could not cure her. The attacks for the last year had




SEPIA.                     127
come on every month, at the menstrual period, two days
before which she always felt a vague but very severe pain
above the right eye; her head became hot; speaking, light,
and noise augmented her pains, so that she was obliged to lie
down in a room with closed doors and shutters; she suffered
night and day without cessation; had sleeplessness and vertigo
during the whole period of menstruation, after which the
headache changed to a pain in the left temple attended with
such acidity of the stomach, that it seemed as if she were
under the influence of some corrosive poison, from which,
however, she was soon relieved by vomiting. If the headache
did not come on before, it was sure to set in during menstruation; the attacks lasted about eight days, but occasionally
left behind them a pain on the top of the head, as if it would
be forced open, often extending to the occiput, and plunging
her into despair. Her mlenses anticipated two days, and were
very abundant, attended with urgency to urinate, and with
diarrhcea; at other times she was rather constipated; she had
had an attack of gout eighteen years before, of which traces
were still present about her hands.
Treatment. —Six doses of Nux 30, at intervals of five or six
days, exerted no effect upon her head, although her menses
became less copious, and her gouty hand improved; then three
doses of Sepia 30, at intervals of eight days, relieved her so
much that she only felt some heaviness of the head at the
next menstrual period; two doses more of Sepia 30, at intervals of fifteen days, cured her entirely.-Ibid., p. 12.
CASE 163.-A lady, vigorous and brunette, aged 30, had
suffered with migraines ever since her youth, and before she
became regular for the first time. For the last six or eight
years they had become more frequent and severe, so that a
day scarcely passed without some suffering, which, however,
was most severe during menstruation. If she rode in a
carriage, or looked at any object attentively for some time,
she was sure to have an attack; the paroxysms generally
commenced in the morning; she was soon obliged to lie down,
and if she could get asleep, she would wake up well; incli



128                    SYNOPSIS.
nation to vomit and actual vomiting often set in; the pain
generally attacked one side of the head, although at times it
settled in both temples; menses, and general health normal.
Treatment.-She had but one or two slight attacks after
commencing the use of Sepia 30, one dose every five days.Ibid., p. 13.
CASE 164.-A servant girl, aged 19 years, had suffered
for five years with headache, which had increased in violence
during the last two; formerly she had attacks only every
week, now almost every day, especially in the afternoon or
evening.
Symptorms.-She had throbbing in the head, especially on
stooping; tearing and lancinating pains in the forehead and
face, as if her head had been bruised, often so violent as to
oblige her to lie down, when vomiting of bile relieved her for
some time. Her menses were always scanty and infreqluent,
coming on only every five or six weeks; her stools were also
scanty, and took place only every second day.
Treatrment.-Pulsat. 12, relieved her head somewhat, and
her menses became more free; 1Nux 24, rendered her less
costive; and Sepia 30, restored her entirely to health, the cure
lasting for at least two years, at last accounts.-Beauvais,
vol. 2, p. 28.-DR. SCHULL.
SILICEA.
In headaches attended, or followed by severe pain in the
small of the back, with heaviness and uncomfortable feeling
in all the limbs.
Obstinate morning headaches, with chilliness and nausea.
CASE 165. — liss N., aged 26, had suffered for several
years with a periodical affection of the head, the paroxysms
of which lasted several entire weeks. Her former physician
had declared her incurable.
Symptoms. —She had lancinating and drawing pains, sometimes commencing near one temple, at times in both, from
whence they extended down into the bones of the face and
lower jaw, where they generally attained their greatest inten



SILICEA, SPIGELIA, STAPHYSAGRIA.       129
sity. The pain became lancinating in the chin and extended
to the teeth, which were in an imperfect state. The pains
were present during the day, were often felt in the evening,
and commonly awakened her after mid-night. Changes of
air did not influence the pains in the head, but exposure to a
current of air would. At times the localities of the pains
were exceedingly sensitive to touch, at others pressure lessened
them. She had long suffered with decayed teeth; was otherwise healthy, and not subject to eruptions.
fTeatmenrt.-IBellad. 30, produced no relief in two weeks;
then Silex 30, was followed by relief, more or less great for a
fortnight; in two weeks more, the pain ceased entirely and did
not trouble her again for at least nine months, at last account.
-IBeauvais, vol. 1, p. 567.-DR. D HARTLAUB.
SPIGELIA MARILANDICA
Is a main remedy in the headaches of very hysterical
subjects with excitable circulation, subject to violent pain in
the back of the head, vertigo, dimness of vision, dilated pupils,
to the peculiar hysterical spasms of the eye-lids and face, and
even to general convulsions.
Headaches attended with fatiguing palpitations of the heart.
STAPHYSAGRIA.
CASE 166.-An elderly lady had suffered for a long time
with violent headache; she awoke in the morning without
pain, but while engaged in dressing, washing, or brushing
her teeth, throbbing and boring pains set in, in the forehead
and part of the left temple; they were increased by lying
down again, but gradually became more supportable after
sitting down quietly for some time; the pains also diminished
gradually in severity during the morning, and disappeared
entirely during dinner, but recurred immediately afterwards,
although in a moderated degree, and soon ceased entirely for
the day, if the patient did not indulge in an afternoon nap.
Treatment.-One dose of Staphysag. removed the disorder
immediately and it did not occur again; she soon could dress
9




130                    sYNOPSIS.
with comfort, and indulge in her after dinner nap with impunity.-IEGIDI.-Attomyr, p. 477.
SULPHIIUR.
In the most obstinate and chronic rheumatic headaches,
with tearing pains.
In chronic periodical headaches, occurring every other
morning, at 8 or 9 o'clock and continuing till bed-time; or
every eight days, attended with tearing pains and stupefaction;
or violent headache on the top of the head, lasting for twelve
hours, and recurring every morning like a periodical fever.
Headaches followed by fetid perspirations.
CASE 167.-A man who worked daily in brass and tin,
and who also used paint and varnish occasionally, had suffered
for several years with a kind of periodical headache. Every
Sunday he experienced a pressure, aching and heaviness of
the head, which lasted the whole day and was attended with
lassitude, and loss of appetite. On the other six days, he felt
nothing of the kind.
Treatment.-Bryon. and Nux were given without benefit;
then one dose of Sulph. 3, every six weeks, cured him completely. —Beauvais, vol. 1, p. 551.-DR. SCHULER.
CASE 168.-SCHELLING cured two cases of regularly intermeitting Heemicrania, in young persons, with Sulph. 8. One
cure was effected in four days, the other in five.-Attomyr,
page 477.
CASE 169.-An excitable brunette, aged 30, had suffered
for many years with a violent, periodical headache, always
occurring simultaneously with the monthly period, and
characterized by a raging and painful hammering in the
forehead and left temple, which was very much increased by
mental emotions, or exertion. She had great irritability of
all the senses, pulsations in every part of the body, chilliness
of the body with glowing hot face, occasional bleeding from
the nose, far sightedness, and roaring in the left ear, when
she lay upon it; her stools were hard and difficult; her hair
fell out profusely; she was irritable and inclined to anger.




SULPHUR, VERATRUM ALBUM.            131
Treatment.-Three doses of Sulph. 30, one dose every three
days, followed after the lapse of four weeks by Sepia 30. She
was entirely cured by this course of medication, and it seemed
as if Sulph. was by far the most beneficial remedy.-Attomyr,
p. 478.-DR. WURDA.
VERATRUM[ ALBUM.
It acts upon the nerves of sensation as specifically as Nux wv.
does upon the nerves of motion; and acts upon the cerebral
nerves much less decidedly than upon the great sympathetic,
and spinal nerves of sensation. Veratrunz and Veratrine
excite and arouse the nerves of sensation, Aconite stupefies or
paralyzes them.
On account of its specific action upon the abdominal organs
and nerves and secondary action upon the head, it becomes a
principal remedy in the true dyspeptic or sica-headache.
The indications for its use are numerous and important. It
is useful in headaches attended with vomiting of green mucus;
in those with pain in the small of the back, colic, and desire
to vomit; in violent headache, attended with profuse flow of
urine; aching pain in one side of the head, with pain in the
stomach; severe headache, increased while the patient is
walking, to such a degree that he staggers; drawing pain in
the head, and in the small of the back; excessive headache,
ceasing on the setting in of the menses. Headache with
feeling as if the hairs were electrified, with tendency of them
to stand on end.
In nervous headaches and nervous conditions attended with
electric sensations; electric current in the nerves radiating in
various directions; sensation as if boiling water were running
down the back; electric current shooting to the nervous
plexuses of the abdomen, breast and heart; pricking and
tingling sensations in various parts, or burning and prickling
sensations followed by electric emanations shooting in every
direction; feeling as if cold air were blowing on several parts
of the body, followed or not by sensation as if hot drops were
poured on the limbs. Intense feeling of pain extending over




132                      SYNOPSIS.
the peripheral nerves, with drawing pains all along the spinal
marrow, &c.
In headaches attended with burning, or a peculiar feeling
of coldness in the stomach; with water-brash, disgust for food,
nausea, colic and diarrhcea, irritation of the bladder, pains in
the back, hips and knees, and increased flow of menses.
Headache with constant sickness at the stomach, with
spinal irritation, constant twitchings of the limbs, diarrhea,
increased secretion of bile.
It cures headaches, and neuralgic pains which shoot to
various parts, much more readily than it does fixed pains.
I have succeeded in curing several most obstinate and
distressing headaches with Tinct. Verat., and with the 2d or
3d dilution of Tinct. Veratrine.




INDEX.
A.                                                    PAGM
PAGE      Coloc.,...     114
Aconite, remarks on,.   1, 4, 102      Gratiola,....   118
Cases 1,2,.... 2, 3        Merc.,....        119
Dose,.             4   Bernard, Experiments on SymAdditional Cases,           vii, 101       pathetic Nerve.          xiii
Cases 2, 3, 5, 6, 7, 18, 19, 20,     Bryonia, remarks on,     19,23, 108
40, 41, 47, 55, 56, 58, 59, 62,      Cases 21 to 26,          20 to 22
63, 64, 71, 82, 83, 84, 85, 86,      Case 135,..         109
89, 98, 111, 112, and 128            Dose....    23, 24
to 169 inclusive.                 Budge, Experiments on Corpus
Acidity of Stomach in Headache,  xv         striatum, &c.,.   ~    xiv
"  Nervous-bilious Headache, xvi
Agaricus, remarks on,. 4, 102
Case 3,.~.,,'        Calcarea, remarks on,    24, 28,109
Dose,.                          5      Cases 27 to36,..25 to 28
Anatomy of Great Sympathetic             Dose,...        29, 30
Nerve,.... xvi   Camphor, remarks on,.   30, 110
Arnica, remarks on,. 6, 103      Case7        39,               30
Case 4,                         6                                     31
Dose,.                          6    CGarbo animalis, remarks on,  31, 110
Anaemic Headache,.     xxvi       Dose, xxv31
Arsen.,.                     G.'~.  9 Carbo vegetabilis, remarks on,   110
Bell.,                        12       Cases 40, 41,..       31
Cale. c.,                 25,109       Case 136,....  111
China,               35, 112, 113      Dose,                         31
Natrum m.,..         55,120    Catarrhal Headaches               96
Sepia,                        79    Capsicum, remarks on,        32, 111
Arsen.,.103    Dose23
Arsenicum, remarks on  7, 8, 103,104    Causticum, remarks on,     32, 112
67Cases5 6,7,                        Cases 43, 44. 33
Cases 128, 129, 130,          104      Case 137,...   112
Dose.10            Dose,                          33
Asarum europcum, remarks one  105    Chamomilla, remarks on,  33, 34, 112
Asarum europCunm, remarks on,. 104                                     3
Case 8,..        10       Case 45,..       34
Dose,..10 
Arum, remarks on,.          105    China, remarks on    34 35, 36,112
Aurum, remarks on,. 11,105       Cases 46, 47,.                35
ArDose,..  11,105        Cases 138, 139,.   113
Dose,                1       Dose,                     36, 113
a.                    Cocculus, remarks on,.    36, 113
Belladonna, remarks on,  11, 12, 16,     Cases 48, 140,..  37, 114
17, 74, 106 to 108    Dose,....         44
Cases 9 to 17,.    12 to 16    Coffea, remarks on,          38, 39
Cases 131 to 134,.      107    Colocynth, remarks on,   40, 42, 114
Dose...      17, 18      Cases 50, 51, 52,.        41
Bilious sick Headache,. xv, xvi     Dose,42
Agar.                        102    Claude Bernard, on Sympathetic
Carb. an.,                   110        Nerve,.... xiii
Cham.,....  112.6rjPs Striatum,.       xiv




134                              INDEX.
PAGE                                   PAGE
Corpora quadrigemina,.        xiv.
Course of Headache along the          Hepar sulph., remarks on,. 45, 118
Sympathetic Nerve,.      ii     Cases 55 56,...   45
Congestive Theory of Headache, xxiii   Headache from irritation of eyes
Congestive Headaches,  xxiii to xxvi       and Iris,            xvii, 18, 74
Acon.,..    2, 3, 102 
Agaricus,..4, 5                                 I.
Aurum,                    11, 105   Ignatia, remarks on,.    45, 118
Bell.,.  11, 12, 13, 23,106     Case 59,...       46
Bryonia,...  19,108    Dose,....    47
Calcarea,.. 24, 29, 109   INTRODUCTION,             xi to xxviii
Camphor,... 30, 110   Iris versicolor, remarks on,.  47
Carb. an.,...           3      Dose,....    47
Carbo. veg.,..    31, 111                     L.
Capsicum,....   32   Lachesis, remarks on,.47, 118
China,             34,35, 67, 112     Cases 58, 59,.           47
Crocus,                  43, 115      Dose,                          48
Magnet.,                      48   Lycopodium, Case 148,.    119
Natrum on.,.. 52, 56   List of Remedies for Headache     1
Nux vom....   57, 63
Opium,                        67                     M.
Phosphor.,..       67, 121    Magnet. Case 60,.           48
Sanguinaria,.         77, 124   Magnesia carb. Case 149,        119
Sepia,....  78, 83   Mercurius, remarks on,  49 to 52, 119
Silex,....   84        Cases 61 to 64,. 50
Sulphur,...   91, 93         Dose,.52
Constant Headache, Arsen., case       Menstrual Headaches, Aurum, 11, 105
7; Bell., cases 9, 11,14, 17;       Arnica,..103
Bryon., case 25; Calcarea,          Asarunm,                   10, 105
p. 25, 26, 29.  Camphor,            Bell.,                        106
case 37; Carb. veg., case 41  Bryon.,                              22
Causticum, case 42; Hepar           Calc. c.,. 25 to 28, 110
s., case 55; Ignat., case 57;       Caust.,..    32, 112
Lachesis, case 59; Merc.,            Cham.,...            113
cases 61, 62, 63, 64; Natrum        C                          35, 11
m., p. 52, cases 68, 71; Nux,37, 114
cases 77, 78, 80, 81, 86;           Crocus,                   43, 115
Phosphor., case 88; Platina,         Creosote,                    115
case 89; Puls., cases 92, 93,       Lachesis,                     119
95, 97, 98; Sepia, p. 78,           Magnes.c.,. 119
cases 105, 106,110,111, 112;        Natrum,.             54, 5
Silex, p. 84. Spigelia, p. 87,120   Nux,.57
Phos.,....    122
Creosote, remarks on,.   43, 114    Plat.,.           69, 122
Case 53,....        43      Puls.,..         71, 72, 75,
Dose,...       43      Sepia,.         79, 81, 124 to 128
Crocus, remarks on,.. 43, 115       Spigel.,. 87, 99
Dose,..               44      Sulph.,..130
D.                      Verat.,.132
DOSES, remarks on,... vii   Megrim or Migraine,.. xviii
Dulcamara, Case 54,.         44                     N.
Dose,.. 44   Natrum m., remarks on,.  52, 120
G.                      Cases 65 to 71,..   52 to 55
alonoine, remarks on,.. 115      Dose,...  56
Cases 141 to 147,      115 to 117   Nervous Headaches,             i, xii
Dose,.Ibid.   Nux vomica, remarks on, 56 to 58, 63
Gratiola, remarks on,.     44, 118                               64, 120
Dose,...,.  44          Cases 72 to 86,.. 58 to 62




RNDEX.                                135
PAGE                                    PAG
Cases 150 to 152,. 120                                s.
Dose,.                       64   Sanguinaria, remarks on,   77, 124
o.                       Cases 100, 101,                77
Opium, remarks on,            65, 66      Dose,.                   77
Cases 86, 87,...  65   Sepia, remarks on, 78, 79, 82, 83,124
Dose,. 66      Cases 102 to 111,.    79 to 82
P.                       Cases 158 to 164,.    125 to 128
Phosphor., remarks on,  67, 121, 122      Dose,.         83, 84
Case 88,...  67   Sick Headaches,    xi, xii, xx, 96, 74
Case 153,.                 122      Acon.,..            102
Dose,..                       69       Ars.,..            104
Platina, remarks on,         69, 122      Arum..105
Case 89,...  69       Aurum,                        105
Dose,.... 70   Carb. an.,                             111
Pulsatilla, remarks on,    70, 74, 75     Carb. v.,.                  112
Cases 90 to 98,.         70 to 73      Caust.,..            112
Cases 154, 155,..        123       Cocc.,..               113
Dose,.                 76       Creos.,...         114
PREFACE,..            to x      Lach.,.                119
Pain, remarks on,.               viii     Lycopod.,.               119
Periodical Headaches,           xviii     Magnes,..                119
Agar...                        5      Natrum,..             120
Arsen.,.       9, 104      Phos.,..              122
Asar.,..           10, 105      Rhus,... 123
Aurum,..             11      Sanguin.,..            124
Bell.,.         12,13,14, 106       Sepia,
Bryon.,...  21, 22   Silex, remarks on,.           84, 128
Calc., Carb. v.,.      31, 111      Cases 113, 165,.        84, 128
China,..                35      Dose,..                   85
Cocc.,..       37   Successful cases,..       x
Coloc.,...     41    Spigelia, remarks on, 85, 86, 89, 90,
Crocus,... 43                                      129
Merc.,... 49, 52         Cases 114 to 120,.     6 to 88
Natrum mur.,.       52, 120       Dose,.              90
Nux,..    57, 58, 59, 60, 63   STATISrICS of Cures of Headache,  ix
Puls.,.                71, 75    Staphysagria. Case 120,.        89
Sanguinaria,.               79      Case 166,...     129
Sepia,.. 81 125, 126   Sulphur, remarks on,            90, 130
Spigelia,..           86, 89      Cases 121 to 126,.         91,92
Sulphur,.             93, 130      Cases 167,168, 169,..   130
Glonoine,.                 116   Dose,....          93
fMagnes. c.,. 119    Thuja, remarks on,              94
Phos...                       122  Dose,..94
Silex,....128.
R.
~R.             K ~Veratrumn remarks on. 94,131
Rhus toxicod., remarks on,   76, 123      Dose..    94  95
Case 99,.             76       Dose, 
Cases 156,..         124                      z.
Dose,.           76    Zincum, Case 127,..          95
Rheumatic Headaches,           xxvii      Dose,..               95
NOTICE.
To obtain the most rapid yet thorough and practical knowledge of the contents of' this
volume:
1st. Glance over the Preface and Introduetion;
2d. Read carefully the remarks on the action of the different remedies against headache,
in the Synopsis.
3d. Read the General Remarks before, and the Revieos and Notes, after the cases given
in the body of the work.
4th. Look over the Cases both in the body of the work, and in the Synopsis.
5th. Finally, make use of the Generag Review and Indexn.




HOM(EOPATHIC MEDICINES.
WM. RADDE, 322 Broadway, New York, respectfully informs the Homceopathic
Physicians, and the friends of the System, that he is the sole Agent for the Leipzig
Central Homceopathic Pharmacy, and that he has always on hand a good assortment of the best Homceopathic Medicines, in complete sets or by single vials, in
Tinctures, Dilutions and Triturations; also, Pocket Cases of Mledicines; Physicians' and Family Mfedicine Chests to Laurie's Domestic (60 to 82 Remedies)
-EPP'S (60 Remedies)-HERING'S (60 Remedies to 102).-Small Pocket
Cases at $3, with Family Guide and 27 Remedies —Cases containing 415 vials,
with Tinctures and Triturations for Physicians.-Cases with 260 Vials of Tinctures and Triturations to Jahr's New Manual, or Symptomen-Codex. —Physicians'
Pocket Cases, with 60 Vials of Tinctures and Triturations.-Cases fiom  200 to
300 Vials, with low and high dilutions of medicated pellets.-Cases from 50 to
80 Vials of low and high dilutions, &c., &c. Homceopathic Chocolate. Refined
Sugar of Milk, pure Globules, &c. Arnica Tincture, the best specific remedy for
bruises, sprains, wounds, &c. Arnica Plaster, the best application for Corns.
Urtica urens and Dr. Reisig's Homoeopathic Pain Extractor are the best specific
remedies for Burns. Also, Books, Pamphlets, and Standard Works on the
System, in the English, French, and German languages.
HOM(EOPATHIC BOOKS.
JAHR'S NEW  MANUAL OF HOM(EOPATHIC  PRACTICE; edited, with
Annotations, by A. Gerald Hull, M. D. From the last Paris edition. This
is the fourth American edition of a very celebrated work, written in French
by the eminent Homceopathic Professor Jahr, and it is considered the best
practical compendium of this extraordinary science that has yet been composed. After a very judicious and instructive introduction, the work presents a Table of the Homemopathic Medicines, with their names in Latin,
English and German; the order in which they are to be studied, with their
most important distinctions, and clinical illustrations of their symptoms and
effects upon the various organs and functions of the human system. The
second volume embraces an elaborate Analysis of the indications in disease,
of the medicines adapted to cure, and a Glossary of the technics used in the
work, arranged so luminously as to form an admirable guide to every medical student The whole system is here displayed with a modesty of pretension, and a scrupulosity in statement, well calculated to bespeak candid
investigation.  This laborious work is indispensable to the students and
practitioners of Iomceopathy, and highly interesting to medical and scientific men of all classes. Complete Symptomatology and Repertory, 2 vols.
bound, $6.
JAHI R'S NEW MANUAL: originally published under the name of SYrMTOMENCODFX. (Digest of Symptoms.) This work is intended to facilitate a comparison of the parallel symptoms of the various Homueopathic agents,
thereby enabling the practitioner to discover the characteristic symptoms
of each drug, and to determine with ease and correctness what remedy is
most Ionmceopathic to the existing group of symptoms. Translated with
important and extensive additions from various sources, by Charles Julius
Hempel, AM. D., assisted by James M. Quin, M. D., with revisions and clinical notes by John F. Gray, M. D.; contributions by Drs. A. Gerald Hull,
George W. Cook, and Dr. B. F. Joslin of New-York; and Drs. C. Heriglo
J. Jeanes, C. Neidhard, W. Williamson, and J. Kitchen, of Philadelphia;
with a Preface by Constantine Hering, M. D., 2 vols., bound 11
1




TREATISE  ON APOPLEXY:
WITH AN APPENDIX
ON
SOFTENING OF THE BRAIN, AND PARALYSIS.








ON THE
NATURE AND CAUSES
OF
APOPLEXY.
APOPLEXY has generally been regarded as so, simple and
decided in its nature and required treatment, that any selfsufficient and semi-ignorant physician who knows how to
bleed and purge, has been thought competent to understand
and manage it. But the truth is, as COrEL'D says: There
are but few diseases which present a greater variety of modes
of attack; or which arise from a greater number of affections
both of the brain and its vessels, or of other and remote
parts; or which differ so widely in the extent and severity
of the injury done to the brain;-consequently there are
but few diseases which require such precise and prompt, but
varied, and comprehensive treatment. A glance at some of
the names of the different admitted varieties of Apoplexy,
will render this more evident than many words; we have:
(1.) Apoplexy from excess of blood in the whole system;
the quantity of blood being absolutely greater than the
organism requires for its proper nutrition and sustenance
(PLETHORIC APOPLEXY).
(2.) Apoplexy from retention, or rush of blood to the
head, without rupture of any blood-vessel, or excess of blood
in the system (CONGESTIVE APOPLEXY).
(3.) Apoplexy from rupture of some blood-vessel, in, or
about the brain, not necessarily caused by plethora or congestion, but frequently arising from brittleness, or other disease of the arteries of the brain (H&MoRREAIC A POPLEXY).
12




138                    APOPLEXY.
(4.) Apoplexy from debility, or other nervous disorder of
the brain, or nervous system, and not necessarily accompanied with any disease of the blood, or blood-vessels (NERVOUS
APOPLEXY).
(5.) From an increased quantity of watery fluid poured out
suddenly upon, or in the brain (sEROUS APOPLEXY).
(6.) From primary disease, or enlargement of the heart
(CARDIAC APOPLEXY).
(7.) From disease, or disorder of the liver, and retention of
bile in the system, which are notoriously apt to cause heaviness of the system, and drowsiness (BILIOUS, OR HEPATIC
APOPLEXY).
(8.) From  Bright's, or other disease of the kidneys (NEPrRITIC, OR ALBUMINOUS APOPLEXY).
(9.) FEBRILE, OR INFLAMMATORY APOPLEXY.
(10.) From debility, or loss of blood (ASTHENIC, ATONIC, OR
ANEMIC APOPLEXY).
(11.) From indigestion, repletion, or other disorder of the
stomach (GASTRIC APOPLEXY).
(12.) From convulsions in general, and epilepsy in particular (CONVULSIVE, OR SPASMODIC APOPLEXY).
(13.) From the effects of pregnancy (PUERPERAL APOPLEXY).
(14.) From injuries, blows on the head, &c. (TRAUMxrTI
APOPLEXY).
Many other varieties, and very many combinations of these
forms of Apoplexy might easily be given, and I believe that
not only all those above mentioned, but others, also, will be
exemplified by the cases to follow in the body of this work;
but sufficient has been done to give a fair view of the mAany
different causes which are capable of producing Apoplexy,
and to justify at the outset a protest against a routine treatment of all apoplectic conditions.
It must be equally evident that all cases of Apoplexy are
not equally dangerous and fatal; some, will recover with little
or no treatment, mainly by the recuperative powers of
nature; others, will prove fatal in spite of all remedial means,
-either gentle, or heroic. But by far the most dangerous and




nTRODUCrON.                   139
frequent occurrence in Apoplexy, is the rupture of a bloodvessel in, or about the brain; and the result in recovery or death
depends mainly upon the fact whether the artery which has
given way be large or small, the quantity of blood which is
poured in or upon the brain be great or trifling, and the
laceration, contusion or compression of the brain be extensive
or moderate. I repeat that the result in recovery, partial
recovery, or death, does, or ought to depend, as much upon
these circumstances, as upon the mode of treatment; although,
it seems unfortunately, but too probable, that some of the
milder cases are either allowed to progress into the severer
forms by inefficient treatment, or else are treated so savagely
and heroically as to be rendered fatal, when they would have
terminated favorably with very gentle management.
WATSON candidly informs us: that " after a formal attack
of Apoplexy, the results of allopathic treatment will be very
uncertain; a large effusion of blood in, or upon the brain
will prove fatal; a smaller amount of extravasation cannot
be removed at all promptly by ordinary medical means; and
that the best which the unfortunate patient can expect in too
many cases, will be a long-continued or permanent palsy, a
weakening of the mental powers, and sometimes a state nearly
approaching to idiocy."
On the other hand, YELDHAM (see Homceopathy in Acute
Diseases, p. 173) says: "It must not be supposed that
Homceopathy, any more than Allopathy, pretends to cure
every apoplectic pa<'ient; on the contrary, it is well known
that there are many cases (as, for example, where, from the
rupture of a vessel, a large quantity of blood is poured out,
and presses on the brain) in which all medical treatment
must, from a physical necessity, prove unavailing. In cases
of this kind, the two systems, as far as relates to a cure, are
on an equality."  But while I admit th.is, I think it may be
asserted positively that in the majority of these cases, the
most prompt and heroic allopathic treatment does not, and
cannot save life; and that the gentle, or so-called inefficient
bomnioepathic treatment is not the cause of death.




140                     APOPLEXY.
But we are ni't obliged to deal in general assertions only:
COPEMAN has colh 3cted 250 cases of Apoplexy treated allopathically, and many  of them  by the magnates of the profession, such as Morg'agni, Portal, Abercrombie, Andral and
others, and yet only si'xty-eight recovered, seven escaped with
their lives, and no less than 175 died. He says that this
proves, not only, that the mortality from Apoplexy under oldschool treatment is fearf'lly great, but that the proximate
causes of the disease are ei.ther beyond the reach of medical
art, or that the measures usually adopted in the dominant
school are inapplicable, ineffcliesnt, or prejudicial.
In the New-York Hospital froruW 1847 to 1851, of thirty-five
cases of Apoplexy, seventeen cases died, or about one-half;
of seventeen cases reported by Dr. Iluss, in the British and
Foreign Medical Review (see Oct. No., 1846, p. 461), and
treated allopathically, in 1842, eight cases proved fatal, or
about one-half; in the preceding year, however, only four
cases died out of fifteen, or about one-fourth.
On the other hand, we learn from the General HIomeopathic Hospital Report, that of twenty-one cases of Apoplexy
treated according to the views of Hahnemann, six died, or
about one-third; four were not cured, or about one-fifth; and
eleven recovered, or about one-half. These'results are fully
as favorable as those of the best, and much better than the
general average of allopathic treatment; besides, in the
following pages, upwards of sixty cases of recovery from
Apoplexy under homceopathic treatment will be given. Still,
the number which die under both modes of treatment, is certainly sufficiently great to render it but simply just, that each
of the great contending parties should exercise great charity
in judging of each other's practice. It seems equally true
that in the present state of medical science, in at least onefourth of all the cases of Apoplexy, every painful and cruel
endeavor to save the patient's life should be instantly or
quickly abandoned, and the physician's sole and earnest
attention limited to soothing the fast-fleeting moments of
the sufferer.




INTRODUCTION.                  141
Premonitions of Apoplexy.
COPELAND has given the best resume of the premonitory
symptoms of Apoplexy, especially of the plethoric and congestive varieties. HIe says that, " The most common precursory symptoms are: a tendency to sleep at unaccustomed
periods, a heavier sleep than usual, particularly if accompanied
with profound, laborious or stertorous breathing; gritting of
the teeth; nightmare; sudden jerks or starts of the body, when
on the point of falling asleep; lethargic feelings and drowsiness, even during the waking hours; pains in different parts
of the head; or general headache, with a sense of weight or
fulness in the head; and pulsation of the arteries, especially
if there also be a turgid appearance of the veins of the head
and forehead, with lividity or Tedness of the countenance;
slight or imperfect attacks of bleeding from the nose; loss of
recollection, or an unusual serenity, or apathy of the mind; a
disposition to shed tears; more especially if there also be torpor
and numbness, or pricking of the extremities; partial or slight
paralytic affections, marked by distortion of the mouth, drooping of the eyelids, imperfect utterance, or unsteady, or tremulous gait, and tripping on ascending, or descending stairs.
According to DAY, these premonitory symptoms require
the utmost care, and caution on the part of the physician-for
there are various and perfectly distinct conditions which may
give rise to apparently similar head-symptoms; excess of blood
and deficiency of blood; general debility; and an impure
condition of the blood, from poor digestion, or imperfect
action of the skin, liver, kidneys, or bowels, may all give rise
to very similar symptoms. Anaemia, or deficiency of blood,
may very easily be mistaken for hypervemia, or excess of
blood, and simple irritation of the brain may be mistaken for
inflammation.
Headache, vertigo, or dizziness, singing in the ears, and
throbbing of the arteries of the head may arise from either of
the opposite states of excess, or deficiency of blood in the
head. But, if excess of blood be present, the patient generally
presents the appearance of rude health, is stout, short-necked,




142                    APOPLEXY.
and even bull-necked; his face is flushed, he has headache,
a tendency to doze, and dizziness which is increased by stooping, or looking upwards; nausea also is a common symptom of
pressure on the brain.
When there is anvemia, or deficiency of blood in the whole
system, and also in the brain, we usually observe the face to
be pale, the heart's action quick and tumultuous, a tendency
to faintness and dizziness, which are most felt on suddenly
assuming the upright position. Still, the presence of headache, the feeling as if an iron band were around the forehead,
with noises in the ears, throbbing in the head and neck, will
be very apt to mislead the old-school physician, especially as
it unfortunately happens that bleeding will give temporary
relief. Aconite, and other depressing agents must be used
most cautiously by the homceopathist, who fortunately has a
strong prejudice in favor of the use of china in such states.
Again, aged persons are liable to a peculiar form of headaffection, depending for the most part on passive congestion,
arising from want of tone in the vascular system. The
compound infusion of horse-radish is much recommended in
the old practice —Carb. veg., in the new.
There is also a state of brain common in advanced life,
~haracterised by alteration or diminution of the nervous
energy, arising from general debility, over-exertion of the
intellectual faculties, or long-continued anxiety, and distress
of mind. Bleeding would most probably induce incurable
paralysis, while Anacardium, Baryta, or other homceopathic
remedies, may cause great relief.
A few more remarks may be made here, on other of the premonitory symptoms of Apoplexy. A flushed face, tendency to
sleep, dizziness, nausea and headache, have already been
alluded to; but sometimes unusual wakefulness points to an
irritation of the brain, which may bring on Apoplexy, unless
allayed by sedative treatment; a general incapacity for exertion, and an indescribable sensation of weight in the limbs
may arise fiom fulness of blood about the head and spine,
from a sluggish circulation, or from great debility; torpor,




INTRODUCTION.                  143
numbness, or a sense of creeping, crawling or formication,
loss or perversion of feeling, so that everything touched feels
like velvet, or felt, or itching in the limbs may arise from
fulness or sluggishness of the blood, from a purely nervous
affection, or from softening of the brain; slight paralytic
affections, such as drooping of an eyelid, or distortion of the
features, may arise from congestion of the brain, or slight
apoplectic effusion, or from debility of the nerves of the part;
double vision, difficulty of writing in a straight line, or of
reading, the presence of motes or corruscations before the
eyes, noises in the ears, or dulness of hearing, may be caused
by excess or deficiency of blood in the head, by great debility
of the nerves of the eyes or ears, or by indigestion; the substitution of one word for another, difficulty in pronouncing
certain words, a sudden loss of memory, may all arise from
weakness of the brain, a deficient flow of blood to it, or from
the pressure of an excessive quantity of blood.
If the physician can constantly keep these distinctions
and differences in his mind, he will rarely go wrong in his
treatment; unless he be so slavishly wedded to system, that
he will not follow the dictates of his own, and others' reason,
and experience. But it unfortunately happens that in very
many cases no premonitory symptoms precede an attack of
Apoplexy. RocHoux even goes so far as to declare that in 69
cases in which he collected the histories, only 11 presented
precursory symptoms; in such cases a fit of Apoplexy will, of
course, set in without any warning, and the physician must
treat the attack as best he may.
Prevention of Apoplexy.
The principal point generally dwelt on, is: to prevent too
great fulness of blood in the head. This may arise either from
too great a quantity thrown to it, by excessive action of the
heart and arteries (Aconite); or, too great retention of blood
in the brain and head, from retarded circulation (Conium,
Carbo); or from diminished nervous energy (Nux, Plumbum).
HARTMANN says that in most cases we are undoubtedly




144                    APOPLEXY.
called upon to treat, or prevent nervous Apoplexy, because
passive congestive-Apoplexy generally depends on nervous debility; and active congestive-Apoplexy upon nervous irritation
of the brain, exciting increased flow of blood to it; or upon
excitement of the sympathetic nerve, which presides over the
circulation (Veratrum, Nux, Coffea). If there be a ruptu'e
of a small blood-vessel, Arnica, Veratrum, IMillefolium, or
Kreosote deserve attention.
We can prevent too much blood being made, by great care
in diet and regimen. Watson gives the case of Dr. Adam
Ferguson, of Edinburgh, who was a man of full habit, at one
time corpulent and very ruddy, and, though by no means
intemperate, lived fully. He had premonitions of Apoplexy,
to which he paid no attention, and finally, in his 60th
year, had a decided attack of Apoplexy, with paralysis.
He recovered, and then became a strict Pythagorean in his
diet, eating nothing but vegetables, and drinking only water
and milk. He got rid of every paralytic symptom, became
even robust and muscular, and died in full possession of his
faculties, at the advanced age of 93; full thirty years after his
first attack. Long after his 80th year his firm step, and ruddy
cheek, contrasted agreeably and unexpectedly with his silver
locks.
This course of diet is necessarily only suited against true
plethora, or that state of the system in which an absolutely greater quantity of blood is made than the organism
requires for its sustenance.
On the other hand, those who are pale and delicate, have lost
much blood, or are reduced by chronic cough with profuse
expectoration, by severe dyspepsia, or long-continued diarrhcea, or diabetes, or profuse flow of menses, or piles, &c.,
may require tonic diet, meat, even wine, China, Ferrum, &c.
Still, if there be disease or brittleness of the blood-vesselswhich may often be detected by the presence of a peculiar
fulness or hardness of the pulse at the wrist-we should be
very careful of stimulants.
Anything which is calculated to hurry the circulation




PREVENTION OF APOPLEXY.           145
and increase the force of the heart's action, such as strong
bodily exercise, anger, violent passion, loud and earnest talking, brisk or hurried walking, galloping on a hard horse,
should be avoided; holding the breath, especially when some
muscular effort is made, such as tugging at a tight boot, holding a high note in singing, in a violent paroxysm of coughing,
or in straining at stool, are particularly dangerous; in all
these acts blood is thrown violently to the head, the face may
turn purple, the patient become giddy, the eyes bloodshot, and
a fit of Apoplexy come on. Violent vomiting, sneezing, laughing, crying, singing, shouting, all have a somewhat similar
effect. In short, a person liable to Apoplexy is obliged to
exert such control over body and mind, that SOLLY categorically asserts, he must be content to live like a cabbage, to
vegetate, merely exist, and barely live..Far better would it
be for them to live like Dr. Adam Ferguson, already alluded
to, whose mixture of original thinking with high moral feeling and extensive learning, his love of country, contempt of
luxury, and especially the strong subjection of his passions
and feelings to the dominion of his reason, made him, perhaps,
the most striking example of the stoic philosopher which
could be seen in modern days. —(WATsoN.)
Dr. Fothergill thought it very unsafe for short-necked
people to look backwards for any length of time, without
turning the rest of the body, thus twisting the neck. He
gives the case of a man seized with Apoplexy, while crossing a river in an open boat, keeping his eyes fixed upon a
particular ship, until long after he had rowed past her.
Tight cravats are also injurious. A Swedish officer who
was desirous that his men should look well in the face, caused
them to wear tight stocks; in a short time quite a number of
his regiment died of Apoplexy. The case of a boy is also
given who had drawn his neckcloth remarkably tight, and
was seized with Apoplexy, while exerting himself whipping
a top.
Cold, is another frequent exciting cause of Apoplexy; it
drives the blood from the surface, and accumulates it in the




146                   APOPLEXY.
large vessels of the interior of the body. I have known several elderly persons, with a marked tendency to congestion of
the head, attacked while dressing or undressing in a cold
room, loitering about with their shoes and stockings off, and
remaining partially, or very nearly undressed for a long time.
On the other hand, expansion of the blood may be caused
by hot and stimulating food and drinks, large fires, crowded
rooms, excessive heat of the sun, hot baths, &c. The whole
mass of the blood becomes expanded, and cooling and refrigerating means are required.
This last state of the blood has been greatly overlooked by
almost all writers on affections of the brain, although it was
well known to the ancients. According to them, the so-called
Plethora ad volumen depends upon an apparent quantitative
increase of the blood from expansion, or increase of its volume, without actual increase of quantity. It was supposed to
arise from vital turgor, nervous orgasm, or simple expansion
of the blood from excessive heat. The best marked examples
occur in sun-struck persons.  SOLLY'S friend, Dr. SAMmEL
ROGERs, gives a most graphic description of this form of Apoplexy, as caused by great exposure to the heat of the sun.
He says: "About 8 o'clock, a most melancholy scene commenced among the troops; men were seen to drop down and
instantly expire; every hour added to our melancholy situation, for notwithstanding the utmost exertions of the physicians, the day ended with no less a loss than 18, and left us
with 63 sick in the hospital. When warning of the attack
was given to the patients, they usually complained of difficult
breathing, with a sense of tightness and oppression about the
chest, followed by giddiness, burning heat of the eyes, and a
sense of great fulness about the head, in many amounting to
excruciating pain, succeeded by loss of sense and motion, faltering of the tongue on attempting to speak, fulness of the
eyes, dilated and fixed pupils, violent twitching of the muscles of the face, particularly those about the mouth, subsultus
tendinum, and involuntary stools. Along with these symptoms the patient also had a strong, full, and frequent pulse,
tremendous throbbing of the carotid and temporal arteries,




PREVENTION OF APOPLEXY.           14T
flushed, swollen, and sometimes livid countenance, and
throughout, a parched and burning skin."
Rogers says that " the violence, suddenness and urgency of
the symptoms seemed to require immediate and profuse
depletion; blood was accordingly abstracted from every assailable point, viz., the arm, jugular vein, and temporal artery;
cold was applied to the head, and the feet were immersed in
hot water; blisters were applied to the head, neck and legs;
brisk purgatives were administered, and their operation
assisted by purgative injections. In some cases, fifty, sixty,
or even one hundred ounces of blood were taken, but the
remedy was sometimes worse than the malady; in fact, two
individuals became convulsed, and died shortly after they
were bled, and after death it was found that although the
heart was empty, the vessels of the head were loaded with
blood. This clearly indicated that, whatever it was, that
excited the heart's inordinate action, bloodletting would not
subdue it, for as long as a drop of blood remained, it was
sent to the head. How lucky it was for us (Dr. S. ROGERS),
and truly so for our patients, that a most effectual remedy
was found in the cold affusion. Just as one man had expired,
as one might say, almost under the lancet, another was
brought into the hospital; he was put into a bathing tub,
and a constant stream of cold water poured on his head until
he was relieved."-(SoLLY on0 the Brain, p. 392.)
Treatment of the Premonitions of Avoplexy.
I trust it has been made evident, that there is no more
delicate, or momentous question in the practice of medicine,
than that of the prevention, or primary treatment of attacks
of Apoplexy; because, as we have seen, these seizures may
arise from such different, or even opposite causes, that the very
course of treatment, and regimen which is most conducive to
safety in one case, has an opposite tendency in others.
If the patient be decidedly and undoubtedly plethoric, or
full-blooded, a moderate bleeding may be allowed, if the
symptoms be urgent, in order to reduce the whole quantity




148                    APOPLEXY.
of blood to the healthy standard. This may avert danger,
and certainly will not interfere with the action of the most
delicate homzeopathic remedies; but if the symptoms be not
urgent, the excess of blood may be more slowly reduced by
dietetic, and medical means. In deciding on the propriety of
blood-letting, it is very important to be certain whether true
ylethora be present, or an absolutely greater quantity of blood
than the organism requires for its sustenance, or can readily
control the circulation of. If true plethora, or exceedingly
active and dangerous congestion be not present, the physician
should discard the lancet; but there can be no earthly
objection to bathing the feet in simple hot water, or in hot
pepper-, or mustard-water; the head and shoulders should be
raised, the clothes all loosened, and cold applications made to
the head. If the bowels be obstinately costive, or even
moderately sluggish, some mild but efficient purgative, such
as castor oil, may be given at once; or if the attack arise
from the suppression of piles, or menses, Aloes should be preferred as a purgative. Aloes may also be given when there
is bilious derangement, although as HARTMANN says, that.Mercurius solubilis corresponds to every variety of Apoplexy,
it may be allowable to give this in sufficient quantities to act
on the liver and bowels, in appropriate cases. I say appropriate cases, because there are others, which are characterised
by pallor of the patient, an inclination to dizziness with faintishness, palpitation, nervous tremors and timidity, in which
all the symptoms are increased when the stomach is empty,
or the bowels are freely moved, or from looking upwards, or
resuming the upright position after stooping, or rising from
bed, and in which all the above treatment would be injurious.
Aconite is regarded as the principal remedy when there
is great heat and feverishness of the head and body (see
article on Aconite); Bellad. or Stramonium, when there
is great and active congestion to the head, with excessive
restlessness, and more or less delirium; Opium, when there
is a more passive- and venous-congestion, with much drowsiness, great constipation and some stupor; Cocculus, when
nausea and giddiness constitute the prominent symptoms;




PREVENTION OF APOPLEXY.            149
China, when there is beating in the head, with palpitation
of the heart, dimness of sight, buzzing in the ears, heavy
breathing, &c. Hartmann says that when the excessive use
of coffee or wine causes an assemblage of symptoms much
resembling those of Apoplexy, viz: fulness of blood about the
head, bursting pain with commotion of the blood and throbbing of the arteries, constant uneasiness and heaviness of the
limbs, languor and lassitude even from the least exertion,
redness of the vessels of the eye, with sudden and frequently
recurring paroxysms of loss of sight or darkness before the
eyes with dizziness, obliging the patient to lie down, noises in
the ears, &c., then Nux will remove many of the symptoms,
especially if constipation also be present, but Belladonna may
be required, and also to be assisted by several doses of Mercurius. Coffea has also been recommended, if the attack be
of a nervous character, occurring in delicate and nervous
persons, from great mental excitement, or from indigestion
after a hearty meal, -especially when the patient is excessively
nervous, sad, sleepless from excessive bodily and mental
excitement, with frequent flushes of heat to the face, dizziness, heaviness of the head, anxious restlessness of the whole
body, sensitiveness of hearing, &c. Arnica has also been
strongly recommended when symptoms of congestion to the
head appear after a full or improper meal, especially if the
head be hot, and the hands and feet cold. When spasmodic
symptoms are prominent, Nux and Ignatia are the most
homoeopathic remedies. If suppression of perspiration has
brought on the attack, Aconite and Opium should be thought
of; if the urine be scanty, Cantharides and Digitalis; if the
menses be scanty or suppressed, Pulsatilla and Stramonium,
or Conium; while Ipecac. has been highly recommended in
Gastric Apoplexy when the patient is restless, starts frequently, is irritable and inclined to vomit. Veratrum is particularly indicated, when the patient is pale, cold, and faint.
The treatment of fully developed attacks of Apoplexy will be
given minutely, when treating more especially of the different
varieties of the disease.




150                    APOPLEXY.
TRUE) OR TYPICAL APOPLEXY)
With preceding plethora and congestion, followed by hemorrhage and paralysis.
The model type of Apoplexy occurs in persons with a robust
body, ruddy complexion, who are hearty and stout by nature
or good living, have too much blood in the whole system,
and proportionately still more in the brain, or head. This is
by far not the most frequent form of Apoplexy, althoutgh it
has fixed the ideas of world about the nature and treatment
of the disease.
Symptoms.-Such a plethoric, juicy and heavy man, apparently in good health, suddenly falls down deprived of all his
senses, wholly unconscious of surrounding objects, his countenance livid, the vessels of the face and head tulgid with blood,
his breathing snoring or stertorous, his pulse full, slow, and
intermitting, his limbs powerless. In the most violent cases,
all the limbs are paralysed, but generally, the paralysis is
confined to one-half of the body, in the form of hemiplegia;
sometimes only a single limb is affected, and in this case the
arm is much more frequently paralysed than the leg. The
paralysis may be confined to the face, tongue, eyes, their lids,
or other parts (see Hemorrhagic Apoplexy). From this state
the patient may never rally, even under the most active allopathic, anti-phlogistic, and revulsive treatment; he often sinks
without any change for the better in his symptoms, and dies
in the course of forty-eight hours. This, SOLLY truly says, is
an awful disease to suffer from, to witness, or to administer to;
but death soon closes the scene, and the brain when examined
after death, is found to have been more or less torn and
destroyed by large masses, and clots of blood extravasated into
and upon the brain. The case is typical beclause the extravasation of blood is so copious and severe that all the effects of
extravasation are produced; all the centres of nervous power
within the skull are either crushed, torn or compressed; or
ploughed up by, and intimately mixed and intermingled with
gore; while the neighborhood of large and rather large elots is




TYPICAL APOPLEXY, PLETHORA.           151
converted into a more or less suffused, red, soft, and very moist,
papescent mass consisting of comminuted and crushed brainsubstance (SOLLY). Hence, the destruction of the brain is
often so extensive that the patient cannot live by any possibility, except as a mere wreck of his former self; a burthen
and a loathing to himself, an object of pity and the tenderest
cares, perhaps, to his nearest and dearest relatives.
Typical Apoplexy is both congestiee, i. e., an increased
quantity of blood is thrown to, or retained in, or about the
brain; and hacmrorrkagic, i. e., more or less of blood has burst
the bounds of its blood-vessels and been poured out, in or
upon the brain. Too much blood was present in the system
before the attack; too much blood has, perhaps, frequently
flowed to the brain, but subsided without dangerous consequences; the blood-vessels of the brain have, doubtless, been
frequently distended with blood before, but now the brain
remains intensely crowded with blood, and one or more bloodvessels have given way, and are pouring out blood copiously
upon the brain. The indication is, of course, to reduce as
rapidly as possible the whole amount of blood in the system,
at least to the natural standard, and especially to relieve the
brain from its excess of blood, and stop the bleeding into, or
upon its substance.
Plethora.
The principal points in typical Apoplexy, are: general plethora, or blood-fulness of the body, attended with great congestion to the head. Hence we propose to examine the subject of plethora more fully in this place. Watson says: in the
adult state when the growth of the body has been completed,
that blood may be made in greater abundance and more rich
in the materials of nutrition than the wants of the body
require, is not only conceivable, but true; full living and
sedentary habits are causes likely to occasion general plethora,
and they do occasion it;( full diet, so long as the digestive
powers are perfect, provides more chyle and conducts into
the blood a larger quantity of its pabulum; a sedentary life




152                     APOPLEXY.
precludes that freer circulation of the blood, and that more
liberal expenditure of it through the skin, and by means of
the other organs of secretion, which would occur under more
active habits. Such persons are apt to become fat, the adipose
tissue seeming to form a kind of safety-valve for the diversion
of the superfluous blood; the muscular and fibrous tissues,
however, suffer in their nutrition, because the imperfect respiration of heavy and sluggish persons does not form fibrin in
sufficient quantity for their full development. Such persons
naturally have turgid and florid cheeks, red lips, red mucous
membranes, and not uncommonly ferretty eyes; their entire
vascular system is preternaturally distended, and if you open
a vein, you find that they bear a large abstraction of blood
without fainting, and are even refreshed by it; while the blood
drawn separates into a large, but not very firm mass of
coagulum, with but little seren (WATSON).
The blood of the plethoric is also deficient in fibrin, and
hence, decidedly inclined to hemorrhage. According to
BADRAL, in plethora and congestion of the brain, the fibrin
of the blood is apt to diminish from  YV30 to TJ10; the
quantity of blood globules to increase from  1-'2-7' to 1-T;
the solids of the serum  to increase from 0,  to -0~-%, and
the quantity of water or serum to diminish from  -AOA  to
17-4 0   Hence the blood will be thicker, more sluggish in its
action and less inclined to form a clot or coagulate, and even
is disposed to exude from its vessels in the form of hemorrhage. The effect of this kind of blood upon the brain and
other organs, is admirably described by BECQUEREL and
RODIER; they say, that in true plethora or full-bloodedness,
not only is the whole mass of the blood increased, but sudden
accumulations of it in internal parts, frequently in the brain,
are apt to occur, disturbing its functions, causing fits of
insensibility, and sometimes even death itself. It is only too
true, when blood already exists in too great abundance throughout the body, that it is apt to fall in excess upon any debilitated, or irritated organ. Above, we have referred almost
exclusively to triue plethora (PLETHORA EAu), or that state in




TYPICAL APOPLEXY) PLETHORA.            153
which a greater quantity of blood is present than the
organism requires for its healthy nutrition and sustenance.
True plethora is necessarily universal, (plethora universalis)
as contradistinguished from local or partial plethoras, (plethora  partialis); it may also be not only venous, but also
arterial in its character (plethora venosa et arteriosa); and
of course, is widely distinguished from dyscratic-plethora,
such as occurs in albuminuria, hydraemia, and other affections
(plethoras cacoc/hyma). The principal causes of true plethora
are: 1st, excessive production of blood, especially when associated with diminished consumption of it; this is particularly
apt to be the case in true plethora, in which we have seen that
the blood is deficient in fibrin, hence is less plastic, less
inclined to assume a coagulable or solid form, consequently
more disposed to remain as blood, rather than to be converted
into any organized product. Arterial congestion and plethora
are closely allied to the above state of things; the conveyed
arterial blood is changed too slowly into venous, in consequence either of diminished nutrition of the tissues, or other
causes, and consequently the arterial blood is only slowly and
imperfectly driven from such parts.
Another form of plethora is the so-called plethora ad vires,
in which the quantity of blood in the system, is relatively too
great for its powers; this is apt to occur from nervous or
mental exhaustion, long continued or extravagant grief, or
anxiety, sudden fright, depressing mental emotions, &c. Of
course the principal indication is not to remove blood, but to
arouse and invigorate the nervous system.
The so-called plethora ad volumen has already been alluded
to; but the fact that the blood in a dead body occupies only onetenth part of the space which it occupies in the living one, may
here be referred to in proof of the close connection which the
volume of blood has with its life, or with its amount of orgasm,
or vital turgor. The opposite'of this state, or collapse of the
blood, may be produced by depressing agents such as Digitalis, Prussic acid, Tobacco, deficient nervous energy, &c.;
the pulse is then apt to be small, soft and fiequent; the surface
13




154                      APOPLEXY.
pale and cold, sensation and motion either deficient or extinct.
In plethora ad volumen the pulse is apt to be full, large, slow,
heavy and oppressed.
One other form may be mentioned, viz.: the plethorac ad
spatiutm, such as is apt to occur from diminution of the
calibre of the blood-vessels, or after the loss of large and
important limbs. (STARK.)
Although plethora is only one element of true or typical
Apoplexy, particular attention has been paid to it here because
the other elements, viz.: congestion, hemorrhage, and paralysis will be treated of more fully under the heads of Congestive, Hceimorrhagic, and Paralytic Apoplexy.
Treatment of Typical Apoplexy.  Ferrum  is the most
important homceopathic remedy against true plethora and
Apoplexy. It is well known to increase the quantity of blood
globules; but it is not so well known to diminish the quantity
of fibrin in the blood. SIMON found the fibrin to diminish
from the normal standard of  3  as low as l 3  after the
use of sixty-four grains of iron in the course of seven weekls;
ANDRAL and GAVARRET found it to lessen the quantity of fibrin
in one case from the normal standard, to  2, in the course of
four weeks; in another case from  T35, or an excess above
the normal mean, to T, or the natural standard. Ferrum
is also well known to diminish the quantity of water in the
blood. Hence as far as the pathology of the disease is a guide,
it is ca, or even the, most homceopathic remedy to true arterial
congestive plethora; while Opium is perhaps the most homceopathic remedy to true venous congestive plethora; in the
former disease, the face of the patient is red and flushed, in
the latter it is purplish, or livid.
Symptomatic indications for Ferrum. Active, sthenic
congestion and haemorrhage, with great vascular irritation.
Rush of blood to the head, puffiness around the eyes, swelling
of the veins and paralytic weakness. Headache from rush of
blood to the head. Vertigo with disposition to fall forwards;
staggering in walking; momentary shock in the brain, with
giddiness; dizziness, dulness and confusion of the head;




SIMPLE) OR CONGESTIVE APOPLEXY.        155
hammering and throbbing headache, lasting for two, three or
four days, and recurring every two or three weeks; drawing
headache from the nape of the neck into the brain, with sense
of hammering, and roaring in the head; undulating pain in
the head; headache as if the brain were rent asunder; rush
of blood to the head, with swelling of the veins and flushes of
heat. Faint feeling in walking, with blackness before the
eyes, roaring in the ears and head at every step, and sensation
as if threatened with Apoplexy. Violent burning and pain
in the head, with thirst. All the vessels of the brain turgid
with blood, and six ounces of blood extravasated into the
cerebellum (NoAcK and ThRINKS). Pain in the eyes, as if
from excessive drowsiness. Darkness before the eyes, in the
evening, with aching pain, and discharge of a few drops of
blood from the nose. Heat and anxiety after meals, with
drowsiness, gloominess and headache over the root of the
nose. Dulness of, and pain in the head, violent eructations,
and heat in the face. Tremor of the hands, cramps in the
fingers, with numbness and insensibility. Numbness of the
thigh, feeling as if the thighs had gone to sleep. Coldness of
the feet, and such weakness that he is scarcely able to drag
them along. Constant weariness and drowsiness in the day
time; heavy sleep in the morning. Orgasm of blood in
the day time, with heat in the hands, heat of the body and
redness of the cheeks (NoACYK and ThIKxS).
It will be unnecessary to multiply remedies here for this
form of Apoplexy; in due time and place all the others will
be treated of.
SIMPLE, OR CONGESTIVE APOPLEXY,
With or without 2lethora, but with rush of blood to the head,
and without the frequent occurrence of Acemorrhage orpermanent vparalysis.
The symptoms in this form greatly resemble those of true'
or typical Apoplexy, except that paralysis, or hemiplegia is
generally wanting-it is often wanting entirely, or present
only transiently when simple congestion is present, but it is




156                     APOPLEXY.
thought to be very seldom absent when there is hemorrhage.
The patient falls down suddenly deprived of sense and motion,
and lies like a person in a deep sleep; his face is generally
fushed, or more frequently livid or purple, his breathing
stertorous, his pulse full and not frequent, generally slower
than the natural standard; sometimes slight convulsions of
the limbs, or contractions of the muscles of one side of the
body, and relaxation of those of the other are present. Of
course, if the congestion be sufficiently great to cause unconsciousness, or paralyze parts of the brain, it may also cause
greater paralysis of some parts or limbs, than of others;-still,
as has already been said, paralysis is not commonly present.
The patient may continue in a state of profound stupor for
several days, or he may recover after some hours, especially
if judiciously treated; a perfect recovery, however, rarely
takes place after the attack has lasted over one or two days,
although it does in some cases of several days duration.
In a larger proportion of this class of apoplectic cases,
excessive injection of the vessels of the pia mater, and engorgement of the whole vascular system of the brain are the chief
lesions. Under allopathic treatment the cases consisting of
congestion solely, almost always recover; the patient may,
indeed, survive numerous attacks of this form of Apoplexy,
but there is always danger that a congestive stroke may be
followed by one of a hemorrhagic character; and even when
this danger is escaped, the disease is apt to leave traces behind
it, of an enfeebled condition of the memory and intellect; and
it sometimes happens that a patient has numerous attacks,
which reduce him at length to a state of mental imbecility,
little short of idiocy. (WooD.)
It is sometimes possible to make a distinction between
Apoplexy from active congestion of the brain, and that from
passive; in the former, there is often a full, strong, but sometimes slow pulse, with a red flushing of the face; in the latter
the pulse is apt to be comparatively weak, or else natural, and
the face has a livid hue. The symptoms of active congestion
have already been sufficiently detailed among the precursory




SIMPLE, OR CONGESTIVE APOPLEXY.        15T7
symptoms of Apoplexy; those of passive congestion are said
to be a feeling of fulness, weight, and sometimes of coldness
in the head; an actual diminution of temperature in this part
is particularly apt to occur when the arterial blood conveyed
to the brain is very slowly changed into venous blood. There
is also apt to be a strong tendency to drowsiness and stupor,
dizziness, faintness, impaired vision, motes before the eyes,
forgetfulness of words or things, dulness of countenance, a livid
or purplish hue of the lips and face, with paleness, and
depression of the pulse, and breathing.
Congestive Apoplexy does not necessarily take place only
from excess of blood in the whole system. WATSON says, even
a deficiency in the whole mass of blood contained in, and
circulating through the body does not protect many parts of
the system from congestion, i. e., from having an undue share
of blood sent to them. Far from it; local determinations of
blood, especially to the head, are very common in persons in
whom the mass of that fluid, and the proportion of its nutritive elements have been considerably diminished by nature,
disease, or loss of blood. (ANEMIc APOPLEXY.)
This remarkable tendency to an unequal distribution of the
blood may thus be explained-a due supply of healthy blood
is requisite for the steady and equable performance of the
functions of the brain and nerves-when this supply is defective or uncertain, those functions become disorderly, irregular,
and the flow of blood to the organs also becomes disordered
and irregular. The circulation of the blood is more or less
under control of the nervous system, as is seen in the flush of
shame and anger, and the paleness of fear; hence persons
endowed with great sensibility and irritability of the nervous
system are very liable to partial, or irregular congestions.
ROKITANS:KY takes somewhat different views of congestive
Apoplexy from those ordinarily adopted. He says, it is a
question of much importance, whether the frequent cases of
sudden or unexpected death, in old-school practice, in previously healthy persons, in which the only, or the principal
post-mortem appearance is a certain amount of congestion of




-1i5                     APOPLEXY.
the brain, are solely produced by this congestion, and are to
be regarded as cases of paralysis of the brain from pressure,
by the excess of blood?
(a.) He answers, that in a certain small number of cases,
this congestion of the brain is the only morbid appearance in
the body, and has reached a degree, which in the present
state of our knowledge justifies the conclusion that the brain
Yhas been pressed upon, and paralyzed by it.
(b.) If, in a greater number of cases, moderate congestion of
the brain is found associated with congestior of the lun~gs, it
is scarcely possible to say which of these conditions was the
primary, and which the secondary, or whether they did not
arise simultaneously from the same source and cause, and
which of them. actually produced death. But as it is quite as
common for congestion of the lungs to be the only morbid
appearances in cases of sudden death, and as it is decidedly
the more marked appearance in many cases in which congestion of the brain is also present, we may often conclude
-that the congestion of the brain is of secondary importance.
(c.) Besides cases of these two kinds, there is still a number
of others, in which all that is discovered upon examining the
body of persons dead under allopathic treatment, is so slight
a congestion of the brain, that it would not be thought of, if
any other morbid appearance presented itself. Such cases
prove fatal only when there is a peculiar tendency of the
brain to exhaustion, or paralysis. (NERvoUS APOPLEXY.)
Dr. NEIsSER, of Berlin, has lately described a severe form of
congestion of the brain, connected with dilatation of its arteries; he has termed it Ectasis vasorum cerebri; thinks it is
most common in young persons of a plethoric habit, short
neck, thick head, and stunted growth; that the disease most
frequently attacks the basilar artery and its branches, which
become simply and equally dilated along their whole length,
and not in aneurismal pouches; the blood consequently moves
more slowly along them.
Symptoms.-The patient is readily heated, complains of
overflow of blood, and these symptoms recur continually in




SIMPLE, OR CONGESTIVE APOPLEXY.          159
spite of the most energetic and methodical allopathic treatment. Finally the patient complains of vertigo, and a peculiar
heaviness and dulness of the feet; he has neither pain, nor
tingling, but walks with a tottering, uncertain step, staggering
first to one side, then to the other, as if intoxicated; he often
becomes so dizzy as to fall, especially towards evening, and in
the dark; all the symptoms are aggravated at night, and remit
in the morning; there are partial sweats on the head and face,
and in some cases partial blindness. Dr. NEISSER found the
most energetic antiphlogistic and revulsive treatment to be
entirely  inefficacious.  Death, finally, generally  occurred
suddenly.
Treatment of Congestive Apoplexy. OPIuM is perhaps the
most important homlceopathic remedy; at least WooD and
3ACHE: say, that it in full doses reduces the frequency though
not the force of the pulse, diminishes muscular power, and
brings on languor and drowsiness which soon eventuate in a
deep apoplectic sleep; the breathing is stertorous, there is a
dark suffusion of the countenance, a full, slow and laboring
pulse, an almost total insensibility to external impressions,
and when a moment of consciousness has been obtained, a
confused state of the intellect, and an irresistible disposition
to sink back into comatose sleep are present. The pulse,
though slow, is often full and powerful in its beat. But in the
space of a few, say six or eight hours, a condition of genuine
debility ensues; the patient will have a cool and clammy skin,
cool extremities, a pallid countenance, a feeble, thread-like,
scarcely perceptible pulse, a slow, interrupted, almost gasping
respiration, and a torpor little short of absolute death-like
insensibility.
It will be seen that Opium is homceopathic to some of the
most formidable apoplectic conditions; even allopathic physicians need not, and do not fear to use it in some of the nervous
and asthenic forms of the disorder, as it in moderate doses
increases the force, fulness and frequency of the pulse, augments
the temperature of the skil, invigorates the muscular system,
quickens the senses, animates the spirits and gives new energy




160                     APOPLEXY.
to the intellectual faculties, all followed by calmness, delightful
placidity of mind, with quiet, but vague enjoyment.
It will be unnecessary to enter here into the minutiae of the
indications for the use of Opium in Apoplexy; but it may be
well to notice some of the broader and more striking peculiarities. * According to CHRISTISON it is most homceopathic to
congestive Apoplexy, or rather to turgescence of the vessels
of the brain, and watery effusion into the ventricles, and on the
surface of the brain. It is very rarely homceopathic to hsemorrhagic Apoplexy, at least CURIsTIsoN says that extravasation
of blood is a very rare effect of Opium; but he gives one case
in which several clots of blood were found in the substance of
the brain, one of which in the anterior lobe, was an inch long;
in a second case, the sinuses and veins of the brain were turgid,
and a moderately thick layer of blood was effused over the
arachnoid membrane; NoacK and TRrIKS report RYL's case in
which the veins of the neck were turgid with decomposed
black blood, the sinuses of the head and all the cerebral vessels
were distended with blood, while the ventricles of the brain
contained a teaspoonful of a bright-red fluid; also COLIN's case
in which extravasated blood was found in the brain, and the
cerebral vessels were very much distended; LEROUx found in
one case, about a teaspoonful of bright-red blood at the base
of the brain, and the choroid vessels very much distended;
JOURD found several clots of coagulated blood in the substance
of the brain; in a child the sinuses of the dura mater were
filled with dark coagulse, and there was slight extravasation
of blood on the surface of the posterior lobes, while all the
internal vessels of the brain were turgid with blood, and there
was effusion of serum at the base of the brain, and in the
ventricles. Still it must be remembered that these cases,
although they seem numerous, are in reality exceptional.
Opium is also homceopathic to the congestion of the lungs
which so frequently attends congestive Apoplexy according to
]RoKITANSKY. CHRISTISON says that the lungs are sometimes
found gorged with blood, as in many cases of Apoplexy; four




HIEMORRlIAGIC APOPLEXY.           161
cases are alluded to, in one of which they were so gorged with
fluid blood that it ran out in a stream when they were cut.
It is also decidedly homceopathic to venous-plethora, and
plethora ad volumen.
H.EMORRHIAGIC APOPLEXY,
With or without previous congestion, or plethora, blutfollowed
by paralysis.
The type of this variety is the form so graphically described
by ABERCROMBIE, and called the gradually increasing, or
Ingravescent Apoplexy, by COPELAND. It depends upon the
sudden rupture of a blood-vessel of considerable size, without
any necessary previous disturbance of the circulation, such as
fever, congestion, or plethora; the rupture probably arising
from disease of the artery, at the part which gives way.
Symptoms. —The patient often experiences a severe shock
in the head, or a sudden or violent pain in the brain at the
moment when the blood-vessel gives way; sometimes attended
with the feeling as if something were suddenly torn, or rent in
the interior of the head; and very frequently accompanied
with paleness, sickness, and vomiting. The pain in the head
is sometimes so severe that the patient sinks down pale, faint
and exhausted; or even experiences a severe shudder, or a
slight convulsion. When the calibre of the ruptured vessel is
smaller, the sudden attack of pain in the head is accompanied
by slight and transient confusion only, and the patient does
not fall down. In either case he commonly recovers in a
short time from these symptoms, becomes quite sensible, and
is able to walk; but the headache does not leave him, his
pulse is apt to remain frequent and feeble, his face cadaverous
and sunk, while his spirits are depressed, although he is quite
conscious, and in full possession of his intellect. After this
state has endured from a few minutes to several hours, or
even more, the patient becomes heavy, forgetful, incoherent,
and sinks into coma from which he never rouses again; or his
skin acquires some heat, his pulse improves in strength, his




162                     APOPLEXY.
face becomes flushed and his features turgid; the oppression
then increases rapidly, he answers questions slowly and
heavily, and at last sinks into a profound stupor and coma.
(COPELAND and WATSON.)
This is the most fatal form of Apoplexy, and it is all-important to be fully aware of this, for, to an inexperienced eye
these cases, at first, do not seem so terrible as those in which
the patient falls down profoundly comatose from the commencement. The apparent amendment is fallacious, and apt to lead
physicians and friends to indulge in hopes of recovery, soon
to be dreadfully disappointed. A large quantity of blood is
usually found extravasated in, or upon the brain.
The primary management of these cases is very difficult to
the allopathic physician; the violent pain in the head, the
faintness, sickness, vomiting, the paleness and ghastliness of
the face, the weakness, frequency or irregularity of the pulse
cannot be treated with bloodletting, and dare not be met with
stimulants, although the preparations of Ammonia are generally relied upon. As by far the majority of patients soon
rally from the first shock, and coagulation of blood with the
formation of a clot is more apt to take place during the cold
and faint stage, while fresh bleeding almost always occurs as
soon as the circulation is restored, and reaction sets in, the
physician should be bold enough not to be in too great a hurry
to rally his patient. He should aid nature in forming a clot,
and should first use styptic and blood-coagulating remedies,
rather than stimulating ones. The principal astringents in
use in old-school practice are: Acetic acid, Tannic acid,
Elixir vitriol or Aromatic sulphuric acid, Alum, Catechu,,Creosote, Chalk, Sulphate of Copper, Per-nitrate, and MIuriate
Tincture of Iron, Sulphate of Iron, Geranium maculatum,
Logwood, Kino, Rhatany, Vlatico, IMonesia, Acetate of Lead,
Bistort, Oak bark, and Acetate of Zinc. Some of these, such
as Plumbum, Cuprum, Ferrum, Zincum, &c., are more or
less homceopathic to some of the symptoms and forms of
Apoplexy. But MIillefolium has the highest homceopathic
reputation in controlling bleedings from various parts. I




HIEMORRHAGIC APOPLEXY.             163
believe that the use of styptics against hsemorrhage of the
brain has never before been so distinctly recommended as is
here done, or will again be urged.
A glance at the principal effects of a great outpouring of
blood in, or on the brain, will still more forcibly impress us
with the importance of checking the bleeding as rapidly as
possible.
ROKITANSKY says, that: Hoemorrhagic Apoplexy consists in
the pouring out of blood into the substance, or upon the surface of the brain, and a proportionate laceration, breaking
down, contusion and compression of its substance. There are
various grades of this process:
(1.) A larger or smaller spot of white or grey cerebral
substance becomes speckled or striped with a small number
of dark red dots and streaks of extravasated blood (ecchymosis);
the fibres of the brain are then generally separated, not
entirely torn by the effusion of blood. The recovery of the
patient should be perfect, although the symptoms may be
severe, and some paralysis be present.
(2.) These minute extravasations may be more numerous,
lie closer to one another, and some of them may have run
together, so that some portions of the brain are uniformly
suffused with red blood, are of a soft and pulpy consistence,
and many of its fibres are broken into numerous shreds, and
softened to a red pap. Recovery from this state of things is
apt to be slow and imperfect.
(3.) In consequence of the continuance or recurrence of the
bleeding, a single small extravasation may increase rapidly,
or by degrees, from the size of a poppy seed, tearing and
separating the surrounding brain, until a large clot and cavity
are formed.  It is this process which old-school physicians
are so anxious to prevent by means of prompt and copious
bloodletting; but as it is very generally caused and aggravated by the existence of hypertrophy of the left ventricle of
the heart, it is also very important for them to use Aconite,
Digitalis or Veratrum viride, to lessen the impulse of the




164                      APOPLEXY.
circulation; and antiphlogistic styptics such as Acet. plumb.,
Alum, or Creosote to control the bleeding.
HIemorrhage into the brain should be treated somewhat as
the haemorrhagies of other organs are treated-no old-school
physician would attempt to control bleeding of the rectum,
uterus, bowels, stomach, or lungs without the aid of remedies
more or less styptic, as well as antiphlogistic. In point of fact
simple antiphlogistic treatment is next to useless, if not injurious. COPEMAN says, when there is a rupture of a bloodvessel
in the head, and consequent extravasation of blood has already
taken place, then the mischief is done, the blood is effused,
and the system has received a great shock, which bloodletting
will aggravate, while it cannot remove the extravasated blood.
But it may be said, that it will prevent farther extravasation
by lessening the impetus of blood to the brain. But has it
this effect? Do we not generally read that during the bleeding
the pulse rose and became more free? and may there not be
some truth in the proposition that extravasation is promoted,
rather than counteracted, by the greater thinness of the blood
and its diminished tendency to coagulate, induced by large
bleedings?
When the clot is large, the portions of the brain around it
are stretched and torn, the segment of the brain containing it
is enlarged, swollen and more or less altered in form, it may
be forced outwards against the dura mater and skull, and
inwards towards the opposite half of the brain; the convolutions are driven close together, flattened, and diminished in
size; the structures at the base of the brain are flattened; the
opposite ventricle is narrowed, and its contents displaced; and
when a cavity of this size and kind opens into the ventricle,
the opposite hemisphere also shares in the compression and
enlargement.
(a.) It is evident that haemorrhagic Apoplexy may prove
fatal at once, suddenly and primarily (Apopolexie foudroyawzte); or after short time, viz., in some hours, or a few days.
Death results in such cases from the extensive destruction of
the substance of the brain, and from pressure. This happens




IHEMORRIAGIO APOPLEXY.             165
especially when there are large central cavities of the size of
a hen's egg, or somewhat smaller.
Still more certainly fatal are larger extravasations which
burst into the meshes of the pia mater without, or into the
cavity of the ventricles within.
In certain parts of the brain, again, such as the Pons variolii,
Medulla oblongata, or Corpora quadrigemina, a cavity which
is not absolutely of inordinate size, may prove fatal, on account
of the greater vital importance of these parts.
(b.) Apoplexy may prove fatal secondarily, after a shorter
or longer interval of time, when reaction sets in, and the
inflammation about the cavity and clot becomes excessive, or
is followed by yellow softening of the brain.
(c.) The first effect of extensive Apoplexy is a permanent
loss of a portion of the cerebral mass.
(d.) A very frequent, if not invariable consequence of this
is a manifest Apoplexy of other parts of the brain, extending
to considerable distances in the direction of those fibres which
are included in the original apoplectic spot.
(e.) This Apoplexy, coupled with the subsequent diminution
and closure of the apoplectic cavity, by the process of healing,
gives rise to a corresponding amount of vacuum within the
skull.
(f.) This atrophy of the brain, when it is not associated
with cedenma of the brain, is constantly combined with Sclerosis, i. e., induration, condensation, and leather-like toughness
of the white substance; it gives rise to premature marasmus
of the brain, and early failure of its powers.
(g.) The vacuum in the skull thus produced, leads to
frequent congestions of the head, and consequent repetitions of
apoplectic attacks, followed, or not, by acute or chronic
cedema of the brain; finally a varicose state of the cerebral
vessels occurs in the neighborhood of the apoplectic clots,
cyst, or cicatrices.
IROKITANSKY, from whom all the above remarks have been
borrowed, says that the hitherto unnoticed congestions, arising
from the vacuum which attends atrophy of the brain, are of




166                     APOPLEXY.
the utmost importance. These, especially when combined
with brittleness of the blood-vessels, are without doubt the
cause of the frequency of Apoplexy in advanced life, and
especially of its frequent recurrence in some cases.
Hoemorrhagic Apoplexy is generally supposed to depend
upon the relative, or proportionate thinness, fragility, or debility of the blood-vessels of the brain, as compared with the
amount of blood circulating through the whole system, and
especially of that which is thrown to the head by the action
of a strong and vigorous heart, or active circulation. But it
arises quite as frequently, from too great stress and pressure
upon these fragile, thin, or weakened blood-vessels by a
sluggish return of blood from the head into the general circulation; and also, from such an actual and absolute degree of
attenuation, brittleness, or weakness of the blood-vessels, that
they are not able to withstand the ordinary pressure of the
circulation under the usual, and more especially from any
extraordinary exertion of body or mind.
Under all circumstances hemorrhagic Apoplexy will be
most apt to occur in those localities where the blood-vessels
of the brain and its membranes most abound. In the brain
itself, the most vascular parts are: the Corpora striata, the
Optic thalami, and their immediate neighbourhood; hence it
is to be expected that haemorrhagic Apoplexy will, and does
frequently happen in those parts. Of 386 cases of Cerebraland Spinal-hemorrhage collected by ANDRAL, no less than
202 cases showed extravasation of blood in the hemispheres
of the brain, on a level with these bodies, and at the same
time in them; in sixty-one other instances the Corpora striata
alone were involved; and the Optic thalami only, in thirty-five
additional cases; amounting in all to 298 cases out of 386.
Of the remaining eighty-eight cases, out'of the 386; the
Cerebellum was the seat of haemorrhage in twenty-two, the
Spinal marrow in eight, and all other parts of the brain in
fifty-eight.
It would be very natural to draw the inference, that the
most common and frequent symptoms and phenomena of




MHEMORRHlAGIC APOPLEXY.             167
hsemorrhagic Apoplexy arise from the mutilation of these
organs. Loss of motion and sensation are the most common
phenomena of haemorrhagic Apoplexy, if we except more or
less loss of consciousness; paralysis of motion is far more
frequent than loss of sensation; paralysis of one side (iemiplegia) is far more frequent than paralysis of both sides;
paralysis of the arm is far more frequent than the same affection of the leg; and supposing the patient to recover wholly,
or partially from hemiplegia, it is the leg, in nine cases out of
ten, which recovers first and fastest, i. e., sooner and faster
than the arm. In accordance with these pathological facts,
we find: 1st, that hsemorrhage into one side of the brain is
much more common, than into both sides; 2d, the Corpora
striata are implanted on the motor tracts of the Crura cerebri,
which descend into the pyramidal columns, and we have seen
that extravasation of blood into the corpora striata is at least
twice as frequent as with the optic thalami; accounting perhaps for the greater frequency of loss of motion in Apoplexy,
than loss of sensation; 3d, the sensory tract of nerves may be
traced upwards from  the olivary columns until it spreads
itself almost entirely through the substance of the thalamus;
moreover, the optic nerves and the peduncles of the olfactive
may be shewn to have a distinct connection with the thalami;
the former by a direct passage of a portion of their root into
these ganglia, and the latter through the medium  of the
Fornix; hence we may regard the thalami opticii as the
chief focus of the sensory nerves, and more especially as the
chief ganglionic centre of the nerves of common sensation,
which ascend to it from the medulla oblongata and spinal
cord; we have already seen that the optic thalami are the
seat of hsemorrhage only one half as frequently as the corpora
striata, and that loss of sensation occurs not nearly so frequently as loss of motion. Why paralysis of the arm is more
frequent and obstinate than that of the leg, is still an enigma.
Apoplexy of the Corpus striatum. SOLLY says, he believes
it to be invariable fact that extravasation of blood into
-this body is followed by paralysis; and consequently that




1 68                     APOPLEXY.
there is no portion of the brain which pathology has so clearly
indicated the function of, as the corpus striatum, in so far as
its connection with the course, or production of voluntary
motion is concerned. This fact was known as early as the
times of MORGAGNI and WILLIS.
Apoplexy of the Optic thalami. ANDRAL says: although
sensation is perhaps more frequently affected by haemorrhage
into this part, than motion, still this body is not the only
source or origin of sensation, for feeling may remain when it is
diseased, and may be lost when other parts of the sensor tract
are affected. Besides, we may add, that congestion of, or
bleeding into one part may, and does cause sympathetic disorder and compression of more or less remote parts, attended
with corresponding symptoms.
Apoyplexy of the Medulla oblongata. The pouring out of
blood into this part is more suddenly fatal than any other
form of Apoplexy. This is the only variety that resembles,
and is liable to be mistaken for death from disease of the
heart. It fortunately is very rare, for the medulla oblongata
is not very vascular, its blood-vessels are not very large, and
they are well supported. Extravasation of blood takes place
more frequently on its surface than into its substance, but this
proves equally fatal, although not so very suddenly. The
reason that this occurrence is so rapidly destructive to life,
must be obvious to every physiologist; for, it is from this
centre that the nerves of respiration, and the muscles which
they supply with nervous energy receive their power of action.
Apoplexy of the medulla oblongata may take place secondarily when blood is poured out primarily, either into the
third ventricle, or from rupture of the vessels of the optic
thalami, or corpora striata, and gradually finds its way down
to the medulla oblongata. This is a very frequent termination
of such cases under allopathic treatment. (SOLLY.)
Apoplexy of the Pons vacrolii. When the pouring out of
blood takes place first in the pons varolii, and secondarily into
the medulla oblongata the symptoms are so characteristic that
the lesion may be easily recognized by the practitioner.




HIEMORRHAGIC APOPLEXY.              169
Extravasation into the Pons produces paralysis of one or both
limbs, according to its extent, but after the first effect of the
effusion is over, it does not affect the intellect, because the
brain proper is left intact; but as the blood advances towards
the medulla, the organs of respiration become affected; first
the muscles of respiration are unnaturally and irregularly
stimulated, and the sensibility of the respiratory passages
abnormally exalted, until the stage of excitement is succeeded
by one of paralysis of the organs of respiration, and the
patient dies suffocated. (SOLLY.)
Apoplexy of the Crus cerebri. Extravasation into, or upon
this organ, will produce paralysis of the limbs on the opposite
side of the body, and often of the opposite eye, from its also
affecting the optic eye. The intellect may remain clear as
long as the brain itself is not involved. (SOLLY.)
Apoplexy of the white, or tubular substance of the brain.
In these cases, after the first effect of the extravasation is
passed, the intellect remains intact, or only slightly disturbed,
while decided paralysis of the side opposite the clot is present.
Apoplexy of the Cerebellum. Disease of this part of the
brain has, perhaps, excited more attention than its importance
demands. GALL and SERREs have assumed that erections, or
seminal emissions in man, and discharges, sometimes of blood
from the female organs, are the distinguishing signs of Apoplexy of the cerebellum; but there is as much proof to the
contrary as in favor of this assumption, although COPELAND
suggests that effusion into that part more immediately connected with the medulla oblongata, occasions a partial
asphyxia and stasis of blood in the lungs, and thus produces
a state favorable to erections, &c. The cases of Apoplexy
which take place during coitus, especially if there has been
severe pain in the back of the head, followed by great vital
depression, sickness or vomiting, convulsions, and general
paralysis of sensation and motion, may with some certainty
be predicted to depend upon disorder of the cerebellum.
Apoplexy of the cerebellum is said to cause a more serious
lesion of the functions of respiration and circulation, and to
14




170                   APOPLEXY.
be more dangerous than the same amount of disease in the
brain itself. This seems quite probable, as it is in union with
each segment of the great nervous centres upon which all the
movements and sensations of the body depend, viz.: the
antero-lateral columns of the cord, and the anterior pyramids
and olivary bodies, supplying all the anatomical conditions
necessary for the development of acts of sensation and volition.
It has even been assumed that the cerebellum is the regulator
of all the voluntary movements, and the source of sensibility.
(COPELAND.)
Although Apoplexy of the cerebellum, like that of the brain
itself, generally produces paralysis of the side of the body
opposite to the seat of the injury, yet ANDRAL asserts that
when haemorrhage into the cerebellum occurs simultaneously
with that of the brain, or a little time after it, but so that the
blood is effused on the right into the cerebellum and on the
left into the brain, or vice versa, then there will be paralysis
only on the side of the body opposite to the hemisphere of the
brain where the bleeding has taken place; i. e., on the same
side as the extravasation of blood into the cerebellum. It is
most interesting and extraordinary that the movements of the
limbs of the right side should be abolished when there is an
effusion of blood into the left side of the brain, while the
effusion which takes place simultaneously into the right side
of the cerebellum should no longer possess the power of paralyzing the limbs of the left side.
Ventricular Apoplexy. The symptoms of this form are
not positively known, but the bleeding has been traced by
MORGAGNI, DE HAEN, and HUFELAND, to rupture of the vessels
of the choroid plexus, in many of those cases in which the
extravasation is confined to the ventricles of the brain, without
being preceded by laceration of the surrounding cerebral
substance.
Aneurismal Apoplexy. COPELAND says that small aneurisms
in various parts of the cerebral vessels may form, and by their
rupture occasion hmmorrhagic Apoplexy. SERRES relates
cases in which rupture of an aneurism occurred in the basilar




HEMORRHAGIC APOPLEXY.. 
artery, and in one of the small arteries of the circle of Willis.
Numerous other cases have been observed by Blane, Hodgson,.
Morgagni, Lieutaud and others, but especially by Bouillaud
and Bright. COPEMAN, too, cites six or eight cases, one of'
which, viz.: case 102, occurred in a patient only 19 years of
age; case 32, aged only 21; case 43, aged 30; and case 2,
aged 35. These ages are certainly younger than those in
which aneurism is thought to be most common.
Arterial Apoplexy. An immense number of cases of
haemorrhagic Apoplexy arise from disease of the arteries of
the brain, without aneurism; in fact COPELAND asserts that
the most common causes of hanemorrhage in the gradually
increasing, or ingravescent Apoplexy, are: ossification, earthy,
and atheromatous deposits in various places on the arteries,
and a peculiar brittleness, or friability of the vessels of the
brain. COPEMAN gives but few cases of this kind occurring
in young persons; still case 120 in his book happened in a
person aged only 20 years; case 202, aged 35; cases 12 and
34, aged 40; case 80, aged 42; cases 109 and 119, aged 45;
and case 190, aged 46. Six other cases happened in persons
between 50 and 60 years of age; five cases between 60 and
70 years.
3leningeal Apo2plexy. This variety has been studied
minutely and curiously by several physicians, especially by
PRtss and HEWETT. Pain in the head is said always to accompany it, and when the effusion of blood takes place slowly, the
pain experienced is excessive; it is excruciating, there being
blood enough poured out to irritate the membranes of the brain
and arouse their sensibility to the uttermost, but not enough
to smother or paralyze the organs whose office it is to receive
impressions, and recognize pain. At times this extreme
suffering lasts for some or many days, but generally coma,
comes on rapidly, and relieves the patient. (SOLLY).
Another of the most important occasional characteristics of
meningeal Apoplexy is the intermission of the symptoms, and
the consequent masking of the disease. HEWETT had a case
in the person of a lady, aged 65, who after having suffered




172                   APOPLEXY.
for several days with great mental excitement, was suddenly
seized with violent pain confined to the right eyebrow, which
lasted for two or three hours, and then disappeared. This
pain continued for several days to recur twice in the 24 hours,
presenting all the characters of brow-ague, and it was apparently relieved by quinine, but was succeeded by a train of
low symptoms, accompanied by a brown tongue, wandering
and impairment of the intellectual faculties, terminating in
coma. This lady died in twelve days, without having had
any paralysis, or contractions of the limbs; a large quantity
of blood was found extravasated into the cavity of the
arachnoid.
According to DAY the premonitory symptoms of Apoplexy,
such as headache, drowsiness, numbness, vertigo, &c., may or
may not occur; premonitions were only present in eighteen
cases out of forty-one recorded by BONDEL. Occasionally the
attacks set in so rapidly and severely as to merit the expressive term of the French writers, Apoylexiefoudroyante.
PRuss has endeavored to establish the diagnosis between
sub-, and intra-arachnoid Apoplexies. In the former, the
bleeding, even if considerable, is followed by no paralysis of
motion or sensation, when the blood is poured out by exhalation, or from rupture of a vein; but when an artery is
ruptured, paralysis sometimes occurs, owing to the greater
impulse and shock with which the blood escapes. In intraarachnoid Apoplexy paralysis of motion is very common,
while paralysis of sensation is more rare.
In sub-arachnoid Apoplexy there is never a sudden loss of
consciousness, whereas, in the latter there is.
In the sub-arachnoid variety there is somnolence and coma,
without headache, fever, dryness of the tongue, or delirium;
in the latter, all these symptoms are very apt to be present.
In the former we are apt to find neither convulsions, contraction or rigidity of the limbs; in the intra-arachnoid
variety we generally have at least one of these phenomena.
Sudden loss of consciousness and paralysis do not occur so
friequently in meningeal Apoplexy, as in Apoplexy of the brain;




IHEMORRHAGIC APOPLEXY.               173
deviation of the mouth to one side, is also much less frequent;
while both forms of meningeal Apoplexy frequently assume
an intermittent character, which is very rare in ordinary
Apoplexy.
It is sometimes impossible to distinguish it from softening
of the brain. The duration of sub-arachnoid Apoplexy does
not often exceed eight days; while the intra-arachnoid variety
may last for a month or longer, and then occasionally terminate in recovery.
Treatment of Hcamorrhlagic Apoplexy.
(Atheroma.)
The preventive treatment of a very large number of cases
of haemorrhagic Apoplexy will consist in the prevention of
that disease of the arteries which leads to the formation and
deposition of atheroma, and to ossification of the arteries.
According to ROKITANSKY atheroma is formed, and poured
out from the walls of the internal coat of the arteries; at first
it resembles coagulated albumen; although it is generally
associated with an arterial crasis of the blood, still, it is not
the product of inflammation of the arteries; it is rarely associated with tubercular disease of other organs; but is frequently coexistent with an excessive formation of fat in the
whole body. Chemically, atheroma has been found to consist
of a great number of cholesterine crystals, some oil globules,
and of large, small, and very small molecules consisting of
albumen, and salts of lime; this atheromatous mass often
thickens and is transformed into a moist, soft, mortar-like
substance, and finally into a granular, rough, stalactite-like
lime concretion; another transformation of the deposit is
ossification of parts of the walls of the arteries, which is very
frequently preceded, and associated with fatty degeneration
of the fibrous coat of the arteries.
The homceopathic treatment of atheroma has not yet been
pointed out; if there be a preceding arterial crasis, Ferrum,
China, Natrum muriat., Manganese, &c., would be homceo



174:                    APOPLEXY.
pathic; if there be a strong tendency to the development of
adipose tissue, Calc. c., Antim. crud., Kali c., iKIali hydriod.,
&c., will be most indicated, although CEAmBERS (see work on
Corpulence) gives most striking results from the free use of
Liquor potassme in excessive corpulence. When atheromatous
deposits are fairly formed upon the arteries, we must get rid
of them as best we may; we have already seen that they
consist mainly of cholesterine crystals; cholesterine is a white,
crystallizable, fatty substance, somewhat like spermaceti, free
from taste and odor, and composed almost entirely of carbon
and hydrogen; it may be obtained by a chemical process of
no great complexity from  the serum  of the blood, and is
conjectured by some physiologists to be altered Serolirn, or
the natural non-saponifiable fat of the serum; one of its most
striking characteristics is, that it is not affected by a solution
of Caustic potash, and that concentrated Nitric, Muriatic, and
Arsenious acid exert no chemical effect upon it. On the
other hand, WAGNER found that four parts of soap solved in
water would dissolve one part of cholesterine; according to
SIMON it dissolves so freely in heated Holz-geist or Nvaphthsa,
that the solution appears crystalline when it cools; ether,
the fatty oils, and turpentine also dissolve it; but, the latter
only in a moderate degree; while it requires twelve parts of
cold ether, to solve one part of cholesterine. As cholesterine
exists in the normal brain and nerves in considerable quantities, and is a principal constituent of atheroma, we may
readily infer that the arteries of the brain would often be
found in an atheromatous condition. Again, CARPENTER has
suggested that one of the principal sources of bile is the continual waste of nervous matter, which in some respect so
nearly approximates to bile in its composition, that it is
asserted by FREMY, that the peculiar acids of the brain may
easily be detected in the liver; hence we may infer, the
frequent practical connection of bilious derangements, with
Apoplexy and atheroma. For want of better remedies
against atheroma, it may be justifiable to use the chemical
ones, above pointed out, viz.: Naphtha, Ether, Sapon. commun.,




FEBRILE AND INFLAMMATORY APOPLEXY.      1T5
some of the fatty and volatile oils, and Terebinth. Turpentine is homoeopathic to some of the symptoms of Apoplexy,
especially when attended with urinary troubles, and there is
sudden dizziness with dimness of sight, stupefaction and deep
sleep, from which the patient awakes confused and languid,
and with reeling; when there is dull headache with colic,
aching pains in the whole head, going and coming, and
attended with vomiting; heavy oppressive pain over the left
eye; tearing headache on the right side for nine days, &c.
If there were any provings on the healthy, with the other
remedies, doubtless one or more of them could be shown to be
homceopathic to some of the varieties of Apoplexy.
The albuminous condition of athemora in its first stages,
may be treated with Merc. corr., Nitric acid, or Kali hydroid.;
the fatty degeneration of the fibrous coat of the arteries may
be treated by, 1st, Calc., Caps., or Ferrum; or 2d, by Ant.
crud., Cuprum, Lycopod., Puls., Sulph., or other remedies.
The calcareous and ossific deposits on the arteries, may be
treated with Calc. c., Calc. phos., Silex, or especially by the
Silicate of Potash, which was found so useful by URE against
the earthy, and tophaceous deposits of gout.
When an absolute rupture of one of the arteries of the
brain has taken place, after, or in connection with the ordinary symptomatic treatment, we must also depend much upon
styptic, or anti-haemorrhagic remedies. This has already been
alluded to before; among the strictly homzeopathic remedies,
Arnica, Millefolium, Ferrum acet., Plumbum, Acidum sulph.,
and others deserve most attention.
FEBRILE AND INFLAMMATORY APOPLEXY.
Apoplexy with bleeding into, or upon the brain may occur
in consequence of an exudation from the capillary vessels,
owing to a febrile excitement and inflammatory congestion.
This mode of hmemorrhage is indicated, apart from the febrile
symptoms, by the gradual accession of the signs of Apoplexy;
if a blood-vessel had been ruptured, the fit, would be more
sudden and instantaneous. In fact, in some of these cases the




176                    APOPLEXY.
brain being already excited, resists the oppressive effect of the
effused fluid longer than it would in its natural condition; so
that at first the symptoms of compression are not in proportion
to the amount of the effusion.
In febrile and inflammatory Apoplexy we always have
increased heat of skin, and a febrile pulse; while Apoplexy
from hemorrhage is characterized by a slow pulse and
diminished temperature. One of the most common causes of
this form of Apoplexy, is extension of rheumatism of the
muscles of the nape to the membranes of the brain; the
muscles of the neck will, then be found to be tense, swollen,
and so tender to the touch that if but slightly pressed the
patient's countenance expresses pain, he will often be roused
from his unconscious state, and mutter loudly some unintelligible words; he will hold his neck in a constrained position,
and if we attempt to move his head or neck there is an
expression of pain on the countenance, and the head returns
at once to its unnatural position. (NEISSER.)
The treatment of febrile and inflammatory Apoplexy is so
well known that it requires but few words to indicate it.
Aconite, Belladonna, Bryonia, and Tart. emetic, are the most
important remedies.
SEROUS APOPLEXY.
WATSON says, that a moderate quantity of serous fluid
poured out rapidly during life will certainly occasion a degree
of pressure adequate to the production of fatal coma —but
how the serum comes to be so effused, it is not always so easy
to say-yet there is one condition of the blood-vessels of the
brain which, when it can be proved to exist in a given case,
is sufficient to account for the effusion. Any real or virtual
retardation of the blood in the cerebral veins would lead to
what is tatamount to dropsy, there, as well as in any other
part of the body.
SOLLY assumes that serous Apoplexy is always more or less
dependent on general debility, with local vascular excitement,
and congestion of an asthenic character-for instance, a man




SEROQUS APOPLEXY.                177
of intemperate habits gets a blow upon the head causing concussion; if this is judiciously treated, he will recover in the
course of a few days-but if he be bled largely from the arm,
and purged freely the result will almost certainly be serous
Apoplexy. But the most unequivocal cases of asthenic serous
Apoplexy are those which occur from suppression of urine,
the result of disease of the kidneys. Convulsions, and apoplectic coma are among the most common fatal terminations
of Bright's disease of the kidneys, especially in pregnant
women. Whenever a pregnant woman has a bloated, or
tumid state of the hands and face, the urine should always be'
tested for albumen; if this be present, and a peculiar and
intense pain in the forehead set in, especially if accompanied
with a severe pain in the stomach, and vomiting of bile, puerperal convulsions and Apoplexy will almost certainly set in.
The attacks may perhaps be prevented by the timely use
of Mere. corros., Nitric acid, Cantharides, or Kali hydroid.;
but if there be a great deficiency of urea in the urine, Colchicum will also be required. If an attack fairly set in,
Venesection and Opium are the most reliable remedies; with
them, only forty-two mothers were lost out of 152 cases, or
rather more than one-fourth; without them almost all die,
except the cases of purely hysterical, or epileptic convulsions
and Apoplexy. It is not a little singular that the majority of
cases of puerperal convulsions and Apoplexy occur in primaparae; thus, of thirty-six cases related by Dr. Merriman,
twenty-eight were with first children; of Dr. Ramsbotham's
more than two-thirds were with first children; and of Dr.
Collins' thirty cases, twenty-nine were with first children.
The majority of those women who suffer thus with their first
child, are not particularly liable to a recurrence with their
other children.
CoPEMrA gives several cases of serous Apoplexy especially
when attended with more or less general dropsy, and Bright's
disease of the kidneys, viz.: cases 57, 61, 63, 64, 65, 66, 87,
101, 205, 229 and some others. Case 229 of Copeman's
collection deserves to be reprinted here. A hearty woman,




178                    APOPLEXY.
aged 30, but somewhat dropsical, and near the full period of
gestation, fell down suddenly; she instantly became insensible, with stertorous breathing, a hard vibrating pulse, and
violent convulsions, which recurred paroxysmally. Delivery
of the child occurred in a few hours, but the symptoms of
Apoplexy remained unabated, until thirty drops of laudanum
were given. The next morning the insensibility, stertorous
breathing and convulsions returned, and remained after an
injection, which had a proper effect, had been administered;
then twenty drops of laudanum were ordered every ten
hours, until the symptoms should abate. At the end of the
third day manifest advantage had been gained over the
disease; in four days recovery appeared certain, and it happened accordingly. (KIRKLAND.)
I claim the credit of being the first to point out a truly
homeopathic, and specifically curative remedy, viz.: ilercuw.Tius Corrosivus, against one. variety of Bright's disease of the
kidneys (see Homoeopathic Examiner, new series, vol. 1,
p. 285), as long ago as the year 1846. Besides the successful.cases there recorded, I have heard of numerous other fortunate recoveries, both in our public allopathic medical institutions, and in private practice. It is well to add that RoxITANsKY distinguishes no less than eight different varieties of
Bright's disease; hence we require at least eight different
remedies to cure all these varieties, and doubtless several
more will be necessary to meet all the peculiarities of some
cases. Of course Mercurius corrosivus will not cure all cases
of Bright's disease; some require Cantharides, others Nitric
acid, or Hydriodate of Potash, or Copaiba; while remedies
for the remaining varieties have yet to be discovered. Marsh
Marigold will probably cure some cases. (PETERS.)
NERVOUS APOPLEXY.
WooD says it is now generally admitted by old-school
authorities that death may occur, even after, and perhaps in
consequence of the most active treatment, with all the phenomena of Apoplexy, without leaving any observable lesion in




NERVOUS APOPLEXY.               179
the brain. Such cases are denominated by some, nervous
Apoplexy. He says they are rare, but the probability seems
to him, to be, either that some slight phenomena of congestion
have been overlooked, or that some of the blood-vessels of the
brain have been violently distended, sufficient to press upon
and paralyze the action of some of the nervous centres essential to life, but have become emptied of blood before death,
after the mischief has been produced.
In fact, in hemorrhagic and congestive Apoplexies the
symptoms are owing to distension, or compression and consequent paralysis of some portions of the brain. This paralytic state of the brain may occur quite independently of any
congestive trouble, and give rise to all the symptoms of
Apoplexy.
CoPELAND says, that the circulation of the brain is chiefly
under the dominion of that portion of the sympathetic nerve
which is ramified on its blood-vessels, and that an exhausted
or morbidly depressed state of the influence which these
nerves exert on the circulation and manifestations of the
brain, particularly in dilating or congesting the capillaries
and disposing to their rupture, is the principal cause of, and
often constitutes the whole of the apoplectic seizure. From
this it may be inferred that the proximate cause of a large
proportion of the cases of Apoplexy, not excepting even those
which are attended with retarded circulation and hemorrhage
is here imputed primarily to the weakened condition of that
part of the sympathetic nerve which supplies the blood-vessels
of the brain, and the brain itself.
Hence, the most important indication of treatment is to give
tone and vigor to these nerves. Nux, Veratrum, Quinine,
Arnica, &c., should be more useful than bloodletting. HUFiELAND, in particular, considered Apoplexy frequently to proceed from that state of the nervous power which he considered defective.
CooxE (see Burrows, p. 79) says, the opinion that Apoplexy
is caused by an obstruction of the passage of the nervous fluid
into the organs of sense and motion has been the favorite




180                    APOPLEXY.
hypothesis of physiologists, and seems more satisfactory than
any other to explain the manner in which the exciting causes
act in producing the symptoms of the disease. (Ibid. p. 80.)
ABERCROMBIE says, it is an important fact that Apoplexy
has, by extensive observation, been ascertained to be fatal
(under allopathic treatment) without any morbid appearance
in the brain, or with appearances so slight as to be altogether
inadequate to account for the disease. There is a modification
of Apoplexy, depending on a cause of a temporary nature,
without any real injury done to the substance of the brain;
and that the condition upon which this attack depends may
be speedily removed, or it may be fatal without leaving any
morbid appearance on the brain. B3URSERIUS relates instances
of the kind, and quotes Vallisnieri, of Mlodena, who asserts
that in several bodies of persons who had died of Apoplexy,
to the great amazement of the dissectors, not the smallest
injury was discoverable either in the membranes of the brain,
or in the cortical or medullary part, or in the ventricles, or in
the vessels, or in any other part of the head. WILLIS, NICOLAI
and KORTUN, have seen such cases, and finally such distinguished pathologists as GRISOLLE and Lous have met with
them. Grisolle has reported a case in which the brain was
examined into its most minute parts, and VALLEIX saw in the
service of Louis, a patient who after having succumbed in
consequence of an attack of Apoplexy, attended with complete loss of consciousness and hemiplegia, did not present a
single visible cerebral lesion, although the examination was
most minute. Such cases as these should lead the dominant
school to be more charitable and just in their judgments of
homceopathic physicians. If such a case should by chance
happen to a homceopathist, there would be no end of the
contumely and reproach which would be heaped upon him,
and his mode of practice; but the very numerous fatal cases
of this kind which happen under allopathic treatment, are
very cavalierly ignored, or forgotten.




CARDIAC APOPLEXY.                 181
CARDIAC APOPLEXY,
Or Apoplexy connected with, or arising from  preceding
Organic disease of the heart.
In every case of threatened or happened Apoplexy, it should
be regarded as imperatively necessary for the physician not
only to examine the pulse carefully, but also to investigate the
condition and action of the heart. According to BURROWEs,
"simple hypertrophy of the left ventricle of the heart will
cause an increased activity in the general circulation; the
blood will be thrown to the head with more than usual force,
and there will be a more rapid transit of the blood through
the arteries of the brain. But, after a time, this constantly
increased force of the left ventricle will have the effect of
dilating the cerebral arteries, and thus of overcoming the
healthy elasticity of their tunics. Congestions of the brain
will now ensue, and the coats of the dilated vessels no longer
protect the surrounding substance of the brain from the inordinate momentum of the blood propelled from the heart.
Apoplectic coma is now very likely to occur from some
sudden accidental increase of pressure of blood on the brain,
or from rupture of an artery, and pouring out of blood into
the brain.
Hence, enlargement of the left ventricle of the heart must
be admitted as a powerful predisposing, or even exciting
cause of Apoplexy, and sudden paralysis. In 132 cases of
Apoplexy collected by various authors, the heart was found
diseased in no less than eighty-four instances, or sixty-three
per cent. Andral, in twenty-five cases, found the heart diseased
in fifteen; Clendinning, in fifteen cases, out of twenty-eight;
Hope, in twenty-seven cases, out of thirty-nine; Burrowes, in
twenty-three cases, out of thirty-four; Guillemin, in four cases
out of six; Rochoux, in four cases out of fourteen.
But, simple enlargement is not the only disease of the heart
apt to cause Apoplexy; in Andral's fifteen cases, there was




182                    APOPLEXY.
valvular disease in eleven cases; in Burrow's twenty-three
cases, there was valvular disease in sixteen.
A careful examination of the state of the heart of an apoplectic patient is much more necessary for the safety of one
under allopathic treatment, than under the homceopathic.
For if the Mitral valve be diseased, and allow of regurgitation from the left ventricle, then the small and irregular
pulse so generally attending that state of the valves, will
probably dissuade the allopathist from that free abstraction
of blood, which the state of the brain seems to require, according to his mode of treatment. Again, if in another case of
Apoplexy or paralysis, the Aortic valves be found diseased to
the extent of not only obstructing the onward current of blood,
but also of allowing regurgitation into the ventricles, there
will probably be associated with this lesion, considerable
enlargement of the left ventricle. Then we will find a full
and vibrating, or thrilling pulse, but a pulse of increased
action without real power, and hence a deceptive pulse; and
one which, if it be regarded without reference to the disease
of the heart, would tempt the physician to a more copious
abstraction of blood than will be called for by the general
symptoms. (BuRROWES.)
It will be unnecessary to enter here upon the treatment of
those affections of the heart which are attended with Apoplexy,
because the treatment of Organic affections of the heart has
been given minutely and completely by the translator in the
Homceopathic Examiner, vol. 2, (new series, 1847), and
reprinted, both in Hull's Laurie's (Appendix), and in Hull's
Laurie (new edition, 1853,) all published by Wm. RADDE.
BILIOUS APOPLEXY.
BuDD (see Treatise on Diseases of the Liver,) has made quite
a large collection of fatal cases of jaundice, followed by delirium, coma, paralysis or convulsions. RoKrrIwsT, however,
was the first to call attention to this formidable disorder,
under the name of acute yellow softening of the liver; owing
to his researches, the disease can now be readily detected




BILIOUS APOPLEXY.               183
during life; its course is acute, there is extreme pain in the
region of the liver, which organ rapidly becomes extremely
soft, and diminished in size; this diminution of size can easily
be recognized by means of careful percussion, and this diagnostic sign is of very great importance, as in most other
diseases in which jaundice occurs, the liver is generally
enlarged. The prognosis in severe jaundice with decided
diminution of the size of the liver, is much more serious than
when the liver is enlarged. Until quite lately this form of
disease was regarded as almost necessarily fatal, but now the
patient may often be saved, even after he has fallen into a
state bordering on apoplectic coma, the patient being unable
to speak, with slow pulse, dilated pupils, and almost total loss
of sensation and voluntary motion.
Among the remedies homceopathic to Apoplexy, Cuprum
aceticum, and Phosphorus are also decidedly homceopathic to
profound bilious derangement and jaundice. According to
CHRISTISON, (uprum is homceopathic to violent headache with
vomiting, cutting pains in the bowels, cramps in the legs, and
pains in the thighs; he also mentions six or eight cases in
which it proved homzeopathic to jaundice; and others, in
which it was found homceopathic to convulsions, palsy, coma,
and insensibility; others, again, in which the patient was
insensible, with the jaws locked, the muscles rigid and frequently convulsed, the breathing interrupted, and the pulse
small and slow; one case in which there was convulsions and
loss of consciousness followed by extraordinarily paralytic
weakness of the arms and legs, and attended with congestion
of the surface of the brain.
CHRISTISON also gives a case in which Phosphorus proved
homceopathic to spasms, delirium and palsy of the left hand,
the limbs being neuralgic, the intellect clouded, and the
breathing stertorous, while the whole of the skin was generally yellow.




184                   APOPLEXY.
GASTRICG APOPLEXY.
A very large number of cases of Apoplexy occur after a
full meal; a person predisposed to Apoplexy, either from
plethora, or disease of the arteries of the brain, but especially
when both are present, is very apt to be attacked with Apoplexy, after a full meal. This is best illustrated by a case.
A colored woman, aged about 50, and somewhat corpulent,
after a hearty meal of meat, peas and rice, fell down in a
state of insensibility, and soon expired. As soon as the skull
was opened, a considerable collection of blood was found
about the base of the brain, and large clots were discovered
in its substance; the arteries of the brain were rigid, much
dilated, and studded over with numerous points of ossification; the bleeding had taken place in consequence of a
rupture of some of these arteries. On examining the stomach,
that organ was found impacted with peas, rice, hominy and
other articles of the individual's repast, to a degree to which
it would scarcely be possible to believe could be borne without extreme suffering, and an extensive embarrassment of the
functions of the whole of the associated organs. It was so
distended as to encroach upon the intestines, compress the
aorta, and the vessels given off by it in the epigastric region,
press upon the plexus of nerves behind the stomach, and
finally, force up the diaphragm upon the lungs so as to interrupt their play, and thus embarrass the function of respiration, thereby interrupting the passage of blood through
them, and consequently impeding its return from the head.
The blood being thus confined on the one hand to the vessels
of the brain, by these causes, and driven upon it, on the other
hand, by the pressure sustained by the aorta, which prevented
the distribution of the usual quantity of blood to the lower
part of the body, it is not to be wondered at, when the fragile
state of the coats of the arteries of the brain is considered, that
they should have been unable to sustain the pressure thus
suddenly thrown upon them, and that they gave way under
its influence. (COPEMAN.)
The above is a fair exposition of one cause of a very large




GASTRIC APOPLEXY.               185
number of cases of Apoplexy. The frequency of this occurrence has given rise to the dispute among physicians as to
the propriety of administering emetics in Apoplexy, or not.
COPEMAN says, that the practice of giving emetics when the
attack has succeeded a full meal, has not only been safe, but
effectual; case 36 in his hook, recovered from Apoplexy
excited by eating cucumbers and whortleberries, after the
action of an emetic; also case 37; case 26, after vomiting
some pints of fcetid bile; case 90, recovered after spontaneous
vomiting set in. On the other hand, WATSON says, that the
treatment of Apoplexy with emetics is an extremely hazardous
measure, which is almost sure to do harm if there is already
any extravasation of blood. He merely mentions the practice
to protest against it.
Still, an overloaded stomach must be relieved from its
excessive and often disgusting contents; we have seen that it
exerts an exceedingly injurious pressure upon various important organs, and obstructs the return circulation from the
head; it must be manifestly the height of folly to put
infinitesimal and delicate doses in a foul stomach; hence, if
emetics are injurious, what are we to do? The bowels may
evidently be fully emptied, thus leaving more room in the
abdomen; the whole quantity of blood may be reduced, if the
patient be decidedly plethoric, and then the stomach may
probably be evacuated, with safety and benefit; after the
stomach has been thoroughly cleansed and purified, infinitesimal doses may be used.
Dr. W. HERING (see Brit. Jour. of iom., July, 1852, p. 377)
gives eight instances of apoplectic attacks arising from excessive or improper feeding; in three cases, free vomiting was
induced with great relief to the patient; in three other cases,
large draughts of hot water were used to relax the pyloric
orifice of the stomach, and allow the offending substances to
pass out of the stomach into the bowels, and be carried off by
spontaneous diarrhcea.
This may not be an improper place to speak of the use of
cathartics in Apoplexy. WATSON says, that "purgatives are
15




186                    APOPLEXY.
of signal service; they empty the intestines, which are sometimes loaded, and which by distending the abdomen have
perhaps occasioned undue pressure against the diaphragm,
embarrassed the breathing, and through it the circulation in
the brain; another very important purpose of hard purging,
is the producing of copious watery discharges from the bowels,
whereby the blood-vessels are drained, and the tendency of
blood to the head especially relieved."
I am sorry to say that in my experience, purging has had
no such good effects; in at least four cases of Apoplexy,
previously treated by allopathic physicians and in several by
myself, I have seen decided purging produce not only no
good effect upon the patient, but render his condition one of
great misery and filth to those around him, all the evacuations
being necessarily passed in the bed, while the necessary
attentions in cleansing and moving the patient have certainly
aggravated a state which requires the utmost repose and
quiet. COPEMAN even gives two cases, viz.: cases 193 and
194, in which hypercatharsis seemed to bring on Apoplexy.
"A foreman of a mill, strong and stout, was under the care
of a physician for disorder of the liver, which was treated by
mercury; this produced a hyppcatharsis so prodigious that
he nearly became bereft of all power, and all pulse; he rallied
partially, but in twelve hours presented all the symptoms of
cerebral Apoplexy; he was lethargic and flushed; notwithstanding the usual treatment, he went on into all the degrees
of Apoplexy, and died in twelve hours more.
A stout, unwieldy lady, aged 70, in her usual health in the
morning, had taken a purgative, which produced a hypercatharsis; after the evacuations she was struck with Apoplexy.
COPEMAN exclaims: Emptied vessels, with great debility, yet
the blood determined fatally to the head!"
WEST gives the case of a child attacked with diarrhcea, producing great exhaustion; and while suffering from this affection, he suddenly became comatose, cold and almost pulseless,
and his breathing became so slow that he inspired only four
or five times in a minute. In. this state he lay for twenty



INFANTILE APOPLEXY.              187
four hours, and then died quietly. Nearly six ounces of dark
coagulated blood were found in the cavity of the arachnoid.
(See Lectures on Diseases of Infancy and Childhood, p. 54.)
INFANTILE APOPLEXY.
ALOIS BEDNAR, of the Vienna Foundling Hospital, met with
thirty-seven cases of haemorrhage into the pia mater in the
course of three years; viz.: twenty-two times in boys, and
fifteen times in girls. In the same space of time, he met with
Apoplexy of the arachnoid, only fifteen times, viz.: in seven
cases in boys, and in eight, in girls. Of the thirty-seven cases
of Apoplexy of the pia mater, the bleeding was extensive -in
three cases only; oft the fifteen cases of arachnoid Apoplexy
the disease was extensive in all but three cases. BEDNAR also
met with sixteen cases of bleeding into the substance of the
brain, viz.: eleven times in boys, and only five times in girls.
The principal symptoms of bleeding into the cavity of the
arachnoid membrane are: distension and pulsation of the
anterior fontanelle, dimness of the cornea, clonic cramps,
rigidity or paralysis of the limbs, sopor, coolness and blueness
of the skin, slow beating of the heart and slow respiration.
The age of the child, the recency of birth, and the course of
the disease will aid the diagnosis.
According to WEST all periods of childhood are not equally
exposed to this accident, but it is oftenest met with immediately after birth. The head of the infant has been subjected
to severe, and long-continued pressure; immediately on its
birth the course of the circulation is altogether changed, and
should any difficulty occur in the establishment of the new
function of respiration, a long time will elapse before the blood
flows freely through its unaccustomed channels. The tumid
scalp and livid face of many a still-born child point to one of
its most important causes, since they are but the external
signs of that extreme congestion of the vessels within the
skull, that has at length ended in a fatal effusion of blood on
the surface of the brain.
There will be reason to fear that this occurrence has taken




188                   APOPLEXY.
place, if an infant when born, were to present great lividity
of the surface, and especially of the face; and if the heart
were to beat feebly, and at long intervals, although the pulsations of the cord were slow, or faint, or had altogether ceased.
Death may take place without any effort at respiration being
made, the beatings of the heart growing feebler and fewer till
they entirely cease; but at other times the child breathes irregularly, imperfectly, and at long intervals. The hands are
generally clenched, and spasmodic twitchings are of frequent
occurrence about the face; or these twitchings may be more
general, and more severe, and may amount almost to an
attack of convulsions. (WEST.)
Bleeding within in the skull in the new born infant takes
place almost under the same circumstances that bleeding into
the tissue of the scalp, or extravasation of blood between the
bone and pericranium takes place (Cephalhue/atoma).
Infantile Apoplexy, though at no time so frequent as immediately after birth, may occur at any subsequent period of
childhood, either under the influence of causes which favor
congestion of the brain, or even independently of any cause
that we can discover.
WEST) LEGENDRE, RMLIET and BRTHEZ, all concur in representing its symptoms as exceedingly obscure; paralysis was
observed only twice in twenty-six cases of hoemorrhage into
the cavity of the arachnoid, owing probably to the pressure
exerted on the brain being generally diffused over its surface,
and being nowhere very considerable; just enough, perhaps,
to cause general dulness and torpor. On the other hand, the.sudden occurrence of violent convulsions, and their frequent
return, alternating with spasmodic contraction of the fingers
-and toes in the intervals appear, to WEST, to he the most:~frequent indications of effusion of blood upon the surface of
Athe brain.
Both BEDNAR and WEST lay some stress upon hsemorrhage
into the brain, in children, being connected with an altered
state of the blood, and with disease or enlargement of the
liver; bilious symptoms are often present, the region of the




SECONDARY EFFECTS OF APOPLEXY.          189
liver is often tender to touch, and the liver itself is sometimes
found enlarged. WEST has met with only two instances of
distinct extravasation of blood into the substance of the brain
in older children; one was in a little girl, aged 11 months; the
other also in a girl, but aged 11 years.
SECONDARY EFFECTS OF APOPLEXY.
Having made some remarks about the nature and treatment of the principal varieties of Apoplexy, it may not be
out of place to refer to the precautions and remedies necessary
for the after-effects of the disorder.
A principal precaution is to prevent the patient from
making any exertion for some time after the first effects of the
attack have passed off. A very large number of lives have
been lost from want of attention to this. In Copeman's 18th
case, the patient, after being successfully treated, so that he
became conscious, knew his friends and was able to walk with
assistance from one bed to another, soon relapsed after this
exertion, and finally died. In case 21, the patient had recovered sufficiently to walk across his room, when he cried out
suddenly with pain in the head, fell down insensible, and died
in thirty minutes. It will be useless to multiply cases to this
effect; BURROwES (see on Disorders of the Cerebral circulation,
p. 146) has an excellent chapter on, and very instructive cases
illustrative of the bad effects of premature exertions of body or
mind after Apoplexy.
In other cases, two or three days after the emergence
from coma, we often observe the patient's face to become
flushed, the scalp hot, a frowning or knitting of the brows,
slight squinting, and complaint of pain on one side of the
head. This pain is usually referred to the side opposite to
the palsied limbs; and if the patient be deprived of the power
of expressing his sensations, his uneasiness is often indicated
by the occasional movement of the sound hand to the forehead; at the same time the paralysed arm is perhaps observed
to be occasionally drawn up to the face, or across the chest.
This latter movement taking place after the fit, often gives




190                    APOPLEXY.
rise to the hope that the paralysis is not so complete as it was
at first supposed to be; but such movements are involuntary,
and arise from commencing irritation and inflammation in the
substance of the brain immediately around the extravasated
blood. At the same time, the circulation becomes more active,
the patient is thirsty, and is sometimes troubled with an oppres*sive heat of the skin. These symptoms, which are indicative
of inflammatory action commencing around the clot of blood
in the brain, should be met by the application of cold to the
head, restricted diet, extreme quiet in the sick-room, and the
use of Aconite, and other antiphlogistic means and remedies.
Simultaneously with the above-described train of symptoms,
or soon after their appearance, the paralysed limbs are not
uncommonly affected with involuntary movements, which
usually consist of spasmodic contractions. The patient will
also, most probably, complain of severe pains in the palsied
limbs, of burning heat in them, so that he will long to plunge
them into cold water; the integuments of these limbs often
feel hot, and are red and swollen. These pains in the paralysed limbs often constitute a most striking feature in the
after progress of a case of Apoplexy. At each visit of the
medical attendant, the patient piteously demands something
to alleviate his sufferings, which greatly interfere with his
night's rest. These wearing pains are not confined to the
integuments, but appear to pervade the deeper-seated parts,
so that the periosteum of the bone of a palsied limb will
become swollen and painful. In some cases these pains have
appeared to be attributable to the continuance of irritation
from the clot upon the brain; in others, there is no evidence
of irritation of the brain, but this painful state of the limbs
seems to depend upon returning functions in the nerves, and
partly upon the capillary circulation in the tissues of the limb
not being duly regulated by the nervous system. These pains
in palsied limbs are very analogous to those which are experienced in a part when the circulation and animal temperature
are returning to it after it has been benumbed by cold. Almost
all local applications except Aconite are useless. It will some



SECONDARY EFFECTS OF APOPLEXY.         191
times happen that the redness and heat will subside, but the
neuralgia remains. These cases are very distressing to witness,
on account of the constant suffering which we cannot remove
by allopathic treatment; nevertheless, after the lapse of some
time, weeks or months in different cases, the pains gradually
disappear (BURROWES). Aconite, Nux and Veratrum are important homceopathic remedies against the irritative, inflammatory, spasmodic and neuralgic affections, although Creosote,
Phosphorus, Colocynth, Spigelia, and Ranunculus bulbosus
may also be required.
Another most important point in the after-treatment of
hoemorrhagic Apoplexy is to aid nature in the removal of
the clot; old-school physicians generally depend upon the use
of mercury, given so as to act as a purgative, and to slightly
affect the gums, but not allowing it to produce salivation,
which is always very distressing to the patient, whose powers
of mastication and swallowing are already impaired by his
disease. Kali hydriodicum would probably effect this object
more promptly than Mercury, and might at the same time
relieve the pains and swelling about the periosteum  and
bones, and consequent neuralgic pains. Arnica and Baryta
also deserve attention. (J. C. PETERS.)




ON THE
HOM(EOPATHIC TREATMENT
OF
APOPLEXY.
RtCKERT has furnished twenty-four cases of Apoplexy, treated
and cured by means of homeopathic remedies. I have added
about thirty additional cases from BLACK, SIMPSON, DUNSFORD,
MALAISE, iBEAuVAIS and others. I have also thought it advisable to include the cases of Congestive vertigo, collected by
RUCKERT, and those instances of "Affections of the Speech,"
which seem to depend upon some disorder in, or of the brain;
they are so closely allied to Apoplexy, or its premonitions,
that I trust no excuse will be necessary for this liberty.
RtiCKERT truly says, that quite favorable results have been
obtained in these formidable disorders by homceopathic treatment. He also assumes, that these not very numerous cases
prove that, whenever life can be saved at all, it can be saved
without the aid of exhausting bloodletting, and quotes ScHurBERT, who asserts that whenever he bled his apoplectic patients,
their disease and recovery progressed more slowly than when
he omitted it. SCHUBERT only found bloodletting useful when
decided plethora, or full-bloodedness was present; but always
found homceopathic remedies useful, and even indispensable.
Of RtCKERT'S cases he has assumed that fourteen cases were
instances of sanguineous  pop2lexy, while nine cases are
assumed to be examples of nervous Apoplexy.




ACONTE.                    193
The remedies treated of by ReeCERT, are: Aconite, Arnica,
Baryta, Belladonna, Cocculus, Crotalus, Ipecac., Hyosciamus,
Laurocerasus, Nux vomica, Opium and Phosphorus.
Numerous notes and several additional articles have been
added. (PETERS.)
1. ACONITE.
GENERAL REMARKs. —(a). [Fortunately, both old and new
school physicians agree about the utility of Aconite, in the
treatment of congestive and inflammatory affections of the
brain, although they entertain almost diametrically opposite
views about the general action of this remedy. Dr. FLEMING,
President of the Royal iMedical Society of Edinburgh, thinks
that it exerts a purely sedative action upon, and diminishes
the flow of arterial blood to the brain, acting in the same way
as excessive loss of blood, between which and the action of
Aconite, he says there exists a very strong analogy. On page
30, he draws the inference that it is an advisable antiphlogistic
in Apoplexy, inflammation of the brain, or in any disease in
which the circulation of the brain is excited, because it exerts
a direct, sedative influence upon the vascular system, reducing
more or less, according to the dose administered, the strength,
volume and frequency of the pulse. He asserts that the pulse
often falls to 60 per minute, and in some cases sinks to 48, 40
and even 36. On page 36 he draws the inference that Aconite
is a powerful antiphlogistic, and that it is calculated to be of
great value in all cases where there is an inordinate activity
of the circulation. (See Inquiry into the Physiological and
MAedicinal Properties of Aconitium napellus. London, 1845.)
A majority of the most able old-school writers on the
Materia Medica, viz.: PEREIRA, WOOD and BAcHE, TAYLOR,
CHRISTISON, NELIGAN and others, now agree with these views
of FLEMING; but it should not be forgotten that HAHNEMANN
pointed out the use of Aconite in congestive and inflammatory
affections full fifty years ago.
Many old-school writers now compare the action of Aconite
on the circulation to that of Digitalis, Tobacco, Colchicum,




194             TREATMENT OF APOPLEXY
and Veratrum viride, excepting that Aconite has also been
found to act specifically on the skin, causing ready and profuse perspiration, while Digitalis acts more decidedly on the
kidneys, causing a free flow of limpid urine; Tobacco acts
more decidedly on the stomach and muscular system, causing
great nausea and muscular debility, while Colchicum not only
diminishes the action of the heart, but causes profuse flow of
bile from the liver, and an increased excretion of urea from
the blood and kidneys. Hence of late, various uses and
combinations of these remedies have been proposed, in the
dominant school; in congestive, comatose, febrile and inflam,
matory affections. Colchicum has been more particularly
recommended in cases of Apoplexy arising from or connected
with bilious derangements, jaundice, or deficient secretion of
bile; but still more, especially by Dr. McLAGAN, of Edinburgh,
in all cases of coma and Apoplexy connected with suppression
of urine, presence of albumen and deficiency of urea in the
urinary secretion; in all cases in which albumen and urea
appear to be vicarious, and where coma supervenes evidently
from the accumulation of urea in the blood, viz.: in all casesT
of Bright's disease of the kidneys, and dropsy dependent
thereon. The use of small or moderate doses of Aconite,
Digitalis and Colchicum, promises ere long to usurp the place
of profuse bloodletting, active purging, and other savage treatment in the dominant school.] (PETERS.)
(b). According to KREUSSLER, Aconite is decidedly indicated
against sanguineous Apoplexy, and almost every other remedy
must yield the priority to this, which generally affords the
most speedy relief. HIence, he always gives it, even in cases
in which he is somewhat undecided about the proper treatment, without being fearful if it does not afford relief, of not
being able to make up the lost time by some other remedy;
still, he only waits a quarter of an hour for signs of improvement,
which in the majority of cases become evident in the course
of a few minutes.
It is most indicated in the Apoplexies of persons who present the appearance of the apoplectic habit, or constitution;




ACONITE.                   195
who have previously suffered with disease which can be traced
to some affection of the vascular system; or who have been
attacked with Apoplexy in consequence of the suppression of
accustomed hemorrhages. In these cases the head is apt to
be hot, the carotids to beat violently, the skin to be warm, the
pulse full, strong, hard, or labored, but not intermitting.
(c). [Of all the narcotic remedies, Aconite is most homceopathic to Apoplexy, as proven by the case of a young man
who had incautiously chewed some seeds of this plant; he was
shortly afterwards seized with a sense of numbness of the face,
soon followed by complete Apoplexy, complicated with paralysis, from which he recovered with great difficulty, and with
palsy of one side, with which he is still affected, now upwards
of twelve months from the time of the attack.] Diet. Prat.
Med., p. 92. (PETERS.)
(d). Aconite is most homceopathic, when Apoplexy is
attended with paralysis of sensation, rather than of motion;
according to TAYLOR, (see Medical Jurisprudence, p. 225,)
it proved homceopathic in one case to tremors of the muscles,
a pricking sensation over the whole body, unconsciousness,
followed by confusion of sight and intense headache, the skin
being cold and clammy, the pulse slow and irregular, the
breathing short and hurried. Also in another case, with:
a sensation of swelling of the face, a general feeling of numbness and creeping of the skin, restlessness, dimness of sight
and stupor, almost amounting to insensibility, arising from
exhaustion, however, rather than from congestion; followed
by speechlessness, frothing at the nose and mouth, clenching
of the hands and jaws; the patient appearing occasionally as
if dead, and then again reviving; cramps and tingling in
the flesh succeeded, and he did not entirely recover for five
weeks. Sir BENJAMwN BRODIE found Aconite homceopathic to
staggering, excessive weakness, slow and laborious respiration,
with slight convulsive twitches. CEIRSTISON founid it homceopathic to a gradually-increasing paralysis of the muscles,
which terminates in immobility of the chest and diaphragm,
and consequent asphyxia. PEREIRA thought it most homceo



196             TREATMENT OF APOPLEXY.
pathic to an extraordinary diminution of common sensation,
evidenced by insensibility to pinching and pricking, there
being a total absence of stupor. Dr. FLEMING found it most
homceopathic to weakness and staggering, gradually increasing paralysis of the voluntary muscles, slowly increasing
insensibility of the surface of the body, more or less blindness
from excessive weakness of the eyes, with great contraction
of the pupils, excessive languor of the pulse, and convulsive
twitches. FLEMING also infers decidedly, that Aconite is more
homeopathic to nervous paralysis and Apoplexy, than to
sanguineous Apoplexy, as it does not occasion vascularity of
any membrane to which it is applied; even the lips and
tongue while burning and tingling from its topical action, do
not show the least sign of redness or inflammation, and hence
this peculiar effect is decidedly a nervous phenomenon. FLEMING
also found it homceopathic to warmth in the stomach, nausea,
fnumbness and tingling in the lips and cheeks, extending more
or less over the rest of the body, diminution of the force and
frequency of the pulse, which sometimes sinks to 40 in the
minute, great muscular weakness, confusion of sight or absolute blindness. In very severe cases, there may be a sense of
impending death, sometimes a slight delirium, and a want of
power to execute what the will directs, but without any loss
of consciousness. The warmth of the skin to which Aconite
is homnceopathic, is a purely nervous wacrmlth, being unattended with any elevation of temperature, vascularity of the
skin, or acceleration of the pulse. It does not cause any true
hypnotic effect, but merely drowsiness from excessive exhaustion, debility, or languor; but by inducing serenity or deadening pain it may also predispose to sleep.
According to FLEMING, it is homceopathic to extreme
depression of the circulation; also to an overwhelming
depression of the nervous system, so severe that it may prove
fatal in a few seconds, without arresting the action of the
heart; and finally to asphyxia, or arrestment of respiration,
the result of a paralysis gradually pervading the whole muscular system, respiratory as well as voluntary.




ACONITE.                    197
FLEMING also assumes that the least variable symptoms to
which it is homeopathic, are: numbness, burning, and ting1 ing in the mouth, throat and stomach; then sickness, vomiting
and pain in the pit of the stomach; next general numbness,.prickling, and impaired sensibility of the skin, impaired or
annihilated sight; deafness and vertigo; also frothing at the
mouth, constriction of the throat, false sensations of weight,
and enlargement in various parts of the body; great muscular
weakness and tremor, loss of voice, laborious breathing;
distressing sense of sinking and impending death; small,
feeble, irregular, and gradually vanishing pulse; cold, clammy
sweats; pale and bloodless features, together with a perfect
possession of the mental faculties, and no tendency to stupor
or drowsiness. Slight spasmodic twitches of the muscles may
be present, and probably depend, as Dr. FLEMING suggests, on
venous congestion, the result of incomplete asphyxia. Stupor
and apoplectic insensibility do not always preclude the use of
Aconite, when they arise from the same kind of venous congestion above alluded to, but there is every reason to believe
that it is more homceopathic to extreme nervous depression
and faintness, than to the stupor and coma, for which they
are often mistaken.
PEREIRA found Aconite homceopathic to burning and numbness in the lips, mouth and throat, extending to the stomach,
and followed by vomiting; when the extremities became cold,
the lips blue, the eyes glaring and the head covered with cold
sweat; provided there was no spasm or convulsion, but some
tremor; no delirium, stupor or loss of consciousness, but
violent headache. In another case he found it homceopathic
to such weakness and stiffness of the limbs that the patient
was unable to stand; could utter only unintelligible sounds,
but had no spasms or convulsions. He experienced a strange
sensation of numbness in the hands, arms, legs, diminution of
sensibility over the whole skin, especially of the face and
throat, where the sense of touch was almost extinguished;
some dimness of vision, giddiness, and at times an approach
to loss of consciousness, but no delirium, sleepiness or deafness.




198             TREATMENT OF APOPLEXY.
In another case, Mr. SHERVIN found Aconite homeeopathic to
sensation of swelling of the face and contraction of the throat;
the patient was nearly blind, and excessively feeble, but did
not lose her consciousness; although her eyes were fixed and
protruded, the pupils contracted, the jaws stiff, face livid,
whole body cold, pulse imperceptible, heart's action feeble
and fluttering, and breathing short and laborious, yet she
was at all times so sensible, as to be able to speak about her
condition. PEREIRA, and PERRIN, of Bordeaux, found it
homceopathic to pungent pains in the limbs, cold sweating,
anxiety, extreme general prostration, great slowness and
irregularity of the pulse, convulsions and congestion of the
whole venous system.
BALLARDINI found it homceopathic to great injection of the
pia mater and arachnoid membranes (congestive Apofplexy);
much serous effusion under the arachnoid, and in the base of
the skull (serous Apoplexy); and to considerable engorgement
of the lungs with blood (pulmonary Apoplexy). In PEREIRA'S
case it proved homceopathic to venous congestion of the head
and chest; the lungs in particular being much gorged with
blood. PALLAS, when the lungs were dense, dark and gorged
with blood, and the vessels of the brain turgid.
Of all the symptoms of Apoplexy, Aconite is most homceopathic to great and general muscular debility and paralysis;
slowness of the pulse and failure of the circulation; excessive
numbness and tingling; and to the severe pains in the bones,
periosteum, and paralyzed parts which sometimes follow an
attack of Apoplexy (see page 190).
Aconite-general nmuscular debility, and paralysis.
AETIus and AVICENNA report, swooning and sinking together
of the legs; RICHARD, great weakness; paralysis of one arm
and leg; MATTHIOLUS, great powerlessness, paralysis of left
arm and thigh, so that all power of moving them was lost,
but left hand could be moved a little; recovery of the use of
the left side, but then the right became paralyzed; this paralysis was transient and affected each side alternately, thus




ACONITE.                    199
when the patient could lift the right arm, he could not move
the left, and vice versa, but finally he recovered the control
of both arms. BACON noticed such exhaustion of the strength
that the patient was obliged to lie down; weakness and unsteadiness of the joints, especially of the knees; BALDRIANI:
rapid prostration of strength in ten cases, with an unusual
degree of exhaustion. SHERVIN: failure of the legs to such an
extent that the patient fell down and had to be carried to bed.
PEREIRA: trembling of the limbs, swooning. DEVAY: trembling of the legs so as to produce a peculiar, staggering gait.
PEREIRA: excessive trembling, great weakness, yet with ability
to walk until a few minutes before death, in one patient;
while in another, the muscular debility was so great, that
standing was impracticable; in animals it weakens the muscular, system so much as to cause staggering in walking.
IHAHNEMANN: weakness and instability of the ligaments of all
the joints, unsteadiness of the knees, paralysis of the rectum
and bladder, transient paralysis of the tongue, loss of power
in the thighs, which prevents walking, paralytic weakness of
the thighs and legs, with staggering and fear of falling; in
fact, many signs of paralysis of the lower portion of the spinal
marrow, and of the pelvic nerves. AHNER: feeling of paralysis
in the right forearm and hand while writing, disappearing
after more active exercise of the limb, to return again when
at rest. HORNBURG: immediate trembling of the arms and
hands. RUCKERT: trembling of the hands, great lassitude of
the limbs, while walking; forty drops of the tincture produced
such heaviness and weakness of the limbs, in a stout peasant
girl that she was forced to lie down. ARNETI: lameness and
weakness of the left shoulder-joint, weakness of the knees, so
that he could not stand straight, nor walk without his knees
giving way (from forty drops of the tincture). BOHM: (from
twenty drops), walking and talking tired him quickly; he felt
lassitude and feebleness. GERSTEL: (from ten drops), unusual
but transient weakness of the legs; (from forty drops) persistent weakness of the feet, when going up stairs; (from fifty
drops) lassitude of the feet. MAscnAUER': (from fifteen drops)




200             TREAT]MENT OF APOPLEXY.
great lassitude; (from twenty drops) great general lassitude;
(from ten drops night and morning) feverish lassitude; (from
twenty drops) lassitude with chilliness; (from fifty drops)
palpitation, with slow pulse, and such sudden loss of strength
that he was unable to stand up; (from sixty drops) excessive
relaxation. REISINGER: (from one hundred and twenty drops)
leaden heaviness of the feet, while sitting or standing; (from
one hundred and forty drops) tottering of the legs and leaden
heaviness of the feet, so that he can scarcely move; (from two
hundred drops) leaden heaviness and relaxation of the limbs;
(from one hundred and sixty drops) extreme relaxation of the
limbs, tottering of the knees, general debility, so that he was
unfit to attend to his business; anxious trembling. Trembling
of the limbs. General relaxation. Relaxation of the arms and
thighs. Relaxation and lassitude of all the limbs. Sudden
prostration of strength. Paralytic stiffness of the outside of
the right arm. lassitude of thefeet, especially while at rest.
The feet refuse their office. Trembling of the legs. Sensation
as if the ligaments of the joints had given away. DIERBAcH:
extraordinary sensation of weakness and lassitude.
Aconite-failure of the circulation, has already been sufficiently alluded to. (See page 193.)
Aconite-numbness and tingling.
BRODIE: singular numbness of the lips. CHiRIsTISON: numbness and prickling from chewing a single seed; tingling in the
jaws, extending subsequently over the whole body. DuNGLISON: one or two grains of Aconitine to a drachm of alcohol
or lard, if rubbed for a minute or two on the skin, causes heat
and prickling, followed by a sense of numbness and constriction, as if a heavy weight were laid upon it, or as if the skin
were drawn together by the powerful and involuntary contraction of the muscles beneath; this lasts from two to twelve
hours or more.  DIERBACH: the leaves, roots and seeds if
chewed, occasion a violent burning in the tongue and lips
which lasts for many hours, and is attended with a peculiar
feeling of numbness. VOGT: large doses excite a peculiar




ACONITE.                    201
sensation of numbness and heaviness in the stomach, pharynx,
tongue and neck. BAcoN: Tingling heat in the tongue and
jaws, which gradually extended farther, until it involved the
whole body, especially the extrmnities. SHERVIN: piercing
and prickling in the arms and fingers, then numbness in the
shoulders, tongue and mouth, finally in the thighs and feet.
-DEVAY: Insensibility of the palms of the hands, so that deep
pricks with a needle were not felt. PEREIRA: burning and
numbness of the lips, mouth, and throat; in another case: some
burning and numbness of the lips, mouth and throat; curious
sensations of numbness in the hands, arms, legs; sensibility of
the body was greatly impaired, so that face and throat were
almost insensible to touch. TAYLOR: burning in mouth, throat,
cesophagus, and stomach, general feeling of numbness and
creeping in the skin, tingling in the flesh. PEREIRA: Aconite
destroys common sensation, without causing stupor: a dog
-under its influence will sometimes follow his owner around the
room, recognize him by wagging his tail, and yet be totally
insensible to pinching, pricking with needles, &c.; in ten minutes a dog has been rendered insensible to the pains caused by
the introduction of pins into his legs, paws, body, tail, nose,
&c. HAHNEMANN: Pricking sensation upon the tongue, and
throat; crawling sensation in the fingers, cheeks, and chest;
scrabbling in the chest as if from bugs; crawling and itching,of the skin. HOMBURG: Crawling and pricking on the left
side of the head, as if caused by a hair brush; crawling in
the fingers, even while writing. GERSTEL: (from twenty drops)
Prickling and biting in the eyelids; crawling in the cheeks;
pains in the left side, especially in the thigh and arm, which
pass over into numbness; minute piercing, drawing, and prickling in the left upper and lower jaw, in the right molar teeth,
in both shin-bones and arms, and especially in the left side of
the nape. Prickling, pricking-burning sensations in the skin
in various parts of the body, attended at times with a sense of
heaviness, numbness, or swelling. REISINGER: (firom five
drops) slight crawling with sense of warmth in the left fingers; (60 drops) prickling and burning upon the tongue; (80
16




202              TREATMENT OF APOPLEXY.
drops) numbness from the sacrum down to the legs, while sitting or standing; it seemed as if his feet fell asleep, or as if an
attractive power held them fast to the earth; this feeling disappeared instantaneously while walking, but returned again
as soon as he stood still, or sat down; falling asleep of the right
foot, while walking; a sense of boiling and simmering through
the body, as if the hands and feet would fall asleep; (160 drops)
a kind of numbness spread itself from the teeth, over the jawbones to the external angle of the eye, and then almost over
the whole body; (from 108 drops) numbness of the lower
limbs, especially of the feet, even while walking, so that he
was often obliged to stand still, in order to get rid of this unpleasant sensation by moving his feet to-and-fro. WATZKE:
sensations not unlike those produced by a pretty large electromagnetic apparatus; prickling in the forehead, back, sides of
the chest, fingers, backs of the hands, and other parts of the
body, as if he stood upon the isolating stool of an electrical
machine, and sparks were drawn from him. Tickling in various parts of the muscles, especially of the forearms, as if
one held the conductors of an electrical apparatus in the
hands. ZLATAROVITCII: Over the whole body a peculiar sensation, comparable with that felt when steam falls rapidly upon
one in a steam-bath, and one feels the drops upon the skin;
crawling over the scalp; falling asleep of the feet; crawling
and creeping (from 150 drops) over the whole body, attended
with a troublesome rather than a violent chilly sensation, first
in one place, then in another, but most marked in the arms
and legs; formication in the scalp, down the back, and over
the arms and thighs; numbness of the fingers and toes; (from
170'drops) creeping and crawling in the skin, over the whole
body, and at the roots of the hair; a constant crawling and
creeping, especially in the right leg, with the sensation at
times, as if the cuticle were separated from the true skin by
a thin layer; (from 200 drops) chilliness and formication, especially between the shoulders and down the back, increased
by motion; numbness and coldness of the fingers and toes;
the sealp feels as if swollen and numb; creeping and crawling




ACONITE.                     203
again over the whole skin; creeping and biting over the whole
skin, first here then there, as if from fleas.
Aconite-nervous, and -rheumatic pains.
VOGT (see Materia Medica) says: After great restlessness
comes relaxation, diminution of pulse and heart-beats, the head
becomes confused, and often very painful, the face puffed up
and livid, while pains set in, in the limbs, especially pains in
the bones and joints.  SOBERNHEIM (see Materia Medica) says:
It causes painful sensations in the bones and joints, which
disappear after the breaking out of a profuse sweat and abundant flow of urine, and adds that it differs from Conium by its
more prominent action on the fibrous system, as is evident
from the bone- and joint-pains which it causes. HARNISCH:
It causes painfulness and trembling of the limbs, especially of
the legs, and the patient suffers from the most violent pains
in the bones and joints. KiTTNER: General painfulness of all
the joints not unfrequently arises, after the use of large doses
of Aconite. CLAuDIus RICHARD'S case of poisoning, is probably the source of the above old-school writer's information, he
says when the delirium passed away, the patient complained
of pain in the stomach and head, in the jaws, chest, and here
and there in the joints; after the lapse of seven hours, all his
joints were painful. IMIATTHIOLUS, noticed such violent pains
in the jaws, that the patient held fast to them in the fear that
they would drop.off. PEREIRA: trembling and formication in
the limbs, attended with piercing pains. HAHNEMANN: aching
compressing pain in the sides of the chest; pain as if bruised
in the sacro-lumbar joint; rheumatic 2pain in the nape, only
felt when movinzg the head; drawing piercing pain in the bones
of the forearm, piercing pain in the right side.  ARNER:
violent piercing, boring pain for two hours along the whole
left side of the spine down to the sacrumn, so much increased
by inspiration, that it repeatedly forced tears from him (rheumatism of the spinal muscles or ligaments). DR. GERSTEL says
that the most of the pains experienced by AHNER, were of a
piercing-boring character, which points to an affection of the




204             TREATMENT OF APOPLEXY.
periosteum, or of the fibrous aponeuroses of the muscles; the
rending and drawing pains are probably seated in the muscles
themselves. WAHLE: burning, biting pain in the right side
of the spine; aching pains to the left of the cervical vertebrae.
ARNETH: (from  40 drops of tincture); pain and sense of
shortening in both tendo-achilles lasting for twenty days, preventing the free use of the feet, and depending according to
Dr. Gerstel, upon a slight inflammation of the tendons.
GERSTEL: (from eight drops,) Bruised feeling in the nape,
when moved, especially in the evening and at night; (from
10 drops) pain in the nape again; (from 16 drops) same pain
in the nape again); (from 40 drops) pain in the nape during
the whole day; sensation of swelling of the whole body, especially of the left side, attended with various pains, such as
bruised feeling in the muscles, bruised or aching sensation in
the bones, first in one, then in another rib, then in the left
arm; pain in the bones around the ear; constant penetrating
piercing about the left wrist; constant pressing pain in the
left shoulder, in connection with a drawing, and numbfeeling
in the le'ft side of the occiyut, and in the posterior surface of
the left arm, followed at a later period by a bruised feeling in
these parts, especially in the arm (from 40 drops); drawing
pain in the right side of the nape. WACHTE: (from 20 drops)
bruised pain in the sacrum; stiffness, with bruised pain in the
left side of the neck, extending beyond the left shoulder-joint
to a portion of the back, aggravated when in- bed, and lying
down, relieved in the free air, and by motion, lasting three
days, alternating at times with similar feelings in the arms
and legs, then suddenly returning to its original seat in the
back, (this reminds one of wandering rheumatism, or spinal
irritation). WURSTL, it is a little remarkable, although predisposed to rheumatic affections, experienced none while using
Aconite, though he took it in divided doses, for six months.
The homceopathicity of Aconite to numbness, paralysis, and
the severe pains which often attend apoplexy has been made
abundantly evident. PETERS.




ACONITE.                    205
CASE 1.-A maiden, aged 20, of blooming health but
apoplectic habit, being extremely plethoric, although subject
to profuse menstruation, was attacked with Apoplexy after
sudden fright and vexation.
Symnptoms.-She fell down in a death-like state; her
breathing was slow and stertorous; her face andbody corpselike, marbled with livid and violet spots; her pulse could not
be felt; her heart beat slowly and trlemblingly; her pupils
were insensible to light; urine was passed involuntarily, and
her limbs were cold and stiff.
Tireatment and resezt.-Aconite, 1st dilut., cold applications
to the head, and dry, warm clothes to the body and limbs.
After taking five doses of Aconite, 1st dilut., one dose every
quarter of an hour, she gave signs of life; then Aconite was
given every one, or one and a half hour, and at the end of
eight Ihours life and consciousness were restored, but the
whole left side was paralyzed, the left arm and foot being cold
and incapable of making the slightest movement; her speech
was stuttering; her tongue was drawn to the right side, when
it was put out; she was deaf in the left ear, and had roaring
noises in it, and in the whole head; the lips of the left side
scarcely moved in breathing; the breasts were cold to touch,
and retained the impression of the finger.
One drop of Aconite, 3d dilut., was now given every two
hours, and in the course of thirty hours her whole condition
was inmproved, with the exception of the loud roaring in the
head, and the paralysis of the limbs.
Opium, 1st dilut., was given in drop doses every six hours,
and on the fourth day of the disease the congestion of blood
to the head was relieved, her speech could be understood, the
tongue could be put out in a straight line, and she began to
move her limbs. Opium 6, one dose every twelve hours,
enabled her to leave her bed on the sixth day. Arnica 3,
one drop daily, removed a remaining swelling of the left foot
and paralytic weakness of the knee, in the course of ten days.
-Gen. Iom. Journal, vol. 1, p. 66. (STURM.)




206             TREATMENT OF APOPLEXY.
CASE 2. —A robust man, aged 64, with short neck and
broad shoulders, much given to excesses with wine and
women, was attacked with sanguineous Apoplexy, with all
the signs of departing life.
After the use of Aconite, 1st dilut., one drop every hour,
signs of returning animation ensued; then Aconite 3, every
three hours, and cold applications to the head were used with
such good effect, that in twelve hours consciousness was
entirely restored, with warmth of the body, mobility of the
upper limbs, but paralysis of the lower, and also of the bladder
and rectum. He complained of great pain in the loins and
back. Nux vom., 6th dilut., followed by the 15th dilut.,
repeated every twelve or twenty-four hours, restored him
perfectly in ten days.-Ibid., p. 67. (STURM.)
CASE 3.*-A lady of full habit of body, laboring under
well-marked enlargement of the heart, was very subject to
congestion of the head; for this she had always been cupped
and purged, and such attacks were apt to occur three or four
times a year. She derived some benefit from my prescriptions,
as regarded the heart; but when one of these attacks threatened her, her confidence was much shaken, and with difficulty
her scruples in favor of cupping were overcome. The attacks
came on with sensation of great fulness and heat in the back
of the head, giddiness, stiffness of the nape of the neck, roaring
noises in the ears, flushing of the face, and full, bounding pulse.
Treatment.-Aconite, 3d dilut., for a few hours, followed
by Belladonna, speedily gave relief; in some attacks Lachesis
was more useful than Bellad. —Brit. Jour. Hom., vol. 5, p. 49.
Dr. BLACK.
CASE 4.*-A commercial traveller, aged 35, with short
neck and stout body, had returned the night before from one
of his circuits, and had for some days previously indulged in
eating and drinking too much, although not habitually intemperate. His breathing was so stertorous through the night as
to alarm his wife; he was unable to stand or sit up, his eyes
were prominent, his face turgid, and of a sub-purple color;




ACONITE.                   207
he complained of great fulness in his head, of dimness of
sight, and giddiness; his pulse was slow and labored, he was
aroused with difficulty to answer a few questions, his breathing was oppressed, in fact an apoplectic seizure seemed most
imminent. I bared his left arm to look at his veins, it being
my opinion that he must lose blood; but I then observed on
his wrist an immense malignant carbuncle, very much raised
above the surface, blue and turgid. The sight of this made
me pause; the carbuncle, according to allopathic treatment,
required generous diet, bark, &c., while the threatened Apoplexy demanded the lancet; I gave him Aconite, 3d dilut., a
dose every hour, and in a few hours I was sure that the danger
was over, for his eyes were less fixed and prominent, his face
had a more natural expression, the breathing was greatly
relieved, and the pulse more free. The Aconite was continued
with directions to take it only every two hours, if he should
improve much. The next day the danger of Apoplexy had
passed away, but the tumor on the wrist seemed gangrenous,
and a deep slough was to be expected. He took Aconite and
Lachesis,'7th dilution, alternately every two hours; on the
second day his pulse and breathing were natural, he had slept
calmly, the carbuncle had improved, as it had shrunk considerably, and was now of a pale brown color. On the seventh
day he was able to go out, as there was only a healthy-looking
circular sore of the size of a shilling on his wrist, and that
healed perfectly in a few days more. —Brit. Jour. Hom., vol. 5,
p. 50. Dr. CHAPMAN.
CASE 5.*  A lady, aged 30, in delicate health, from strong
mental excitement was suddenly seized with dizziness, and
confusion of thought, but shortly afterwards recovered so far,
as to be able to converse; in the course of two hours more,
however, she fell into a state of stupor, which gradually
became confirmed, and in which she continued for nearly a
fortnight, during which period she frequently had severe convulsive paroxysms, which affected only the left side of the
body, the right being completely paralyzed. I had almost
relinquished hope in this case, but homceopathy triumphed




208             TREATMENT OF APOPLEXY.
over the disease, although the constitution of the patient was
exceedingly delicate.
Treatment and result. —Under the use of Aconite, Bellad.,,
Ipecac. and Cocculus, the patient gradually recovered her
faculties; and although the paralyzed limbs were not immediately restored, yet in about three months afterwards almost
every trace of this most serious illness had disappeared.DUNSFORD, P. 108.
CASE 6.* —W. D., aged 31, stout built, florid complexion,
works at a furnace, but is very temperate; has been liable to
dizziness off and on for years, and has been bled for it; has
now been suffering for a month, and is forced to leave his
work.
Symptoms.-He complains of a hard, thumping, plunging
pain in the head, attended with dizziness and swimming; he
is worse on lying down, when everything seems to run around,
and he sees sparks flying before his eyes; his sleep is disturbed and unrefreshing; his appetite very bad; pulse not
much accelerated.
Treatment and result.-Aconite 2, directly, and repeated
three times a day; followed by Bellad. 12, in 6 hours. On
the third day he was better, but still felt badly when lying
down, especially on waking from sleep; his pain was now
chiefly in the back of his head. Took Bryonia, three times a
day, and in three days more was much improved, had slept
soundly for three nights, no dizziness or swimming, eye-sight
clearer, but still felt very weak, and had no appetite. China
3, once a day; in two days more felt stronger, appetite was
good and head seemed right; was quite restored in three days
more.-YELDHIAM, P. 176.
CASE 7.-A man, aged 40, light blond, but with much
color; healthy, but formerly accustomed to be bled, had not
been bled for four years.
8ymptoms. — ad suffered for four weeks with attacks of
general heat, with redness of the face, perspiration, and violent
dizziness, so that he was obliged to sit down; lasting for two




ACONITE.                       209
hours at a time. Latterly, he has had two such attacks,
attended with vomiting, and great weakness; his walk was
unsteady and slow.
Treatment.-After taking six doses of Aconite, 3d dilut.,
one drop night and morning, he was entirely restored.Gen. Horn. Jour., vol. 32, p. 228.  Dr. LEMKE.
CASE 8. —A young man of apoplectic habit, suffered from
frequently-returning attacks of dizziness, with roaring in the
head; he was often affected with transient loss of consciousness, and was obliged to hold on to something to prevent his
falling.
Aconite, 3d dilut., one drop per dose, daily, cured him
entirely.-Hygea, vol. 5, p. 102.  Dr. SCRROEN.
CASE 9.-A lady, aged 43, was attacked with vertigo,
after a fright, recurring whenever she attempted to rise, with
great anxiety, and feeling as if she would die, so that she was
obliged to lie down again.  After the fiight she had a feeling
of turning in the stomach, ascending up into the head, and
attended with trembling, faintness, and dizziness.
Treatmnent.-Aconite, 15th dilut., followed by two doses of
Opium, 9th dilut., relieved her entirely.-Annals, vol. 1, p. 72.
BETHMANN.
Dose. The 1st dilution was used successfully in two instances; the
2d dilution in one case; the 3d dilution, in six instances; the 15th
in one case, while Dr. Kreussler prefers the 15th or 18th. The very
high dilutions do not seem to have been trusted to in any case, of so
severe a disease as Apoplexy. NOACK prefers 1 or 2 drop doses of the
2d dilution every half, one, two, or four hours. In very acute and severe
cases, 3 or 5 drops of the tincture, or of any of the above dilutions
which may be preferred, may be put in a tumbler half full of water, and
a dessert- or tablespoonful given every five, tell, or fifteen minutes in
very urgent cases, or every half, one, or two hours, in less dangerous
attacks. Or, six globules may be dissolved in a wine-glassful of water,
and one teaspoonful given as often as above recommended; or two or
three globules may be given dry upon the tongue, at the same intervals
of time. It is rarely used in chronic cases. PETERS.




210             TREATMENT OF APOPLEXY.
2. AGARIOUS.*
GENERAL REMARKS. —[Dr. BLACK  suggests Agaricus as
homeeopathic to some varieties of Apoplexy, because the
proving of Ayaricus muscarius, by HAHNEMANN shows symptoins approaching to those of complete Apoplexy.
A man who ate of Agaricus campanulatus, mistaking it
for A. campestris, was suddenly seized ten minutes after commencing his repast, with dimness of vision, giddiness, debility,
trembling, and loss of recollection. In a short time he recovered so far as to be able to go in search of assistance; but he
had hardly walked 250 yards when his memory again failed
him, and he lost his way. His countenance expressed anxiety,
he reeled about, and could hardly articulate; his pulse was
slow and feeble; he soon became so drowsy that he could be
kept awake only by constant dragging; an emetic was administered and the stupor gradually went off.-Brit. Jour. Hom.,
vol. 5, p. 54.
A remarkable set of cases of pure narcotism has been related
by Dr. PEDDIE. In half an hour after eating Agaricus procerus, an elderly man, and a boy of 13, were attacked with
giddiness, and staggering as if they were intoxicated; in an
hour they became insensible, the man indeed so much so, that
for some time he could not be roused by any means; when
sensibility was in some degree restored by means of emetics
and powerful stimulants, occasional convulsive spasms ensued,
and afterwards furious delirium, attended with frantic cries
and vehement resistance to remedies, all followed by a state
like delirium tremens. The pupils were at first much contracted, afterwards considerably dilated as sensibility returned;
and in the boy, contracted while he lay torpid, but dilated
when he was roused. In neither instance was pain felt at any
time. Another boy, who took a small quantity only, had no
other symptoms but giddiness. drowsiness, and debility.
A singular form of the narcotic effects occurred in the case
of a boy of 14, who had eaten of the Agacricus pcanterirnus, near




AGARICUS.                   211
Bologna. In the course of two hours he was seized with delirium, a maniacal disposition to rove, and some convulsive
movements; ere long these symptoms were succeeded by a
state resembling coma in every way, except that he looked as
if he understood what was going on, and in point of fact, he
really did so.
The Amanita. citrinna caused vomiting, followed by deep
sopor, in a lady, servant, and one child; her other children
became profoundly lethargic, and comatose.
The effects of the small mouse-colored, conical fungus,
called paddock stool, or Hypophyll7um sanguineurnm, are still
more peculiar; it is homceopathic to convulsions, as well as
sopor; in a family of six persons, four of whom were children, it caused pain in the pit of the stomach, a sense of impending suffocation, and violent efforts to vomit; which symptoms did not commence, in any case, under twelve hours after
partaking of it, in one not till twenty hours, and in another,
not till thirty hours. One child had acute pain in the belly,
which soon swelled enormously; afterwards he fell into a
lethargic sleep, but continned to cry; in twenty-four hours the
limb became affected with permanent spasms, and convulsive
fits, followed by a tetanic state. Another child, aged 10 years,
had convulsions of still greater violence. The mother had
frequent bloody stools, and vomiting, her skin became yellow,
the muscles of the abdomen were contracted so spasmodically,
that the navel was drawn towards the spine; profound lethargy,
and general coldness supervened. A third child had trembling, delirium, and convulsions.\ The father had a severe attack of dysentery for three days, and remained speechless for
five days.
A striking circumstance, in relation to the effects of these
fungi, is the great durability of the symptoms; even the
purely narcotic effects have been known to last over two (lays;
a deep lethargy may prevail for fifty-two hours.
In five cases, mushrooms produced a kind of tertian fever
and the formation of abcesses, which discharged a thin, ill
conditioned pus, and passed rapidly into spreading gangrene.




212              TREATMENT OF APOPLEXY.
Pathological appearances: Lividity of the body, very great
fluidity of the blood, abdomen distended with fetid air, excessive enlargement of the liver, congestion of the lungs, vessels
of the brain very turgid.
The Agaricuas muscarius is homceopathic to enormous distension of the sinuses of the dura mater, as well as the arteries
with blood; scarlet color of the arachnoid and pia mater;
excessive engorgement of the vessels of the membrame between the convolutions of the brain, together with the Plexus
choroides; redness of the substance of the brain; clot of
blood as big as a bean in the cerebellum. CHRISTISON. P.
Dose. No cases of Apoplexy treated with Agaricus have yet been
reported. Noack prefers 1 or 2 drop doses of the 2d or 3d dilution,
repeated as often as occasion requires. The same doses as those directed
for Aconite, may be used. It is most serviceable in acute'cases, or in
acute aggravations of chronic attacks. PETERS.
3. ARNICA MONTANA.
GENERAL REMARKS. —[This remedy, too, is beginning to find
some favor in the dominant school, in the treatment of apoplexy, or its consequences. It has long been supposed to
possess the power of promoting absorption of extravasated
blood-SOBERNHEIM  asserts that it facilitates the circulation of
the lymph, increases the absorbent powers of the whole lymphatic and venous systems-hence its well-known efficacy in
extravasations of blood from mechanical injuries, viz.: from
falls, blows, concussions, and rupture of blood-vessels; for
these reasons it has also received the name of Fall-Kr~aut,
and was admitted as an ingredient of the Thea Helvetica, or
The Suisse of the French Codex, for wounds, bruises, &c.
TABERN.EMONTANUS, once physician to the Churfurst Von Plalz,
says that in olden times it was customary, in Saxony, for persons who had fallen, or injured themselves, to use this remedy;
it also came into use in the town of Danzig, but as it did not
grow in that neighborhood, it was imported in casks from
Lower Saxony.
Besides its absorbing powers, the root of Arnica, from its




ARNICA MONTBA.                  213
Tannin-like properties, is supposed to exert an astringent action
upon asthenic and profusely-secreting mucous membranes, and
to check passive hoemorrhages, such as asthenic dysenteries,
scorbutic, septic, and petechial fluxes.
As an absorbent remedy, it was used, and highly recommended in Arachnoiditis infantuzm, by the celebrated GoLIs,
of Vienna-he had the head of the child bathed with Arnica,
when signs of effusion, or of a sub-paralytic state of the
brain came on-and regarded it as a main remedy in concussions of the brain or spinal marrow, in sanguineous, or serolymphatic exhudations from contusions, falls, blows, concussions, &c.
It must prove as useful in the apoplexies of debilitated persons, as it has often done in the stupor and coma of typhus and
typhoid fevers. VOGT recommends it in asthenic fevers, attended with indifference to everything, dejection of spirit, sleepiness, dull unconcerned look, or when there is sopor, or even
stupor and other signs of a suppressed, sunken, torpid, or
paralytic state of the nervous system. Also in typhus fever,
when blue or brownish petechie are present, oppression and
sluggishness of the vascular system, torpid state of the nerves,
and when the skin is cool, thick and flabby. SOBERNHEIM also
recommends it strongly in typhus fever, when there is great
prostration, dulness of the senses, typhous hebetude of the
brain, with muttering delirium and sopor; tongue trembling,
cracked and black, the look inexpressive, and the eyes staring
-in typho-septic affections. when attended with colliquative
h~emorrhages, passive sweats, decubitus and septic meteorism.
The following are the celebrated STOLL'S indications for the use
of Arnica in fevers-great weakness, slow pulse, dry tongue,
or coated with much sordes, especially if the patient be dull
and sleepy, hears badly, has a slight delirium, and a miliary
eruption, or petechime show themselves.
In addition to all this, the careful use of Nux-vomica has
been found useful in both schools, in some of the torpid and
paralytic states which follow apoplexy-too frequently the
incautious use of Kux and Strychnine in the hands of old




214             TREATMENT OF APOPLEXY.
school physicians, causes great irritation and mischief, but
fortunately, according to A. T. Thompson, the flowers of Arnica contain a small portion of Igasaures strychnion, and
experiments upon, and accidents to the healthy, have proved
that some of the effects of Arnica are similar to those of Nuxvomica and Strychnine-and hence it is much more safe in the
earlier stages of paralysis from apoplexy, than these remedies;
it promotes the absorption of the apoplectic clot, which Nux
and Strychnine do not, and acts, perhaps, quite as powerfully,
and certainly much more safely than Mercury, in promoting
absorption of effused blood, and serumn; it tends to check
hemorrhage, while Mercury dissolves the blood, and perhaps
favoring increased bleeding.
Again, Arnica has been admitted, and decreed to act like
the nervines, exciting and giving strength in certain regions of
the nervous system; and used to obviate the incautious, and too
hasty use of stimulants in apoplexy with great depression.
Of course it cannot now be a matter of surprise, that Arnica
should have been found useful in some forms of apoplexy and
paralysis. The oil of Arnica is said to have done wonders in
the hands of Schneider in old apoplexies, even after several
attacks had occurred; when a new attack was about setting
in, he gave ten drops of Oleum arnicoe at once, with admirable effects. Another old physician kept at bay upwards of
thirty attacks of apoplexy; a priest who had had no less than
four attacks of nervous or congestive apoplexy, prevented all
recurrence for six years. It has been particularly recommended against the congestions of the head, and threatened
apoplexies, which so often attend the cessation of the menses
in women.
Notwithstanding all this, it will be very easy to prove from
the distinguished old-school writers on the Materia Medica,
from whom the above observations have been obtained, viz.:
from DIERBAIH, SOBERNEEIM, VOGT, ABLES, MITSCHERLICH and
others, that Arnica, is more or less homceopathic to some of
the symptoms, or forms of apoplexy. DIERBACH says it not
unfrequently causes a sensation of formication, and a prickling,




ARNICA MONTANA.                215
piercing, spasmodic feeling, which may be compared with that
produced by slight electric shocks-also headache and vertigo.
SOBERNHEIM says it may produce hebetude and heaviness of
the head, formication, anxiety, flow of blood to internal parts.
VOGT says it may affect the whole organism, especially the
brain and spinal marrow, and cause vertigo, stupefaction and
hebetude of the head, glittering before the eyes, roaring in the
ears, anxiety, pusillanimity, oppression at the pit of the stomach, and inability to hold ourself upright; at a later period it
may cause increased action of the pulse, violent congestion,
especially to the head and chest, formication, prickling, and
piercing sensations, with trembling, and subsultus.] PETERS.
CASE 10O. —A man, aged 72, after having complained of dizziness, fell suddenly to the ground, struck with apoplexy; he
was inconscious, his jaw dropped, the limbs on the left side
were perfectly paralyzed, and without feeling; he stammered
inarticulate and incomprehensible words; and pointed to his
head with his right hand; his pulse was strong and full,
intermitting every seventh beat; and his face was flushed.
Treatment.-After taking 2 doses of Arnica, he was able,
in the course of twelve hours, to speak more plainly, could
move his jaw, swallow better, his consciousness returned, and
he felt a creeping or crawling in the paralyzed limbs; the
redness of his face had disappeared. Nux-vomica, was now
given for fulness and torpor of the bowels, and heaviness of
the head; on the following morning his bowels were relieved,
his head more clear, speech more sonorous, and he began to
move his paralyzed limbs.
Archiv, vol. 14, part 1, p. 128. Dr. SCHULER.
CASE 11. —A man, aged 53, of medium stature, with a short
neck, otherwise healthy, but fond of whiskey, had had an apoplectic attack for which he had been bled. After the lapse of
several days, he remained in the following state:
Symptoms.-He awoke at night in order to swallow much
fluid which had accumulated in his mouth; followed by shiv



216             TREATMENT OF APOPLEXY.
ering, stretching and yawning, recurrring every half hour,
without his being conscious of it; during the day he complained of aching in the forehead, roaring in the ears, vertigo,
sparks before the eyes, and illusion that some one attempted
to put something into his mouth; his limbs felt as if bruised;
his legs were cold; cold shiverings ran through his body; his
pulse was moderately strong, labored, beating 60 per minute,
and at times irregular. He had an outbreak of nettlerash,
with itching, and burning upon the skin.
Treatment and result.-One dose of Arnica 30, 2 drops,
repeated on the second day, relieved him entirely by the third
day. Five months after he had a similar attack, followed by
eructations at night, hiccough, with rumbling and rattling in
the bowels; attacks of rigidity, with dull, staring look, and
loss of consciousness for one hour, followed.by coughing, with
cold sweats, and bad odor of the breathing. Such attacks
recurred several times, but in a slighter degree. On the
next day he had aching in the forehead, cructations, thirst,
and nettlerash as before; his pulse was small and slow. He
took Arnica 1, 1 dose of 1 drop, and all his symptoms ceased, and did not return again. —ygea, vol. 8, p. 149. Dr.
KdSEMANN.
CASE 12.-A Teacher, aged 37, had had an attack of apoplexy five years before, since which time he had been annoyed with great forgetfulness; he forgot his train of thought,
and whatever he read escaped his memory very quickly.
Several doses of Arnica 3, cured him  entirely.-Hygea,
vol. 8, p. 34. KSSEMANN.
CASE 13.-Dr. FRANK refers to sixteen cases of Paralysis
and Apoplexy, arising from mental emotions, and mechanical causes, occurring in patients of various ages and sexes,
most of whom had been treated fruitlessly with bloodletting
cured by drinking of an infusion of Arnica, half or one ounce
of the flowers, to one pound of water, aided by the alternate
or subsequent use of Extract of Aconite. ATTOMYR.




ARNICA.-BARYTA.                     21.
Dose, In Riickert's cases the 3d and 30th dilutions were used.
Noack prefers 1 or 2 drop doses of the pure tincture, or of the 1st or
S2d dilution, repeated every one, two, four, six, or eight hours, according
to the urgency of the case. If preferred, globules may be dissolved
and given as directed for Aconite; or given dry upon the tongue, in the
-same quantities, and at the same intervals of time, as there recommended.
Arnica is useful against the first shock of apoplexy, before reaction has
taken place; also after the first force of the disease has been moderated
by Aconite and other remedies; and finally in the latter stages of the,disease, to promote absorption of the clot, and to remove paralysis.
PETERS.
4. BARYTA.
GENERAL REMARKS: [Baryta has been supposed to possess
a peculiar curative relation to dulness of intellect, softening
and other morbid states of the brain, either when preceding,
or following an attack of Apoplexy. Also against the almost
idiotic condition which follows Apoplexy. According to
NEUMANN, the Muriate of Baryta is an admirable curative
remedy against many affections of the brain, and irritations
of the cerebellum, or Apoplexy of this latter organ, when the
sexual inclination is very much increased.  Many old-school
writers assume that it is a liquefacient or absorbent remedy;
assert that it improves the appetite, increases the flow of
urine and perspiration, and causes looseness of the bowels;
that with no other more obvious symptoms than these, glandular swellings, enlargements, indurations, thickenings, &c.,
will become softer and smaller, and finally disappear; and
hence the inference has been drawn, that it might also liquefy
and dissolve apoplectic clots, and finally absorb or remove the
softened mass.
It is very easy to prove, from the same authorities, that it is
more or less homceopathic to some of the varieties, or at least
symptoms of Apoplexy.  PEREIRA found the Carbonate of
Baryta hoinceopathic to dimness of sight, double vision, ringing in the ears, pain in the head with throbbing, and palpitation of the heart. He also says that it is homceopathic tQ
decided staggering, great muscular weakness, almost amounting to paralysis, with trembling; also to pain in the head




218             TREATMENT OF APOPLEXY.
with deafness. It is suited to some of the after-effects of
apoplexy, viz., when a febrile state sets in, with dryness of the
tongue, giddiness, debility, and some pains in the legs and
knees, with cramps in the calves of the legs.
CHRISTIsoN adds his testimony to the homceopathicity of
Baryta to brain-affections; he says that its remote effects are
indicated by narcotic symnptoms, and that this narcotic action
is more decided and invariable in its occurrence, than in the
case of any of the other metallic remedies. GMELIN noticed
that it causes strong signs of action upon the brain, spine
and voluntary muscles.  BLAKE and CAMPBELL found it
homneopathic to languor, slow respiration and feeble pulse, to
excessive muscular debility, amounting to absolute paraplegia
of the limbs, lasting twenty-four hours, and then gradually
going off. Campbell always found it hommeopathic to congestion of the brain and its membranes, and in one case the
Baryta post-mortem appearances were precisely those of ordinary congestive Apoplexy; it is most indicated when there is
thick, dark blood in the vessels of the dura materl in those
of the brain and cerebellum; and when the falciform  and
lateral sinuses, the plexus choroidei, and the ventricles of
the brain are filled with blood.
NoxAcK (see Jahr's Symptomen-Codex, translated by Chas.
J. Hempel) says, Baryta is particularly suitable for aged persons with mental or physical debility; in ]Marasmus Senilis
luarked by childish, thoughtless manners; in disorders of old
persons characterized by groaning and murmuring, fixed
pupils, dim and reddened eyes, circumscribed dark redness of
the cheeks, cold hands with blue spots on them, weak pulse
which may be either quick or slow, frequent micturition, constipation, and weakness which obliges one to walk, or sit very
much bent over. In the apoplectic affections of drunkards,
when the mouth is distorted, the tongue paralyzed, the voice
hoarse or indistinct, with partial paralysis of one or the other
arm, but the consciousness remains pretty clear. In the Apoplexies of old people and drunkards, and in organic affections,
and tubercles of the brain. Noack also gives an admirable de



BARYTA.                     219
scription of the despondency, pusillanimity, weakness of mind
and irresoluteness to which Baryta carb., is so homceopathic.
It should not be forgotten when the patient is troubled with
forgetfulness, dulness, gloominess and heaviness of the head,
with drowsiness; and with vertigo, headache and nausea.
The specific action of Baryta upon the cerebellum, as conjectured by iNEUMANN, is fully borne out by a reference to the
Materia Medica Pura. It is homceopathic to pressure in the
brain below the vertex, extending towards the back of the
head, most severe on waking from sleep, and attended with
stiffness of the nape of the neck, probably from pressure on
the twelfth pair of nerves; also to dull aching pain in the right
side of the back of the head, extending from the bones of the
neck obliquely to the side of the head, and recurring regularly
at 4 o'clock, P.M., for several days in succession; sense of weight
in the whole back of the head, close to the nape of the neck,
with tension; sudden and intensely-painful drawing pain,
extending from the back of the head across the right ear, as far
as the lower jaw; tearing pain in the left side of the occiput;
rheumatic pains in the back bone of the head, with swelling
of the glands of the nape, so as to compress the blood-vessels;
tearing pains, shooting deep into the brain behind the right
ear. Dull stitches in the left side of the head from the occiput to the forehead. Pain with feeling of fulness and distension, commencing in the left side of the head, traversing
the whole left side of the occiput, and terminating in the
bones of the neck. Throbbing in the occiput, the impulse
of which is felt as far as the forehead. Considerable rush
of blood to the head, so that the blood seems to stagnate in
it, and circulate slowly; whizzing in the head as if from
boiling water; heaviness and heat in the head.
Slowness of the pulse is very common in Apoplexy, and
BLAKE found Baryta homeopathic to depressed arterial
action; two grains, injected into the veins, completely arrested the heart's contractions in twelve seconds.
In one case it was found homceopathic to dimness of vision,
followed by double vision, ringing in the ears, pain in the




220             TREATMENT OF APOPLEXY.
head, throbbing in the temples, and violent palpitations; the
skin was hot and dry, the face flushed, pulse 80, full and
hard; sleeplessness from pain in the head and ringing in the
ears, followed by profuse perspiration; then cramps in all the
limbs, with a sense of weight in them, and soreness to the
touch; severe pain in the head, with great and long-continued
palpitations.
WILsoN also found it homceopathic to severe headache,
throbbing in the temples, frequent and long-continued palpitations, abnormal vision, ringing in the ears, cramps, pain,
sense of weight, and numbness in the limbs.
In another case it proved hommeopathic to twitching of the
muscles of the face, and convulsive jerking of the hands and
feet. It is also decidedly homceopathic to Apoplexy, arising
from, or attended with great disturbance, or inflammation of
the stomach and bowels; to brain affections from inflammation of the peritoneal coat of the stomach; from ulceration of
the stomach, especially when the ulcer assumes the perforating form; and when the colon is contracted throughout its
whole extent, so that its calibre is more than one-third less
than that of the small intestines in their natural state.PETERS.]
(b.) According to KREUSSLER, Baryta carb. 30, is indispensable in the apoplectic affections of old, cachectic persons, of
scrofulous constitution, especially when gouty derangements
are also present.-Kreussler's Therapeutics, p. 129.
CASE 14. —An old man, aged 84, remained in the following state, on the third day after an attack of Apoplexy.
Symuptoms. —He sat crooked and helpless, unable to speak
an intelligible word, or to put out his tongue; he was unable
to think clearly; his manners were childish and thoughtless;
he was drowsy, but his sleep was disturbed, and attended with
groaning and muttering; his pupils were sluggish, his eyes
dull and somewhat reddened; there was a circumscribed, dark
redness upon his cheeks, his hands were cold and mottled with
blue spots; his pulse was weak, and rather quick; he was
troubled with frequent urination, and constipation.




BARYTA.-BELLADONNA.                   221
fTreatment.-Baryta acet., 1st and 2d dilut., restored him
after 3 doses had been taken.- Hufeland's Journal. Dr. MESSERSCHMID.
CASE 15.-An aged drunkard was attacked with Apoplexy,
after taking cold.
SyS/nptoms.-Speechlessness, with paralysis of the tongue;
the mouth was drawn to one side; the right arm could not be
moved by any exertion of the will, although he seemed conscious.
_reatment.-Baryta, 30, effected a cure in the course of
forty-eight hours.-Archiv, vol. 15, part 1, p. 103. Dr. GRoss.
CASE 16.-HIARTMANN thinks that Baryta is the principal
remedy in paralysis of old people, especially when it remains
after an apoplectic fit, and refers to a case in which it did
more goodtllhan Causticum  or Stannum.  (See Hartmnann's
Acute and Chronic Diseases, translated by Dr. C. J. Hempel,
vol. 4, p. 7.)
Dose, Messerschmid preferred the 1st and 2d dilut.; Gross and
Hartmann, the 30th. Noack advises grain-doses of the 1st, 2d, or 3d
trituration to be given dry upon the tongue, once or twice a day in
chronic cases; or 1 or 2 drop doses of the 1st, 2d, or 3d dilutions. If
preferred, 2 or 3 globules may be given, per dose, dry upon the tongue;
or 5 globules may be dissolved in a wineglassful of water, and 1 or 2
teaspoonfuls given at a time. Baryta carbonica is only suitable in
chronic, or sub-acute, or slow cases; while Baryta acetica and muriatica
may be used in acute cases, and given in doses as large, and as frequently
repeated as those recommended for Aconite. PETERS.
5. BELLADONNA.
GENERAL REMARIS. —[It proved homceopathic in a case
with vertigo, faintness, and dimness of sight in a lady, so that
she had to keep her bed all the next day-for thirty or forty
hours she could not lift her head from her pillow without experiencing a strange and disagreeable sensation. In another
case, with slight delirium and great vertigo.
JOHNSON says it is one of the most effectual remedies in reducing morbid sensibility of parts, and morbid contractility
of the muscular fibres, and may be used when there is irritation,




222             TREATMENlT OF APOPLEXY.
-with rigidity; hence it may prove homeopathic in the pains'and stiffness of the limbs which follow attacks of Apoplexy, and
especially in the painful disorders about the head and face.
BAILEY, of IHarwich, England, published an octavo volume,
some years ago, on this point.
It proved hoincopathic in the cases of two boys; at first
*they could not speak, but laughed immoderately and kept
grasping at imaginary objects; afterwards their silence was
changed into immoderate and incoherent loquacity, with constant bodily motion; they were laughing and talking alternately; their extremities were in violent almost constant motion; eyes fixed; pupils dilated and insensible to light; jaws
firmly locked; respiration loud and croupal; face swollen and
red; in four hours their breathing became loud and stertorous;
face turgid and swelled; skin cold; pulse weak; and there
was an occasional strong inclination to sleep. [Next day there
was a loud croupy cough; and they were not sensible to surrounding objects for three days; they were quite blind, and
candles held to their eyes produced no effect, nor did they
seem at all conscious of the light.
Old-school writers, GRAVES especially, have recommended
Bellad. in cerebral affections when the pupil is contracted,
which is one of the most alarming symptoms in these affections; —pin-hole pupil is a fatal sign in Apoplexy and typhus.
In Apoplexy with quick pulse; LEURET in seventeen cases
of epilepsy found Bellad. to quicken the pulse from the second
day of treatment, and to continue to do this for three or four,
or ten or even twenty days. It is homeopathic when the
pulse is quick, and pupil dilated. Another of the most frequent and durable of the effects of Bellad. was a very marked
development of the papillse of the tongue.
PEREIRA says Atropin is homceopatic to vomiting, dilatation
of the pupil, and stupor. One-tenth of a grain caused difficulty of swallowing, dilatation of pupils, and headache.
FLOURENS thinks it acts specifically on the tubercula quadrigemina.
BAILEY found it homceopathic to dilatation of the pupils,




BELLADONNA.                   223
obscurity of vision, absolute blindness, anaurosis, visual illusions, suffused eyes, singing in the ears, numbness of the face,
confusion of the head, giddiness and delirium; all of which
symptoms may be combined with, or followed by stupor.
These symptoms are usually preceded by a febrile condition,
with redness and swelling of the face, hurried and small pulse.
DIERBACH says it is peculiarly homceopathic to violent congestions to the head, redness and swelling of the face, and
inclination to sleep, which may pass over into deep sopor and
coma, but be interrupted by delirium.
It is indicated in paralysis of the sphincters, when the faeces
and urine pass off involuntarily.
VOGT Says ROGNETTA exercised considerable ingenuity
when he indulged in the opinion that Bell. was an antiphlogistic remedy, and placed it in the same category with bloodletting.
VOGT also asserts that in the first degree of Belladonnaaction we observe a more active motion of the blood, quicker,
fuller, and harder pulse, greater flow of blood to the skin and
head, whence the face seems more reddened, and the skin,
especially that of the head, hotter. After a while the increased arterial action ceases, and greater venosity supplies its
place, soon followed by increased secretion from skin and
kidneys; the throat also becomes moist, and mucus is ejected
from the bronchise, and genitaliae.
Bellad. is homceopathic when there is a violent and convulsive change of arterial into venous blood, while Aconite,
Digitalis, l1yosciamus, Prussic acid, &c., do this without previous orgasm and excitement of the vascular system.
It is homceopathic when there is fever, dryness of the throat,
glimmering before the eyes, with flocculi and sparks, even actual
blindness, with dilated pupils, dulness of feeling, and roaring
in the ears; when the eyelids droop and sink with heaviness,
are half closed, and the patient is sleepy; or when the eyes
are widely open, and the look is fixed and fiery; when there
is a feeling of heaviness in the head, staggering, confusion, and
drunkenness, which may gradually pass over into a perfect




224-             TREATMENT OF APOPLEXY.
loss of consciousness. The pulse from the first is more frequent, fuller, and harder; the skin becomes hot, red and
itching; the face swollen and very red; the lips dark, blood
red; the eyes red and protruding. Everywhere there is greater
vital turgor, and excited arterial action; breathing is quicker
and shorter; the limbs rather stiff, and tongne rigid.
After the lapse of twelve hours the arterial storm ceases,
and great venosity becomes evident; the redness of the face
becomes livid, the veins everywhere seem to be filled, the
muscles are more relaxed, confusion and stupefaction of brain
ensue.   Finally profuse sweat and urination restore the
balance of the system. But headache, vertigo, imperfect vision,
general lassitude, continued inclination to sweat, burning and
itching of the skin remain.
The third degree of action of Belladonna-action is marked
by paralysis of the nerves and decomposition of the blood,
the patient becomes soporose and paralytic; blue spots and
petechiae form on the skin; and decomposed, dissolved, brown
and stinking blood exudes from the various openings of the body.
With the exception of Stramonium, it causes a more constant
and far more violent action on the circulation than the other
narcotics; the brain is at first not only quickened and excited,.
but forcibly excited, and rendered delirious; still the collective,
action of Bellad. does not represent a pure inflammatory fever,
but a Febris inflammatorica nervos. VOGT.
SCHNUCKER, SELLE, and E VENS, have cured paralysis after
Apoplexy with it. PETERS.]
(c.) Dr. BLACK advises Belladonna in Apoplexy, in the stage
of excitement, when the face is flushed, head hot, eyes suffused and glistening, with hallucinations of sight, dilated pupils,
throbbing of the carotids, incoherence, tremors, and convulsions, followed by coma; especially when the disease has not
progressed beyond general congestion of the brain and its
membranes.-Brit. Journ. Horn., vol. 5, p. 53.
(d.) [According to CI-IRISTISON, Bellad. is homceopathic to
apoplectic symptoms, with dilatation of the pupil, also to blindness, even when this is a very obstinate symptom, sometimes




BELLADONNA.                    225
remaining after the affection of the brain has disappeared;
it was homceopathic in two cases in which the eyes were insensible to the brightest light for three days; and in general,
when the dilated state of the pupils continues long after the
other symptoms have departed; the pupil is not only dilated
in all cases, but likewise for the most part insensible, and the
eyeballs are often red, and prominent.
It is generally supposed that delirium with dilated pupils,
generally precedes Belladonna-coma, but sometimes the relation of the delirium to the coma is reversed, as in a case related
by Mr. CLAYTON, where sopor came on first, and delirium
ensued in six hours; but sometimes delirium again returns
when the stupor goes off; still the most frequent order of the
symptoms is dryness of the throat and delirium, soon followed
by drowsiness and stupor; this succeeding, stupor may remain
for nearly two days, and the departure of the stupor be attended with a return of delirium for some hours longer; SAGE
has related a case in which the patient was comatose for thirty
hours.
In Belladonna-apoplexy convulsions are rare, and when
present, slight; in one case there were convulsive twitches of
the face and extremities; in another case the muscles of the
face were somewhat convulsed; there is also, at times, more
or less locked-jaw, or subsultus tendinum, and occasionally
much abrupt agitation of the extremities, but well-marked
convulsions, or paralysis do not appear to be ever present.
From CIHRSTISON'S remarks we may also infer that Belladonna will prove homceopathic to some of the severest, and
most hopeless stages of Apoplexy, viz.: when there is aphthous
inflammation of the throat and mouth, great swelling of the
belly, when the body is almost putrid, even before the patient
is fairly dead, when the skin is covered with dark vesicles, the
brain soft, the blood-vessels of the head gorged, and the blood
everywhere fluid, fowing profusely from the mouth, nose and
eyes. PETERS.]




226             TREATMIENT OF APOPLEXY.
(e.) Bellacdonna-Apoplexy.
ATTOMYR (see Prirnorcien eirner N-aftuargeschichte cler  Kran/heitens, )p. 487) has given so accurate a delineation of this
disorder, in all its nuances, degrees, and stages, that we give
it, even if at the risk of being considered tedious.
Prenonitions of Belladonna-apoplexy. Vertigo. Vertigo,
as if objects staggered to and fro. Turning in the head, vertigo
with nausea, as after rapid turning in a circle, or after the
morning sleep, which succeeds a night-debauch. Turning in
the head, accompanied with a similar turning in the pit of the
stomach; after getting up, these sensations increased while
walking, to such a degree, that he could no longer distinguish
anything, and everything disappeared from before his eyes.
Vertigo, as if everything turned around in a circle. Dulness,
and turning in the head, relieved in the open air, aggravated
in the room. Attacks of dizziness, both while at rest, and
when in motion. Vertigo, and trembling of the hands so that
he could not accomplish anything with them. While walking
he staggered, was obliged to hold on to the wall, complained
of oppression and dizziness, and often speak irrationally like
a drunken person. Attacks of dizziness and dulness of the
senses, lasting for several minutes.
Stupidity. Intoxication. Feeling as if intoxicated immediately after a meal. The slightest quantity of beer caused
immediate intoxication. Confusion of the head, and feeling of
intoxication, with swelling and redness of the face, as if one
had been drinking wine. The whole head seems confused and
empty for many days. Cloudiness of the brain, as in intoxication. Mistiness of the forehead, as if an oppressive mist
moved to and fro, especially under the frontal bone.  His
senses deceive him. Reverie, he sat as if in a dream. Loss
of consciousness. Dull fulness of the head, increased by motion. Stupefaction. Head feels as heavy as if he would fall
asleep, and he is indisposed to any exertion.
Disinclined to all mental labor. Relaxation of body and
mind. Stupidity.




BELLADONNA-APOPLEXY.              227
Loss of memory. Great weakness of memory, he forgets
immediately what he intended to do, and cannot remember
anything.
The blood rushes to the head, when one stoops, and one
becomes heavy and dizzy. Congestion of blood to the head,
without internal heat in the brain. When one bends his head
backwards, it seems as if the blood rushed into it. Swelling
of the external veins of the head. The veins of the limbs are
distended, and the arteries of the neck beat so violently, that
when he opens his mouth the lower jaw is constantly forced
against the upper, so that a slight chattering of the teeth ensues; attended with a warmth, and a sensation of warmth in
the whole body, especially in the head. Beating of the arteries of the head, and of the whole body, early in the morning,
on awaking. Excessive heat of the whole body, with especially frequent and more violent beatings of the temporal
artery, with dulness of the head, all followed by profuse perspiration. Great heat of the body, especially of the head, so
that the face becomes very red, from time to time, occurring
daily after dinner. Frequently, excessive paleness of the face
is converted immediately into redness, with coldness of the
cheeks, and hotness of the forehead. Unusual redness of the
face. Great heat and redness of the face, not followed by
perspiration. Great heat and redness of the face, with icycoldness of the limbs. Glowing-redness of the face, with
violent, and inexpressible pains in the head. Heat and redness
of the head only. Congestion of blood to the head, with red.
ness of the cheeks. Heat and redness of the whole face, as
if he had been drinking. Dark redness of the face.
The whites of the eyes are streaked with red, early in the
morning, with aching pains in them. Dimness, darkness and
blackness before the eyes. Dulness of sight, with trembling
in all the limbs. Darkness before the eyes, as if from a mist.
Roaring in the ears. Noises in the ears, and dizziness, with
dull pain in the abdomen.  Deafness, as if a skin were
stretched before the ears. Difficulty of hearing.




228             TREATMENT OF APOPLEXY.
Immediate bleeding of the nose. Epistaxis early in the
morning, and at night.
Violent gritting of the teeth. Gritting of the teeth, with
frequent flow of spittle fromn the mouth.
Sensation in the morning, as if the tongue were asleep,
numb, dead, and covered with fur. Trembling of the tongue.
Stammerinyg weakness of the organs of speech, with cl earness
of the intellect, and dilatcation of the p2uqpils.
Attacks of nausea in the forenoon. Frequent nausea and
retching. Vomiting, dizziness and flushes of heat. Excessive
vomiting, [from pressure on the brain].
Trembling in all the limbs, inability to walk, swelling of
the veins of the whole body, and unpleasant irritation in the
throat, all lasting for several days. Trembling and tired
feeling of the limbs. Lassitude of the limbs. In the evening he is so tired he can scarcely walk. Sluggishness of
all the limbs, and disinclination to work. Disinclination,
antd disgust for all labor abnd motion. Weakness of the
body. Loss of strength. General debility. Frequently recurring, transient paroxysms of great weakness, in which
everything seems so heavy, and presses downwards as if he
must sink together. Fainting fits.
Sleepiness. Persistent dulness and drowsiness. Frightful,
and vividly-remembered dreams.
Attack of Belladonna-Apofplexy.
He lay without sense or consciousness. Extreme stupefaction of all the senses. Unconsciousness. Perfect unconsciousness, so that he does not recognize anything. Loss of sensation. Apoplectic condition. He lay motionless for four days,
without taking any nourishment. Lethargic, apoplectic state;
he lay night and day without moving a limb; when griping
pains set in, he opened his eyes, but did not utter a sound.
Noise and rattling in the air-tubes. Difficult respiration.
Violent, short, frequent and anxious drawing in of the breath.
At times he breathed, at others the last gasp seemed to have




BELLADONNA-APOPLEXY.              229
escaped him; recurring in paroxysms, four times in the course
of fifteen minutes.
During his drowsy stupefaction he opened his eyes, looked
wildly about him, and then relapsed into a heavy slumber,
with rattling in the throat. Choking attacks of snoring, during inspiration, while asleep.
Largeness, fulness and slowness of the pulse. Very small,
quick pulse. Largeness of the pulse, which is ten beats too
frequent. Strong and quick pulse.
Widely-opened eyes. Contracted pupils. Dilcated pupils.
Dilated and immovable pupils. Excessively-dilated pupils.
Protrusion of the eyes, and enlargement of the pupils.
Fixedness of the eyes. Staring look. The eyes are staring
and sparkling. Glistening, and glassy appearance of the eyes,
with widely dilated pupils.
Spasmodic motions of the lips. The right angle of the
mouth is drawn outwards. Distortion of the mouth from
spasm (Risus Sardonus).
Bloody foam before the mouth.
Stuttering speech; he stutters as if intoxicated.
Difficulty of swallowing; painless inability to swallow.
Involuntary discharge of fTeces; paralysis of the sphincter
ani. Small, sudden and involuntary stools. Suppression of
stools and urine, with profuse perspiration.
Difficulty in urinating. Suppression of urine. Retention
of urine, which only passes off in drops. Involuntary discharge of urine. Paralysis of the neck of the bladder. He
cannot retain his urine.
Paralysis of the right arm. Heaviness and paralysis of the
upper limbs, but most decided in the left arm. Paralysis of
the feet. Paralysis of the right arm, and right leg. The left
side, especially the left arm and thigh, are quite paralyzed.
Cold sweat on the forehead.
CASE 17. —A plethoric man, aged 60, of short stature, was
found early in the morning, lying by -the side of his bed, in a
fit of Apoplexy.
Syrnptoms.-He lay immovable, stretched out as if dead,




230             TIEATMIENT OF APOPLEXY.
and stiff; frothing at the mouth, snoring, and groaning; he
was unnconscious, the upper eye-lids were paralyzed, his pupils
dilited and immovable; his face was swollen, and somewhat
reddened; he had twitchings and jerkings; the carotids beat
violently; his lower jaw was dropped, and much spittle ran
from his mouth; his lips quivered; he had incessant snoring
respiration, with frequent groaning; slow, deep respiration,
increased warmth of the body; skin soft, but not moist; pulse
full, strong, somewhat hard, bounding, and quickened.
[Tecatment andl result.-A small venesection, followed by
Ipec. 6, 1 drop, every two hours; in a quarter of an hour,
great restlessness set in, he tossed from side to side, grasped
about with his hands, opened his eyes, had frequent twitchings of the facial mnuscles, and gritted his teeth; his pulse became quicker, and his skin moist; vomiting of mucous and
bilious substances set in, followed by a loose stool, and discharge
of urine.
After the lapse of eight hours, he was in a state of comavigil, and unconscious; when loudly spoken to, he mumbled
and stammered, looked at the person who spoke, and then
closed his eyes again; his pupils were dilated, his face pale,
but bloated, and twitching; at times he chewed and gritted
his teeth slowly, then his jaw dropped again; tough spittle flowed from his mouth; he groaned and snored incessantly,
and grasped, at times, at the somewhat swollen genitalia; his
breathing was slow and deep; skin dry; pulse full, regular,
and somewhat quickened. lie took 1 drop of Bellad. 30, and
in the course of twelve hours his improvement had progressed
so far, that his consciousness had returned, he could speak,
and all immediate danger was over. A kind of mental derangeinent, which remained after the apoplectic attack required
farther treatment, before full recovery ensued.-Archiv, vol.
6, part 9, p. 104. Dr. SCHUBERT.
CASE 18.-A woman, aged 45, was attacked with Apoplexy, and suffered with the following
Syrpntomns: Loss of motion and sensation on the right side
of the body; inability to speak, loss of sight and smell;




BELLADONNA-APOPLEXY.              231
mouth drawn towards the ear; consciousness undisturbed;
convulsive motions of the face and left arm; difficulty in
swallowing; increased flow of saliva; thirst; bloating of
the face; redness and protrusion of the eyes; constipation.
Tr'eatrent.-Bellad. 24, removed the whole attack.-Dr.
BIGEL, vol. 2, p. 97.
CASE 19.-A powerful girl, aged 19, fell down unconscious,
after an attack of vertigo and anxiety.
Synptoms.-She lay stupefied; with dilated pupils, reddened, and somewhat mottled face; eyes reddened; she could
neither speak nor swallow; made signs of having pain from
the root of the tongue to the pit of the stomach, and in the
left leg; she ejected every kind of fluid from her mouth with
force; her pulse was hard; and she had not improved any
for two days.
Trealment. —In two hours after taking Bellad. 30, she made
signs that she could swallow; in five hours she could speak,
the redness of her face had disappeared, and she commenced
to move the left leg. In three days she was perfectly restored.
Archiv, vol. 5, part 1, p. 165. Dr. BAusDIs.
CASE 20.-A man, aged 60, of apoplectic habit, and asthmatic, fell suddenly to the ground in a fit of Apoplexy, after an
attack of dizziness. He lay in a soporose state, unconscious
and speechless, with much rattling upon the chest.
Treatment.-Two doses of Bellad. removed the stupor, and
rattle in his breathing, after it had induced perspiration. Rhus
and Cocculus cured the paralysis of motion and sensation in
the course of fourteen days.-Archiv, vol. 14, part 3, p. 129.
Dr. SCeULEn.
CASE 21.-A priest, aged 33, of lymphatic temperament,
and unusually corpulent, had three apoplectic attacks in the
course of one month, followed by paralysis of the right side.
Symptomrn.-Dejection of mind, with uneasiness about his
condition; confusion of thought; he was affected by the
slightest movement; heaviness of the head, as if it would fall
off; fulness, especially in the forehead, with dizziness; anx



232             TREATMENT OF APOPLEXY.
ious feeling in the stomach, which ascended to the head; dulness of the head, as if he were intoxicated; noises and beating
in the head; sleepiness during the day; paleness and bloating
of the face; dilatation of the pupils, intolerance of light,
squinting of the right eye, with laclrymation, and constant
winking. Paralysis of motion and sensation of the rig/t side
of the face, with a sense of crawling and pulling; his mouth
was greatly drawn to the left; his food fell out of his mouth;
he chewed with great difficulty, could not hold a cigar between
his lips, bit his tongue while eating, and swallowed with difficulty. His speech was tedious and difficult; he had much
thirst; his mouth was pasty; he had no appetite; his abdomen was much distended, chest oppressed, and breathing
difficult. He had troublesome constipation, with internal
piles. Stiffness of the joints of his legs, and weakness of the
whole right side.
Treatment and result.-One globule of Bellad. 2000, followed in a few hours by tearing pains in the shoulder, as if
the head were drawn backwards; his head became more
clear, and on the next day he was entirely restored.-Genl.
Iom. Jour., vol. 34, p. 152. Dr. NunEz.
CASE 22.-Capt. S., aged 72, short, stout and plethoric,
was attacked suddenly with the following
Synzptonzs: Redness and bloating of the face; redness and
lachrymation of the eyes, with complete paralysis of the lids;
dilatation of the pupils; face drawn to the right side; violent
shaking only caused him to mumble a little; clean spittle
flowed over the drooping lower lip, out of the distorted mouth;
his tongue was thick, and projected beyond the lower lip; his
inspirations were snoring, his expirations blowing; he was in
a constant slumber; the arteries of the neck and face beat
violently; his pulse full and slow, and urine passed involuntarily.
Treatment and result.-1 drop of Bellad. 15, to be given
immediately, was followed by such improvement in twelve
hours, that he could move his tongue and open his eyes; his
face was less red, and pulse not so tense; he could move the




BELLADONNA.                  233
limbs of the right side, but could not close, or grasp with his
left hand. During the next day he slept much, and spoke
irrationally; for which he received Opium 10, 1 drop every
three hours; in the evening he was able to walk about the
room. He then took one dose of Bellad. every second day, until
the fourteenth day. Despondency, loss of memory, and difficulty in speaking, were entirely removed by Anacardium,
Baryta, and Rhus.-Gen. Hom. Jour., vol. 8, p. 68. Dr.
ELWERT.
CASE 23.-A lady, aged 61, was attacked with vertigo and
(confusion of the head. In the course of a few hours she had
an unusual snoring and blowing out air through the lips; her
face was red and bloated; her mouth somewhat drawn to the
right; lips and left side in alternate convulsive motion; she
had fits of yawning, entire unconsciousness, paralysis of the
eft half the body, and violent throbbing of the carotids; her
pulse was full and slow; urine was passed involuntarily; her
pupils did not contract when exposed to light; she made no
sound, except a kind of groaning noise; her hands were cold.
Treatment and result. —Several drops of Bellad. 2, were
mixed in water, and a teaspoonful given every half hour, at
first; afterwards, a drop of the pure Tincture was occasionally
put between the lips. The above condition of things persisted
for two days, and the same treatment was continued; then
she groaned more frequently, seemed to hear when she was
loudly spoken to, and could swallow some food; she lay on
her back, unable to alter her position, but could move the
limbs of the right side. On the fourth day, her consciousness
returned; her stuttering speech could be comprehended; she
knew not what had happened to her; complained of weakness, especially of the left side, which she could move, however;
and could take nourishment, although swallowing was difficult.
The remainder of the disease was removed by Bellad. 3,
Nux-vom. 3, and Rhus 2. Dr. ELWERT, p. 40.
CASE 24.< —HARTMANN (see Acute and Chronic Diseases,
translated by Chas. J. Hempel, M. D., vol 4, p. 6,) reports a case
18




234             TREATMENT OF APOPLEXY.
of Apoplexy in a weakly, emaciated woman, aged 80, suffering with dropsy of the legs. The arms and head dropped
suddenly; her mouth was drawn to one side; she could not
speak; her breathing was short and rattling; skin cool; pulse
small, weak, and scarcely to be felt; all her secretions were
suppressed; she was entirely unconscious; and food dropped,
or poured out of her mouth again from inability to swallow.
Treatment.-Bellad. improved her condition very much.
The remaining paralysis was removed by Stannum, Causticum,
and Baryta, after the oedema had been cured.
CASE 25. —A man-cook, aged 40, having received a repulse in the presence of his master, from his betrothed, which
he took much to heart, was attacked on his return to the
kitchen with vertigo, but still continued to do his work, although
his sight became much obscured, and he went staggering
around the room, scarcely knowing what he was about; at
length he fell senseless to the ground. He was carried to bed
in an insensible state; his face was swollen, and of a reddish
yellow color; his eyes red and fixed, pupils dilated; he gave
no signs of hearing; from time to time he had violent convulsive movements in his arms, particularly in the right; breathing very slow; pulse slow and hard; forehead very hot.
Treatment.-Bellad. 20, 9 pellets dissolved in an ounce of
water, a spoonful every half hour; in two hours the convulsive
movements were less frequent and violent, his face less flushed,
he gave signs of hearing, and put his hand to his head. In the
course of the night he fell into a general perspiration, and on
the following day he replied in a distinct voice when spoken
to, opened his eyes and looked about with an unsettled and
frightened air, and wished to be carried into his own room,
where in fact he then lay. His sight was obscured, his eyes
moved spasmodically, and were rolled upwards, always with
a profound sigh; he complained much of severe pain and
weight in the head, especially in the forehead; his face was
still much flushed; tongue yellowish-white; mouth slimy. with
a bitter taste, loss of appetite and great thirst; bowels consti



BELLADONNA.                  235
pated; urine red and clear; pulse freer, and less hard. Ignatia 20, 12 pellets in solution, a spoonful every half hour. In
the evening, Bellad. was repeated; he perspired again, and
more copiously during the night, and on the following morning
he could see better, recognized his room and the bystanders;
his eyes were less red, but the rolling iotion upwards recurred occasionally, always accompanied with sighing; pulse
febrile, but skin almost natural. Ignatia at longer intervals;
and on the fourth day he was nearly well, although some
bilious symptoms required C/hamomilla.-Brit. Jour. Hom.,
vol. 4, p. 370. Dr. LADELCI.
CASE 26.*-A lady, aged 23, had a good confinement, four
days after which the lochia ceased, and fever with pain in the
bowels set in. Her allopathic physician prescribed injections of Assafcetida. On the 9th day, headache came on,
increased steadily, became constant and often intolerable;
her physician diagnosed neuralgia, and gave Castoreum,
without benefit. By the 12th day the disease had assumed a
serious aspect; the patient lay on her back motionless; her
features were spasmodically disturbed and expressed much
suffering; she was very weak, entirely unconscious, her tongue
was almost immovable, and she cried out distractedly at
long intervals; her right arm and leg were paralyzed. She
passed urine involuntarily; her abdomen was soft, and she
was constipated. Her physician now leeched and bled her
on account of congestion and irritation of the brain, but she
became more heated, convulsions of the left arm occurred,
her pulse became thread-like, her face pale, and she lay as if
dead. Dr. RAMPAL was now called in consultation and advised Belladonrna, but the other physician would not consent
and gave more Assafcetida; the next day she was still worse,
and Bellad. was given, 4 grain of the extract, in six ounces
of water, a spoonful at night; the night was more tranquil
and some color returned to the face; in the morning twospoonfuls were given within four hours, and in the evening
the patient moved the right leg several times, noticed a little,




236             TREATMENT OF APOPLEXY.
and put out her tongue; that evening and the next morning
she got another spoonful of the medicine, and the improvement went on, so that on the 17th day she could move her
arms and legs; on the 18th, she ate with appetite, and soon
recoveredly completely. —Brit. Jour. Hom., vol. 8, p. 281. Dr.
IRAMPAL.
CASE 27. —A man, aged 42, of sanguine-choleric temperament, who had suffered for a long time with his head, and
with pains in his limbs, was seized with an attack of apoplexy one afternoon, in the midst of most violent pains in
his head; he was left paralyzed on the whole of the right
side.
Symptoms. I-e was unable to speak; his mouth was drawn
to one side; at times the sound left side was agitated with
convulsive movements; the saliva flowed constantly from his
mouth; he had some hiccough; his pulse was full and hard;
eyes red and prominent; his face flushed; thirst excessive;
he had been constipated for four days; but he retained his
eonsciousness, understood his situation, and felt that his great:misfortune had reduced his beloved family to a very distressiinag situation.
Treatment and result. —He took two pellets of Bellad. 30,
and a quarter of an hour had scarcely elapsed before a change
was observed in his state; the pain in his head became less
violent; the redness of his face less decided; the convulsive
movements less severe, and in half an hour after, he fell into
a pleasant sleep, which lasted two hours, and from which he
awoke in a slight perspiration; he was able to speak in a brief,
comprehensible manner; sensation and motion had returned
in a slight degree to the paralyzed parts, and in twenty-four
hours more the paralysis had entirely disappeared; some pain
and heaviness in the head persisted for a few days after.
Beauvais' Clinique Homnceopathique, vol. 1, p. 276. Dr.
BETHM ANN.
CASE 28.*-A printer, aged 36, fell while at dinner, with
an attack of apoplexy, followed by paralysis of the whole left
side; when his arms or legs were raised, they fell heavily like




BELLADONNA.                   237
inert masses; his face was red, his eyes brilliant, and full of
tears; he had not entirely lost consciousness, but was unable to speak a word; his tongue was drawn to one side; and.
his pulse was full and strong.
]Treatnent aczcd resgu.- Bellad. 30, 1 drop. In the evening
the paralysis had entirely disappeared; his speech had returned, but his voice was stammering; his pulse was frequent,
but soft. The same prescription was repeated, and by the
next day he was out of danger.-lalaise' Clinique Homceco
pathique, p. 1.
CASE 29. —-A woman, aged 38, of violent temper, but pale
and delicate, had suffered for several years with Congestiwv
vertigo.
Symptoins. —The attacks occurred several times a day, generalb
ly in the morning, after stooping; were attended with flimmering before the eyes, and dimness of vision; she was obliged to
lay hold of something to prevent her falling, on account of
staggering and pitching about; afterwards she felt exhausted in body, and mind.
She also was annoyed with aching pain in the forehead
over the eyes, increased by bodily exercise, and attended
with throbbing in the head, and heat in the face. She had
but little appetite, an aversion for meat-diet, with nausea and
inclination to vomit. In the forenoon she had flushes of heat,
attacks of unconsciousness, and aching, and pulsation in the
epigastrium after eating, and while walking. She was costive, with bearing down upon the uterus; also had a chronic
cough, and shortness of breath.
Treantment.-After nine doses of Bellad. 15, one drop per
dose, the vertigo and headache had entirely disappeared.
Nux., Sulph., and Stramon., removed the remaining symptoms. Genl. I-Iom. Jour., vol. 19, p. 313. Dr. ELWERT.
CASE 30.*-A boy, aged 15, who had suffered for a year
with attacks of vertigo and transient fits of unconsciousness,
was cured by Bellad. 4, one dose every day, for four weeks
Genl. Itom. Jour., vol, 19, p. 314.  Dr. ELWERT.




238             TREATMENT OF APOPLEXY.
CASE 31.* —A girl, aged 13, had suffered for several years,
with attacks of turning-dizziness attended with anxiety,
pressing headache, and staggering about, occurring several
times every week. She was entirely cured by Bellad. 5,
30 drops in 2 drachms of Alcohol, 10 drops to be taken
every other day.-Gen. Hom. Jour., vol. 19, p. 313. Dr. ELWEnT.
CASE 32.*-A lady, aged 48, was subject to vertigo on rising from her seat, so that all objects seemed to stagger to and
fro; she was also apt to fall down, and to vomit mucus.
Symvptoms.-The attacks of vertigo were preceded by a
putrid taste in the mouth, nausea, and at times by bilious
and mucous vomits; occasionally, she was dizzy at night; the
vertigo was increased whenever she lessened the quantity of
meat she ate; she had a disgust for milk; and was every now
and then troubled with diarrhcea, or acrid leucorrhcea. She
often awoke at night in alarm; her sleep was disturbed before
midnight, and during the day she was anxious, unhappy,
and irritable.
Treatment and result.-She was somewhat relieved by
Bellad. 10, but still the dizziness and loss of memory remained; whenever she sat bent forwards heaviness in the back of
the head came on; near objects were seen indistinctly: she
had pain in the urethra while urinating; her urine was turbid
with mucus, and an acrid leucorrhcea was increased; her
stools were still loose; and she had a frequent inclination to
doze. Conium 10, then cured her almost entirely, although
Lycopod. was required for the vertigo when stooping, the
flatulent distension, and the stools which had now become
too hard. —Annals, vol. 1, p. 231. Dr. SCHRETER.
CASE 33. —A man, aged 26, of large and robust constitution, had suffered for three days with turning vertigo, and
dimness of sight after rising up from sitting or lying, from
moving the head or eyes, and from rising up from stooping.
He also complained of lassitude in his limbs, with trembling




BELLADONNA.                       239
of them while walking, of fulness in the head and pain in the
chest..Treatmernt. —Four doses of Bellad. 9, were giyen, one drop
per dose, every six hours, with decided improvement: then
four doses of Bellad. 12, 1 drop per dose, every six hours,
cured him  entirely.-Gen. Hom. Jour., vol. 44, p. 47. Dr.
IIAIUSTEIN.
CASE 34.* -The patient, aged 34, suffered with numbness
and weakness of the left side; paralytic drooping of the eyelids: lachrymation and squinting of the left eye: double
vision; distortion of the mouth. The head was dull and
confused; the tongue coated; appetite poor; pulse rather
tense; sleep restless.
Trealment.-Bellad. was administered in repeated doses of
the pure Tincture, for four weeks. For the obstinate remains
of the Paralysis, Rhus 1st dilut., was given every forty-eight
hours, for four weeks more, when the patient was entirely restored.-Dr. ELWERT, (Ilomceopathy and Allopathy in the
Balance, p. 42).
Dose. Of the eighteen cases treated by Bellad., three were treated with
the pure Tincture, which effected a cure in one case where the 18th
dilution had failed; the 1st, 2d, 3d, 4th, 5th, 9th, 20th, 24th, and 2000th
dilution, were each successful in one case; the 15th in two cases, and the
30th dilution in six cases.  In four cases, single doses of the 15th, 24th,
and 30th dilution, sufficed to effect a cure; in other cases the doses were
repeated as frequently as every half hour, and from four to five, or even
nine or ten doses were required. In six cases, favorable results ensued
in the course of two hours; in three cases, after the lapse of ten or
twelve hours; in others, in the course of a few days. NOACK prefers
one or two drop doses of the 1st, 2d, 3d, 6th, or 12th dilution, repeated
every two, three, four, six, eight, or twelve hours, in acute and severe
attacks. In very severe cases, they may be given every five, ten, or fifteen minutes, or every half, or one hour.  If preferred, from 3 to 6
pellets may be dissolved in a wineglassful of water, and a teaspoonful
given as often as above directed. PETERS.
6. BLOOD-LETTING.
Even if it be admitted that allopathic physicians bleed too
much in apoplectic attacks, it is generally supposed that ho



240             TREATMENT OF APOPLEXY.
mceopathic physicians bleed too little —if the strength and
vascular condition of the patient permit of it, or seem to require it, it seems very certain that bleeding will not interfere
with the action of homeopathic remedies-and it is even supposed that in some apoplectic and congestive affections of the
brain, the pressure upon it and the nervous system may be
so great, that they are as it were benumbed, and unable to respond to the action of any remedy until the pressure be relieved by blood-letting-hence I will endeavor to state as
fairly as possible the advantages and disadvantages of bloodletting in apoplexy.
WOOD, the latest American writer on the theory and practice of medicine, says: " If the strength of the pulse admit,
blood should be drawn from the arm-l but bleeding is not to be
indiscriminately resorted to, or pushed to an unlimited extent;
much injury has probably been done in this disease by excessive bleeding; if nature have already accomplished a great
reduction of the heart's impulse, if the pulse at the wrist be
small and feeble, no advantage is to be derived from the further loss of blood. It should be remembered that in the
hoemorrhagic and serous cases of Apoplexy, the disease is
not over when the effusion is suppressed; the brain has sustained a great shock, and a long series of actions will be necessary to repair the mischief done; it is bad practice to destroy
all the resources of the system which may be necessary to
sustain this course of action, by an inconsiderate and exclusive obedience to the first indication, viz., that of arresting
effusion, or correcting congestion. The practitioner should
be guided by the strength of the pulse whether he shall bleed
or not."-Vol. 2, p. 628.
SOLLY says, " blood-letting is the most dangerous remedial
agent in some cases of Apoplexy. Many a valuable life has
been saved by the prompt and free use of the lancet; but more
have been hastened into eternity by its indiscriminate employment. At one time this opinion of theimperative necessity of
blood-letting in Apoplexy was almost universal, but it has lately been much modified; the deservedly-high reputation of




BLOOD-LETTING.                241
AIERCROMBIE gave too much value to the use of the lancet in
Apoplexy. WATSON, he says, advises after one full, and sufficient bleeding from the arm, to abstain from farther use of
the lancet; the disease itself is most depressing, and in its
treatment we must not consider the present moment simply,
but we must also look to the future. SOLLY is convinced that
large abstraction of blood gives rise to serous effusion, or
dropsy of the brain. HIe also quotes Dr. HOLLAND, who asks,
" Is not depletion by bleeding, a practice still too general and
indiscriminate in affections of the brain"- he believes that the
soundest medical experience will warrant this opinion. WATSON says, that he does not mean altogether to praise the modern (allopathie) practice in apoplexy; for it is often one of
mere routine-this routine may be most proper in many
cases; unnecessary in others, and pernicious in some, but
there are persons who seem to think that they have not done
their patient justice if any part of the usual active intermeddling has been omitted-they think that the patient must be
copiously bled, cupped or leeched, blistered, and thoroughly
dosed with calomel, senna and croton oil, and mustard poultices must be applied to the legs, &c.
BunRows says: until a very recent period, repeated and copious blood-lettings and active purgatives were the principal, if
not the only remedies recommended to be employed in all
Apoplexies by authors held in the highest esteem. Several,
however, of the present day have pointed out many circumstances which would cause such profuse expenditure of the
vital fluid in the treatment of apoplexy to be highly prejudicial-BURROWS says that his experience leads him fully to concur in reprobating the indiscriminate use of the lancet in
these cerebral affections. HIe also adds that: the principles
of treatment of apoplexy recommended by so eminent and
experienced a physician as Dr. ABERCROMBIE, have, he doubts
not, misled many into the abuse of the lancet. They have
been afraid to abstain from blood-letting, since that remedy
has been declared to be almost a panacea by this writer.
Several modern writers have alluded to states of the brain




242             TREATMENT OF APOPLEXY.
simulating congestions of its vessels, and where depletion
would only aggravate the symptoms.
But the most formidable antagonist ill the old school
against blood-letting is COPEdIAN. He asks, " Could things be
worse under any plan of treatment, or would the mortality be
greater without any treatment at all. Surely there is a complete justification for leaving the well-beaten allopathic track
that has hitherto been trodden with so little satisfaction, and
endeavoring to find out a path that might lead us to more encouraging prospect. Of 155 cases, 129 were bled and only
26 were not; of the 129 who where bled only 51 recovered
and 78 died; of the 26 who were not bled, 18 were cured and
8 died.-See p. 6.
" From these facts," COPEMAN infers, that " bleeding generally speaking, is so ineffectual a means of preventing the fatal
termination of Apoplexy, that it scarcely deserves the name of
a remedy for this disease. That bleeding in the foot was the
most successful mode of abstracting blood, but that the treatment without loss of blood was attended with most success;
and that the mortality of the disease increased in proportion
to the extent to which bleeding was carried; the more copious
the loss of blood, the more fatal the disease."  (See Collection
of Cases of Apopleay, by Ecdwardc Copecman, p. T.)
COPLAND says, that during his own experience he has often
had cause to regret that apoplectic and other sudden seizures
had been treated by blood-letting by the first medical man
who had seen the patient. [For many hundred years an idea
has been entertained by medical practitioners that active practice was good practice: that blood-letting was the best part of
active practice; and that this constituted the chief and greatest part of a medical reputation. They could not perceive
the fact that blood-letting could be injurious in any of these
cases; and they fully believed that patients died notwithstanding the bleeding, and not in consequence of it. Now matters have somewhat amended with the progress and diffusion
of medical knowledge; but there still remains much to reform
even in this, and other practical measures. The number of




BLOOD-LETTING.                243
cases collected by COPEMAN might have been easily very much
increased, and especially in support of the views which he has
espoused, and which had been fully insisted upon by myself
(COPLAND) and others long before he wrote."  (See Copland
on Palsy and Apoplexy, p. 275.)
We have already seen that ABERCROMBIE was most enthusiastically in favor of free blood letting in Apoplexy, and that
he carried his prejudices and practice in this respect so far as
even to be blamed by his fellow allopathic practitioners therefore. It would almost necessarily be supposed that ABERCROMBIE was unusually successful in his treatment; it would hardly
be guessed that a celebrated physician could carry his opinions
and practice out in spite of the repeated and abundant ill success. In COPEMAN'S work we find 28 cases of Apoplexy reported by ABERCROMBIE, no less than 24 of which terminated
fatally; in 4 of these fatal cases "' all the usual allopathic
remedies were employed in the most active manner without
the least effect in alleviating any of the symptoms, and on
inspection after death, either no vestige of disease could be
discovered in the brain, or at most, there was but a slight
turgescence of the blood-vessels.
I trust that I have honestly made the case strong enough
against the universal applicability of blood-letting in the treatment of Apoplexy; I trust that I have done enough, and that
right fairly to prove that the sound and learned medical practitioner is often imperatively called upon to avoid blood-letting
in many apoplectic attacks; but. notwithstanding all this, I
am fully convinced that blood-letting is safe and useful in
some cases; even COPEMAN, the great opponent of blood-letting in Apoplexy, says that in his opinion, the only cases in
which bleeding i4 proper, are those which occur in plethoric
habits, and where in addition to the symptoms of what is generally understood by a full habit, there is evident distension
or f ulness of the suyperficial vessels of the head and neck, and
that it is rarely necessary to carry the bleeding beyond the
point of relieving entirely the external visible fulness of the
vessels. COPLAND admits the safety and benefit-of blood-let



244             TREATMENT OF APOPLEXY.
ting where there is slowness and fulness of the pulse, stertorous
or strong breathing, and a tumid, flushed or livid countenance.
RAU says, bleeding may be necessary in those rare cases of
true plethora where the brain and nervous system is overwhenlled by the excess of blood, and in violent congestions of
noble organs, such as the brain or lungs, where there is imminent danger of Apoplexy in the former, and of suffocation in
the latter. In these cases the bleeding simply averts the present danger, but does not cure the disease: this has to be accomplished by appropiate medicines, and if this be not attended
to, every drop of blood may be taken away without relieving
the patient; beyond a certain moderate point, we weaken the
body by abstraction of blood, without lessening the quantity
circulating in the brain.  [PETERS.]'. COCCULUS.
(a.) Dr. BLACK says that this remedy somewhat resembles
Nux-vomica in its, action; it is most indicated when the patient has not entirely lost consciousness, although it is more
homceopathic to stupor than Nux; the best indications for its
use are the presence of: Violent pains, especially in the forehead; severe headache with much vertigo, nausea and vomiting; numbness, sometimes of the hands, sometimes of the
feet; or transient fits; and paralysis of one side.-Brit. Jour.
iom., vol. 5, p. 56.
(b.) It is used, perhaps, more frequently, to prevent Apoplexy,
and against apoplectic-vertigo, than in the fit itself, although
it may prove useful in many cases of gastric-, nervous-, and
convulsive- or epileptic-Apoplexy. NOACK and TRINKs recommend it in Nervo-apoplectic conditions with hemiplegia; in
congestion of the brain and Apoplexy, even after profuse
blood-letting; when there is great nausea with a tendency to
faint; dizziness with inclination to vomit; attacks of dizziness
with feeling of intoxication, dulness of the head, nausea, pressing
and beating in the temples, alternate falling asleep of the feet
and hands, difficulty in speaking, thinking or reading; severe




coccuLus.                   245
headache with nausea and vomiting; headache with feeling
of emptiness and hollowness of the head, increased by eating
and drinking; when there is vertigo, with nausea and falling
down without consciousness; vertigo, as from intoxication, and
stupid feeling in the head, as if he had a plank before it;
vertigo, when raising himself in bed, as if everything turned
around, with inclination to vomit, obliging him to lie down
again; headache with inclination to vomit, as if he had been
taking an emetic; stupid feeling in the head, with cold sweat
on the forehead and hands. Attacks of paralytic weakness.
Apoplexy of the left side; epileptic- or convulsive-Apoplexy,
in which the patient first feels as if intoxicated, then becomes
quite still, and stares for a long time at one spot, without hearing or answering any questions, then falls down unconscious,
writhing and muttering unintelligible words, with involuntary
emission of urine, spasms of the limbs, convulsive clenching
of the fingers, paroxysmal choking in the throat, the mouth
being open as if he would vomit, the hands being cold, the
face covered with cold sweat, the eyes glassy and protruded;
after the attack he is partly unconscious and bewildered.
PEREIRA says it is homceopathic to nausea, vomiting, staggering, trembling and convulsions; 3 or 4 grains of it have proved
homceopathic to nausea and fainting, although it is frequently
added to malt liquors for the purpose of increasing their intoxicating powers. TAYLOR says it is homceopathic to vomiting and
intoxication. ATTOMYR regards Cocculus as indispensable in
some of the consecutive affections of Apoplexy, especially
against the weakness and irritability of the stomach, weakness
and dizziness of the head, and the paralysis. He regards it,
however, as more homceopathic to epilepsy than to Apoplexy.
Others regard it as most homceopathic to asthenic Apoplexy,
when the face is pale and sallow, but puffy and bloated, the
pulse feeble and easily compressed, the respiration heavy and
laborious; especially when these symptoms have been ushered
in by headache, giddiness, loss of memory, illusions of hearing, inarticulate speech, and inclination to somnolency. —
PETERS.]




246             TREATMENT OF APOPLEXY.
CASE 35.-A maiden, aged 18, slender, and not yet menstruated, fell suddenly to the ground.
Symptoms. —Her face was red, and glowing hot; her eyes
closed, eyeballs in constant rotation, and her pupils much dilated; breathing short and noiseless, scarcely to be heard for
hours together; pulse full, hard and frequent; entire unconsciousness.
Treatment. —Bleeding was followed by groaning respiration, restless and anxious moving of the left arm and leg; the
right side was entirely insensible to severe pricking with needles. She then received Cocculus, 12th dilution, and in the
course of one hour she moved herself, turned over upon her
side, her breathing became more quiet, but stronger and more
equal, and she opened her eyes, although still without consciousness, or ability to speak. Consciousness returned at the
end of four hours, but perfect paralysis of the right side
remained; at the end of twelve hours feeling and power
of motion began to return in the paralyzed parts. Recovery
in two days more.-Annals, vol. 4, p. 47. Dr. TIETZ.
CASE 36.-Mr. L. had suffered for a long time with vertigo,
which returned daily at 11 A.M. Whenever he looked up, he
had a tendency to fall to the left side; when he stooped it
seemed as if he would fall backwards, so that he was obliged
to hold on to something quickly. He often had stitches of
pain in the top of the head, and pains in the back and sacrum.
Tireatment. —Two doses of Cocculus caused some improvement, but Causticum 30, effected a cure.-Archiv, vol. 17,
part 1, p. 6. Dr. B. of D.
CASE 37.-A youth, aged 17, had suffered with attacks of
dizziness recurring every fourteen days, and lasting for several
days.
Symptomns.-Vertigo while sitting, when rising from bed, or
from a chair, also while standing, but most frequently after
dinner, and attended with a feeling of intoxication, and stupidity, with nausea, pressing and throbbing in both temples,
and alternate falling asleep, first of the feet, then of the hands.




COCCULUS.-CONIUM-MACULATUM.            247
During the attacks he could scarcely speak; afterwards he had
difficulty in reading and thinking.
Treatment.-Nine doses of Cocculus 15, one dose every six
days, cured him entirely. —Gen. Hom. Jour., vol. 8, p. 70.
Dr. ELWERT.
Dose. The 12th and 15th dilutions have been used successfully. In
other cases the same doses as recommended for Nux may be given. —
PETERs.
8. CONIUM-MACULATUM.*
GENERAL REMARKs.-According to ATTOMYR, the principal
homceopathic remedies against Apoplexy are: Belladonna,
CONIUM, Hydrocyanic acid, Hyosciamus, Opium, and Plumbum.
According to CHRIsTIsoN, Conium acts as specifically in
causing paralysis of motion, as Aconite does in producing
paralysis of sensation. It is homceopathic to palsy, first of
the voluntary muscles, next of the chest, finally of the diaphragm, causing asphyxia from paralysis, without insensibility, and with slight occasional twitches only of the limbs.
In several soldiers, it proved homceopathic to such drowsiness that they seemed to drop asleep while conversing; but
they soon became giddy with headache; in one case there
was such a state of insensibility, that the patient could only
be roused for a few moments, his face was bloated, pulse only
30, and extremities cold.
It is also homceopathic to great congestion of the head, with
an unusually fluid state of the blood.
Conium also differs very widely from Bellad., Stramon., and
other narcotic remedies, in not producing violent orgasmr,
commotion, and active congestion of the blood; POHLMANN
found after taking one-third of a grain of Conium, that his
pulse fell from 70 to 59, with slight dizziness, and a remarkable sensation of heaviness in the arms and legs, but especially
in the left arm. VOGT thinks that it checks the arterialization
of the blood, and renders it much more venous. ABLEs also
thinks that it acts sedatively on the arterial system. SOBERJ



248             TREATMENT OF APOPLEXY.
HEIM asserts that it diminishes the frequency of the pulse, and
relaxes the muscular, and vascular fibres.
It exerts a similar depressing action on the brain; it is not
only much more apt to be homnceopathic to paralysis and
coma, than to delirium and convulsions, but it causes a most
intense passive stagnation, and venous congestion of the blood
about the head, and brain. In this respect it acts almost
antagonistically to Ferrum; (see page 154); and in like manner as this latter remedy is, perhaps, the most homceopathic
to true arterial congestive plethora and Apoplexy, so is
Conium the most homceopathic remedy to true, simple, and
uncomplicated venous plethora and Apoplexy.
Its action upon the functions of the brain are also decidedly
depressing; it is homeopathic to weakness of the intellectual
faculties, loss of memory, inclination to shun society, yet with
fear of being alone, dread of thieves, and liability to be easily
frightened; to want of mental energy, unfitness for exertion,
confusion of ideas, as if from drowsiness, slow conception of
ideas, ready forgetfulness, hypochondriacal indifference, dejection of mind, &c., all pointing to a torpid and sub-paralytic
state of the brain, which may easily be followed by Apoplexv.
It is also homceopathic to apoplectic attacks, connected
with, or dependent upon derangement of the liver; according
to VOGT it is homCeopathic to excessive distension of the vessels of the vena-porta system, with great enlargement of the
liver, and profuse efuision of bile. PETERS).
(b.) According to ATTOMYR, Conium is indicated when the
following
Pr'emonitions of Apoplexy occur:
Vertigo, in which everything seems to turn around in a
circle; dizziness when rising up from stooping, with feeling
as if the head would split; dizziness, which is more severe
while lying down, and then attended with the feeling as if
the bed turned around; dizziness on going up stairs, he was
obliged to hold fast to something, and for a few moments did




CONIUM-MACULATUM.                249
not know where he was. Dulness of all the senses. Confusion
and heaviness of the head; persistent stupefaction of the
head; with constant inclination to lie down. Dimness of sight.
Roaring in the left ear with hardness of hearing, aggravated
while eating. Roaring in the ears, as if from a wind-storm,
increased from  after dinner until bed-time, aggravated by
mental exertion, but particularly by lying down in bed; it was
also noticed at night when he awoke.
Bleeding from the nose, gritting of the teeth, difficulty of
speaking, waterbrash, nausea and inclination to vomit.
Dead feeling of the left hand, especially when clenching
the fist; numbness of the fingers, falling asleep of the legs
while sitting; numbness and coldness of the fingers and toes.
Trembling of all the limbs, and incessant trembling. Great
lassitude, relaxation of body and mind, nervous debility, fainting fits. Sleepiness during the day, so that he can scarcely
keep his eyes open while reading; drowsiness, even while
walking in the open air; sleepiness in the afternoon, so that, in
spite of all his exertions to the contrary, he was obliged to
lie down and sleep. Sleep disturbed by unpleasant dreams.
Coniuni is indicated in attacks of Apoplexy when the
patient lies without consciousness, in a deep sleep, and breathes
with extraordinary difficulty and exertion, (see Apoplexy of
the Medulla-oblongata, page 168); when the breathing is slow
and difficult; when the pulse is unequal in force and quickness, large and slow pulsations being followed at irregular
intervals by several small and quick pulse-beats; slow, weak
pulse; pulse small, hard and slow, only 30 beats per minute.
Protrusion of the eyes, dilated pupils, followed by contraction of the pupils.
Paleness of the face; blueness, or bluish and swollen state of
the face; blueness of the face, as if crowded with venous blood,
as in strangled persons. Constipation, involuntary discharge
of faces while asleep. Suppression of urine, ischuria, frequent
urination, with inability to retain the urine. Paralysis and
coldness of the extremities. ATToivYn.
From the powerful action which Conium exerts upon swell19




250              TREATMENT OF APOPLEXY.
ings and exudations, it is very probable that it will also aid
powerfully in the absorption of apoplectic clots; and from
its depressant action on the vascular system, it may prove
antipathic to the inflanmmatory irritation which is so apt to set
in around the clot. PETERS.
Dose. No cases of Apoplexy have as yet been reported, as cured by
Conium. NOAcKi advises I or 2 drops of the pure tincture per dose, or
of the 1st or 2d dilution.  Those who prefer them, may use the globules, either dry upon the tongue, or in solution. PETERS.
9. OROTALuS.
CASE 38.-A man was suddenly attacked with Apoplexy.
Symptoms.-Iheadache, oppression of the chest, and burning fever with quick pulse; inability to speak; deep slumber,
from which he could not be roused; muttering to himself.
Trecatment.-Crotalus 30 effected a speedy cure.  Genl,
Hom. Jour., vol. 39, p. 280. Dr. WEBE-R.
10. CUPRUM- AND PLUIB3UiM-ACETICUAM.
GENERAL REN:t AREs.-BPEER, of Vienna, in 5 cases, found
Copper to be homceopathic to very severe headache, slight delirium, convulsive movements of the legs, great exhaustion, and
somnolence, which in 3 cases amounted to coma.  From
CHIRISTISONS iemarks we also learn that it is often homceopathic
to violent headache and other affections of the brain, in which
symptoms of narcotism appear first, and are followed by irritation.
It is also peculiarly homnceopathic to Apoplexy which arises
from disorder or disease of the liver; to the brain-affections
which are so common in bilious persons, and in those who
have acute or chronic jaundice, although we will soon see that
Phosphor. also deserves attention.
From DANA's American edition of TANQUEREL'S work on
Lead Diseases, we learn that Lead is decidedly homceopathic to
some varieties of coma and partial Apoplexy. It is so when
the patient suddenly falls into a comatose state in the midst
of an appearance of good health, or during the course of severe colic. In the highest degree of this variety of disease,




CUPRUM- AND PLUMBUM-ACETICUM.          251
the patient is immovable, the limbs gathered upon the body,
the eyes closed or half closed, and snoring may be heard like
that from one in a sound sleep; from time to time the patient
utters heavy groans, but if spoken to he cannot be roused from
the comatose state in which he is plunged; still at times, if
he be pinched sharply, he may open his eyes, look around, and
then fall again into his lethargic sleep without replying to any
question. Involuntary automatic movements of the head,
trunk, and limbs take place from time to time; the pupils may
be dilated or contracted, and light either has no effect upon them
or else causes them to slowly contract; sensibility and motion
are lessened, but not abolished; the jaws are firmly clenched;
and from time to time there may be an abrupt motion of the
lips accompanied with a strong expiration, a movement common in Apoplexy, and often called " smoking the pipe."
Lead is also homceopathic to a sub-delirious form of coma;
the patient after having been plunged into a sleep, more or less
profound, seems to awake suddenly, opens his eyes, nearly always mutters the same unintelligible words, or distinctly pronounces them without any meaning; he may turn, and turn
again in his bed, rise and take the most fanciful postures, and
then finally fall back into his first sleep. If he be briskly
aroused from his lethargic state, he at first opens his eyes a
little, then closes them immediately, or if he opens them completely they look fixed and haggard, and if he then be questioned with much earnestness he will sometimes look fixedly
at the person without speaking, or else he replies in a stammering, very laughable and sing-song manner; there is a
constant tendency to repeat the same, or similar sounding
wor'ds.
Sometimes when the patients are awakened from their stnpor, their harsh jargon often expresses discontent, and they
turn with ill humor away from their interlocutor; sometimes
when they are awakened, they articulate the first words of a
reply, and mutter the rest as they fall again into their stupor.
In some cases they can give a rational reply if it does not require more than one word, such as yes or no. All the organs
of the senses are blunted.




252             TREATMENT OF APOPLEXY.
Lead is also homceopathic when these two varieties of simple coma and sub-delirious coma occur in alternation, or appear
and disappear without any particular order of occurrence.
Lead is peculiarly indicated when the above states set in without premonitory symptoms, and almost instantaneously; but it
is very rare that the comatose variety occurs alone, without
being preceded or followed by delirium or convulsions.;Lead-Atrophy of the Brain.
In 21 cases Lead proved homceopathic to a flattening and
shrinking of the convolutions of the brain, with increase or
diminution of the firmness or cohesion of the medullary substance, and of the size of the brain. In 19 cases, to yellowness of the substance of the brain; in 32 other cases there
was serous infiltration, more or less slight; congestion of the
membranes of the brain, more or less great; and diminution of
the consistence (softening) of the white cerebral substance,
without any change of color.-TANQUE-REL says, that the shrinking and flattening of the cerebral convolutions deserve serious examination, because they have been noticed by
numerous and skilful observers, and consequently are worthy
of the highest credence-in some of these cases there was also
an increase of the volume and consistency of the brain, in
fact, an hypertrophy; but in other cases there was also a flattening of the cerebral convolutions, with diminution of the
size of the brain, in short there was either an atrophy, or at
least a shrinking, or condensation of the cerebral mass. In
other cases there is only a turgescence of the cerebral tissue.
It will be seen that if homceopathy be true, Lead must prove
a most important remedy in some of the most serious chronic
affections of the brain; in acute swelling of the brain, in
hypertrophy, in white or yellow softening, in atrophy and
induration of the brain.
ROKITANSKY in particular has laid great stress upon the
more or less frequent occurrence of premature atrophy of the
brain in Apoplexy, associated or not with manifest premature
senility of the whole organism-he thinks it a very important
condition in itself, but it also becomes still more so from its




PLUMBUM.-IPECAC.                  253
immediate and subsequent consequences. Tblese consequences
are:
(a.) Congestion of the brain, or Iyfyperceribnia ex vacuo, giving
rise to those transient or protracted attacks which simulate
Apoplexy, and are so frequent in old age.
(b.) Acttua Apoplexy, with h.Tmorrhage, is one of the most
common consequences of atrophy of the brain, and the congestion to which it gives rise.
(e.) (Eademac of? t/ e b1acn, is a very common occurrence in
the atrophied brains of the aged and imbecile —-it may be
chronic or acute.
Atrophy when it involves the whole brain and has reached
a certain degree, terminates fatally either by paralyzing the
brain, or through some of the consequences described above.
(See page 165.) PETERS.
ScmIID found Cuprum-acet. exceedingly useful in nervous
Apoplexy marked by loss of consciousness, twitchings of the
face, distortion of the mouth, partial paralysis and distortion
of the tongue, paralysis of the tongue, immobility of one or
the other limb.-Hygea, vol. 12, p. 127.
Dose. NOACK advises 1 grain doses of the 1st, 2d, or 3d trituration; or 3 or 4 grains of the 100th, 150th, or 200th, in a tumbler of water, a tablespoonful to be given every quarter, half, one or two hours.
PETERS.
10. FERRUIM.
See pages 18 and 19.
11. IPECAC.
CASE 39. —In an attack of nervous and serous Apoplexy,
attended with dizziness, paralysis of the lips, inability to speak,
flow of spittle out of the mouth, and paralysis of the limbs,
much good was accomplished with Ipecac.: but Cocculus was
necessary to perfect the cure. (See case 17.) Dr. RIMMEL.
12. GLONOINE.*
This extraordinary remedy promises to be useful against
headaches, congestion of the brain, and congestive apoplectic




254             TREATMENT OF APOPLEXY.
attacks. It is particularly indicated, according to HERING,
against throbbing headache, aggravated by shaking the head,
and attended with great quickness of the pulse, which may
range as high as 120 per minute, and even more; it is more
homeopathic to these symptoms than any known remedy.
It is also indicated against: "sensations of swelling about
the face and neck; uncertainty of step; dizziness from moving
the head; heaviness of the head, especially over the eyes, and
extending to the ears; dull headache, with warm sweat on the
forehead. Headache ascending from below upwards, especially on the top of the head; from within outwards, especially
in the temples, with feeling as if the brain were swelling, or
getting too large; fulness in the head, especially on the top,
with throbbing and heat. Congestion to, and heat of the head.
Throbbing in the forehead, ternples and vertex, extending back
into the nape, increased by every step, and by every motion
of the head. A bruised and sore feeling in the head. The
pain, heat and fulness of the head are peculiarly apt to ascend
from below upwards, i.e., to commence in the chest, nape of
the neck, or occiput, and then pass up into the upper part of
the head. Shaking of the head aggravates the pain very
much. The headache is attended with quick pulse, redness
of the face, and perspiration of the forehead, with redness of
the eyes, heat in the eyeballs and lids, soreness and aching of
the globe. HERING.
There may be sparks, spots, and dimness before the eyes;
fulness and noises, with sense of stoppage of the ears; pain
and stiffness of the jaws; nausea and vomiting; increased
flow of clear, spastic urine; (an unfavorable sign in Apoplexy,
according to SCIICENLEIN); suppression of menses, with congestion to the head and chest, or with headache and fainting fits.
Also oppression of the chest, sobbing, violent palpitation of
the heart, pain and stiffness of the nape of the neck (from
congestion of the brain); pain, throbbing and fulness in the
nape; pain, heat and shivering down the whole of the back;
heaviness, weakness, and numbness of the arms, with pain
and trembling; fainting fits; throbbing, crawling, thrilling,




GLONOINE.                 255
and curious feeling of warmth through the whole body, moving
from above downwards; twitchings of the fingers; yawning,
with congestion to the head; sleepiness; feeling of warmth,
especially in the face, and ascending from the pit of the
stomach to the head; perspiration, especially on the face.
HERING also advises it against the effect of mental-concussions or shocks, fright, or mechanical injuries of the head; in
congestions of the head, Apoplexy, headaches, and sun-stroke.
CASE 40.* —Dr. ZUTMBROCK, subject to frequent attacks of
headache, almost always after taking cold, and always on
damp days; they generally lasted a whole day, or longer;
always commenced in the occiput, and spread from there over
the whole head; were increased by shaking the head, but
relieved by gentle walking, especially in the open air. During the attacks his face became red, he could not see distinctly, and he had black specks before the eyes.
Treatnent.-Aconite and Bellad. did not relieve, but
Glonoine 1-300 relieved him quickly and permanently for
months.-HERING upon Glonoine, p. 52.
CASE 41.* —A patient, with frightful arthritic pains in the
head, and vomiting, followed by a fainting fit, was very
quickly relieved by Glonoine, but not cured-in several other
cases it only produced transient relief. Dr. GEIST.
CASE 42.* —Flushes of heat and congestion of blood to the
head, in a lady predisposed to Apoplexy, were quickly relieved
by Glonoine. Dr. OnIE.
CASE 43.* —In two cases of throbbing headache in the forehead, and between both temples, with violent palpitation of
the heart, and throbbing of the carotids, speedy relief was
induced by Glonoine 2. Dr. DURHAM.
CASE 44.*-A young man, from working in a garden, in
the hot sun, was taken with nausea, violent headache, which
soon became throbbing, and attended with fever; his face had
a yellowish red color, his eyes were fixed, dull and glassy,




2 5 6           TREATMENT OF APOPLEXY.
pupils contracted, pulse quick and small, he could scarcely
speak, and had frequent retching to vomit.
J'cleatnent. —This case, and several similar ones, were quickly cured by G-lonoine. Dr. CAMrPos, of Norfolk.
CASE 45.*-A  delicate woman had headache  upon the
vertex and in the temples, wbich, without being throbbing,
increased and diminished in intensity, and some of the exacerbations were so severe that she almost wished to die; her
pulse was small, weak, and not quick.
_Treatrent.-Relieved quickly by Glonoine 12. Dr. I-IERING.
CASE 46.Y-'  Rev. WCAAGE had severe symptoms from an
over-dose of several hundred globules, but remained free firom
an accustomed sick-headache fiom Nov. to ltay, i.e., for six
months.
Symptolm8s.-The attacks occurred at every opportunity;
commenced suddenly with the illusion, as if the focus of the
left eye were changed; he then saw everything half-light,
half-dark, and felt as if he must die; in half an hour inclination
to vomit set in, he was obliged to sit down, and then it seemed
as if a cloud rose up and melted away, when his sight would
be restored, but the most violent headache would arise and
persist until he vomited. This headache was always on the
left side. Dr. IIHEING thought the attacks would ultimately
lead to Apoplexy, if not cured.
Treatmzent.-Every variety of homceopathic treatment
had been tried without benefit until Glonoine was given.
Dr. HERING.
CASE 47.* —An aged nurse, suffering with chronic disease
of the heart, was frequently attacked with violent headaches,
lasting all day, especially in damp, foggy weather. The pain
was tearing, ascended from the occiput up to the vertex, where
it became throbbing; motion and stooping increased it; lying
down relieved it; she also had a sense of fulness, as if from
rush of blood to the nape of the neck and head.
ir'eatment.-Relieved in one hour by Glonoine 12; this




GLONOINE.-HYOSCIAMIUS.                257
high potency did not relieve other attacks, and Platina had
to be resorted to.  Dr. RAVE.
CASE 48.*-Congestion of blood to the head in a pregnant
female, attended with paleness of the face, loss of the senses,
and falling down unconscious, with cold sweats.
Treectment.-This and other cases were relieved by Glonoine
6, or 12, or 30. Dr. HERING.
CASE  49.*-Many cases of headache just before menstruation, or during the monthly period, or just after it has
ceased, or when it does not appear, especially when there is
filness of the head, with or without redness of the face and
eyes, with throbbing pains, or the most violent throbbing and
rending ones, may be relieved almost instantaneously by Glonoine 6, 12, or 30. Dr. HERING.
CASE 50.*-A plethoric girl, ever since she began to menstruate,Obecame subject to attacks of congestion to the head,
alternating with rush of blood towards the heart; her face
was pale at times, red at others, and such attacks sometimes
occurred five or six times a day; she was apt to fall down insensible.
Treatment.-Glonoine, repeated every two hours, cured this
case, and also another in which there were alternations of
congestion to the head and heart, with loss of consciousness,
spasms, and frothing at the mouth. Dr. OKIE.
Dose. In these cases, and those already reported in my book on
Headaches, (p. 115,) the 1st dilution was used in one case; the 2d in
one; the 3d in three instances; the 6th in four cases; the 9th in two;
the 12th in six; and the 30th in two cases. It is probable, firom the
experience of WAAGE, if larger doses had been used in some of the
cases, the result would have been far better. PETERS.
13. HYoscIAMrus.
GENERAL REMARKS. —Dr. Schneller experienced from  1~
grains of the extract: confusion of the senses, weakness of sight,
some difficulty of speaking, and a by no means disagreeable state, like that of slight intoxication. From 2 grains:




258             TREATMENT OF APOPLEXY.
confusion in the forehead, afterwards of sight and hearing,
followed by restless sleep. From 3~ to 4 grains: dull frontal
headache, followed in seven hours by cloudiness and weakness of sight, and slowness of the pulse. From 4J to 41
grains: confusion of the head, frontal headache on the left
side, dimness of vision, frequent inclination to yawn, and sleepiness. From 11A grains: giddiness, reticulated vision, frontal
headache on the right side, and sleepiness.
CHOQIUET, in the persons of two soldiers, found it homceopathic to giddiness, stupidity, speechlessness, with dull and haggard look, dilatation of the pupils, and such great insensibility
of the eyes to light, that the lids did not wink when the cornea was touched; their pulses were small and intermitting;
breathing difficult, jaws locked, and mouth distorted by risus
sardonicus.
CHRIsTIsoN asserts that it is homceopathic to loss of speech,
dilatation of the pupils, coma and delirium, generallx of the
unmanageable, but sometimes of the furious kind. Also to
that singular union of delirium and coma which has been
termed Typhomaniac. WINER found it homceopathic to
profound coma, but when the prostration and somnolency
went off, extravagant delirium set in, and the patient became
quite unmanageable. CHRISTISON also says that it is homceopathic when delirium precedes coma, and when the coma
passes off, the delirium is apt to return for some time. Loss
of speech is regarded as one of its most common effects.
VOGT admits that it is homceopathic to vertigo, heaviness of
the head, sleepiness, confusion of the head and headache, and
when the senses commence to deceive one, so that taste and
smell are diminished, noises are heard in the ears, and illusions of vision, such as fliummering before the eyes and double
vision, occur. In one case it caused impotence which lasted
for eight months.
According to ATTOMYR, Ilyosciamus is indicated against
the premonitions of Apoplexy, when there is vertigo with dimness of sight, and staggering to and fro like a drunken person; when the memory is weak, spirits depressed, with red



HYOSCIAMUS.                  259
ness of the face and dilated pupils; when the nose is apt to
bleed, the speech difficult and inarticulate, with sense of crawling and falling asleep in the hands and limbs; great debility,
disinclination to move or work, inclination to faint; great
drowsiness, with gritting of the teeth.
It is homceopathic in attacks of Apoplexy with snoring
respiration; against those profound and long-continued slumbers which are apt to end in Apoplexy; when epileptic attacks
occur in alternation with apoplectic conditions. When the patient falls suddenly to the ground with entire loss of consciousness; when the breathing is quick and rattling, interrupted by
snoring and choking.
When the eyes are fixed and inclined to squint; or are
open and roll from side to side; or are protruded forwards,
and move convulsively; the pupils being widely dilated.
When the patient's face looks as if he were drunk, or is distorted, bluish, or earth-colored, and the jaw is dropped. Or
when the color of the face varies from being pale and cold,
to a bluish, or red and swollen state, or to a brownish red
color.
When there is inability to speak or swallow, the throat
being contracted or paralyzed, so that the patient is obliged
to spit out the things which he has taken into his mouth.
Also when there is looseness of the bowels, with urging to
urinate, retention of urine, or paralysis of the bladder.
Hyosciamits acts more like Opium than any other remedy,
except that it is more apt to cause nervous irritations of various muscles, marked by twitching of the eyes and face, and
jerkings of the limbs. It is homceopathic in those cases in which
Opium seems indicated, yet the pupils are much dilated. It
acts more powerfully on the vascular system than Conium,
yet not so much as Bellad. and Stramon. IPETERS.
CASE 51.-An unmarried lady, aged 59, fell into a comatose state, with frequent snoring, from which she could only
be roused imperfectly for a few moments by hard shaking, and
loud speaking; still she could answer no questions, neither




260             TREATMENT OF APOPLEXY.
could she swallow; her excretions were passed involuntarily.
I-Ter face was red, the veins of the body were distended, her
pulse quick and full; this condition of things had already
lasted for several days; and there was much numbness of the
hands.
Treatment and restit.-A few drops of 1iyosciam. 3 were
put in a wineglassful of water, and a teaspoonful given several times a day, with such good effect that she was almost
well in ten days. Bellad. perfected the cure.
In the course of the following year the saine patient was
suddenly attacked with bloating of the face, staggering-dizziness, distortion of the mouth, twitching of several muscles of
the face, with entire inability to speak, although she was perfectly conscious.
Treatment. — She was perfectly restored in six days, by
means of Laurocerasus 3, given as above directed for Hlyosc.
Dr. ELWERT.
Drs. OZANNE and LADELCI have used Hyose. with benefit,
as an intercurrent remedy in several cases of Apoplexy.
Dose, Same as recommended for Conium.
14. HYDROCYANIC-ACID."*
GENERAL REMARKS.-BLACK says it is indicated in Apoplexy, when the patient is quite insensible, the pupils immovable, the breathing stertorous and slow, the pulse feeble and
only 30, the features spasmodically contracted, eyes fixed
and staring, and turned up, the chest heaving convulsively
and hurriedly.
ATTOMYK thinks it homceopathic when there is dizziness, with
inclination to sleep, and the head seems to turn round and
round. When the eyes are half opened and fixed; pupils dilated
and immovable.; when the face is sunken, dingy, and gray;
breathing difficult and rattling, or slow and almost imperceptible; the pulse small, contracted, and infrequent, or
neither quick nor slow, but irregular as regards the force of
the beats.




HYDROCYANIC-ACID.-IGNATIA.            261
lose. NOACK advises 1 or 2 drop doses of the 1st, 2d, or 3d dilution, repeated every half, one, two, or four hours, in acute and severe
cases. PETERS.
15. IGNATIA.*
GENERAL REMARKs.-The action of this remedy is very
similar to that of Nux., and like it, it is best suited to Apoplexy when attended with convulsions.
CASE 52.*-A man, aged 38, had had an attack of Apoplexy, which weakened his memory of names, but left him
tolerably able to attend to his business. But he was again
seized with a violent attack; he was copiously bled, but his
face and lips still continued livid and swollen; his teeth were
clenched; frothy and bloody saliva exuded from his mouth;
his breathing was stertorous, and he had general convulsions.
He was bled again without relief, and matters seemed growing worse and worse, the patient remaining quite insensible.
Dr. GACHAPIN then, in despair, proposed to his colleague the
trial of a homnceopathic remedy, the indication for which
seemed precise, but as this was his first trial of homeopathy,
he admitted that he could not predict the result. His colleague consented, and 1 drop tinct. Ignatia, was given in a
spoonful of water; this dose was soon repeated, as the
patient could not swallow all of the first. In five minutes,
the convulsions were violently increased, but they soon began
to abate, and gradually ceased. In half an hour consciouness
began to be restored, and he soon recovered. —Brit. Jour.
Horn., vol. 5, p. 51.
16. NUX-VOMICA.
GENERAL REMI~IARKS.-[Dr. BLACK suggests that Nux may
prove homceopathic to the paralytic cases of Apoplexy, in which
there is often but little loss of consciousness; it is, however, far
more homceopathic to Apoplexy which follows epileptic or other
convulsive attacks.  According to WOOD and BACHE it acts
specifically and principally upon the nerves of motion; its operation is evinced at first by a feeling of weight and weakness,
with tremblings in the limbs, and some rigidity on attempting




262             TREATMENT OF APOPLEXY.
motion. It also sometimes produces pain in the head, vertigo,
contracted pupil, and dimness of vision, while sensations analouous to those attending imperfect palsy, such as formication
and tingling, are apt to be experienced on the surface. If the
remedy be pushed a little farther, there will be a tendency to
permanent involuntary muscular contractions, as in lock-jaw,
but at the same time frequent starts or spasms occur, as firom
electric shocks; finally, severe and long-continued spasms
arise.
To FouQuIER belongs the credit of first applying it in the
cure of paralytic affections; WOOD and BACHE say that his
success was such as to induce him to communicate to the public the result of his experience. Other physicians have since
employed it with variable success, but the experience in its
favor so much predominates, that it may now be considered a
standard remedy in palsy. It is a singular fact attested by
numerous witnesses, that its action is directed more especially
to the paralytic part, exciting contraction in this, before it
exerts any perceptible influence upon other parts.  It has
been found more successful in general palsy and paraplegia,
than in hemiplegia, and has frequently effected cures in
palsy of the bladder, incontinence of urine from paralysis of
the sphincter, amaurosis, and other cases of partial palsy.
WOOD and BAcHE also say, that upon the same principle it
has been found useful in obstinate constipation from deficient
contractility of the bowels; but how do they explain its curing obstinate spasmodic asthma and chorea, which they assert
it does?
It may prevent Apoplexy in debilitated persons with scanty
urine, and constipated bowels, for PEREIRA says, it usually
promotes the appetite, assists the digestive process, increases
the secretion of urine, and renders the excretion of this fluid
more frequent, while in some cases it acts slightly on the
bowels.
PEREEIIA also says, it is homeeopathic when the patient has
a feeling of weight and weakness in the limbs, with increased
sensibility to light, sound, touch, and variations of tempera



NUX-VOIaCA.                   263
ture, with depression of spirits and anxiety. Also when the
limbs tremble and a slight rigidity or stiffness is felt; finally,
when the patient experiences some difficulty in keeping the
erect posture, and frequently staggers in walking.
It may also prove homceopathic to Apoplexy of the cerebellum (see page 169), as TROUSSEAu and PIDoux say it is apt
to affect the muscles of the penis, rendering the frequent
diurnal and nocturnal erections quite inconvenient, even in
those who, for some time before, had lost somewhat of their
virility. PEtEIRA alludes to two cases of paralysis in which
Nux caused almost constant nocturnal erection, while females
experience more energetic venereal desires, as proved by confidential communications on this point, which cannot be
doubted.
NXz-Softening of the Brain.
According to CraIsTIsoN both it and Strychnine are homeopathic to softening of the brain and spinal cord, congestion
of the brain and its membranes, and effusions of serum and
blood. In one case the vessels of the brain were gorged, the
membranes of the spinal cord highly injected, and four
patches of extravasated blood were found between the spinal
arachnoid and the external membrane; fluid blood flowed in
abundance from the spinal cavity, where the veins were gorged;
the pia mater was injected, and the spinal column softened at
its upper part, and here and there almost pulpy. There was
also congestion and softening of the brain. In another case
ORFILA and OLLIVIER found it homeopathic to much serous
effusion on the surface of the cerebellum, and softening of the
whole cortical substance of the brain, but especially of the
cerebellum. BLUMHARDT, too, found it hommaopathic to softening of the cerebellum, and congestion of the cerebral vessels,
together with softening of the spinal cord, and general gorging of the spinal veins. CHRISTISON says, this is some confirmation of an opinion advanced not long ago by FLOURENS
that Nux acts particularly on the cerebellum. THOMSON found
it homceopathic to much congestion of the whole membranes




264            TREATMENT OF APOPLEXY.
and substance of the brain and cerebellum, and even some
extravasation of blood within the cavity of the arachnoid,
over the upper surface of the brain (See Meningeal Apoplexy,
page 171). WATT  found it homeopathic to softeninq of the
substance of the brain, and lumbar part of the spinal cord.
CASE 53. —A man, aged 63, much addicted to the use of
coffee, fell suddenly to the ground.
Symnptoms.-He lay snoring, in an unconscious condition;
the spittle ran out of his mouth; when loudly spoken to, he
opened his eyes, muttered to himself, and then fell again into
slumber; his eyes were dim, and the corners filled with purulent matter; the organs of deglutition, and his legs, were
entirely paralyzed; his jaw hung down on the right side; he
had no fever, but his pulse was full and slow; he grasped towards his head, with his right hand; he had a large, protruding inguinal hernia.
recatmernt and restut. —Nux-vom. 30 was given him to
smell, and five drops were added to an injection; in the
course of four hours his consciousness commenced to return,
and he attempted to speak.  Nux 30 was given internally,
and in the course of the following night his rupture was reduced spontaneously; the next morning his speech could be
understood, and he could swallow without difficulty, but complained of heaviness of his head, and dizziness. After taking
several doses of Arnica 9, he was entirely restored in eight
days.-Archiv, vol. 8, part 2, p. 81. Dr. SCHiLER.
CASE 54.-Lady S., aged 55 years, was attacked with
Apoplexy.
Symptoms.-She lay on her back, with rattling respiration;
her eyes were fixed, dim, and did not move even when the
cornea was touched; the pupils were dilated; thick white
mucus collected in the mouth, and her whole body was cold,
and without feeling.
Treatment and result. —One drop of Nux 1 was given in
water, and repeated in a quarter of an hour; in ten minutes




NUX-VOMICA.                  265
a tetanic spasm set in, and lasted for two hours, the previously relaxed limbs becoming stiff and rigid; when this subsided she lay quietly, her breathing became regular, a gentle
perspiration broke out over the whole body, and although she
was unconscious and unable to swallow, still she seemed
sensible to touch. One drop of Opium 6 was given, and in
one hour she opened and moved her eyes, made signs that she
recognized her friends, then fell asleep, and perspired profusely, after which she began to speak. In three days more,
she was entirely restored, although very weak. —Gen. Hom.
Journ. vol. 24, p. 216. Dr. SCIIOLZ.
CASE 55.-A man, aged 49, of medium size, but apoplectic build, had often suffered with rush of blood to the head.
He was attacked with confusion of the head, dizziness, and
trembling of the limbs.
Treatment. —Aconit. and Nux in repeated doses cured him
entirely (see cases 2 and 10). —Hygea, vol. 8, p. 34. Dr.
KiSEMANN.
CASE 56.* —A stout, healthy woman, aged about 50, had
been remarkably well until the morning of the same day,
when she began to complain of pain in the head and giddiness; her head and face were hot, mouth drawn to one side,
the left arm numb, pulse full and strong, but natural in frequency; she complained of dull pain, with fulness in the
head, and great drowsiness.
Treatment.-Nux-vom. 3, one drop per dose, to be repeated
every quarter of an hour for two or three times, and then
every two or three hours, as soon as improvement was
observed; by the next day all the above symptoms had disappeared, but she still had a disagreeable dull sensation in
the head and slight numbness of the left arm. The KNux was
continued every six hours, and by the evening she was quite
well, and remained so for at least two months. —Brit. Journ.
Hom., vol. 5, p. 49. Dr. BLACK.
CASE 57.*-A lady aged 51, short-necked, very stout,
20




266            TREATMENT OF APOPLEXY.
face generally flushed and eyes suffused, was suddenly seized
with Apoplexy, sank down heavily and became insensible,
while stooping over a sick friend. In twenty minutes she recovered her consciousness, but could not open her eyes; her
face was flushed, pulse imperceptible, limbs and bowels cold;
she had numbness of the tongue, with stammering on attempting to speak.
Treatment. —IHot bottles were applied to her feet, and one
drop of tinct. Nux was put in six table-spoonfuls of water, and
one teaspoonful given every half hour for two hours, and then
every three hours. She became warm in the course of an
hour, and then gradually and steadily improved until she
was quite well.-Brit. Journ. IHol., vol. 5, p. 52. Dr. KER.
CASE 58.* — rs. B. was suddenly seized with Apoplexy;
she had been under homeeopathic treatment for some weeks,
for numbness of the right hand and arm, and tingling sensation in the ends of the fingers; the fingers were occasionally
iedematous; numbness of the right leg; weakness of the
whole right side; a painful and indescribable feeling of apprehension; occasional difficulty in pronouncing words; stammers, and says what she did not intend to say; confuision of
ideas; sensation in the top of the head as if electrical sparks
were being emitted; pain, occasionally in the left temple;
dizziness at times, but rarely; the right hand apt to be colder
than the left; pulse 70, and weak. She was of a full habit
of body, with a short, thick neck, red face and suffused eye;
she passed much urine, which deposited a white sediment;
bowels were regular; she was troubled with piles, which bled
profusely sometimes, and then gave relief to most of her
symptoms; her menses were ceasing gradually, and change
of life was taking place. She never had any appetite for
breakfast, and had nausea immediately afterwards; her
appetite was generally not good, tongue coated with a whitish
fur, and fulness in the pit of the stomach; she was also apt
to have a pricking sensation over the face.
Treatment. — For these symptoms she had taken Nux,




NUX-VOMIOA.                  267'Opium, Bellad., Puls., and tinct. Sulph., with benefit, when
the sudden death of a friend excited her greatly, and brought
back most of the above symptoms, in addition to violent pal-pitation of the heart and intense headache, and finally, after
making some exertion in a stooping posture, she fell down
heavily in a comatose state.
Symptoms.-Her face was swollen, eyes turned up, and
breathing stertorous; she remained half an hour in a state of
insensibility, and then began to recover consciousness, but
there was icy coldness of the extremities, and of the whole
surface of the body; her pulse was scarcely perceptible; she
had much headache, with sensation of pricking on the top of
the head; she could not swallow, spoke with great difficulty
and very indistinctly; her eyes were shut, and could not be
opened; the stertorous breathing changed to slow, full respiration.
Treatment. —Hot bottles were applied to the abdomen and:to the limbs. One drop of tinct. Nux-vom. was mixed in a
tumbler half full of water, and one teaspoonful given every
half hour. The next day, the skin was warm, pulse stronger,
and headache slight, but she had acute pain in the pit of the
stomach occasionally; she could open and shut her eyes, and
had somewhat recovered the use of her faculties, although there
was still a great tendency to mistake objects, and call things
by wrong names. Nux was given every four hours. On the
following day she was very much better, with the exception of
her headache; the pain was acute, and darted from one temple to another, and there was a tendency to faintness. Bellad.
3 was given, without much relief for a day or two; but it was
continued, and, in eight days more, she was well enough to go
to church. —Brit. Jour. Hom., vol. 7, p. 169. Dr. IKER.
CASE 59.* —A carman, aged 50, very steady and temperate
in his habits, was seized, whilst loading his cart, with dizziness.and staggering, which caused him to hold by a post to prevent
falling. He recovered himself a little, and attempted to drive,
but had not proceeded many steps before he fell two or three




268             TREATMENT OF APOPLEXY.
times upon his hands, and when he got up, could not stand.
without support. He became confused in his sight, and could
scarcely distinguish the road. He had now a general aching
in the head, with a sensation of swimming and lightness, as
soon as he moved; his forehead was hot, his pulse slow and
throbbing; no thirst, tongue moist and clean, and bowels
regular.
iTreatment. —Nux-vom. 6, every four hours. The next day
he was so much better as to be able to walk out, as he only had
a slight headache, with a little dizziness at times, and occasional singing in the right ear; his appetite was better. Continued the Nux, and in three days he was much better still,
although he yet had a little dizziness when he stooped, or
walked fast.  China 3, two doses at intervals of six hours,
then Sulph. 12, also two doses at the same intervals of
time; he was so much relieved in two days more, that he
could stoop without inconvenience, was cheerful and active@
Took Conium 6 twice a day, for a momentary return of swimming of the head, recurring once or twice a day. —IIom. in
Acute Diseases, p. 175. Dr. YELDHAM.
CASE 60.* —Mrs. M., aged 50, tolerably stout, and generally healthy, had felt heavy in the head for the last fortnight;:
finally she was seized with a heavy dizziness, as if she had
received a blow on the head; this passed off, and she felt
pretty well for a time, when she again felt as if struck violently on the right side of the head, and lost all consciousness,
without falling from her seat, but her head fell to one side, and
her breathing became stertorous. This condition lasted for
some hours, when she gradually revived, but found that she
had lost the use of the right arm, leg and foot. Her head felt
like a dead weight, and there was pain at the top of it; she
vomited as soon as she came to, although she had eaten nothing
indigestible..Treatment.-Nux 3, every four hours; by the next day she
was much improved, her head felt nearly well, but was somewhat heavy at the back part; the use of the leg and arm had




NUX-VOMICA.                 269
returned to a great extent. She continued Nux, and on the
following day there was still further improvement; she had
almost recovered the entire use of her limbs, but had had a
slight threatening of a relapse, in a feeling of faintness, and
numbness in the tongue, and deep-seated pain in the head.
Lachesis 12, three times a day, perfected the cure.-H-Iom. in
Acute Diseases, p. 178. Dr. YELDEHAM.
CASE 61.*-A man, aged 70, of herculean stature, robust
of his age, stout, plethoric, and accustomed to stimulants, was
seized with severe pain in the head, followed in a short time
by paralysis of the right side of the face, numbness and
partial loss of power of the right arm. His head was heavy
and confused, but he was able to sit up, and speak rationally
and collectedly, but his articulation was considerably impaired; his mouth was completely drawn to one side, but the
paralysis did not extend to the tongue; he complained of a
sense of fulness and thickness about the throat; his head was
hot, his pulse firm and regular, and a little quick.
Treatment. —Nux-vomica 6, every four hours; on the next
day his head was much relieved; it was not so heavy and
confused, and also cooler to the touch. He repeated the Nux
every six hours, and then only once a day for eight or ten
days; the muscles of the face, arm, and hand gradually recovered their tone, and at the end of fourteen days there was
scarcely any trace of the attack remaining.-Hom. in Acute
Diseases, p. 179. Dr. YELDHAM.
CASE 62. —A lady, aged 27, eight months pregnant, and
of a phlegmatic temperament, had suffered for several weeks
with dizziness,'both while at rest and when moving about;
she was often in danger of falling, especially after dinner;
she had aching pains in the forehead, intermingled with
sharp stitches, especially early in the morning, while in bed;
btirning in the stomach after every meal, and frequently recurring flashes of heat.
]Treatment.-She was entirely cured by 4 doses of Nux
18, six globules each. In her next pregnancy, a similar




2'70            TREATMENT OF APOPLEXY.
dizziness and headache were relieved by Nux 18. —DIEz,
p. 176.
CASE 63. —Mrs. L., aged 54, who had not menstruated for
seven years, was suddenly attacked, ten days ago, with dizziness, which was so much increased by stooping, and looking upwards, that she was obliged to hold on to something
to prevent her falling; she also had slight signs of blind piles.
She had been bled by another physician in order to prevent
Apoplexy.
Treatment.-After taking Nux 12, she was entirely relieved of her vertigo, on the following day.-DIEZ, p. 177.
CASE 64.-A powerful man, aged 40, without any peculiar predisposition to Apoplexy, had suffered with dizziness
for four years; he also had had itching of the skin for ten
years, ever since an attack of itch.
Symptoms. —The dizziness was preceded by a tense headache, with heat in the forehead, both disappearing when he was
quiet; then the vertigo set in suddenly like an electric shock,
so that his senses seemed to leave him, although he did not fall
down; attacks of dizziness even occurred during the night,
and waked him up from his sleep; he generally awoke early.
His digestion was good, except that he was occasionally
troubled with heart-burn. Although naturally of an equal
temper, if he became irritable, passionate, or anxious, vertigo
would set in, preceded by yawning.
Treatment.-Nux-vom. was given, one dose every three days,
and soon removed everything, except slight traces of vertigo.
Then six doses of Sulphur, at intervals of eight days, cured
him entirely, and he remained well for years. —Hygea, vol.
3, p. 12. Dr. GRIESSELICH.
CASE 65.-A patient, aged 55, had been obliged to keep
his bed for sixteen weeks.
Symptoms.- He is scarcely ever able to get or sit up;
even the slightest change in the position of his head, such as
occurs in eating, brought on such a turning and falling ver



NUX-VOMICA.                     271
tigo, with dimness of vision and nausea, or even retching and
vomiting, that he was obliged to desist.  When he was
obliged to rise, he could not walk without assistance, from
fear of falling. He had heaviness and aching in the head,
loss of appetite, and constipation, with violent hiccough.
iTreatament. —After taking Nux 3, two drops per dose, every
night and morning, he was soon relieved of vertigo, nausea,
and vomiting.-Gen. IHom. Jour., vol. 34, p. 88.  Dr. ELWERT.
CASE 66.-A  man, aged 36, of delicate constitution, remained dizzv, after an attack of nervous fever; he staggered
while walking, and often came near falling; he also had a
permanent pain in the left side of his chest, increased by
coughing and breathing.
]Treatment.-Bryon. 3 relieved his side, but the dizziness
did not leave him  until after he had taken Nux 3.-Dr.
DIEZ, P. 177.
According to RUCKERT, the clinical indications for the use
of Nux, in the above cases of dizziness, are: The sudden occurrence of vertigo, coming on like an electric shock, with
loss of consciousness, but without falling; attacks of dizziness
while asleep at night, so that he seems to waver or stagger in
his sleep; inability to sit or stand up; every motion of the
head, even in eating, brings on a turning-, staggering-vertigo,
with dimness of vision and nausea; dizziness when stooping,
or looking upwards, with danger of falling.
Dose. The pure Tincture was used in four cases; the 1st dilution in
one case; the 3d dilution in five cases; the 6th in two cases; the 12th
in one case; the 18th in two cases; the 30th in one case. The doses were
repeated every quarter, or half hour, in urgent cases; every two, four, or
six hours in less severe attacks. NoAcK advises one drop doses of the
1st or 2d dilution, repeated every one, two, or three hours.-PETERS.
17. OPIUM.
GENERAL REMARKS. —The indications for the use of Opium
in Apoplexy are so well known, that it will be unnecessary to




272              TREATMENT OF APOPLEXY.
dwell long upon them; still, as SCH1Mm truly says, it deserves
the first place in the attention of the physician who treats
disease according to the law "sin ilia s8imilibus curantur."
It is most indicated when the face is of a mahogany red
color, the pupils very much contracted, the sleep profound,
the limbs motionless, but not absolutely paralyzed, the pulse
full and slow, skin hot and perspiring, the urine retained
or suppressed, and the bowels obstinately costive (see pages 159
and 160). Nux-vomnicca is most homcopathic, when the face
is pale or livid, the pupils much contracted, and the limbs
powerfully convulsed, or rigidly contracted. Belladonnca,
when the face is much flushed and bloated, the pupils excessively dilated, the limbs either motionless, or but slightly convulsed. Iyosciamnus, when the face is pale or flushed, pupils
dilated, and twitchings of the eyeballs, muscles of the face, and
risus sardonicus, are present. Aconite, when the face is pale
or livid, the pupils much conZtracted, pulse very feeble, and
much numbness and tingling are present.-PETERS.
(b.) ATTOMYE'S indications for the use of Opium are the
presence of dull stupefaction, with dimness of the eyes, and
extreme weakness; or great activity of mind, and inclination for earnest and important labors.
Unusual redness of the face, with swelling of the lips;
very red face, with wild, protruding and very red eyes;
open and turned-up eyes; paralysis of the eyelids. Spasms
of the facial muscles, convulsive trembling of the face, lips,
and tongue. Distortion of the mouth.
Oppressed, difficult, and irregular breathing. Respiration
at times loud and snoring, then heavy, and then again very
weak. Panting, loud and difficult breathing; single, slow
respirations, followed by absence of breathing for several
moments; long and sobbing respiration; short and snoring
respiration, with absence of breathing for half a minute; loud,
difficult and rattling respiration. Snoring in sleep.
Pulse weak, suppressed, small and slow; pulse at first full
and slow, then weak; slow pulse and breathing; pulse large
and slow, with slow, heavy, and deep breathing.




OPIUM.                    273
Numbness and insensibility of the limbs, coldness of the
body, paralysis of the arm and limbs.
Heavy, stupid sleep; unrefreshing sleep, with profuse perspiration; dreamy and restless sleep, with frightful or pleasant
dreams.-ATTOMYR.
CASE 67. —A man, aged 50, addicted to the use of spirituous liquors, oppressed with much care and sorrow, had
suffered for a long time with sleeplessness, anxious dreams,
and congestions of blood.
Symptoms. —The attack was preceded by vertigo, dulness
and heaviness of the head, dulness of the senses, difficulty
of hearing, noises in the ears, indistinct speech, staggering
walk, fixed staring before him, and sleeplessness, followed by
asthmatic oppression of the chest, spasmodic jerkings of the
limbs, loss of consciousness, and an apoplectic condition.
Treatment.-IIe was bled, and had ice applied to his head;
consciousness returned in a few hours, attended with the following condition: Excessive excitement; he laughed much,
spoke much unconnected and confused stuff; he did not
know those  around him, and kept grasping constantly
towards his head; his face and eyes were red, and his pupils
dilated. Tinct. Opium, in 1 drop doses, at suitable intervals,
removed all the preceding and subsequent symptoms, and
even prevented a return of the attacks.-Gen. Hom. Jour.
vol. 5, p. 305. Dr. IKNOmRE.
CASE 68.-A man, aged 75, with inclination to Apoplexy,
the premonitory symptoms of which had often been removed
by Bellad., suffered with the following symptoms: Indifference to everything; he spoke little, stared fixedly before him;
could not readily recollect himself; the right corner of his
mouth was drawn up more than the left; his pulse was full,
soft, and boundirng.
Treatment.-Bellad. 1, two drops per dose, every three
hours, did not relieve him at all; then Opium 2d dilution,
one drop every two or four hours, removed the apathy, mental confusion, and distortion of the mouth so completely, that,




274             TREATMENT OF APOPLEXY.
by the fourth day, the patient could be regarded as cured.
-Gen. Hom. Jour., vol. 21, p. 233. Dr. FRANx.
18. PHosPHoR.
GENERAL REMARKiS.-This remedy may be useful in some
of those cases of Apoplexy occurring in debilitated subjects,
in which Ammonia is generally relied upon. It is a powerful,
diffusible stimulant; exciting the nervous, vascular and secreting organs. It creates an agreeable warmth in the body,
increases the frequency and fulness of the pulse, augments
the heat of the skin, heightens the mental activity and muscular powers, and operates as a powerful sudorific and diuretiC.-PEREIRA. It is homceopatbic to Apoplexy of the cerebellum, and that which arises from great excitement of the sexual organs (see page 169). It is also homeeopathic to Bilious
Apoplexy (see page 183). DIERBAcH recommends it in the
last stages of Typhus and Apoplexy, when the exhaustion of
the body has reached its extremest degree, and speedy death
is to be feared; when the. pulse is small, sunken and soft;
the limbs cold; hiccough has set in, with difficult swallowing,
coma, rattling respiration, cold, clammy sweats, and even
when the death-struggle seems to have set in. —PETERS.
CASE 69.-A maiden, aged 21, with short and muscular
frame, fell down suddenly in the yard, on a cold, misty morning, and seemed dead.
Symptoms. — Loss of consciousness; the powers of life
seemed quite extinct; she was motionless, pulseless and
breathless; her face was red, but the rest of her body cold;
neither speaking, shaking, or rubbing her, produced any sign
of consciousness, but she seemed to feel deep pricks with a
needle in the soles of the feet.
Treatmenzt.-She was restored by the use-of Phosphor 60.
Dr. SCHMID.
CASE 70. —A woman, aged 75, who had been reduced by
previous blood-letting and hsemorrhage, was attacked with
Nervous Apoplexy, and seemed in a hopeless condition.




PHOSPHOR.                  275
Treatment.-She received Phosphor 1st dilution, 3 drops
per dose; signs of life returned in a quarter of an hour, and
then she took only 1 drop per dose, every hour. At a later
period, she took 1 drop of the 6th and 12th dilution, every
night and morning. In 10 days she was able to leave her
bed. —Gen. IHom. Jour., vol. 1, p. 67. Dr. STURM.
CASE 71.*-A man, aged 35, of full habit, healthy, but
anxious about business, arose in the morning not quite well;
he was dizzy and staggered, but went down town, where he
became stupid and heavy, lost his way, and wandered about;
a friend brought him home; he was cold, and when put to
bed soon became stupid and unconscious; his face was flushed.
Treatment.-He took Bellad. 3; reaction with fever soon
set in, and Aconite was given; but he remained unconscious,
his breathing became stertorous and snoring, and he could not
be roused. Then Opium, 2 drops of the tincture, was put in a
tumbler half full of water, and a teaspoonful given per dose;
improvement soon commenced; he could be roused, and was
able to put out his tongue. The next day he was comparatively well. - Minutes of Pathologico-Therapeutic Society.
Drs. BALL and KINSLEY.
CASE 72. —A lady in the habit of taking heavy suppers,
with wine, went to bed not very unwell, but her husband was
awaked at night by her noisy breathing and snoring; her face
was flushed, and she could not be roused.
Treatment.-Tinct. Opium, 1 drop per dose, every half
hour; she could be roused at the end of six or eight hours, and
recovered with paralysis of one eyelid and arm, which lasted
for two or three months. Is now well.-Ibid. Dr. BALL.
CASE 73.*-A child who had been sick for three or four
days, finally became stupid, and could not be roused. It recovered entirely under the use of Opium.-Ibid. Dr. BALL.
CASE 74.* —A man, subject to attacks of dizziness, fell
down insensible, and remained unconscious for twenty hours:




276            TREATMENT OF APOPLEXY.
then he slept heavily, but could be roused; his skin was hot,
and pulse 65.
Treatment.-He recovered under the use of Opium, aided
by Aconite and Arnica. —Ibid. Dr. STEWART.
CASE 75.*-An old woman, addicted to the use of liquor,
was found lying speechless and powerless upon the floor; her
mouth was drawn to one side; the right arm and leg were
paralyzed.
Treatmert.-She was bled, and remained for twenty-four
days in a very precarious state, but finally recovered entirely
under the use of Opium 3, Bellad. 2, and Hlyosc. 3. —Brit.
Jour. of Hom., vol. 5, p. 65.
CASE 76.*-A man, aged 41, not very robust, had felt queer
and confused in the head, for a week; purgatives did not relieve him; he staggered and reeled like a drunken man, appeared to have lost nearly all command over his movements;
the left arm hung powerless by his side, and the left leg was
scarcely more obedient to his will. He could not sit up without being held; his head dropped down, he spoke thickly
and indistinctly, breathed spasmodically, and was very sleepy.
Treatment.-Opium 3 was given every two hours. The next
day he felt better, could walk more steadily, and raise his
left arm; his head was still light. Under the use of Nux 6,
and Bryonia 6, for indigestion and cough, he recovered perfectly in about ten days.-Dr. YELDHAM.




APPENDIX.
ON THE NATURE AND TREATMENT
OF
SOFTENING OF THE BRAIN AND PALSY.0
SOFTENING Of the Brain is so closely related to, and so frequently connected with Apoplexy, that it would be almost
inexcusable to pass it over entirely here. IRocHoux, and
others, even maintain that the texture of the brain is almost
invariably softened prior to the occurrence of apoplectic effusions, which they suppose are occasioned by the imperfect
support afforded under these circumstances to the blood-vessels
of the brain. Although exceptions to this rule are by no
means few, ROWLAND admits that, in many cases of Apoplexy
suddenly fatal, the brain is not only found softened, but also
bearing the marks of previous disease.
Again, one of the most remarkable varieties of the disease
is the Apoplectic Softening, so called from the suddenness and
severity of the attack; comatose seizures are common to all
its forms, but sometimes the case assumes all the peculiarities of Sanguineous Apoplexy; although precursory symptoms of some kind generally precede these attacks, such as
headache, failure of intelligence, inaptitude of expression, pains
and weakness of the limbs, or other marks of disturbance of
the brain; but these warnings are generally extremely indistinct, when the comatose attack occurs. —RowLAND.
The relation of this disease to Apoplexy is also manifested
in the manner of death; in seventy fatal cases, the death was
comatose in as many as forty, either from a sudden apoplectic




278             SOFTENING OF THE BRAIN.
seizure, or by stupor gradually increasing to coma; in six
of these cases the death was sudden; the patients being taken
off unexpectedly while in their usual health, or were found
dead, no danger having been immediately apprehended.
It is sometimes exceedingly difficult to distinguish the coma
of Apoplectic-softening  from  that of H-emorrhagic-apoplexy, and ROWLAND even thinks that many of the premonitory symptoms, usually enumerated among the precursors of true Apoplexy, are referable, in reality, to Softening of the Brain. Thus, in seventeen cases out of twenty,
of llcem orrhagic-apoplexy, in which a clot of blood was
found in the brain after death, the attacks were sudden and
entirely without warning; in the remaining three cases of
Apoplexy, the precursory signs were headache, vomiting,
vertigo, loss of recollection, drowsiness, and, in one instance, convulsions;-while, on the other hand, in twenty
cases of Softening of the Brain, the comatose seizure
was preceded by premonitory signs in all but two cases. In
sixteen cases out of eighteen, headache was a' prominent
symptom before the attack; it generally came on severely,
either a few hours, or sometimes several days, before the appearance of more decided symptoms; there was more or less
loss of motion prior to the comatose attack in twelve cases;
the Palsy was ingravescent in five cases, gradually increasing from a slight feebleness of the limb, to more or less complete paralysis. In thirteen of the cases of Softening, the
intellectual faculties were disordered in some degree very
early in the disease; in seven cases, some symptoms connected with speech or articulation were observed before the sudden or apoplectic seizure. —RowLAND.
H-ence we may draw the conclusion that, in the majority
of cases in which the attacks are quite sudden, or without
evident warning, the probability is great, that the case is one
of Sanguineous- or IHImorrhagic-apoplexy; while, when there
are many precursory symptoms, the probability is equally
great that Softening is present. Headache and giddiness,
however, are common to both affections at their commence



INFLAMMATORY SOFTENING.             279
ment; but in Softening, the subsequent course is more characteristic. The dulness of comprehension, vacancy of expression,
forgetfulness, especially in regard to language, and hemiplegic
threatenings leading to an apoplectic seizure, are finally sufficient to indicate the presence of Softening.
The apoplectic paroxysm is precisely alike in both diseases;
but in the one case, the frequent transitory character of the
coma, its sudden termination and frequent repetition, resembling, in this respect, the epileptic paroxysm, are characteristic of Softening. The presence of contraction of the palsied
limbs is also a very reliable sign of Softening; but increase
of sensibility of the paralyzed part is not, for they commonly
become painful when a clot exists, either from the irritation
of the clot, or from the occurrence of inflammatory Softening
about it, or from an irritation probably depending upon a curative process going on in the brain. —RowLAND.
Apoplectic-softening corresponds to one variety of redsoftening in which the blood is either stagnated in the minute
vessels of the softened part, or else infiltrated into it, or both
combined. In recent cases the softening has a deep- or duskyred tint, which passes into a dark brown. There are no
exudation corpuscles, coagulable lymph, or pus globules to be
detected by the microscope; venous congestion, hypertemia,
and extravasation of blood, are the principal appearances besides the Softening.
Treaiment.-Nux and Opium are the most important remedies.
Of course all cases of -Softening of the brain are not apoplectic in their nature; some are acute, others inflammatory,
or ataxic, or chronic, or latent. There are as many pathological varieties, viz., red, white, yellow, and dark softening;
also softening from cedema, and fatty degeneration of parts
of the brain.
INFLAMMATORY SOFTENING.
According to ROWLAND, the symptoms of this variety are
not always as clearly defined as might be expected, for the




280             SOFTEN'ING OF THE BRAIN.
disease is usually confined to a small portion of the brain.
The attack does not often commence with a distinct chill, or
the other phenomena that mark the onset of inflammation in
v-ital organs; in some cases, however, there are acceleration
of the pulse, heat of skin and scalp, and other signs of fever,
especially when the disease occupies the surface of the brain.
The first circumstance to excite attention is usually headache,
which is not always severe, but it is excessively harassing;
the pain seems to dart through the brain, and to proceed
from the centre of the organ, occupying now one spot, now
another, but having no fixed seat; it is always jparoxysmal,
and sometimes intermittent. Accompanying the headache
there may be confusion of thought, and a settled apprehension
that the mind will be destroyed; at night, restlessness, excitement, and delirium come on, and sometimes a convulsive
paroxysm. These cases are apt to be attended with nausea
and vomiting.
Shortly afterwards, signs present themselves that foreshadow the coming danger; unusual sensations are felt in one
or both limbs of the same side; tinglings, prickings (pins
and needles), or numbness, with some degree of weakness,
alarm the patient with threatenings of palsy. At this period
the headache has probably fixed itself in one region, which
in many cases is on the side opposite to that of the limbs
whose functions are impaired.
The second stage of the disorder now begins; the delirium
and restless excitement, the feeling of apprehension or terror,
give way to stupor, or indifference; the headache and vomiting cease, and the patient lies in a state of mental and bodily
torpor; the memory fails, there is great difficulty in comprehending questions, and in recollecting words suitable for a
reply; the face is dull and heavy, the pupils contracted, or
sometimes dilated, and insensible to light; the paralysis of
one side becomes more confirmed; the pulse is slow; the
skin at one time flushed, at another covered with a clammy
sweat; the tongue is reddish and inclined to dryness; the
appetite bad, and bowels constipated.




INFLAMMATORY, AND RED SOFTENING.        281
The further progress of the disease varies in different patients. Many have an attack of coma or somnolence from
which it is impossible to arouse them; several such seizures
may occur within a short period of time; or with the senses
apparently intact, and the intelligence in some degree remaining, the power of utterance is suspended, and not a syllable can
be formed upon the lips, (IHyosc.) The palsied limbs are
variously affected; they are often extremely painful (Acon.);
sometimes they are moved convulsively (Bell., Stramon., Op.);
at others kept in a state of tonic spasm, by the action of the
flexor muscles, the limbs remaining permanently contracted,
(Nux, Plumbum, Ignat.) This peculiar contraction of the
muscles is regarded as characteristic of softening of the brain.
- ROWLAND.
In other cases, the patient sinks gradually into coma (Opium); emaciation proceeds rapidly (Iodine); the pulse is quick,
and sometimes intermitting (Glonoine); the tongue is parched
and encrusted in the centre (Opium, Plumbum, Glonoine, or
Alumina); the teeth and gums are covered with sordes; the
eyelids are glued together; bronchial rales are heard in the
chest; the patient becomes stupid, cannot swallow, passes his
evacuations involuntarily (Ifyosc.); and finally sinks into the
most profound insensibility (Hyosc. and Opium).
Inflammatory Softening of the brain corresponds with one
variety of Red-softening, viz., that in which plastic exudation,
and a large proportion of coagulable lymph, are mixed up with
blood globules. The prevailing color of the affected part of
the brain is a pale red, the substance of the brain being uniformly permeated with an inflammatory exudation; but ruptures of small vessels, and bleeding into the softened part, often
occur, causing dark red patches, from blood which has been
extravasated at various times; streaks or stripes of a yellow
and green color may also be met with, from the coagulation
of the fibrin of the exudation; and finally, we may also find
white spots, from an occasional piece of brain which has
escaped disease. All these other shades are planted upon, or
mixed with the more extensive paler reddening arising from
21




282              SOFTrMNG OF THE BRAIN.
the infiltration of the cerebral tissue with the fluid part of
the inflammatory exudation.-RoKrITANSKY.
ATAXIC, CHRONIC, AND LATENT SOFTENING.
The ataxic form is characterized by extreme depression of the
vital powers, either in consequence of previous disease, or from
original weakness of constitution.  The chronic form  approaches gradually, and almost imperceptibly; it is most
common in aged persons, and before the patientSmakes any
complaint, the danger may be perceptible to others in his
altered manner and failing intellect; the headache is seldom
very severe or distressing, neither is the nausea or vomiting.;
but the faculties become clouded, the memory fails, the speech
is slow, hesitating, and incongruous; familiar names cannot
be uttered, nor familiar objects recognized. These premonitory symptoms may last for months; then follow  more
marked symlptoms, such as difficulty of speaking, numbness, formication or pricking of the limbs, and especially
of the fingers, partial loss of power and motion, as shown for
instance in one leg dragging in walking, and in the inability to
grasp objects firmly.  Contraction of the limbs in these chronic cases is much more frequent than entire palsy, whereas
the reverse holds good in acute Softening; still it may be absent in about one-foiurth of the cases. Pains in the limbs and
joints usually accompany these contractions, and they are
generally much aggravated by motion, but not increased by
pressure. There is commonly a partial, but scarcely ever a
perfect loss of sensation in the paralyzed and flexed limbs.
The face becomes partially distorted, and the features are devoid
of expression; the memory is gradually lost, the ideas become
confused, and all reasoning power disappears. The paralysis
gradually extends; the power of retaining the contents of the
bladder and rectum disappears; the limbs waste away, and
yet the force with which they are flexed is almost incredible;
and thus the patient sinks, utterly unconscious of his own
pitiable condition. In some cases the flexure ceases, and the
limbs relax shortly before death.-DAr.




CETRONIC, AND YELLOW SOFTENING, ETC.       283
Such are the ordinary symptoms of chronic Sof'tening; it
may go on for years; while 11 cases of acute Softening terminated fatally in two days, 26 other cases before the fifth day,
43 cases before the ninth day, 7 cases between the ninth and
twentieth days, and 9 lmore cases between the twentieth and
thirtieth days.-DAY.
In these cases, the pathological appearances may be either
Red-softening, from chronic venous congestion and capillary
hemorrhage; or White-softening; yellow patches on the convolutions; or Yellow-softening, with more or less fatty degeneration. These different varieties of course call for quite different treatment.
According to ROrKITANSRKY, Yellow-softening is founded upon
a chemico-pathological process. The yellow color is owing
to the presence of a thin, yellow, acid fluid, containing a number of broken, extremely varicose, primary tubes, with their
contents of swollen blood globules, very transparent fat globules of various sizes, and some yellow amorphous pigment.
FREMY considers the brain to consist of Cerebric acid, either
free, or combined with Soda and Phosphate of lime; of Oleophosphoric acid, both free and in combination with Soda; of
Olein and Margarin; of small quantities of Oleic and Margaric acids; of Cholesterine, water, and of a substance resembling white of an egg, but composed of 7 parts of albumen,
5 parts of fatty matter, and 80 parts of water. The Oleo.
phosphoric acid, which is usually yellow, is very variable in
its composition and combination, and readily separates into
Phosphoric acid and Olein from  very slight causes. ROKITANSKY thinks that obstruction of the blood-vessels near the
softened part, from deposit of atheroma, or impermeability
of them from pressure, and the consequent impeding and
interruption of the circulation in one portion of the brain, may
cause a lower state of vitality there, somewhat similar to that
which occurs in senile gangrene, and thus allow of the liberation of an acid or acids, viz., the phosphoric, and one or more
of the fatty acids, which then play a more important part in
the farther process of Yellow-softening. This conjecture is




284             SOFTENING OF THE BRAIN.
somewhat supported by the very decided acid reaction of the
fluid contained in the softened spot.
Another important phenomenon in Yellow-softening is the
remarkable degree of swelling of the brain which Yellow-softening produces; softened spots, of the size of half a cubic
inch, or of a nut, give rise to quite a disproportionate turgescence. From these facts it may readily be conjectured
that the symptoms of Yellow-softening are severe and acute.
ROKITANSKY says, that it appears to be always, and often rapidly
fatal, still idiopathic Yellow-softening may last a longer time;
but the secondary variety, that which forms around apoplectic
clots or inflamed patches of the brain, often runs a rapid course.
It corresponds more nearly to the so-called acute ataxic variety than any other.
Treatment.-Arsenicum, Secale, and Phosphor are homeeopathic to that stage which resembles senile gangrene. If the
presence of atheroma can be conjectured by the presence of
peculiar hardness and inelasticity of the superficial arteries,
then the remedies pointed out for Atheroma (see page 174,)
will be brought in play. If the Softening be brought about
by a violent tonic, tetanic spasm, or constriction of the bloodvessels, similar to the violent contraction of the muscles which
is so characteristic a sign of Softening of the brain, then
Nux, Ignatia, Angustura, or Conium, and Opium, may be usefill. The excessive swelling of the softened part, and consequent pressure upon the healthy part of the brain, together
with presence of an intensely acid fluid in the diseased part,
may call for Kali-hydroidicum, Baryta, Kali-carb., or Phosphor.
Wlhite-softening of the brain.-According to ROKITANSKY,
this consists in a loosening and subsequent maceration of the
substance of the brain by an interstitial effusion of serum.
Like cedema in general, it sometimes takes place without any
inflammation; at other times it is unquestionably so far inflammatory, that a certain quantity of coagulable lymph, capable
of assuming an elementary organization, is poured out with




TREATMENT OF SOFTENING) ETC.           285
the serum. Examples of it are furnished in the more or less
acute forms of oedema which occur in the neighborhood of
patches of inflammation, and more especially in the cedema
which accompanies acute meningitic hydrocephalus, and destroy the tissue around the ventricles of the brain. In such
cases of Softening, the characteristic products of inflammation
may generally be discovered with the microscope in the diffluent portion of the brain.
This disease apparently approaches in its character the
acute inflammatory, erysipelatous, or cedematous inflammation, similar to that which is so specifically caused by Arsenicum, Cantharides, Rhus, Euphorbium, Marsh Marigold, and
other remedies.
TREATMENT OF SOFTENING OF THE BRAIN, AND PALSY.
As there is but little experience in the homceopathic school
in the treatment of this disease, even in its more common
form, and much less in all its varieties and complications, it
will be well for us to ascertain what has been accomplished
by other physicians; in how far their experience agrees with
the rules of the homceopathic school; and how much remains
for us and others to point out, ab novo,'either theoretically or
practically.
Arsenicumf.-According to ROWLAND, this exerts a wellknown beneficial influence in some nervous affections. For
several years he has been in the habit of prescribing the
Liquor Arsenicalis in palsy, and other conditions depending
upon Softening of the brain. It is, he says, best suited to the
chronic form, or, at least, to that in'which all activity and
excitement have ceased, and where the vital energy is deficient. In such cases, this remedy is frequently of much benefit, and appears to give renewed strength and firmness to the
nervous system. It even seems to possess a curative power
in this complaint; in several instances, I (ROWLAND) have
observed permanent improvement follow its administration,
and in two patients the cure was almost complete. Accord



286              SOrENITNG OF THE BRAIN.
ing to Homceopathy, Arsenicum should prove curative against
that variety of wAite Softening which arises from inflammatory
cedema.  CHRISTISoN admits it to be homceopathic to "gorging of the vessels of the brain, efifusion of serum into the ventricles, inflammation of the brain, and even extravasation of
blood"; i. e., both to the cedematous or white variety of Softening, and to the apoplectic, hinorrhagic, or red Softening.
Turgescence of the vessels, i. e., congestive or red Softening,
has been mentioned in several published cases; andl CRISTISON himself has met with it, and in one case found " gorging
of the vessels of the brain, inflammatory adhesion of the dura
mater to the membranes beneath, and efusio qof eight ounces
of serum into the late7ral csentricles. In another case, CIIRISTISON admits it homceopathic to the apoplectic variety, as the
patient became apoplectic, and a recent clot of blood was
fohnd in the richt anterior lobe.
We have also seen that Pialsy, atnd (ontlractio rf thle limbs,
are among the most common symptoms of Softening of the
brain, yet CmRISTIsoN says that.Arsenicum is hoimcopathic to
Palsy, and RowLrAND, we have seen, asserts that it cures paralysis.
CmRISTISON says a commrion nervous affection to which A.rsenicum is homceopathic is partial Palsy; paralysis in. the
form of incomplete paraplegia is very indicative of Arsenic,
and incomplete paralysis of one or more of the extremities,
resembling Lead-palsy, is often one of the last symptoms which
continues. DEHIAEN relates a distinct example in which Ars.
proved homceopathic to Palsy; cramps, tenderness and weakness of the feet, legs, and arms, increased gradually until the
whole extremities became at length almost completely palsied;
the power of motion returned first in the hands, and then in
the arms. CHRISTISON says than an excellent account of a set
of similar cases has been given by Dr. MIJurmRA  of Aberdeen 
in four cases, Arsen. proved homnceopathic to great muscular
debility; in two cases, to true partial Palsy; in one case, the
power of the left arm was lost altogether, and six months after,
he was unable to bend the arm at the elbow-joint; in another




TREATMENT OF SOFr'EtMNG, ETO.           287
case, it was homnceopathic to great general debility, long-continued numbness, and pains in the legs.
In another case, Ars. was homzeopathic to a dysenteric attack, followed by feebleness of the limbs, almost amounting
to Palsy, attended with irritative fever, diarrhea, and faintness, followed by great stifness, numbness, and loss of power
in the joints of the hands and feet. Another case, somewhat
similar to the preceding, was observed by Mr. LACHESE, of
Angas, in which Arsenicum proved hommopathie to convulsions, followed by almost complete Palsy of the limbs. CamHsTISON also says, a well-marked case of the same nature was
noticed by PROFESSOR BERNIT; the paralytic affection consisted
of loss of sensation, and of the power of motion in the hands,
and of loss of motion in the feet, with contraction of the kneejoints. Dr. FALCONER is also quoted as having frequently
witnessed the homceopathicity of Arsenicum to local Palsy,
and alludes to one case in which the hands only were paralyzed; also to two others, in which the Palsy spread gradually
from the fingers upwards, until the whole arms were affected.
On the whole, then, CHRISTISON admits, Arsenic is quite homceopathic to local Palsy, even to the most obstinate and intractable cases, as in the person of a cook, who had had perfect Palsy of the linmbs for the greater part of a long life.
Occasionally, CHRISTISON also asserts, it is hoInmcopathic when
the limbs are rigidly bent, and cannot be extended. It was
homceopathic in another case, in which the limbs were conr
tracted as well as palsied.
VzYux-vomicc. —The undoubted and even extraordinary homceopathicity of this drug to Softening of the brain has already
been sufficiently alluded to on page 263.
Ferrnm is recommended by 1ROWL&ND, owing to the frequent'alliance of Softening of the brain with anemia, or fatty
degeneration of the brain or other organs, in order to improve
the condition of the blood by making it richer in fibrin and
red particles; it certainly will not increase the quantity
of fibrin, although it will aid in the production of the red
coloring of the blood. In two cases of recent hemiplegia, in




288             SOFTENING OF THE BRAIN.
old and debilitated patients, the symptoms gradually improved, ROWLAND says, under the use of Iron, until voluntary
motion was restored. Several old paralytic patients, with
mental infirmity, also improved in some degree, but the medicine subsequently lost its power; in some it was afterwards
injurious, while others could not bear Iron in any form or
dose. Some of these latter cases might have been benefited
by Plumbum.
Punltzmum.-The homceopathicity of this remedy has also
been sufficiently dwelt upon, on page 252. As its action
is almost diametrically opposite to that of Ferrum, it might
be used with advantage in those cases which are aggravated
by Ferrum without subsequent improvement.
Iodide of Baryta is recommended by NoAcI, and Agaricus
deserves particular attention in the first stages of the disorder
(see page 140). The effects of Agaricus there detailed are
wonderfnlly similar to those of an adynamic condition of the
brain, which may easily lead to Softening.
Opiuz.-Singularly enough, although ROWLAND is an allopathist, he says, that there are circumstances which not only
warrant the administration of Opium, but considerable relief
is derived from it; it even seems most appropriate to the
cases where the brain is extensively disorganized, and sometimes stupor or coma may be warded off by a small dose of
morphine, or a few grains of Dover's powder.
Symnoptomatic treatment.-According to ROWLAND, the most
frequent affection of the intelligence in Softening of the brain,
is feebleness of the intellectual faculties, slowness of apprehension, or imbecility; to these, Baryta and Conium are the
most homceopathic remedies. Wild or noisy excitement, or
delirium, is rarely observed, except in the first stage of acute
Softening, especially of the convolutions; and even this is only
transient, soon giving way to the torpor of the brain, which
more properly belongs to the disease; in fact, the continuance
of high delirious excitement would even warrant a pretty confident opinion that the structure of the brain is still sound —
Bellad. and Stramonium will be most indicated. Attacks of




TREATMENT OF SOFTENING, ETC.          289
lethargy, somnolency, and coma form a most important and
characteristic feature of Softening of the brain; it is very
peculiar that these attacks are generally transient and frequently repeated; in chronic Softening, paroxysms of insensibility or coma may return at intervals for months or years,
and it is remarkable that the intelligence in these patients
undergoes less permanent injury than in that form in which
the disease is not marked by such accessions of stupor; after
the patient has been for some time previously in a state nearly
approaching to imbecility, or somnolency, an attack of coma
will frequently remove a great portion of the oppression, and
be followed by a sense of relief and greater firmness in the
exercise of the intellect, and in fact, at times the mind will
become sufficiently buoyant to permit the patient to attend to
his usual avocations. Another circumstance peculiar to Softening of the brain, is the abrupt manner in which consciousness is restored; at one hour the patient will be suffering under
the symptoms of deep apoplexy, and at the next he may be
found with his memory and judgment in a great measure regained, and even sitting up and conversing cheerfully. —RowLAND. These attacks are not always owing to congestion of
the brain, to spasm, or to the sudden supervention of acute
disease; for in many instances the death-like pallor, the
thready pulse, the suddenness and frequency of the attacks,
and their rapid termination, rather point to sudden exhaustion, debility, or adynamia of the brain. Opium, llyosc., and
Agaricus are the most important homncopathic remedies.
Sometimes that species of imbecility which is manifested
chiefly in the manner and actions, and on that account called
by the French delire d'action, accompanies Softening of the
brain; the patients are occupied continually with some employment, often without motive, almost without consciousness,
and are generally very restless and irritable; they dress and
undress frequently, busy themselves in unmeaning preparations, and continually repeat the same act; finally, they become completely demented, the mind is hopelessly clouded,
the expression vacant and idiotic, and the limbs become para



290              SO'TrENIINSG OF THE BRAIN.
lytic. Agaricus, H:yosciamnus, Spigelia, Bellad., and Stramonium are much indicated, although Arsenicum is sometimes
indispensably necessary, or Plttmbumn.
When the speech is very much affected, 11yosc. is the best
remedy.
In the paralysis, Arsenicur:, Nux, Plumbum, Secale, Staphysagria, and Acidurm oxalicurn deserve attention. It should
be recollected, however, that Palsy from softening of the nervofus centres sometimes subsides without treatment, especially
when the attack has been sudden; it is hard to understand
why a condition occasionedl by a permanent lesion should ble
capable of spontaneous removal, but so it is.
When the lower limbs are paralyzed, I wish to call attention to Secale, and Aciduml oxalic,1um.  Secale acts so specifically upon the lower portion of the spinal marrow, and experience with it has been so frequent and beneficial, that its
name need merely be mentioned to awaken that attention
which it deserves. But the specific action of Acidurn oxali —
cumr is not so well known; in one case, OarSTISON says it
proved homceopathic to great lassitude and weakness of the
limbs, and numbness and weakness in the back, so severe that
the patient could scarcely walk up 6stairs; in another case, the
first thing complained ofi was acute pain in the back, gradually extending down the thiglhs, occasioning great torture ere
long; in a third case, thet patient complained more of the
pain shooting down friom the loins to the limbs than of any
other symptom. It is also homuaopathic to general numbness
approaching to Palsy; to headache, extreme feebleness of the,
pulse, and a sense of numbness, tingling, or pricking, especiallyv in the back and thighs. In another case, it proved
homTceopathic to'I a feeling as if the hands were dead, to loss
of consciousness -or eight hours, then to lividity, coldness, and
almost complete loss of power of motion in the legs: the pa.
tient recovered in fifteen days."
The treatment of the stiffness, rigidity, and contraction of
he limbs, so common in Softening of the brain, has already
been alluded to (see&Nux).




TREATMENT OF SOFTENING, ETC.            291
Convulsions and convulsive tremblings require Nux, Ignat.,
or Mercurius.
The perversions of sensation, such as delusive feelings of
heat and cold, or tingling or pricking sensations are most homceopathically treated by Aconit. rad. The same remedy will
relieve the excessive sensitiveness of the skin and muscles of
the paralyzed side, even when it is so great that the least
touch causes exquisite sufftering, although Agaricus should not
be forgotten.
The headache is best treated by Glonoine.
Blindness of one or both eyes, or indistinctness of vision, or
flashes of light, or black specks before the eyes, may be met
by, Bellad., Plumbum, Pulsatilla, or Phosphor; contraction
of the pupils, if persistent, finds its homceopathic remedy in
Opium or Nux; its antipathic antagonist in Bellad., iyose.,
or Stramonium.
When there is deafness or noises in the ear, QCina is indicated.
In the distressing nausea and vomiting which sometimes
attend the acute form of the disease, Cuprum aceticum, or
Zincum, may be thought of, in addition to the usual remedies.
When the respiration and pulse are slow, Opium, Plumbum, Aconite, and Digitalis should be thought of.




GENERAL REVIEW
OF THE
TREATMENT OF APOPLEXY, ETC.
1. ACONITUM NAPELLUS.
IT may be used antipathically in full doses, when the face
is flushed, skin hot, pulse full, strong and quick, pupils Slilated, with severe pains, and great sensitiveness of the skin and
nerves. Or, it may be used home.opathically in small doses,
when the face is pale and sunken, skin cool, pulse weak and
slow, pupils contracted, and much numbness and tingling are
present.
2. ABSORBENTS.
A very important part of the treatment of hemorrhagic
Apoplexy, is that which has for its object, the safe and rapid
absorption of the clot. Of course this should not be attempted too soon, or renewal of the bleeding might occur. Nitrate
of Potash and the alkaline carbonates possess the power of
dissolving fibrin and prevent its coagulation. Arnica, Baryta,
Conium and Phosphor, also seem to possess the power of
hastening absorption of the clot; while Nux-vomica, if used too
freely, is apt to induce white Softening of the brain around
the coagulum.
3. AGARICUS IUSCnARIUS
Is homceopathic to enfeebled states of the brain, when the
patient is giddy, weak, apt to tremble, and troubled with loss
memory, and dimness of vision; when the patient's memory
fails him, and he loses his way, does not recognize his friends,
and is inclined to sleep. It may also prove homceopathic
to Softening of the brain, and true hsemorrhagic Apoplexy. It




TREATMENT OF APOPLEXY, ETC.           293
is homceopathic to bilious Apoplexy, with jaundice and*enlargement qf the liver; also to those cases which are preceded
by unusual wakefulness, and excitement or irritation of the
brain, especially when there is much twitching of the face and
limbs, with dilatation of the pupils and glistening of the eyes.
4. ARNICA MONTANA
In traumatic Apoplexy, or that which occurs after blows
and falls upon the head. In hoemorrhagic Apoplexy, to check
the bleeding and promote the absorption of the clot; in serous
Apoplexy, to aid the absorption of the watery fluid; in Apoplexy followed by paralysis, especially in the earlier stages,
before more active remedies, such as Nux-vom., are admissible.
5. BARYTA
In torpid and chronic cases, to promote the absorption of
the clot. Against tendency to Apoplexy from excitement of
the sexual organs; in Apoplexy of the cerebellum, with much
pain in the back of the head. In the Apoplexies of delicate,
and old people.
6. BELLADONNA.
It may be given homceopathically in small doses, when the
face is flushed and bloated, the carotids beating violently,
eyes red, pupils widely dilated, pulse full, hard and strong,
and slight convulsions are present.  RiicRERT says it has
effected cures in aged patients, from 60 to 70 or 80 years
old, of powerful, heavy and plethoric constitutions, i. e., in
those with the true apoplectic habit; especially when there
was unconsciousness, swollen andl red, or else pale face; protruding and reddened eyes, with dilatation of the pupils;
loss of sight, smell, and speech; presence of muttering and
and stammering; distortion of the mouth; twitchings of the
face; involuntary flow of spittle and fluids from the mouth;
protrusion and swelling of the tongue; pulsation of the carotids; difficulty or inability to swcllow; involuntary urination; grasping at the genitals; groaning and snoring; obstructed respiration; paralysis of the limbs, either of the
right or left side; fulness, tension, quickening, or retard



294             GENEir     REVIEW OF THE
atidn of the pulse; coma, or sopor. The most characteristic
and important indications are printed in ital ics. —-ETERS.
It may be used antipathically in full doses, in annernic and
1:,ophic states of the brain, when the face is pale, pupils contracted, head dizzy and weak (fiom  insufficient supply of
blood,) pulse slow and small, and urine scanty.
7. BLOOD-LETTING.
According to WlrxsoN, this is required when the patient is
plethoric, the pulse full, hard or thrilling, or else oppressed,
large and slow; and if there are obvious external signs of
great congestion to the head, such as great throbbing of the
carotid and termporal arteries, turgid state of the veins of the
face and scalp, great turgor or flushing of the face, or else a
bloated and livid appearance of the same. If the patient's
skin be pale and cold, his pulse feeble and flickering, bleeding will probably insure his death. REAu, who was second to
rnone but HAHNEMANN in lIomceopathy, also admits the
propriety of occasional blood-letting.
7. cocCULUS
Is most homocmopathic to gastric Apoplexy, when there is
emptiness and hollowness of the head, dizziness, with great
nausea and tendency to faint, falling asleep of the feet and
hands, difficulty in speaking and thinking, &c.
9. CONx'IU'J
Is most homwnopathic to Apoplexy fromn pure and uncomplicated venous congestion, and congestive Apoplexy, when
the face is bloated, purple or livid, the skin rather cool, pulse
slow and feeble, pupils contracted, and the breathing extraordinarily difficult and oppressed. It will also aid in the absorption of the clot in hbemorrhagic Apoplexy, by arousing
the activity of both the venous and lymphatic systems; and
is decidedly hommopathic to the debility and paralysis which
precedes, or follows Apoplexy.
CUPRUM
Is allied in its action to ZNux, Plumbum, Cocculus, Ignatia;




TREATMENT OF APOPLEXY. ErTC.         295
it is homnceopathic to Apoplexy when preceded by, or attended
with conivulsions, viz., in spcasmodic and nervous Apoplexy;
also in bilious Apoplexy. It may prove antipathic when the
complexion of the patient is unusually white and clear; when
there is a: deficiency of bile, not only in the liver and bowels,
but also in the whole systemrn; and when paralysis is a predominant symptom.
Is apparently, altholugh not absolutely allied in somle of its
actions, to I3ellad., Glonoinle, Opium and Phosphor; but it is
imore homrnoopathic to true arterial plethora and Apoplexy,
than any of theseX remedies, except Glonoine and Phosphor.
It is somnewhat antagonistic in its action to that of Coniumn,
Hydrocyanic Acid, and Plumbum.;It is homuneopathic to violent arterial congestion to the head, with powerful beafing of
the heart and arteries, great redness and heat of the face,
heat of skin, severe head-ache, heat and fulness of the head,
and dizziness, from rush of' blood to the head. It is also homeeopathic, both symptomatologically and pathologically,
to hmemorrhagic Apoplexy, especially when there has been a
feeling as if the brain had received a sudden shock, or had
been rent asunder, soon followed by faintness and sense of
sinking, owing to rupture of a blood-vessel and pouring out of
blood in, or upon the brain.
It is antipathic to the Apoplexies of anemnic and debilitated persons; when the skin and lips are bloodless, the body
thin and feeble, the extremities cold, the mind weak and the
pulse feeble.
IPECAC
Is most suitable in gastric and nervous Apoplexy, especially
when there is much nausea, and great asthmatic difficulty of
breathing.
GLONOINE
IB most homneopathic to sudden and violent congestive Apoplexies. It may prove the most antipathic remedy to anaamia




296             GENERAL REVIEW OF THE
and atrophy of the brain, when the patient is in imminent
danger of dying from an enfeebled and bloodless condition,
especially when sudden and alarming syncope sets in from
great depression of the heart, arteries and brain; it may act
almost as promptly as transfulsion of blood.
HYOSCIAMUS
Is most homeeopathic when there is a high state of nervous
excitement, with more or less delirium and twitching of the
muscles.
HYDROCYANIC ACID
Is most homceopathic to Apoplexy attended with extreme
exhaustion and prostration.
IGNATIA
Is indicated under almost the same circumstances as those
which require Klux.
NTUX-VOMIICA
Is most homceopathic in convulsive Apoplexy, when
the limbs are in a state of permanent and rigid contraction,
especially if the face be pale or livid, and the pupils contracted.  It is allied in its action to some of the effects of Arnica, Cocculus, Cuprum, and Ignatia; it is somewhat antagonistic to Belladonna, but especially to Opium, Conium, Plumbum, and IIydrocyanic Acid.
OPIUM.
According to RiiCKERT, it is most indicated when there is
congestion to, with violent roaring in the head; loss of consciousness; or excitement with laughing, and confused, erroneous talking; restlessness; redness of the face and eyes; contracted pupils; grasping at the head; drawing of the tongue
to one side; difficulty of speaking and swallowing; groaning
and anxious respiration; coldness and paralysis of the limbs;
softness, fulness, or weakness of the pulse; and coma.




TREATMENT OF APOPLEXY, &C,.         297
PHOSPHOR
Is homoeopathic to the most active and sthenic cases of
Apoplexy, with much arterial, congestive and febrile excitement. It is antipathic to the Apoplexies of debilitated persons, when the exhaustion has almost reached its extreme
degree, the pulse being small, sunken, rapid and soft, the
limbs cold; when hiccough has set in, with rattling respiration, and cold and clammy sweat.
STYPTICS.
Among the remedies treated of in this book. which may be
used as styptics, Plumbum-Aceticum, Opium, and Ferrum deserve particular attention; Arnica and Ipecac. may also come
in play.




298                             TABULAR REVIEW.
TABULAR REVIEW.
BY RUCKE RT.
=1 1 
k                     a          X     V
iii ih         ii i    
Chewing and gritting of the..
teeth...........Bell.
Coma, (deep sleep)......             Bar. BELL. Cocc. Cupr.
Consciousness, loss of,... Acon. Am.       BELL. Cocc.                       Nux  Op.;~      undisturbed..Bell
Difficulty of speaking..       A..  BELL.        Cupr  Ipec..    Nux.
swallowing,Bell                                          Hyose. Nux. Op.
D)istortion of the mouth,...                BELL.        Cupr.                       Op.
Eyes, dim and fixed......                                                    Nux. Op.'   congested with blood,                   Bell..
"   squinting..........                   Bell.
" rolling of,..........                         Cocc.
Face, corpse-like and pale,. Acon.           Bell.' red and swollen,....         A rn.    BELL. Cot... HYose.            Op.
Forgetfulness,..........        Amrn  Bar.
Groaning and gurgling in.
sleep..................                   BLL.
Head, heat of............ Aeon.'   grasping at........Nux. Op.
roaring in, and ie o
ears,..........                     B...                                    Op.
Heart-beats, slow and trem-.. /
bling.Ae..........on. 
Jaw, dropped...........         Bell.                            Nx.
"  locked, with spasms..
of face...........                               Cupr.
Limbs, cold and stiff     Aecon               Bel...                         Nux.
Lying as if dead..........      Arn.Op.
Mucus, thick in and aboul
mouth,.................   Nux.
Muttering and mumbling,.                     Bell....      Nux.
Paralysis of sensation on                              --
right side...............   on.            Bell.
Paralysis of bladder,.......                                         Hyose. Nux
of the limbs.....       Arn.                     Cupr  Ipec.          Nux.
"    of the left side,..     A.      BELL.Op.
"    of the right side,.                 Bell  Cocc.
Pulsation of the carotids,.., Aeon           Bell.
Pulse, fullAeon A                           Bell. Coc.....Hyosc. Nux. Op.' hard,.............  Aon.                      Cocc...
intermitting,....A..... rn.
" not intermitting,....Aeon.
not to be felt,......Aeon.                                                    Phos.
qui k,                                                           Hyos.  BN
slow........                          Bell..
tense.............. 
weak..............              BrtN'.
Pupils contracted.........ACON       Bary...    Nux.
"  insensible  and  di- 
I~~~~~~~~~~~~~~~Nx Op.
lated..............Aeon
atAo Baryt. BELL. COCC.
Respiration, infrequent,... Aeon.
"4     rattling,...... Acon.            Bell..
it     deep,.........                   Bell. Cocc.
"4     scarcely  per-         "
ceptible.                             Coe..   Phos.
Skin, warm.............. Aeon...
Salivation.......... Bel.                            Ipec          Nux.
Tongue, paralyzed, and
drawn to one side,...Cupr.....  Op.




T R E A T I S E
ON
NERVOUS DERANGEMENTS
AND
MENTAL DISORDERS.








ON THE
NATURE AND CAUSES
OF
MENTAL DERANGEMENT.
MENTAL derangement is made to include all derangements of
the intellectual and moral functions. The primitive type of all
the forms of derangement is supposed to consist in an excess
or perversion of some one of the natural passions or emotions
of the mind. Among the insane we find the same ideas, the
same errors, the same passions, the same misfortunes which
elsewhere prevail. The insane world is the same as the sane
world, but its distinctive characters are more noticeable, its features more marked, its colors more vivid, its effects more striking, because the insane man displays himself in all his nakedness; dissimulating not his thoughts, nor concealing his defects;
lending not to his passions seductive charms; nor to his vices
deceitful appearances. If we reflect upon what passes through
the mind of even the most sensible and virtuous person for a
single day, what incoherence shall we notice in his ideas and
determinations from the time that he awakes in the morning,
until he retires to rest at night,; and how many foolish, wicked
and offensive impulses. His sensations, ideas and determinations, have some connection among themselves, only when he
arrests his attention, and then only does he reason and exert
mental control. The insane no longer enjoy the faculty of fixing and directing their attention, and this privation is the primnitive cause of all their errors. All reasoning and mental control
presupposes an effort, and we are not naturally reasoning, and
self-denying beings; that is to say, our ideas are not instinctively and naturally conformed to objects, our comparisons correct,
our reasonings just, and our actions proper, except by a succession of efforts of the attention, and a ready submission to the
20




296              NATURE AND CAUSES OF
results of the consequent reflections. In the insane, the impressions are so vivid, fugitive and numerous, and the ideas so
abundant, that they cannot fix their attention sufficiently and
justly upon each thought, object, or idea; while with the monomaniac, the attention is so concentrated, and the ideas so few,
that it cannot turn itself aside upon surrounding objects and accessory ideas. Hence a vicious, or imperfect mental and moral
training is a powerful predisposing cause of derangement.
There may be error in two opposite directions. The brain may
be prematurely stimulated to exertion by the ambition of the
child, or the parent; or the evil passions may be allowed to develop themselves unchecked, through a weak and injudicious
indulgence. In the former case, especially if the patient be of
a naturally highly nervous or enthusiastic temperament, the
brainis often brought into a state of excitement and irritation,
which requires but a slight additional excitement to become decidedly morbid; in the latter, the character is left unprovided
with the due safeguards against the temptations, annoyances,
disappointments, and necessary struggles of life, and the mind
sometimes breaks down under the first serious conflict. Mental
and moral training is essentially necessary to those who have
naturally any strong passion in excess, such as ambition, pride,
love of applause. The one-sided, enthusiastic, conceited, or
careless person, will also be very apt to neglect the proper care
of his or her body, natural functions, diet, rest, &c., and hence,
various bodily derangements will soon be ready to add their
quota to natural predisposition, or acquired tendency to mental
derangement.
In accordance with these views, the profession or business of
men has great influence over the number of the insane. The
proportion is vastly greater among classes whose brains are kept
in a perpetual turmoil, either of passion, or of intellect, than
among those who pursue a tranquil course of moderate indlustry and enjoyment. It has also been observed that the number
of insane is greater in a community, in proportion to the politicil and religious freedom of the population; that is, to the opportunity they enjoy of working out their own purposes, whether
in relation to this world, or the next, in the manner most agreeable to themselves. Excitement, powerful effort, and want of




MENTAL DERANGEMENT.                   297
mental balance and control are always greatest in such communities. Perhaps there is no country in the world, in which the
insane are proportionally more numerous than in America.
Excessive mental excitement, whether intellectual or emotional, is probably the most common cause of insanity. Every
excess pre-supposes a want of judgment and mental control,
and consequently, forms the first great step towards derangement. Excessive study; perplexing metaphysical or religious
investigations; over-indulgence of the imagination; struggles
for power, influence, or wealth; religious or political excitement; violent anger; excess of revenge, jealousy, or hatred;
the agitatiohs and perplexities which arise from the entanglements of engrossing business speculations, household cares, domestic unhappiness, and especially the remorse from vicious, or
criminal indulgence. Early mental training is especially necessary'to ward off the bad effects of fear, disappointment, grief,
despair, reverses of business, loss of friends, triumph of enemies, abuse of confidence, betrayed affections, public disgrace,
general destitution, bodily pain and disease. The mental emotions and imagination should be controlled, and the reasoning
faculty and judgment developed, in order to prevent insanity;
for in the insane, the reasoning faculty is always deranged, although not abolished; the patient can often follow out trains of
ratiocination with considerable correctness, and sometimes, even
with much ingenuity; but he is apt to change abruptly from
one course of thought to another, before the first is completed;
each idea that presents itself, however irrelative, becomes the
starting point of a new succession of thought, which is in its
turn, soon interrupted; and his intellectual action is thus broken up into disjointed fragments, which are fitted to no useful
purpose; he often, besides, mistakes some slight semblance,
some mere shadow of association, a similarity of sound in a
word, for example, for a legitimate link in a chain of reasoning,
and thus, even when starting from correct premises, is led into
the most egregrious errors. The judgment is perhaps more
perverted than any other faculty. It is the quality of mind
which is most rarely perfect in health, and which, therefore, may
be expected to be most defective in mental unsoundness. The
maniac cannot duly appreciate his relations to the world around




298              NATURE AND CAUSES OF
him, cannot shape his course in accordance with the various in
terests, opinions and feelings of others, and is therefore constantly encountering difficulties and vexations.  The imagination in mania, is often greatly excited, fruitful in its suggestion,
not unfrequently brilliant in its illusive picturing, but always
deranged; the pictures which it forms, like the workings of the
insane reason, are without due relation of parts, mere jumbled
assemblages of the grotesque, the ludicrous, the wild, the fearful; shifting too, like dreamy phantasms, to which it is probable
they bear no slight resemblance.  Early control of temper, is
all important to those predisposed to insanity, for in general, the
maniac is more irascible than in health, surrenders himself more
readily to every impulse, is often suspicious, revengeful, and
malicious.  Excesses of pride, ambition, and vanity, are frequently witnessed.  Steadiness of the affections and feelings,
should be cultivated, for among the most common results of the
disease, is an alteration of the natural affections; the dislike of
tihe insane for their former nearest and most intimate friends, is
almost proverbial; while the feelings are exceedingly unstable;
the patient passes rapidly from one state to another; the mental chords vibrate in quick succession with the whole gamut of
the passions.
It is unnecessary to follow out this idea farther here; it is as
important, however, to pay equally great attention to physical
and hygienic training; derangements of the stomach and liver
dispose to the melancholic forms of madness, and especially to
hypochondriasis; nothing is more common than to see a depression of spirits approaching to mental derangement, consequent
upon dyspepsia, functional disease of the liver, derangement or
constipation of the bowels, and the superaddition of delusion or
hallucination, converts the affection into insanity. Such affections occasionally clear off like mists before the sun, under the
use of proper regimen, exercise, diet, relaxation from care and'
business, judicious anti-bilious or laxative, or other means;
avoidance of alcohol, tobacco, strong tea, or coffee, &c., &c.
Of 1000 cases of Insanity collected by BARLOW;
110 arose from drunkenness;
73  "    "  excessive ambition;
73  "    "  excessive bodily or mental labor,




MENTAL DERANGEMENT.                   299
69 arose from misfortunes;
54  "    "  chagrin;
47  "    "  disappointed love;
29  "    "  religious enthusiasm;
26  "    "  political events;
12  "    "  ill usage;
9  "    "  crimes, remorse, or despair;
78  "    "'epilepsy;
71 were born idiots;
69 arose from old age;
39  "    "  accidents and injuries;
17  "    "  poisonous effluvia;
100  "    "  consequences of disease;
115  "    "  unknown causes.
Of 704 cases in males, 346, or one-half, were deranged from
moral causes; and only 156, or one-fourth, from physical
causes.
Of 1094 cases in females, 489 arose from vmoral causes, and
282 from physical causes.
The principal moral causes in these 346 cases in males were:
Reverse of fortune in 86 cases;
Anxiety           " 69
Religion.     " 45  "
Love..." 18 "
Principal moral causes in 489 insane females, were:
Anxiety... in 79 cases;
Religion..  " 69   "
Loss of relatives   " 62  "
Love....   " 57  "
Fright....    " 50
Reverse of fortune " 49 "
The principal physical cause in 156 insane males, was: Inemperance in 80 cases.
In females, puerperal disease in 117 cases out of 282.
In 490 cases of INSANITY from vmoral causes, ESQUIREL found
136 cases caused by domestic troubles;
71  "     "    " disappointed affection;
91  "     "    " misery and reverses of fortune;
46  "     "    " fright;




300               NATURE AND CAUSES OF
45 cases caused by political events;
9   "'L"   "  fanatacism;
32   "         "   "  jealousy;
16''      "   "  anger;
17   "       "   "  wounded self-love;
13   "'"   "  excessive study;
2'      "   "  misanthropy;
12   "       "   "  disappointed ambition.
In 730 cases from   physical causes:
255 were caused by hereditary tendency;
70   "'    "    "  apoplexy;
64   "    "6    "  progress of age;
16   6'    "    "  convulsions of mother during pregnancy;
13         " "   "  epilepsy;
16   "    "    "  sun-stroke;
16   "    "    "falls and blows upon the head;
25   cc    "    " C fevers;
38'"    "    c"  critical period of life;
74   ":    "  menstrual disorder;
73   "    "    "  puerperal disorder;
9   "    "    "  syphilis;
32   "    "    "  mercury;
28   "    "    "  intestinal worms.
In 482 cases of MELANCHOLY:
110 cases arose from hereditary predisposition;
60'    " "        domestic trouble;
48   "    "          reverses of fortune;
42'    "    "   disappointed affection;
40   "    "  "       change of life;
35   "    "    "   puerperal state';
30   "    "    "   libertinism;
25   "    "    "   suppressisn of menses;
19    "    "    "   abuse of liquor;
19   "    "    "   fright;
18   "    "'"  anger;
12   i''    "   wounded self-love;
10'    "    "   falls upon the head;




MENTAL DERANGEMENT.                   301
8 cases arose from jealousy;
6   "          "  masturbation.
In 299 cases of MANIA from moral causes:
91 cases arose from domestic trials;
71  C'C         "  disappointed affection;
43   "    "    "  fright;
25  C"   CC  "C reverse of fortune;
22   "    "    "  wounded self-love;
19   "    "    "  want;
17   "    "    " jealousy and anger;
10   "    "    "  excessive study.
Of this long array of the causes of insanity the effects of many
cannot altogether be warded off, and the unfortunate sufferer must
bear up as well as his religious and moral training will enable him
to do. Although, drunkenness, excessive ambition, excessive
bodily and mental labor, religious enthusiasm, crimes, excessive anxiety, fanaticism, jealousy, anger, misanthropy, libertinism, fear, &c., &c., can be and should be controlled; still misfortunes, chagrin, disappointed love, ill-usage, disease, reverse of
fortune, loss of relatives, domestic troubles, misery, wounded
self-love, with or without hereditary tendency, will fall heavily
on all, and too heavily on some.  Religion and moral training
must soften their influence, or the result will be disastrous.
Dr. RAY thinks that defective or perverted education is one of
the most productive causes of insanity.  The gross neglect, he
observes, of the moral powers, those which guide the passions
and determine the notions, is the crowning defect of the education of our times, ruinous in its consequences to the health, both
of body and mind. At home, children should be taught to acquire the power of governing passion and resisting the impulses
of the lower appetites, of discerning the nicer shades of right
and wrong, of sacrificing self to the call of benevolence and duty,
and amid trial and change, steadily keeping in view the great
purposes of life. How many of this generation complete their
childhood scarcely feeling the dominion of any will but their
own, and obeying no higher law than the caprice of the moment.
The legitimate result in the education of our times is, that
finally the ordinary virtues of life are degraded to a very low




302              NATURE AND CAUSES OF
rank. Patient and persevering industry, with its slow and moderate rewards, honest frugality, and a temperance that restrains
every excess, frequent and faithful self-examination, clear and
well-digested views of duty, become distasteful to the mind,
which can breathe only an atmosphere of excitement, craving
stimulus that rapidly consumes its energies, and destroys that
elasticity which enables it to arise from every pressure with
new vigor and increased power of endurance.
A very large class of the insane, however are formed by
bright and sensitive spirits, fully alive to every emotion of pain
or pleasure; over-conscientious and honorable; too anxious to
perform every duty, and comply with every exaction upon them;
if to this be added natural weakness of body, and some ill
health, with frequent and sudden trials and misfortunes, then
reason often gives way under them.
Of 28,548 cases collected from all sources and treated allopathically, 10,757 were cured, and 2955 died, leaving 17,781 in
a more or less hopeless state of mental derangement. In March,
1844, of 984 cases in the Hanwell Asylum, only 30 were regarded
as curable. Of 11,976 cases accumulated in the British Asylums
in 1851 and 52, only 953 were cured, 1183 died, and 9840 were
left uncured. At the York Retreat the average proportion of recoveries during the forty-four years it had been in operation,
in 1846, amounted to nearly forty-seven per cent. The general
average of relapses, is from ten to seventeen to thirty per cent;
and second attacks may occur four, five, eight, fourteen, or even
nineteen years after the first.
The liability to relapse after a recovery from a first attack is
scarcely less than fifty per cent, or one in every two cases discharged as recovered; five out of ten recover, and five die sooner
or later during an attack; of the five who recover, not more
than two remain well during the rest of their lives; the other
three sustain subsequent attacks, during which at least two of
them die. The interval of mental health may last from ten to
twenty years, during which the individual may enjoy all the
comforts cf social life. Of 1300 recoveries, 206 were known to
have relapsed; of 51 other recoveries, 11 relapsed in less than
one year.. Of 320 other recoveries, 47 were visited with a second attack of insanity; 7 with a third attack, 1 with a fourth




MENTAL DERANGEMENT.                   303
and 1 with a fifth. The relapses therefore amounted to about
seventeen per cent on the recoveries. Still, cases of mental improvement, caused by attacks of insanity have been recorded by
several writers. Dr. CHANDLER says, he has known a few persons who recovered to become better citizens than they were before. Their minds and feelings acquired strength and soundness by the disease, and by undergoing the process of cure, as
some musical instruments are said to be improved by being
broken and repaired again.  Of 244 cases by NEUMANN only
131, or fifty-three and a half per cent recovered from the first
attack; of these 131 recoveries, only 45, or eighteen per cent
remained permanently free from mental disorder; while 86 had
one or more subsequent attacks, and only 20 of the 86 were sane
at the time of death. Hence of 244 cases, only 65 were sane
at the time of death, or twenty-six and a half per cent. In
females sixty-seven per cent relapse; in males sixty-five per
cent. Of insane under twenty years of age, fifty-five per cent
recover; between twenty and thirty years, fifty-two per cent;
between forty and sixty years, forty-six per cent; between
sixty and eighty, only twenty-eight per cent.
Of curable cases, those of one month's duration, eighty-three
per cent recover; of from one to three months, seventy-eight per
cent recover; those of from three to six months' duration, fiftynine per cent; six to twelve months, thirty-five per cent; twelve
to eighteen months, eighteen per cent; eighteen to twenty-four
months, only ten per cent; and those of two or more years' duration only four per cent are restored.
Again, according to JAnvIS, of 57,794 cases in males, 23,677
recovered; of 53,946 cases in females, 23,704 were cured;
leaving 64,359 of both sexes more or less hopelessly insane.
Although the females recovered in an excess of nine per cent
over the males, still they are rather more subject to relapses.
Of 112,143 cases, 20,458 died, and the mortality increases in
proportion to age; in those insane from twenty to thirty years
of age, the mortality is from three and a half to five per'cent;
from thirty to forty years, three to seven per cent; forty to
fifty years, three and a half to nine and a half per-cent; fifty to
sixty years, four and a half to six and a half per cent; sixty
to seventy, six to seven per cent; seventy to eighty, eight and




304              NATURE AND CAUSES OF
a half to twelve per cent; eighty to ninety, twenty-one to thirty
per cent.
Mean mortality in all ages, four and a half to seven and a
half per cent. In the English Asylums the mortality varied
from 5.30 to 11.27 per cent.  The cures, from  22.48 to 59.0
per cent.
PINEL says, recoveries generally talke place within five or six
months; at York Asylum fifty percent of the recoveries occur
within three months; ESQUIROL in 2005 cases had 604 recover
in the first year, 497 in the second, 86 in the third, and only
41 in the seven following years, leaving 777 hopelessly insane.
Of all the circumstances which affect the comparison of the
recoveries and mortality of the insane, when treated in asylums,
the stage or duration is the most important; the probability of
recovery, in cases brought under care within three months of
first attack, is as four to one. In cases not admitted until more
than twelve months after the attack, the probability is less than
one to four. On the other hand, the mortality is greater in recent
than in chronic cases. viz., seven per cent in the former, and
only four and a half per cent in the latter.
The probability of recovery is greater, from four to twenty
per cent, in women than men; and the excess of mortality in
males varies from thirty-four to seventy-two per cent.
Of 112 cases of recovery in New-York State Asylum, 36 had
been insane only one month, or under; 44, between two or three
months; 18, from four to seven mohths; 9, from seven to twelve
months; and 3 over twelve months.  Ten of these 112 cases
were cured in two months and under; 6 in three months; 54, in
from four to seven months; 27, in from seven to twelve months;
13, in from one lo two years; 2, in two years.
Of 1355 cases not insane over one year, no less 1089 recovered, leaving only 266 more or less hopelessly insane. GALT,
in the Eastern Asylum of Virginia of 14 recent cases, cured 12,
which success he regards as unexampled; he used Opium in
enormous doses, from six to twelve grains, or from two to three
grains of Morphine, three times a day; he also had Opium
smoked in pipes mixed with" tobacco. MOREL gave Opium to
the extent of nine grains in twenty-four hours, without satisfactory results; so that very large doses seem to be required.




MENTAL DERANGEMENT.                  305
The early and proper treatment of insanity is all important;
it is said that scarcely a single case recovers when left to run
its course either unchecked, or only partially checked by irregular treatment. In every case, the first thing necessary is to
subject the patient to some control, more or less strict, according
to circumstances; control is one of the most important remedial
means; it is a great mistake to suppose that the insane can be
reasoned out of their delusions, or that remonstrance will prevent their absurd conduct; argument and remonstrance are generally prejudicial, unless the patient be under control, and so
far recovered that he may be regarded as somewhat convalescent.
The great question is whether this control shall be at home,
by means of medicine, or in asylums. WooD is in favor of an
early removal to an asylum, because insane persons are very
apt to contract aversion for their nearest friends and relatives,
and are consequently liable to perpetual irritation from their
presence. Instead of being soothed by their kind offices and
affectionate attentions, they are often excited into paroxysms
of rage. Besides the patient often requires control; he has lost
his own self-control, and some opposition to his will is absolutely
essential. But such opposition and control from persons from
whom he has before experienced nothing but kindness, and perhaps submission, become sources of perpetual vexation, and
sustain an excitement highly calculated to aggravate and fix his
disorder, &c., &c.
On the other hand, WILLIAMS says, in an incipient case of
mania, it is far better to treat it at the patient's house; this is
infinitely preferable to removal. The patient can be placed
under control, and the degree of restraint which may be necessary can be properly adapted by having one or more attendants.
It is always in early cases that so much may be done; and more
persons recover during the first six weeks after being attacked,
than in the aggregate of all other subsequent periods. If this
be true in acute attacks, in those cases which come on more
slowly, removal to an asylum must not be delayed too long;
the patient may get somewhat better, but will almost certainly
relapse soon after he again begins to mingle in the world. After
the first two or three months of insanity, the longer an efficient




306              NATURE AND CAUSES OF
course of treatment is postponed, the less is the chance of
success.
The seat of insanity is probably in the cineritious, or grey
portion of the brain; in a few cases the irritationsmay be inflammatory in its nature, but in the very largest portion it is
merely nervous.  Very few cases commence with delirium,.
fever, furred tongue, thirst, heat of skin, and loss of appetite;
in the larger portion the temperature of the skin is not raised,
although there may be some heat of the head, similar to that
caused by a fit of passion, or any irritation; of 222 cases seen
by JAcOBI, only 22 or 23 had fever, and some of these were
hectic, or fever from other causes than the mania. It may be
asserted without fear of contradiction that no pathologist could
in nine-tenths of all the cases of mental derangement which
prove fatal, take upon himself to say from an examination of the
brain, whether the person during life had been of sound mind
or not. BURNETT thought insanity a blood disease depending
upon a derangement, or mal-assimilation of those particular
materials of the blood, Carbon and Phosphorus, which constitute
the bulk of the elementary tissue of the brain and nervous
system-insanity in some cases is immediately caused by the
deterioration of the fatty matter of the blood, by which the
Carbon and Phosphor are unable to combine in healthy proportions and make sound nerves and brain.  In proof of this
BENCE JONES found an increase of phosphates excreted
during a paroxysms of mania; and another remarkable feature
in the urine of the insane is the excess of Ammonia, in the form
of Carbonate, Urate, Hydro-chlorate, or the Ammonio-magnesian
phosphate.
My own opinion is that the irritation in the brains of
many deranged persons is very similar to that which occurs
in scrofulous ophthalmia and spinal irritation. In both these
diseases the redness, congestion or inflammation of the eye or
spinal marrow is very slight, although the irritation is very
great. It is very true that the diseased changes, which pathologists may generally expect to find on examining the heads of
lunatics in a great majority dissections will be:
Ist, Infiltration of the pia-mater with serum,
2d, Congestion of the brain and its membranes,




MENTAL DERANGEMENT.                  307
3d, Effusion into the ventricles.
In 67 cases, 53 had the third; 53, the first; and 38 the second;
30 also had the arachnoid thickened and opaque; in 26 the
color of the brain was altered; 15 had effusion of blood in the
skull; 62 had the organs of the chest disordered; 30, those of
the abdomen.
That insanity is often connected with a tuberculous or scrofulous diathesis is evident from the fact that of 1540 cases of
death in insane persons, no less than 200 died with consumption, or about twelve per cent; cases of marasmus not included. HITCHMAN Says that there is much reason to suppose,
that in the insane, the organs of the chest are more frequently
diseased than those of the abdomen. Consumption is common,
but in a masked form; sometimes tubercles form and even tubercular excavations take place, without manifesting any of
those distressing symptoms of cough, expectoration and restlessness, so common in the sane.
In 145 cases examined by Dr. HITCHMAN the dura-mater
was adherent to the skull in about one-third of the cases, especially in those long insane, and advanced in years.
In 115 cases the arachnoid was more or less opaque and
thickened, and contained a considerable quantity of serous fluid.
These conditions are almost invariable accompaniments in
chronic cases of insanity; in 22 cases out of 27. In recent cases
the arachnoid does not adhere as closely to thle pia-mater, nor
is there so much thickness, opacity, or serous effusion; thus
in' 165 recent cases the arachnoid was thickened and opaque in
62 instances only.
In 118 cases the pia-mater was venously congested and infiltrated with sub-arachnoidean fluid. In chronic cases the piamater is almost invariably found thickened and altered; it becomes much thickened, can be removed from the brain in large
pieces without laceration; is sometimes dark from the congested
state of its blood-vessels; frequently oedematous, and bathed in
a muddy fluid, resembling diluted jelly. The pia-mater is even
more frequently affected in chronic lunacy than the arachnoid
itself. The choroid plexuses were simultaneously congested,
and contain cysts, and sand.




308              NATURE AND CAUSES OF
Pachionean glands were much enlarged in twenty, mostly old
patients.
The convolutions of the brain were sunken, atrophied or soft
in 72 cases out 119, and all these had either been insane for a
long time, or were in a state of extreme imbecility or dementia.
Seen through the thickened pia-mater, the convolutions have a
brownish hue owing to the presence of large quantities of serum.
In advanced dementia, the surface of the convolutions when
cut, sometimes was dark in hue.
In acute mania, the grey substance of the convolutions is apt
to have a pink or roseate color.
In 64 cases in which the patients had long been insane or imbecile, the grey substance was pale or blanched.
The white part of the brain was softened in 19 cases; greatly
congested in 12.
There are quite a variety of forms of mental derangement.
1st, MANIA, or general delirium, including
a) mental derangement without fury;
b) mania, with fury.
2d, MONOMANIA, or delirium limited to one, or a few objects,
with a predominance of one passion.
a) MIonomania of pride, the subjects of which imagine
that they are possessed of great riches or power; that they
are generals, princes, deities, &c.
b) Gay monomania; according to Esquirel, true monomaniacs are always gay and expansive, affording a striking contrast to hypochondriacs.
Haschisch and Aurum are perhaps the most homceopathic remedies against gay monomania (see Appendix).
c) WSad monomania, or the melancholy of the ancients,
lypemania of Esquirol; these patients are deranged on one or
a few subjects, with a predominance of sadness, or depres,
sion; are apt to fear that they are dishonored, condemned to
death, imprisoned, &c.; some are under the influence of a continuous or irresistible fear.}
d) Religious monomania,  including   Demonomaniacs,
Theomaniacs, Ascetics, &c.
The insanity of masturbators is sometimes thought by their friends




MENTAL DERANGEMENT.                    309
to be caused by religious anxiety, because the first evidence of it
noticed, was an extraordinary anxiety about their salvation, an inordinate fear of future punishment; or abandoning all occupation but
that of reading or holding a bible, as if reading; or praying, or mumbling incoherent sentences in an attitude of prayer at improper times
and places, &c.
Another class, frequently placed under the head of religious anxiety,
are religious monomaniacs whose insanity is undoubtedly referable
to dyspepsia, habitual indigestion and constipation. BRIGHAM.
e) Erotomania. This is very different from nymphomania
and satyriasis; it bears the same relation to these, what the
ardent affections of the heart, when chaste and honorable are,
in comparison with frightful libertinism; actions the most
obscene, shameful and humiliating characterise the latter, while
the erotomaniac neither desires, or dreams even, of the favors
to which he might aspire from the object of his insane tenderness.  In erotomania the eyes are lively and animated,
the look passionate, the discourse tender, and the actions expansive: but the subjects of it never pass the limits of propriety.
In two cases of Dementia and two of Mania, caused by masturbation, the Muriate tinct. of Iron in large doses was found to be the
best anaphrodisiac which SMITH could employ; appearing to be the
real agent in the cures which followed its use. Nymphomania in one
case was cured by Bromide of Potash in fifteen grain doses, three
times a day. In the treatment of masturbation BRIGHAM preferred
Conium, Camphor and Belladonna, and thinks that he has indubitable
evidence of its power. WooD thinks that in excitement of the venereal propensity, Dulcamara, very freely employed, is perhaps the
most efficient remedy-Muriate of Baryta also deserves attention.
f) Kleptomania, or monomania for stealing.
g) Pyromania, or mania for incendiarism.
h) Suicidal and Homicidal monomania.
In suicidal insanity, the Meconite, and Hydrochlorate of Morphia
often act like a charm, if uninterruptedly and perseveringly given,
until the nervous system is completely under its influence. FORBES
NVINSLOW has witnessed the most distressing attacks of this form
of insanity radically cured by this treatment when every other has
failed.  He has also seen the suicidal impulse removed after the
administration of a few doses of Belladonna.
3d, HALLUCINATIONS.
a) Hallucinations of sight; seeing of phantoms, imaginary
or absent persons, of forms, or colors.




310               NATURE AND CAUSES OF
b) Hallucinations of hearing; these are the most frequent
of all; are found in at least two-thirds of all hallucinated persons; consist in noises in the head and ears; hearing  of
sounds, voices, cries, &c.
c) Illusions of touch; these are common.
d) Illusions of taste and smell, are rare.
e) Illusions about one's internal organs, in which the patient imagines various extraordinary conditions of his internal
organs, that he has snakes or reptiles within him; or is filled
with sulphurous vapors which will suffocate him, &c.
LEURET'S treatment of Hallucinations consists in the frequent use
of the douche, taking care while the patient is in the bath to speak
on all the subjects connected with his insanity, and making him give
rational replies; he was not contented so long as there was or appeared to be a mental reservation in his words; he obliged the patient
to admit that he was mad or deranged; the douche was repeated daily
and the same system of questioning, &c., continued until the patient
fully understood that he was in the wrong, and was anxious to recover his health and reason.
4th, DEMENTIA, or general feebleness of the mental faculties.
5th, IDioCY.
6th) PUERPERAL MANIA, or mental derangement of lying-inwomen.
a) MENTAL DERANGEMENT soon after confinement.
b)   do.      do.    during or after protracted nursing.
7th, DELIRIUM TREMENS.
8th, MENTAL DERANGEMENT from poisoning with narcotics,
Opium, Stramonium, Haschlisch. &c., &c.
9th, GENERAL PARALYSIS of the insane.
In eight cases, tie structure of the brain was firm and tough; so
tough in one case that the brain could be lifted without breaking it:
BLOODLETTING.
WooD says, to bleed and otherwise deplete copiously for insanity alone, even in its early stages, is he is convinced, a highly injurious practice. Without having the least influence over
the delusions of the patient, it lowers the grade of his vital force.
and renders him less able to support the more or less wearing
influence of the mental disease on the bodily health. It is even




MENTAL DERANGEMENT.                  311
thought by some to dispose to a more rapid decline of mania or
monomania into dementia; and to diminish the chances of a
subsequent cure, or at least to protract the duration of the disease. Dr. KIRKBRIDE, the intelligent superintendent of the
Pennsylvania Hospital for the Insane, informed Dr. WooD, that
depletion is in his estimation the great error in the primary
treatment of insanity. It is not uncommon to mistake some
frequency of the pulse and heat of head, which may be the mere
results of the functional disturbance of the brain, for indications
of active febrile excitement, and the violent maniacal paroxysms
as proofs of cerebral inflammation. There can be no greater
errors than these.  The pulse is often much accelerated by the
want of sleep and the various agitations of the patient, without
fever or inflammation, and indeed may in many instances be
most happily composed by Opium  and other cerebral-stimulants. The maniacal paroxysms, though frequently attended
with signs of general and febrile excitement, are a purely nervous affection, occur as well in debilitated as in elevated states
of the system, and may be quite compatible with a stimulating
or supporting treatment; instead of being relieved they are in
some instances decidedly aggravated by the loss of blood.
In his remarks on bleeding in insanity, Dr. PATTERSON, of
the Indiana Hospital for the Insane, uses the following language:
Raving mania can be'much more permanently controlled by the
use of the warm bath, cold applications to the head, warm footbaths, mild cathartics, and in some cases by nauseants. Bleeding quiets the patient temporarily, but the excitement returns
with greater fury, and the system is less able to bear it than
before. So far as I have observed the practice, bleeding does
not accomplish the desired object, but the contrary; for it impoverishes the blood, reduces the strength of the patient, and
thereby renders the nervous system more excitable.
Dr. HANBURY SMITH, of the Ohio Asylum, says that during the
year 1851, the idea of depletion was entertained in no one case
by any of the medical officers; and those who had lost blood
previously to their admission proved exceedingly difficult to
restore, sank into hopeless dementia, or died. It may be considered as a settled thing that at the present time depletion is
exceedingly hazardous, and commonly contra-indicated in in21




312              NATURE AND CAUSES OF
sanity; the liberal use of stimulants proves eminently curative;
immediately after the action of a cathartic, sometimes previously
to, or during that action, he gives his patient from four to six
ounces of wine, or an equivalent portion of brandy, together with
the most nourishing and easily digested food. Maniacal. excitement commonly ceases very quickly under the above treatment.
BELL'S disease or typhomania is a peculiar form of mental
derangement becoming quite common, particularly in large cities,
and one in which the unpractised physician is almost certain to
pursue a deleterious course of treatment; the patients almost
invariably die after general bloodletting; a fatal result can only
be avoided by active stimulation.
In 913 or perhaps 1806 cases, Dr. KIRKBRI)E did not
practise venesection for insanity in a single instance; he may
have done it for apoplexy, or congestion of the brain, but never
for mania, melancholia, or any of the maladies generally included under the name of insanity.
Dr. RUSH is the great authority in favor of bloodletting, but
in his time, in the early part of the present century, the system
of treatment at the Bethlehem Hospital for the Insane, consisted
of bleeding, purging and vomiting in the spring months. A certain day was appointed on which the patients were bled; another
when they were purged; another when they were vomited.
They were all bled in May, and again in June, the precise time
depending on the weather.  This was the best treatment in
RuvsH's time; for the physicians of the Bethlehem Hospital, were
among the most eminent in London.
The physicians of probably 19/20ths of the institutions for
the insane, not only in America and Great Britain, but in
France, Prussia, and Austria condemn the practice of general
bleeding in insanity, unless it be in rare and exceptional
cases.
In puerperal mania SMITH says, bloodletting is preeminently
contra-indicated; in this matter all authorities agree; CHURCHILL, PRITCHARD), ESQUIROL, HIASLAM, GOOCH, and BURROWS
are equally opposed to it; even where local inflammation is discovered, other means should be used.
In' the treatment of acute mania with violence, raving and
consequent exhaustion, Dr. BRIGHAM employed seclusion, hot




MENTAL DERANGEMENT.                  313
baths, with cold applications to the head and free evacuation of
the bowels. In no case did he find local or general bleedings
admissible; but on the contrary nutritious diet and brandy-punch
are generally required.
Dr. BENEDICT, of the New-York State Asylum, says, he cannot too strongly urge his medical brethren to abstain from
bloodletting in insanity; his plan of treating very acute insanity
is directly opposed to depletion. Not one ounce of blood was
drawn from 825 patients, 54 of whom were deranged less than
one month. He resorts to stimulation in many cases with great
freedom, and has seen the best evidences of its propriety.
Dr. CURWIN, of the Pennsylvania State Asylum, says, that
he must call attention to an error which is very extensively
prevalent, and which consists in the almost invariable resort to
bloodletting in all cases of insanity. All hospital experience
proves that the loss of blood in any form of insanity, is almost
uniformly attended with unpleasant effects, prolonging the
period of cure, and in many cases placing the patient hopelessly
beyond the reach of any benefit to be derived from subsequent
treatment.  Insanity is essentially a nervous disorder, and
must be treated as such.
PURGATIVES.
WOODWARD says: if bleeding is injurious, active purging is
still more so. In torpid states of the bowels he preferred the
Tinct., or Pulv. Guaiac; has been most successful with it in
dyspepsia and distress after eating; it invigorates the stomach,
acts on the skin and bowels, and in females is an emmenagogue;.
the powder is the most useful, if the principal object is to
act upon the bowels.
FORBES WINSLOW says in the early' stage of insanity, and
throughout its whole course, the bowels are often in an obstinately constipated condition.  The concentration of nervous
energy in the brain appears to interfere with that supply
which should proceed to other structures. There is no class of
agents which act so certainly and effectually in relieving the
mind when under the influence of depressing emotions, as
cathartics. The bowels are often found gorged with fecal mat



314              NATURE AND CAUSES OF
ters, and immediate relief follows full action on the bowels. I
have seen several cases of great despondency, obstinacy and invincible taciturnity attended with, and caused by excessive costiveness, cured at once by a single dose of purgative medicine.
NARCOTIC S.
Of these OPIUM is the most important. In acute mania, if
there is much excitement, many physicians have great confidence in GRAVE'S combination of Opium and Tartar-emetic,
and in the proportions originally proposed by him. Afterwards
if the head be not very hot, full and repeated doses of Opium
are given; also in cases marked by extreme irritability, restlessness and want of sleep, with moist, flabby and tremulous
tongue, natural or dilated pupils, frequent, irregular and weak
pulse, cold and relaxed skin; then commonly with wine, and
always with excellent effect.  See GALT'S Opium treatment,
page 52. WooD says, independently of the advantageous influence excited by narcotics in quieting irritation, controlling
excessive nervous excitement, and producing sleep, they probably operate in another mode in the cure of insanity. When
kept steadily under their influence, the brain is rendered in
some measure insensible to those morbid impressions which
have a constant tendency to disturb it. Though the patient
may not be restored to reason, yet the irregular mental movements are much repressed, the proverbially cheering influence of
the drug restrains the tumult of the feelings, and a condition of
the brain is induced, in which a continued presentation of rational objects of reflection, and sources of a healthful interest,
may gradually accustom the organ to a sound mode of action;
while the morbid trains of reflection, and the perversions of the
passions are gradually obliterated from want of renewal. After
the removal, therefore, of physical derangement, no medicine is
so efficient as Opium in favoring a return to a healthy state
of function. It must be given in such quantities as to produce
and maintain a decided impression, and must consequently be
increased with its continued use. After the brain has been restored to a perfectly healthful state of action, the Opium should
be gradually diminished, and'the patient should not be con



MENTAL DERANGEMENT.                 315
sidered well until the medicine can be entirely dispensed with.
WOOD has known patients in the most violent state of maniacal excitement, after being put asleep by Opium, to awake in
the morning quite composed and rational. In some cases Opium
will aggravate the cerebral disorder; when this passes off the
patient will be found in a better state than before the aggravation; new quantities will be followed by fresh exacerbation, and
these in their turn by still more decided improvement. It is an
unpleasant way of treating the patient, but a cure will follow
quite as certainly, as if none but the most pleasant results
had followed. WILLIAMS says, physicians have been much divided in opinion respecting the propriety of exhibiting narcotics
when there is furious delirium, it having been frequently noticed
that even when sleep has followed very large doses, yet the patient has awoke with aggravated symptoms; and hence although
the sleep may for some hours have appeared tolerably easy and
natural, yet from the subsequently increased frenzy on waking, it
has been thought unadvisable to continue the narcotic. Other
physicians would immediately repeat the dose and still larger ones
if required.  WILLIAMS thinks that the stimulating powers of
the Hydrochlorate of Morphia are so slight as to be scarcely
perceptible, the sedative effect being immediately induced.
1) Against an atrophied, or softened condition of the nervous
matter, FORBES WINSLOW thinks more can be done towards a
cure than is generally supposed. He has in several instances
seen brain disease exhibiting all the legitimate features of ramollissement, yield to the persevering use of Iron, Phosphor,
Zinc and Strychnia, combined with generous living.  In general paralysis from inflammatory softening of the brain, BoYD
gave the Liquor Hydrargyri bichloridi, to eight males; two
improved, and one who had been confined to his bed for several
weeks and in a very helpless state, became able to sit up in a
chair and feed himself. Another who was of very dirty habits,
became cleanly, and gained in weight 21 lbs. in six months; two
cases gradually became worse, and four remained stationary.
See also my Treatise on Apoplexy and Softening of the Brain,
p. p. 149 to 155.
2) In some chronic forms of insanity, in dementia and persistent monomania connected, as it was supposed with morbid




316              NATURE AND CAUSES OF
thickening of the dura-mater, and with interstitial infiltration
of that membrane, as well as exudations on its surface, FORBES
WINSLOW has' seen marked benefit from the persevering use of
a strong ointment of Iodide of potassium combined with Strichnine rubbed over the scalp.
In other cases apparently quite beyond the reach of improvement or cure, where the mental symptoms were supposed to be
associated with effusions of serum in or about the brain, he has
applied Iodine externally, and given small doses of Iod., Merc.,
and Digitalis internally, with considerable benefit.
FOOD, TONICS AND STIMULANTS.
It has been unquestionably proved, by long and well tried
experience that a good and liberal scale of diet is necessary for
the insane. A scale of diet above that which the person would
take if well and surrounded by the comforts of home, is certainly
required by those confined in an asylum.  We will find that
when the diet is deficient that the mortality is invariably
higher and the amount of cures less. All authorities agree
upon this point, in chronic insanity.
3) Cases sometimes present themselves where the patient
determinately refuses to take either food or medicine. The refusal of food may be connected with the determination to destroy
life, or it may be associated with delusive impressions. Upon
examination we often find, in these cases, great gastric derangement, obstinate constipation, considerable tenderness of the
pit of the stomach, bilious disorder, foul tongue and offensive
breath, with other symptoms of a morbid condition of the digestive
organs.  In some of these cases the determination to refuse
nourishment arises from a positive loathing of food; or from a
delusion of taste, everything appearing to the patient, bitter,
disgusting or poisonous; or the unhappy patient imagines that
he is commanded either by good or evil spirits not to eat.
Such cases can be speedily cured by removing the visceral
derangement, if there be any, or by specific remedies, if the digestive organs be sound.-FORBES WINSLOW.




MENTAL DERANGEMENT.                  317
MELANCHOLY.
The principal remedies against this form of mental derangement, are: 1st; Arsenicum, Aurum, Bellad., Calcarea, Causticum, Graphite, Ignatia, Lachesis, Natrum-mur., Pulsatilla,
Rhus-tox., Sulphur and Veratrum.  2d; Cocculus, Hellebore,
Hyosciamus, Lycopod., Mercur., Nux, Phosphor., Platina, Sepia and Stramonium.  3d; Aconite, Anacard., Carb.-anim.,
Crocus, Digit., Nitric and Phos.-acid., Ruta, and Staphysagria.
AURuM is indicated when the patient is sad and feeble, with
desire for solitude; when he fears to have lost the love and
consideration of others, with profound chagrin and weeping;
great desire for death, with religious pre-occupation, with tears
and prayers; great anxiety in the region of the heart, with
great weakness and exhaustion, so that one feels as if dying;
scrupulous inquietude; timidity; all attended with derangement of the liver.
CALCAREA. When there is dejection and sadness; restlessness, with commotion of the blood; great disposition to fear
and apprehension; fear of misfortuue or of losing one's reason;
despair about one's health; want of interest and will; disgust
for work.
NATRUM MAURIATICIUM. When there are frequent accessions
of melancholy, with abundance of sombre thoughts, and recalling of unpleasant events long since passed; want of self-confidence, with great inclination to weep; the least trifle, solitude
for a short time, the slightest look from others will produce
tears; even the thought of unpleasant occurrences brings on a
flood of tears. Inclination to remain absorbed in thoughts for
hours; frequent attacks of complete unhappiness and despair;
sudden paroxysms of anxiety as if one had committed a crime.
Graphite and Causticum are indicated under almost sinmilar circumstances.
VERATRUM. When the melancholic patient has nausea and
frequent chills; is taciturn or obstinate, or sits in a corner absorbed in thought. Verat., H1ellebore and Cocculus are particularly suitable in melancholy when attended with marked
derangement of the stomach, bowels or liver.
PHOSPHORUS, PLATINA and SEPIA are often useful in extreme cases of nervousness and melancholy in females, with




318             GENERAL TREATMENT OF
marked derangement of the urinary and sexual organs, suppression of the menses, &c.
HYPOCHONDRIA.
The principal remedies against this disorder are: Calcarea,
Sulphur, Conium, Ignatia, Petroleum, Staphysagria, Gratiola,
Sabadilla and Zincum.
SABADILLA is the principal remedy, when the patient has
illusions about the state of his internal organs, that his stomach
is ulcerated, abdomen disorganised, scrotum swollen, &c., &c.
ZINC is regarded by RADEMACHER, as one of the most powerful and specific brain-remedies. He says that it may be
styled a Metallic Opium.  It will allay the most violent neuralgic pains, headache, toothache, earache, ischias, &c: It is useful against obstinate sleeplessness, and will cause sleep in deranged and delirious persons; but its use must be continued
after sleep has been produced, and the patient must be waked
up regularly to take his medicine, or else he will finally awake
just as much deranged and delirious as ever.
Singularly, he also states that Zinc may be used in the soporose states, which so frequently attend brain-affections, and
which are closely allied to delirium, or at least are frequently
followed by it. Under its use the patient will finally awake
himself, still one will notice when the patient is aroused hourly
to take his medicine, that his mental powers are gradually returning to a natural state, and finally he will awake spontaneously; still the remedy must be used some little time afterwards.
RELIGIOUS MELANCHOLY.
The principal remedies are: Bellad., Hyosc., Opium, Platina
and Sulphur.
MISANTHROPY.
The most useful remedies are: Muriate of Ammonia, Aurum,
Cicuta, Ledum, Manganese, Nitric-acid, Stannum and Sulphur.
MURIATE OF AMMONIA is useful against m#lancholy, connected with marked disorder of some or many of the mucous
membranes, derangement or enlargement of the liver, enlarge



MENTAL DERANGEMENT.                 319
ment of the womb and ovaries; also when the patient has a
well-marked mucous fever, the tongue being coated with tough,
white mucus, with great inclination to perspiration, so that the
sweat breaks out from the slightest exertion, the urine being
strong and ammoniacal, and some diarrhoea is present, with
discharge of tough, glassy mucus from the bowels; in some
cases, the attending fever has a seven-day type.
CICUTA, Aethusa and Bovista are supposed to be useful
against melancholy and other cerebral affections, arising from
suppression of eruptions; also against spinal irritation from
the same cause.
LEDUM is useful against brain-affections, attended with violent headache, restlessness, oppression of respiration, cough,
sleeplessness, pains in the limbs, increased flow of urine, itching, eruptions or pustules upon the skin, contractions of the
limbs, gouty and rheumatic pains, &c.
STANNUM is homoeopathic to extreme nervousness, such as
is sometimes seen in persons who have become exhausted by
loss of blood, excesses, or a long-lasting sickness, attended with
considerable loss of flesh; misanthropy and invincible repugnance to conversation.
SUICIDAL  MONOMANIA.
The principal remedies are: Arsenicum, Aurum, Belladonna,
Drosera, Hyosciamus, Antim.-crud., Alumina, Spigelia and
Staphysagria.
Belladonna and Morphine have been recommended by Forbes
Winslow. (See p. xv.)
NOSTALGIA.
The principal remedies are: Capsicum, Mercurius, and Phosphoric-acid.
MANIA.
The principal remedies are supposed to be, 1st, Bellad., Canthar., Hyosc., Stramon., and Veratrum.
2d, Agaricus, Arsen., Cannabis., Crocus., Cuprum., Kali.,
Lycopod., Lach., Merc., Phosph., and Secale.
I.




320             GENERAL TREATMENT OF
3d, Aconite, Anacard,, Camph., Conium, Moschus, Natrum,
Nitric.-acid., Nux-v., Plat., Plumbum, and Tart.-emet.
The first set of these remedies is most useful in Acute Mliania.  In this disorder the following symptoms generally appear
immediately before the full development of the disease. Every
natural thought and feeling is exaggerated.  At first this is
scarcely noticeable; but, after a short time, the exaltation becomes more and more manifest; soon we observe former objects
of quiet and unobtrusive affection are treated with the most
persuasive and endearing fondness, and at the same time, those
that may have once incurred the displeasure of the patient, are
spoken of with a bitterness and angry vindictiveness totally inconsistent with the previous character of the individual.  The
patient is evidently becoming more and more a creature of impulse, and cannot fix his attention upon the ordinary employments of the day, but is wandering with strides increasing in
rapidity from one thing to another.  As the excitement increases, the wildness and often redness of the eye, begin to
attract attention, and finally actual raving ensues.-PEIRKINS.
The same author says: "If a strong, plethoric and physically
healthy man becomes the subject of acute mania, if the head is
hot, eyes injected, face flushed, pulse full and strong, and at the
same time, if the patient is violent and noisy, the physician
would naturally be tempted to a trial of general blood-letting.
Let him on no account yield to his inclination, for there is hardly any form of insanity in which blood-letting is admissible.
In every case in which it has been employed within the writer's
knowledge, it has proved highly injurious."
Most of the other remedies are suitable in Chronic Mliania.
Anmemia is a common accompaniment of this disease, and a
state of the system decidedly below par, is too often met with.
In these cases, the only efficient allopathic remedies are tonics
and sedatives. Conium and Iron are used with great success,
Morphine may be used with marked good results.
ANTAGONISTIC STATES OF THE MIND.
Anacardium  may be used when the patient seems to have
two opposite wills, one of which excites him to do that which the
other would like to prevent. Is inclined to laugh when he




MENTAL DERANGEMENT.                  321
ought to be seriouo, and does not incline to laugh, even when
tempted by ludicrous things.
SEPIA when he imagines things, which he does not want to
imagine; uses wrong expressions, which he knows are wrong;
proposes to himself things which are contrary to his intentions;
is in contradiction'with himself, and altogether in a disagreeable mood; has paroxysms of laughter and weeping in alternation, without either resulting from a corresponding frame of
mind.
Phosphorus when the patient laughs against his own inclination, being very sad.
Capsicumn and Staphysagria when he is merry, but nevertheless inclines to get angry and be quarrelsome.
ANTIPATHIES.
Conium may be given when the patient is inclined to dislike
every one who passes him, would like to lay hold of them, and
abuse them.
Cicuta when he abhors all mankind, hates their follies, and
seeks solitude.
Aurum when many persons are offensive to him.
Ammon.-mur. when there are involuntary antipathies to certain persons.
Calcarea when there is an aversion to most men.
APATHY.
Antimonium-crud. may be given when the patient is completely apathetic, does not leave her bed, does not speak, desires
neither to eat or drink, but eats readily what is offered and feels
hungry.
Argentum-nitricum, when there is apathy with great debility and tremulous weakness.
GAY MANIA.
The principal remedies are: 1st, Aurum, Bellad., Crocus.,
Lycopod., Platina, Opium, Stramon., and Verat.
2d, Aconite, Anacard., Cuprum, Hyosc., Lachesis, Natrumm., Nux-mosch., Phos., and Phosphoric-acid.
Belladonna is suitable when there is a merry craziness, with
laughing and singing; when the patient tries to compose songs,




322              GENERAL TREATMENT OF
and sings merry, but utterly senseless tunes, or whistles occasionally, but refuses either to eat or drink; or sings or hums
different airs, or smiles a long while to himself, or is disposed
to sing or whistle, with frequent bursts of laughter, or is wild
and wantonly merry, with inclination to quarrel without cause;
or when the patients tear off their clothes, run out into the
street, partially or wholly naked, gesticulating in a strange manner, dancing, laughing, uttering and demanding foolish things.
Cicuta-virosa, when the patient becomes heated while asleep,
wakes up, jumps out of bed, dances, laughs, does all sorts of
foolish things, claps her hands, &c.
Cuprum when he sings merry songs.
Hyosciamnus when the patient dances, laughs in an absurd
manner, makes ridiculous gesticulations like a clown, or performs funny tricks like a monkey.
Opium, when the patient's mirth and bliss increase until
he becomes irrational.
Stramonium, when one seems as if in an ecstacy, and beside
himself; when he seems filled with pleasant fancies, expresses
his wishes by signs, and runs about for some days, exceedingly
busy with his phantasies, and quite cheerful; or when he dances,
gesticulates, laughs and sings; or has paroxysms of constant
talking, or breaks out into loud laughter, or violent rage.
MANIA WITH FURY.
Cuprum is indicated against mania attended with full, quick
pulse, red and inflamed eyes, wild looks, incoherent speech, and
rage, every paroxysm terminating in perspiration.
Opium, against furious mania with distortion of the features,
swelling of the head and face, protruded and congested eyes,
bluish redness and swelling of the lips, paroxysms of rage, with
rolling on the floor, and threats against his own relatives, whom
he does not seem to recognize.
Hyosciamus, when the patient is alternately ludicrous, solemn, or furious; dresses himself in a priest's gown over his
shirt, puts on fur boots, wants to go to church in this guise, in
order to preach, or officiate at mass, and furiously attacks all
those who attempt to prevent him.




MENTAL DERANGEMENT.                  323
RELIGIOUS MANIA.
Lachesis, when the patient supposes himself doomed to eternal punishment.
Stramonium, when the patient kneels down, stretches out
his hands, with pious looks, but starts up from the least opposition, with wild cries and violent gestures.
Aurum, when the patient imagines that she is irretrievably
lost, with depression of spirits, followed by shouts and screams.
Baryta, when he has all sorts of sad notions about his future
destiny, and deems himself utterly lost.
Crocus is also suitable against religious melancholy.
SUICIDAL  MANIA.
Arsenicum, when there is great indifference to life, with inclination towards suicide.
Auirum.  Excessive desire for death, with melancholy; notion that he was not intended for this world, with anxiety
amounting to a desire to commit suicide, attended with derangement and cramps in the stomach and bowels.
Belladonna. Distaste for life, with desire for death, wishes
some one to kill him, attempts to jump out of the window;
anxiety and desire for death, alternating with paroxysms of
fury.
Carbo-vegetabilis. Despair with weeping, every thing seems
clothed in the darkest colors, inclination to suicide, with irrascibility, desire for death, because he thinks that he is most unfortunate.
lux-vomica. Inclination to commit suicide, with palpitation
of the heart, and great anxiety; desire for death, because his
great agony of mind allows him no repose; inclination to commit suicide, because his present pains and misfortunes seem
insupportable to him.
Sepia. Discouragement with absolute despair, attended with
moroseness; distaste for life in an extreme degree, because he
thinks that he cannot endure his pitiable condition, and that he
will be irretrievably lost in this world if he continues to live.
Alumina. Whenever he sees blood or a knife, he is seized
with a crowd of terrible ideas, attended with an inclination to
kill himself, although he has a horror of suicide.




324              GENERAL TREATMENT OF
China, is indicated when there is a distaste for life, with
melancholy, anxiety and feverish heat which drives him to his
bed, attended with inclination to suicide, although he dreads to
carry it into execution.
Mercurius, when there is disgust for life, from  want of
courage to meet its trials and mortifications; or desire for
death, from an insupportable indifference for every person and
thing, even those which are most loved.
Nitric-acid, when there is disgust for life, with discontent;
desire for death, although one is afraid to die.
Phosphorus, when there is disgust for life, because the whole
world seems gloomy and terrible; tears alone bring relief, and
they are followed by the most extreme apathy.
Platina, when there is a distaste for life, as if one was not
suited to the world as it is, attended with great agony about the
heart, fear of dying, and depression of spirits; disgust for the
whole world, with inclination to weep.. Staphysagria.  Desire for death, from an insupportable hypochondriacal indifference to everything; disgust for life, from
anxiety and disquieting thoughts.
Sulphur.  Disgust for life, from  discouragement and sadness, and from the feeling of being exceedingly unhappy.
Of 74 cases of mental alienation treated homoeopathically, -by
Dr. WITTFELD, in his private Asylum at Meurs, near Hamburg, 9 were hopelessly incurable, and had been dismissed as
such from other institutions; they were only admitted to be
taken care of; 2 were dismissed within the first fortnight, on
account of irregularities on the part of the patient's friends; 4
were laboring under incurable organic diseases, such as'softening of the brain and tabes dorsalis; they died respectively in
3, 8, 10 and 21 days, so that no opportunity occurred of healing
their mental affections. Deducting these 15 cases, there were
59 cases submitted to homoeopathic treatment; of these 29
were dismissed cured; 19 more or less improved, and 11 uncured and unimproved.
Of the 29 cured, only 1 had a relapse after 2 years; the remaining 28 continued perfectly well.
Of these 29, 4 were cured within 4 months; 6 within 6
months; 10 within 12 months, and 9 within 2 years.




MENTAL DERANGEMENT.                  325
The average length of treatment for all was 14-1- months;
for those cured within 12 months, the average length of treatment was 61L months; for those cured within 2 years, 23i
months.
It thus appears that nearly one half of all the cases were
cured, and not -L of the whole number were dismissed without
improvement. Dr. WITTFELD Says such success, cannot be
shown by any other Asylum; but it will be seen by reference
to pages viii, ix and x, that the dominant school seems to cure
quite as many, if not more, although relapses seem to be much
more frequent under allopathic than homceopathic treatment.
Among the 29 cured homoeopathically, 13 were affected with
furious mania; 9 with imbecility or melancholy; and 7 with
hallucinations or monomania.
The disease upon admission had lasted, in one case which
was cured, above 9 years; in 2, above 4 years; in 5 above 2
years; in 8 above 1 year; in 10 above 6 months; and in 3
above 4 months.
The medicines chiefly used by Dr. WITTFELD were Bellad.,
Cicuta, Digitalis, Phosphor. and Stramonium, for Furious maniaa; Arnica, Ambra, Selenium and Sepia, for Imbecility; Ignatia and Hyosc., for the consequences of Grief and Unfortunate Love; Secale, Nux-vom., Arsenicum, Staphysagria and
Conium in many different kinds of derangement.  Teucrium
and Viola-odorata, were also frequently used; Hellebore and
Veratrunm very seldom.








NERVOUS DISEASES
AN D
MENTAL DERANGEMENT.
CHAPTER I.
CASES IN WHICH A SINGLE REMEDY PROVED DECIDEDLY USEFULARRANGED ALPHABETICALLY ACCORDING TO THE REMEDIES.
1. ACONITE.
GENERAL REMARKS.-Aconite is particularly indicated where
there is excessive irritability either in the bodily or mental
sphere, and this hyperoesthesia is a frequent attendant in certain
forms of mental derangement. It is also suitable in that form
of mania in which the vascular system is principally involved,
and which increases to phrenzy, evidently occasioned by a hypercomic and inflammatory state of the brain and its membranes, with
a decided tendency.to dropsical effusions. Febrile and acute mental affections may be relieved by Aconite.  In the action of
Aconite paroxysms of anxiety often predominate, and it has
been found useful in various forms of mental depression.;
Hygea, Vol. 23, part. 4, p. 259. —GRIESSELICH.
Besides the more well known effects of Aconite it is particularly apt to produce the most singular sensations of bodily deformity, similar to those which occur in a limb when it is asleep.
Sensations of thickness, swelling, or distortion or displacement
of the features, limbs, &c., &c. arise under its use, while the intellect is less comparatively unclouded, and seem so real that
the experimenter is obliged to examine himself in a glass or appeal to his friends for re-assurance of being in his sound and
undeformed state. Hence it may prove curative in some of
those forms of hypochondria and illusion in which the patient
imagines that various wonderful transformations have taken
place in some one or the other of his internal or external organs.
22




328  NERVOUS DISEASES AND MENTAL DERANGEMENT.
There is but little old school experience with Aconite in Insanity; J. M. Cox, in 1816, said that it had been extolled by
some, but it was too uncertain, and apt to constipate. Milligan,
in 1841, says that Pinel admits that bleeding is now rarely employed by him; he sees many patients cured without bleeding,
and many remain incurable after being bled. When there is
much excitement and increased action of the heart and arteries,
it will be found that Aconite in fractional doses will procure a
state of calmness more rapidly than detraction of blood. PETERS.
CASE 1. —A young woman, aged 20, fancied that she would
die during her second confinement, and in spite of a favorable
issue of her delivery, expected a speedy death, especially as she
had violent congestion of blood to, and excessive oppression of
the chest, to the point of suffocation, with intermission of the
pulse.
Acon. 30. removed all ideas of death in the course of two
hours and restored her equanimity.
Archiv, Vol. 7, part. 2, p. 42.-GRoss.
[The whole affair was probably hysterical.-PETERS.]
CASE 2. —A joyous young woman, set. 20, became depressed
during her first pregnancy, and believed firmly that she would
die in her confinement.
A profuse flooding followed the otherwise regular delivery of
the child and placenta, and the patient now expected a speedy
death. Her body was covered with a cold viscid sweat, she
took leave of her relatives, raved about her approaching dissolution, lay perfectly quiet, but her countenance expressed great
internal agony about the heart, while she occasionally cried that
nothing would help her, and that she must certainly die. Paroxysms of agony set in, she lost her consciousness, and convulsions of the arms occurred. After Acon. 24, she fell into a
slumber, and awaked with renewed cheerfulness.
Archiv, Vol. 9, part. 1, p. 114. - BETHMAN.  See also
Case 95.
[This second case seems very like the first.-PETERS.]
REVIEW. Anxiety and fear were present in all three cases,
especially of approaching death in cases 1 and 2 (see Materia
Med. Pur. Sympt. -537-40.), occurring in puerperal women with
congestive or even inflammatory conditions.




ACONITE.-ANACARDIUM.                 329
Doses, —~ and -0- with speedy relief.
Fear indicates an affection of the organ of Caution, and
Aconite may be supposed to act upon that part of the brain occupied by it.
2. ANACARDIUM.
GENERAL REMARKS.-a) It is indicated in mental affections,
with decided loss of memory, sluggish flow of thought, apathy
and anaesthesia, &c. In general, Anacardium promises much in
hypochondria and melancholy.
Hygea, Vol. 23, p. 265.-GRIESSELICH.
b) It causes a hypochondriacal and gloomy condition, loss of
courage, fear of approaching death, misantrophy; anxiety, want
of moral tone, a wicked, godless, inhuman and hard-hearted
state of mind.  Also a state in which one seems to have two
wills, one of which restrains one from do that to which the other
impels. Sensation as if the spirit were separated from the body.
HAHNEMANN, Chron. Diseases, Vol. 2, p. 156.
c) Anacardium is generally regarded as a spicy aromatic stimulant, which primarily exerts an exciting effect upon the brain,
inducing unusual excitement of the imagination, with great flow
of fresh ideas, which one must follow, the whole gradually passing over into entire absence of thought and utter stupidity. It
has also been said to cause great acuteness of the memory, with
vivid recollection of the slightest and long forgotten things;
great activity of mind, with inclination towards astute investigations, followed by aching pains in the forehead, temples, and
occiput, by a bruised feeling in the brain, and by stomach-ache.
It also causes weakness of digestion, flatulence, profound hypochondriacal humor and derangement of the liver, marked
aching pain in the hepatic region, light colored a-bilious stools,
&c.; hence it may be found as useful in some of the dyspeptic
and hypochondriacal disorders of literary men, as Nux has been
decreed to be.
Besides simple excitement of the intellect, imagination and
memory, Anacardium may cause a pleasant and joyous excitement, followed by laughing at serious things, and gravity about
laughable occurrences, &c.-STAPF asserts that it causes quite
opposite effects, viz, both increase of mental activity and torpor.




330   NERVOUS DISEASES AND MENTAL DERANGEMENT.
-FRANZ experienced very decided increase of memory and mental activity within one hour after taking it. —HIA NEMANN experienced both exaltation and depression, but does not tell us
which occurred first.-RUCKERT has dwelt almost entirely upon
the depressing effects of Anacardium. —PETERS.
CASE 3.-A man, aet. 30, tall thin, of a consumptive constitution, and suffering with chronic pectoral and abdominal affections, suppressed an itch-like eruption with lead water, after
which he fell into a state of mental derangement.
Syrmptoms. —He believed that he was composed of two persons, and that several men slept in his bed. When he drank
any thing he supposed that it did not get into his body and
nourish him, because his stomach was torn in two, or that some
one was concealed in his body, who swallowed every thing away
from him.
Ipec., Verat. and Bellad. helped him but little, while Anacard. 6 cured him quickly.
New Archiv, Vol. 3, part. 1, p. 23.-WAHLE.
CASE 4.-A  widow, aet. 64, after undeserved mortification
fell with a state of mental confusion, in which she talked constantly in stupid and irrational manner.  She was cured in
fourteen days by Anacard. w.
Allg. Hom. Zeit. Vol. 13, p. 23.-LOBETHAL.
CASE 5,-A maiden, met. 22, of a sensitive disposition, and
somewhat over-educated for her station, and disposed to religious enthusiasm, was taken sick suddenly after violent mental
emotion and separation from her lover. In the beginning she
was violent, and was treated allopathically from Jan. to April 21;
latterly a melancholic condition had been developed.  Hyosciamus was useless, while Anacardium. given on the 25th, restored
the patient so rapidly that she could be regarded as cured by
the 30th April.
Pract. Beitriige, Vol. 4, part. 1, p. 15.-SCHINDLER.
REVIEw.-From the above few observations, Anacardium
would seem most suitable, when the patient is melancholic and
shy, suspicious and troubled with illusions about his own body.
Doses. —6th, 24th, and 30th, the last in repeated doses.
According to Phrenology, Anacard. seems indicated against
mental delusions which lead to fixed ideas, hence,, in disorders of




ANACARDIUM.-ARSENICUM.                331
the organ of causality, also in want of proportion in the activity
of the organ of benevolence, compared with those of combativeness and destructiveness.
3. ARSENICUM.
GENERAL REMARKS. —a) Paroxysms of anxiety, which drive
one out of bed at night.-Fear of death. —HAHNEMANN.
Chronic Diseases, Vol. 5, p. 497.
b) Arsenic is especially indicated in periodical recurrences of
melancholy, when there are night-aggravations, paroxysms of
agony about the heart, with intermitting pulse and rapid failure
of the strength.
Hygea, Vol. 23, p. 9. —GRIESSELICH.
Although OTTO says that Arsenicum causes melancholy, this
does not deter Cox from asserting that when there is great debility and relaxation the continued use of Arsen. might contribute to recruit the system and restore reason; nor HALLORAN from saying, " where chronic insanity has decidedly assumed
the periodical type, and also notwithstanding the intervals, together with the paroxysms, has obtained the most desirable
balance, without terminating in health, recovery may be greatly
promoted by the cautious introduction of Arsenicum-he will
not undertake to say that such instances have been numerous
in his experience, for the proper cases to use this powerful remedy
are not of frequent occurrence." SEYMOUR also thinks it might
be beneficially employed in proper cases and hands. STEWARD
thinks that mental derangement coupled with simple cedema is
curable, and Arsenicum might also come in play here.
CASE 6.-A  robust man, mt. 32, had suffered for several
years with paroxysms of melancholy, which lasted from six to
eight days, and had withstood all ordinary remedies.
Symptoms.-By day he had attacks of anxiety as if he had
committed some great crime, which drove him from place to place
so that it was impossible for him to remain quietly in one spot
for a quarter of an hour. He could not control his tears and often
wept aloud; avoided his friends, because he fancied that he had
injured them in some way, and would gladly ask pardon of every
one, because he believed that he had offended them.
Two doses of Arsen. 30, cured him perfectly within four weeks.
Archiv, Vol. 8, part. 2, p. 51. —WEBER.




332   NERVOUS DISEASES AND MENTAL DERANGEMENT.
CASE T.-A blacksmith, met. 36, of powerful constitution,
after an attack of miliary fever and subsequent cold, fell into a
state of melancholy, with anxiety and inclination to suicide.
Syrnptoms.-Expression indicative of great internal disquiet.
He does not know where to go, from restlessness day and night;
thinks that he can never be fortunate or happy in his own house,
and pesters his family constantly with his fears. Paroxysms
of frightful anxiety, attended with heat and redness of the face,
and such inclination to commit suicide that he fears to remain
alone, and begs his friends not to leave him for fear that he would
injure himself.
Bellad. was given without avail, but Arsen. 24, removed the
whole mental derangement in a few days.
Annals, Vol. 1, p. 66.-RUCKERT.
CASE 8.-A woman, a-t. 65, had suffered for a year with
periodical attacks of melancholy.
Syrnptoms.-Anxiety, burning in the stomach, and retraction
of the abdomen. Paroxysms of anxiety drive her out of bed at
night, and she roams about groaning; in the evening she has
anxiety in the pit of the stomach, with palpitation and flushes of
heat, and oppression in the epigastrium. Confusion and tension in the head, bloated face, which is also red and hot, pulse 80,
and rather weak than strong. Twisting, gnawing and biting in
the stomach, with waterbrash-urgency to urinate, with scanty
discharge.
Ars. 30, cured her perfectly in eight days, after an aggravation
lasting two days.
Practical Beitrag, Vol. 2, p. 145.-NEUMANN.
REVIEW.-In all three of the above cases we find an unusually great internal anxiety, although coupled with very differing physical ailments; also fear of being alone both by day and
night, which urges the patient to suicide, although his intellect
is otherwise clear; and finally a state similating remorse and
the sufferings from a bad conscience, leading one to ask forgiveness.
Dose.-24 and 30, with speedy good effects.
The symptoms undoubtedly point to affection of the organs of
conscientiousness and caution.




AURUM.                      333
4. AURUM.
GENERAL REMARKS.-a) HAHNEMANN Says he has quickly
and permanently cured several persons who seriously meditated
suicide, of that melancholy in which Gold is indicated.
Chronic Diseases, Vol. 2, p. 18.
b) Not only Aurum, but Nux-vom. will remove the peculiar
mental depression, with disgust for life, which leads to suicide.
Hygea, Vol. 2, p. 33. —EGIDI.
c) Both Gold and Arsen. produce sensations of anxiety proceeding from the region of the heart; this symptom, which both
have in common, is of importance when we view in connection
with the heart-affections which occur in many cases of mental
disease. But Aurum is not suitable in the regular and typical
occurrence of the symptoms against which Arsen. is so useful;
but is indicated where there is decided congestion to the head,
certain quite peculiar genital symptoms, &c.
NOACK and TRINKS with much reason call attention to the
state of the genitals common in suicidal monomaniacs, with relation to the action of Gold upon the same organs.
Hygea, Vol. 24, p. 10. —GRIESSELICH.
VOGT tells us that in olden times Aurum was used for its
heart-strengthening, vivifying and gladdening powers, RIECKE,
DUNGLISON and DIERBACH state that the remarkably joyous
disposition and loquacity noticed after its use deserve particular
mention. NEIL and PERCY found it to cause general excitement of the nervous system, talkativiness, &c.; and tell us that
it was used by the ancients in hypochondria; melancholy and
idiocy.
As it also has a specific relation to the syphilitic dyscrasia,
while the melancholy occurring after syphilitic gonorrhcea is an
extremely disquieting affection, which often leads to suicide, and
which is scarcely ever cured by ordinary means, it deserves attention; also in the syphilitic monomania so admirably described
by ACTON.
Large doses of Aurum are apt to cause obstinate sleeplessness and fatiguing erections; WENDT says, when given in the
different forms of dropsy in aged men, it rarely failed to arouse
the long-slumbering sexual power. RISNENO also alludes to its




334   NERVOUS DISEASES AND MENTAL DERANGEMENT.
vis aphrodisiaca, &c. —Hence it may prove homoeopathic and
curative in melancholy and mental derangement arising from
excess, or abuse of sexual power.-PETERS.
CASE 9.-Aurum  cured a case of religious melancholy,
brought on by stings of conscience, in consequence of misconduct.
Symptoms. — Great anxiety about the heart, fearfulness,
weeping, praying, anxious frightful dreams, weakness, emaciation, night sweats, painful menstruation, &c.
Archiv, Vol. 12, part. 3, p. 131.-SEIDEL.
Compare case 107, in which a teacher who naturally had
great self-esteem, attempted to strangle himself with a cord
after mortification.
REVIEW. —It requires more numerous observations to determine the cases in which Aurumn is suitable and what organs of
the brain it acts upon, before we can decide positively what kind
of disgust of life, with inclination to suicide, it will most readily
heal.
5. BARYTA.
GENERAL REMARKS.-The salts of Baryta undoubtedly have
the power of depressing the mental powers in such wise as to
diminish the understanding. Muriate of Barytes is well known
to cause, in scrofulous children, a state which borders closely on
idiotcy. This fact should urge us to follow this clue farther,
as that form of idiotcy which follows mental derangement is
looked upon as incurable, because it is supposed to depend
upon profound organic disease, but Baryta, besides its specific
relation to idiotcy, also exerts an undoubted influence upon the
organic mass.  C. H. NEUMANN  has found the Muriate of
Baryta of the greatest efficacy in that form of mania in which
the sexual inclination is much increased; while Baryta-carb.
produces analogous effects, viz, increased sexual power, more
copious secretion of semen, frequent pollutions, and in females
causes premature occurrence of menses, and congestive affections of the sexual organs, and of the sacral region.




BARYTA-BELLADONNA.                   335
6. BELLADONNA.
a) HARTMANN says Bellad. is useful in some forms of melancholy, viz.. in such as have arisen from disorder of the abdominal organs, and in which spasmodic affections of the throat
and the bladder, and gastric derangements occur. He also advises it in melancholy from disappointed love, in which there is
excitement of the genital system-also in home-sickness, and
loss of memory, and in melancholy during pregnancy, and after
confinement.
Still it is more frequently useful in folly and mania.
Archiv, Vol. 2, part. 2, p. 84.
b) Christison says that the Bellad.-delirium is generally of
the extravagant, or of the pleasing kind, sometimes attended
with immoderate and incontrollable laughter, or at others with
incessant loquacity, and hence would seem to exert a specific action upon the organs of Language and Mirthfulness.  Gray,
the botanist, when poisoned with eight or ten grains of Bellad.,
experienced a delirium of a strange but not unpleasant character, he wished to be in constant motion, and states that it certainly afforded him an infinite degree of satisfaction to be allowed
to walk up and down. The operations of the intellect were very
vivid, his thoughts came and went rapidly, and ludicrous and
fantastic spectacles were always uppermost in his mind; he was
conscious that his language and gestures were extravagant, yet
he had neither the will or inclination to control them, as he was
in a state of delightful exhilaration. Dr. Barton witnessed a
case in which the patient in a quarter of an hour became delirious
and insensible, and struggled violently in his unconscious state,
so that the combined strength of several men was required to
hold him; the stage of delirium was brief, and he soon fell into
coma, which was again succeeded in eight or ten hours by violent
delirium, the patient being very unmanageable-the mental delusions were for the most part of an agreeable kind, and the
prevailing fancy was that he had suddenly become rich and possessed of a splendid mansion. Brit. Jour. Hom. Vol. 6, p. 430.
In another case a lady fell into a delirious state, attempted to
bite and strike her attendants, broke into fits of laughter, and
gnashed her teeth; her head was hot, face red, looks wild and
fierce, tongue dry, abdomen swollen, and pulse small and fre



336  NERVOUS DISEASES AND MENTAL DERANGEMENT.
quent. Ibid, p. 430. In still another case a boy could not
speak at first, but laughed immoderately, and kept grasping at
imaginary objects; soon, although laughing continued, his silence
was changed into immoderate and incoherent loquacity, with constant bodily motion, &c. Med. Chir. Rev. Vol. 7, p. 233. Leuret, of the Bicetre, noticed in several cases a degree of restlessness and excitement, approaching at times to inordinate gaiety,
at others to furious delirium, frequent hallucinations, convulsive
crying or laughing, &c.
In another case, a woman met. 36, took twelve grains of Ext.
Bellad. by mistake in the course of six hours; she had illusions
of vision, saw everything confused, as if through a fog or
smoke, even imagined that she saw things which were not present; a stupid laughter, with merry delirium, soon followed, and
were attended with contortions of the extremities, great general
debility and coldness.
The old school experience in the use of Bellad. is extensive,
varied, but not very precise, Mayr in 1817, used it until the fauces became dry and the pupils dilated. Guislain in his Prize
Essay on Mental alienation, 1826, says that Murray obtained
good effects from it in five grain doses; Muller, of Wurtzburg,
saw satisfactory results from it in doses as large as thirty-six
grains of powdered root per day, pushed until blindness and
vertigo occurred; in this way, among other cases, he cured a woman, aet. 40, affected for a year with furious mania. 1MUnch regarded it as an excellent remedy in melancholy and mania;
Frank recommended it in mental alienation with fantastic visions
and when accompanied with epilepsy. Seymour thought Bellad.
well worthy of tria' in mania, especially in that from moral causes and attended with pain and' increased sensibility of brain.
Millingen found Bellad. more useful than Hyos. or Conium, especially when applied externally by the endermic method, to the
epigastric region; very often effectual in reducing excitement.PETERS.
CASE 10.-A strong, blooming primipara, set. 20, fell suddenly on the fifth day after delivery into a state of mania, and was
treated antiphlogistically for nine days without benefit.
Symptoms.-She talked constantly of every kind of confused
and laughable stuff; was much excited, passionate and abusive,




BELLADONNA.                     337
sought to destroy everything she could reach, screamed, scolded,
spit, struck, laughed and cried. Her husband she damned into
the deepest depths of hell, for imagined infidelity to her, &c.
Treatment. —On the fourteenth day after delivery she took
Bellad. 3, ten drops in water, a tablespoonful per dose; in two
days she was more quiet; on the third day she asked for her
child, &c. Bellad. s was continued, two doses per day, and in
three weeks she was cured.
Hygea, Vol. 20, p. 223. MAYRHOFER.
CASE 11.-A girl -et. 12, otherwise healthy, was left debilitated after an attack of influenza, then was taken with paralysis
of the feet, and finally fell into a state of mania.
Symptoms.-Towards evening she suddenly lost her recollection of every one, screams out aloud, laughs, weeps, talks unconnectedly, at times in a frighted state, at others in despair about
death, and the arrangements therefor, believes that she sees
strange persons about her who abuse her, and from whom she
attempts to escape. She also has twitchings of the face and of
all the limbs, wrings her hands and tosses them wildly into the
air. In the morning she does not recollect anything that has
transpired during the night-she has boring pain in the head
and vertigo, so that she cannot raise herself up in bed.
Treatment. —Bellad. 3-, two doses cured her.
Allg. Hom. Zeit. Vol. 13, p. 300. Bicking.
CASE 12.-A strong, powerfully built brunette, and blooming girl of 16 years, exhibited in consequence of a long-continued
sedentary mode of life, excessive indulgence in reading, and bad
mental training, at each access of menstruation traces of wildness and folly, which gradually increased to perfect mania, which
recurred repeatedly, in spite of allopathic treatment.
Symptoms. —-Babbling, laughing, weeping, scolding, at times
she attempted to creep away and hide, at others she fell into
paroxysms of rage and spit at those about her, and tore off her
clothes. Pulse generally slow, but quickened during the paroxysms; abdomen hard and tense; involuntary urination.
Treatment. —Bellad. 2, one drop every forty-eight hours, cured
her entirely and permanently in twenty-four days.
Hygea, Vol. 21, p. 139. —KESSELBACII.




338   NERVOUS DISEASES AND MENTAL DERANGEMENT.
CASE 13. —A farmer's lad, aet. 17, had been deranged for
four weeks.
Symptons. —Had not slept for five days and nights; spent
the night in sitting up, alternately crying and laughing; romanced about soldiers and war, imagined that he was pursued
by soldiers, or bulls, and crept away in fear that he should
be found. Attempts various foolish things, and goes through
the pantomine of shooting; scolds at and strikes his brothers and
sisters; frequently walks bent and limping; crowds his hat
down over his eyes, eats but little, and does not work at all.
His pupils were very much dilated, and his countenance disturbed, yellow and bloated.
Treatmelnt. —Bellad. 3-, three doses at intervals of eight days
cured him.
Archiv, Vol. 12, part. 3, p. 79.-ATTOMYR.
CASE 14. —A sickly woman, met. 37, had been deranged for
six weeks.
Syiymptoms.-Great restlessness and anxiety, so that she could
not remain in one place, in constant bodily motion, so that she
cannot remain in bed; talks incessantly of silly stuff, at times
jovial, at others gloomy, or shameless, her eyes being in constant motion. At times she smiles to herself, then bursts out
into uncontrolled laughter, or sings religious songs, then scolds,
or strikes her hands against the wails or windows, or attempts
to jump out of the window, spits all about herself and tears
her clothes. Coughs up mucus, and has frequent attacks of
choking.
Treatment. —Bellad., —, six doses, two or three per day, cured
her with the exception of an increased loquacity of an indecent
character, which was removed in a few days by Stramon. -.
Allg. Hom. Zeit. Vol. 8, p. 121 —ELW ERT.
CASE 15.-A man, set. 28, of powerful build and choleric
temper, became deranged without known cause.
Symptoms. —He scolds, riots and attempts to kill his wife,
has a frightful, insolent and somewhat anxious look, his eyes
glisten and are reddened; his answers are rough, insolent, very
abrupt and often threatening. He has cedema of the abdomen
and thighs, with scattered red spots.
Treatment. —Bellad. -  one drop cured him of his mania in




BELLADONNA.                     339
the course of fourteen days, when Bryon. and China were required to free him from his dropsy.
Archiv, Vol. 19, part. 1, p. 93.-S. ZLARTORAVICH.
CASE 16.-A lad, aet. 12, of delicate and irritable constitution was left with headache and anxious restlessness after an
attack of typhoid fever.
Symptoms.-Pressing, stupefying pain in the forehead, especially after mental exertion or emotion; evening restlessness,
and anxiety, with unsteady gait. Dreamy sleep, with sudden
jerks through the whole body, which causes him to rise up,
make anxious motions, cry, scream out complainingly, and attempt to escape. On the following morning he recollects nothing
that has transpired.
Treatment. —Bellad. - in repeated but not frequent doses
restored him.
Allg. Hornm. Ztg. Vol. 13, p. 299.-BICKING.
CASE 17.-A widow, aet. 50, became deranged and was allopathically treated unsuccessfully for a long time.
Symptoms.-She destroys every thing in her reach, riots,
raves and spits. With fixed wild looks and dishevelled hair, she
utters frightful curses.  Her mouth is always covered with
froth; she avoids drinking, and when she attempts it she seems
to swallow with difficulty.
Treatment.-Pulv. I-Ierb. Bella fixed grains, divided into 8
doses, one dose night and morning Hored her perfectly.
Annals, Vol. 4, p. 329.-ScHu ing av
Itv.
CASE 18.-A widow, Pet. 30, brunette, of a melancholic
disposition and high tempered, had been deranged for six years,
and was on the point of being placed in an asylum.
Symptoms.-Fearful mistrust of every one, great anxiety
day and night, no rest in any place and attempts to escape;
her only pleasure is to stare at the sun by day, and the fire
at night. She finally escaped into the woods, built herself a
large fire and remained there four or five days without food.
Always sought to be alone, and fled from all company; whenever she was' alone she played ludicrous tricks, and twisted
her mouth in all directions-money she threw out of the window;
was never disposed-to converse, and scarcely returned an answer,




340   NERVOUS DISEASES AND MENTAL DERANGEMENT.
unless asked two or three times, and then with great vexation
and screaming.
Treatment.-Bellad. -v, two doses, given in the course of
fourteen days restored her completely.
Annals, Vol. 4, p. 340.
CASE 19 —A man, aet. 29, became deranged after great disappointment, and from grief at the death of his sister.
Symptoms. —He calls out constantly the name of his deceased sister, and beats his breast and body with his fist in despair; he strikes at all who approach him, thrusts everything
away from him with hands and feet; laments, groans, froths at
the mouth; grasps at his throat, and tears off his cravat, as if in
danger of suffocation.
Treatment. —One dose of Bellad. -,-, soon restored him to
quiet and reason.
Annals, Vol. 4, p. 193.-L. in L.
CASE 20. —An old man had suffered for several years in
succession.
Symptoms. —lHe  sees in rapid succession strange figures,
houses which are being built before his windows, peacocks which
seem to walk about in his garden, &c.; he attempts to observe
his visions more accurately with a spy-glass. Anxiety drives
him unclothed out of his bed; pulse quick and full; urine
scanty and very red.
Treatment. —Bellad. 3, two doses cured him speedily.
Practical Communications, Vol. 4, part. 4, p. 223. —THoRER.
CASE 21.-A puerperal woman, oet. 25, still nursing her
child, was obliged to keep her bed in consequence of intestinal
irritation, when she suddenly commenced to talk all kinds of unconnected stuff, with incredible fluency and entire sleeplessness.
This was followed by a period of perfect silence, after which she
again commenced to sing snatches of disconnected songs, and to
grasp at neighboring things.
Treatment-Bellad. — 4 in water, a table-spoonful every three
hours caused the most speedy relief.
Allg. Hom. Zeit. Vol. 37, p. 56.-SOLLIER.
CASE 22.-A man, zet. 34, and another, set. 55, became deranged from grief and vexation.
Symptoms.-Would not believe that he was sick, would




BELLADONNA.                    341
attend to his business, spoke of much work to be done, complained of men who had injured him; imagined that his wife
floated around him, and that he heard her voice proceeding
from every object; thought that he was praying with her, and
that he must soon die; sleeplessness in consequence of the
above illusions. He had a burning miliary eruption upon the
chest; felt great lassitude on going up-stairs, his legs felt as
heavy as lead; his head was heavy and felt as if it would fall
off; darkness before his eyes and vertigo when walking, as if he
were drunk. Frequent flushes of heat over the body, with
trembling; pulse full, quick and hard; pain in the chest from
deep inspiration and cough; noises in the ears, with hardness
of hearing; piercing pain in the temples; sensation of icy-coldness upon the temples.
Treatment.- One dose of Bellad. cured him.
Jahrb. f. Hom. Hospital, Vol. 1, p. 145, and Vol. 2, p. 120.
CASE 23.-A lad, met. 20, blond, pale, thin, and easily provoked, suddenly because maniacal on August 31.
Symptoms.-He attempts to destroy every thing near him, or
to throw them at his attendants; swallowed his food and drink
hastily; pays no attention to any person or question, but
screams, hums and runs about, tears his clothes and goes naked;
his pupils were contracted and his look wild and fixed. Skin
and pulse natural.
Tr-eatment.-Tartar emetic, in emetic doses, did not relieve
him. Sept. 2d he took Belladonna-juice, two drops in water;
on the 3d and 4th he took a like dose night and morning, and
on the 5th he was perfectly restored to his senses, and could be
dismissed cured in a few days more.
Allg. Hom. Zeit, Vol. 19, p. 18.-KNORRE.
CASE 24.-A woman, wet. 77, previously always healthy,
began to be deranged without known cause.
Symptoms. —At first she imagined there was a peculiar vapor in the room, thought that others must notice it also, and
wished it to be removed. She felt unhappy, fearful, anxious,
and thought she could not be saved. Is timid, easily frightened when any one entered her room, and hid herself.  Did
not know her own son who stood before her, insisted that he
was dead, and could not be convinced to the contrary; did not




342   NERVOUS DISEASES AND MENTAL DERANGEMENT.
know her physician, but regarded him as a judge who had
been present when she made her will, and hence would not see
him again, although she insisted that the right physician should
be brought to her. If her friends spoke about indifferent subjects which did not concern her, she would sometimes join in
the conversation rationally.  She was costive, and had congestion to the head, with flushing of the face.
Treatment.-From May 6, to June 6, she received various doses
of Verat., Pulsat., Nux-v., Hyosc. and Sulph., but without
visible good effect, except from the Sulph. the action of which
was waited for several days. On June 2d, she received Bellad. T,
and on the next day she was nearly restored, and recollected
every thing she had said during her illness.
Minutes of the L. Society.-Enge]hardt.
CASE 25.-A man, t: t;38, suddenly fell into a maniacal
state after vexation.
Symptoms.-Face bluish-red, eyes sparkling, pupils dilated;
he spat incessantly without excreting much spittle, and had
signs of sore throat on swallowing; his forehead was covered
with sweat, his limbs cold, his pulse quick and irritable; he
talked about the most frantic and disconnected'things, and
imagined that he saw frightful figures.
Treatment.-Bellad. 6, followed by increased excitement,
then by a more quiet state, and the frantic paroxysm occurred
only every three hours. On the following day he could be liberated, and his whole condition was changed.
Symptoms.-Face paler with but slight redness of cheeks;
he assumed a dignified manner, took great pains to speak correctly, broke off a bit of his whip and put it behind his ear for
a pen, moved his hands constantly, as in St. Vitus' Dance,
spilled his drink involuntarily, and talked constantly of quarrels
which had not happened.-Abdomen tense, bowels sluggish.
Treatment.-Stramonium 9, after which quiet and sleep at
night followed; a remaining sad, almost melancholic mood was
cured by Tinct. Hellebor.-RAU, p. 190.
CASE  26.- A boy, met. 13, became unexpectedly  very
thoughtful.
Symptoms.-When any one approaches him in the street he
is seized with an irresistible inclination to attack and stab him




BELLADONNA.                     343
with his'pocket-knife; as he approaches the person, he is seized
with great anxiety which hurries him away; then he runs home
and weeps over his conduct.
Treatment.-Bellad. 30, followed in eight days by Nux-vom.
30; cured him.
All. Hornm. Zeit. Vol. 6, p. 213.-FIELITZ.
Besides, Bellad. was also given in cases No' 3, 7, 39, 41, 42,
56, 61, 71, 72, 88, 91, 94, 99, 101, 106.
REvIEw.-In the above cases we notice the following circumstances, with regard to:
a) Age and sex.
In 34 cases, 18 were males, and 16 females. Of the 18
males, 11, and of the 16 females, 9 were benefitted or cured
by Bellad.
Of 28 cases, 14 were between 8 and 25 years old.
" "   "   17  "      "   28  " 77''    4"
b) Of the groups of symptoms upon which Bellad. acted decidedly curatively, we notice two principal groups, and two lesser
ones.
In the first principal form we notice a state of evident excitement, attended with rioting, scolding, swearing, a ttempt at destruction of things and persons. (See cases No. 10, 15, 23, 100,
106.)
In the second principal form, we find a state of dejection; the
patient exhibits an uneasiness which drives him about, and makes
him fearful of even imaginary objects; is suspicious, fearful, has
an inexpressible anxiety, especially about phantoms of the imagination, has fears of death, and is driven to make his escape. (See
cases No. 11, 13, 16, 18, 20 and 22.)
In several cases these two principal forms of mania occurred
in alternation. (See cases No. 12, 14, 19, 94.)
As a third and' lesser form, we find a silly, indecent behavior,
with foolish tricks, laughing, gossipping and imitating. This
occurs alone in case No. 100, and either mixed with one or both
of the principal forms in cases: No. 10, 13, 14, 18.
As a fourth and also lesser form, we find the predominance or
occurrence of fixed ideas; the patients busy themselves about
dead persons, (see cases No. 19, 22.)-or regard well-known persons as strangers (see No. 24).  Still this form never occurs
23




344   NERVOUS DISEASES AND MENTAL DERANGEMENT.
singly, but is always mixed with the first or second principal
form.
c) Among the cases in which Bellad. was used with little or
no good effect we notice in:
Case No 100, a restlessness and complaining from fear that he
would not be forgiven; in case No. 91, a restlessness which
drives the patient away, but without evident anxiety as its cause,
(see also cases 72 and 56). We notice anxiety with inclination
to suicide, but without urgency to run away in case 7. In
case 29 we find a state of excitement, but dependent upon increased self-esteem.  Farthermore, Bellad. was not useful in
case 71, marked by suspicion and anthrophophobia; nor in cases
39 and 41, attended with shameless and lecherous conduct; nor
in case No. 42 with visions of animals and convulsive cramps.
d) As regards the Doses of Bellad. and their repetition, we
find that in thirty cases,
the Herb. Bellad. two grs. in eight doses was used once.
"Tinct. Bellad. two drops in water"   "    "
Dilut. 2    one dose in 1 case.
ig   3      (''''  1  s
t"    4    repeated in 3 cases.
4"    4    one dose in 1 case.
"    6     " drop, repeated in 1 case.
"'  6      " dose in 1 case.
12        "   "    1  "
15    repeated doses in 2 cases.
" 21    one dose in 1 case.
"   24    in solution, in 1 case.
"   30    one dose in 1 case.
"   30    repeated doses in 5 cases.
"   60   in solution, in 1 case.
Hence we find that the cases in which one dose sufficed
are not as numerous as those cases in which repeated doses
were required, for only seven cases were cured by one dose,
while sixteen cases required a repetition of dose.
The doses varied from quantities of the crude vegetable
through the whole scale of dilutions up to the 60th; still the
majority, viz., fifteen cases were cured by dilutions lower than
the 30th.




BELLADONNA.- BRYONIA.                345
If we examine fourteen cases marked by accurate data
about sex, age, duration of the disease, rapidity of improvement, in order to determine the relative value of high or low
dilutions, we find nothing to lead us to give a preference to
one above the other. Equally rapid improvement follows the
use of the plant or tinct., as from the 3d, 6th or 30th potency.
The right remedy would cure in any dose.
The cures were effected in fourteen cases, in from one to
fourteen days in ten cases; and in from fifteen to twenty-four
days in four cases; and this happened as well in cases of longstanding as in recent attacks.
e) As regards the organs of the brain principally affected in
the cases cured by Bellad., we find:
1. Combativeness and destructiveness in an excited state
(see ist form);
2. Caution aroused with depression of combativeness
(see 2d form).
N.B. In those cases in which the 1st and 2d forms occurred
in alternation we find the above organs in an alternate state of
excitement and depression, as is also the case in the 3d and!
4th forms to a lesser degree.
In the production of fixed ideas we find'
3. The organ of adhesiveness, and
4. "    "   " form in an abnormal state of excitement
or depression or pervertion, so that the patient constantly
romances about the dear departed, or mistakes the form
of the well known physician for some other, or even
does not recognize that of his own son.
7. BRYONIA.
HARTLAUB of REICHENAU states that when puerperal women
feel unhappy and depressed, especially about their property, and
imagine without reason, that they can no longer meet their expenses, &c., that Bryonia has often proved useful. This experience might lead us to suppose that Bryonia acts upon the
organ of acquisitiveness.




346   NERVOUS DISEASES AND MENTAL DERANGEMENT.
8. CALCAREA-CARB.
GENERAL REMARKS. —a) That state of despair which occurs
in many chronic diseases, which leads the patient to give up all
hope of cure, but still does not prevent him from being exceedingly fearful of dying, nor from pestering their friends with
constant complaints and lamentations, may often be cured by
Calcarea.
Archiv, Vol. 17, part 1, p. 8.-B. in D.
b) Anxiety, shuddering and horror, occurring on the approach
of evening; agony occasioned by thinking; agony from hearing
of cruelties; paroxysms of despair about ruined health; irritability.
HAHNEMANN, Chron. Dis. Vol. 2, p. 308.
CASE 27.-A feeble irritable woman, wet. 35, had suffered
with melancholy for four years after her last confinement. Pulsat. and Sulph. had been given without benefit.
Symptoms.-Frightful appearances before the eyes and great
anxiety about the heart; despairs of her salvation to such a
degree that she often wishes to strangle herself; dislikes her
children; is fearful of the future and imagines that she will be
reduced to poverty; face pale and bloated.
Treatment.-Calc. -3- soon cured her, and her menses, which
had been suppressed for 21 months returned again. About the
same time she passed a large piece of tape-worm.
Archiv, Vol. 17, part 1. p. 8.-B. in D.
REvIEw.-The absence of hope of recovery, and even despair
about it, the want of hope of salvation, &c. point to a depressed
state of the organ of hope; while the fear of becoming poor
points to an affection of the organ of acquisitiveness.
The presence of tape-worm in this case will certainly be regarded by some as the exciting cause of the disease, which
would be regarded as seated in the vegetative sphere, while the
mental affection would be regarded as a sympathetic and secondary disorder.




CAUSTICUM.-CHINA.                 347
9. CAUSTICUM.
GENERAL REMARKS.-a) Many of the consequences of longcontinued grief and care may be cured by Caust.
Archiv, Vol. 17, part 1, p. 8,-B. in D.
b) Melancholy; sorrowful thoughts at night and weeping by
day; fearfulness, and want of confidence in the future; hopeless, passionate and irritable.
HAHN. Chron. Dis. Vol. 3, p. 85.
10. CHINA.
The old-school experience with China and Quinine is very
large and very loose. PINEL says, melancholy marked by atony
and extreme depression is to be remedied by the use of Bark
with Opium, of the cure of which he can cite many examples.
The success of the justly celebrated WILLIS and his relatives he
thought arose greatly from their decided conviction of the danger
of the lancet and debilitating means, and from a thorough reliance
on tonic treatment, China being requisite if the irritability proceed from a weak state of the constitution, or occasioned by
bloodletting, chifd-bed or typhus fevers, &c.; it is the more
useful in proportion to the quickness of pulse, increase of heat
and irritability. GUISLAIN, says, in all ages the success of tonics
in some cases has demonstrated the existence of asthenic cases
of insanity. HERRIAE obtained the most happy success in madness with depression from Peruvian bark; PERFECT cites different
cases in which China was given with success. REIL has proved
the excellent effects of it in dementia with the intermittent type.
GEORGET assures us that he has employed China with success
in remittent insanity. CaSTEL says, that he has more than once
seen insanity yield to China.
CASE 27.-A young woman, met. 24, deranged for six weeks,
until she became inexhaustibly loquacious; spoke on various
subjects without the least judgment; she was bled and became
furious in consequence; was then leeched and became insupportably gay and loquacious; was then ordered China, and next
morning her delirium had almost disappeared and in four weeks
she\was well.




348   NERVOUS DISEASES AND MENTAL DERANGEMENT.
CASE 28.-A man wandered about without sustenance until
his body became wan, eyes dull, pulse very frequent, limbs and
face cold, remarkable paleness of tongue, loquacity continual,
confused and incoherent; finally the delirium became complete,
and he did not speak a rational word. China was given with
amelioration in fifteen days and cure in a month.
CASE 29. —A young theologian abandoned himself to study
with a sort of fiury, and finally became maniacal; various
means were used without success, until China was given, when
relief and cure soon followed.
Still in a case of mania, the attacks occurring on a fixed day,
the delirium lasting six days, and succeeded by perfect sanity,
it was given several times without success.
It has been useful when there is loss of appetite, paleness of
the tongue and slow digestion. It is particularly useful in most
cases of periodical mental alienation, in those from onanism, or
complicated by it; in dementia, and especially in that which
arises from protracted or badly-treated intermittent fevers.
Also in the mental derangement which follows typhoid fevers.
BOSTEX found it useful when the paroxysms -seemed to have
somewhat of an intermittent character. DUNGLISON did not find
it to have the same good effects as in other intermittent affections; more useful in long-protracted cases of insanity, when
the skin is moist and relaxed, limbs cold, skin shrunk and shrivelled, with a livid and blotchy or a pale and yellow complexion,
and feeble circulation.-PETERS.
CASE 30.-A young and powerful man became deranged
suddenly, at eleven, A. M. every other day (Tertian type); he
became unconscious of his actions, spoke and acted confusedly,
in an excited manner, ran to and fro, &c. This state lasted an
hour, with gradual increase and diminution, and then ceased
without the patient having any distinct recollection of what had
occurred.
Treatment.-After the use of China in strong doses the affection ceased after three attacks.
Hygea, Vol. 24, p. 4.-Griesselich.
11. CROCUS.
CASE 31.-A boy, met, 10, whose father had died suddenly in
a lunatic asylum, fell into a feverish state, attended with con



CROCUS-COCCULUS.                  349
gestion to the head, and after awaking from sleep exhibited the
following appearances.
Symptoms.-He sat up or stood up in bed, and quickly made
various strange motions, without knowing what he was about;
after such a paroxysm he recovered his senses, but without recollecting what he had been doing. After a period of quiet
there soon followed a like attack, again succeeded by a remission, &c. He was beside himself, but soon became conscious
and refreshed; his eyes were fixed and glistening; his face red
and hot; urine pale and scanty; no desire for food or drink;
pulse slow, scarcely sixty per minute.
Treatment. —Tinct. Crocus, twelve drops in four ounces of
water, six doses, at intervals of two hours, and then repeated
at longer periods. In four days he was quite well.
Schmid, H. A. and G. p. 121.
12. COCCULUS.
GENERAL REMARKS.-Cocculus in its sphere is as great a
spinal remedy as Secale, and manifests this relation by numerous phenomena. Physicians of lunatic asylums should attend
to this, and think of Cocculus in the mental affections of irritable and torpid book-worms and house-bodies, of sensitive romance heroines and dreamy moon-struck women, whose menstruation does not proceed as regularly and quietly as the course
of the moon.
Mental derangement with vertigo, constant desire to run
away, great anxiety, and loquacity has been cured by Baumbach with Cocculus, in doses of one-sixteenth or one-eighth of a
grain.
Hygea, Vol. 23, p. 264.-Griesselich.
It was also used in cases No. 94 and 98. In case 94, the patient had lost his decision of character, could not resolve upon
any course of conduct, and complained much of stiffness in the
joints and limbs.
Treatment.-Cocculus -, one drop night and morning; soon
the limbs became more flexible, the patient returned to his employment and took short walks.
Bellad. and Cocc. in alternation completed the cure.
Very little is known of the action of Cocculus, except what




350 NERVOUS DISEASES AND MENTAL DERANGEMENT.
has been derived from the labors of Hahnemann and his disciples. It has been used immemorially in the East, for the purpose of stupefying and taking fish, and is familiarly used for the
same purpose in some parts of France, the inhabitants living
for one-half the year on fish caught with it. (Christison.) In
some parts of the world it is used by robbers to intoxicate their
victims, and to this form of intoxication the term  of hocussing
is applied. (Taylor.) London porter and ale often owe their
intoxicating properties to a decoction or extract of Cocculus,
which gives an inebriating quality, which passes for strength of
liquor. Its action has been compared to that of Nux-vomica
and Camphor, and in poisonous doses is said to cause vomiting,
vertigo, staggering, trembling, tetanic spasms and coma.-PETERS.
13. CONIUM-MACULATUM.
GENERAL REMARKS. —Dejection, anxiety, discontent, sadness
and want of courage.
Hahn. Chron. Dis. Vol. 3, p. 177.
In the case of a robust peasant girl, wet. 20, who had taken a
strong decoction of Herb. Conii-maculat. to produce abortion,
the patient vomited several times, the expression of countenance
was calm, but like a figure of wax, eye immovable and staring,
body, limbs cold, with cold sweat on head and forehead, pulse
extinct and voice hoarse; her mind was perfectly calm and intellect clear, so that she could tell what she had done; she soon
died. Socrates was poisoned with Hemlock, probably Conium,
and as is well known, retained his senses to the last. It seems
to cause failure of the circulation, coldness of the limbs, lowering of the pulse down to thirty, or less, enormous stagnation of
blood in various organs, especially in brain and liver, conversion
of all the blood from an arterial to a deeply venous state, diminution of the quantity of fibrine, and consequent production of
petechiae, vibices, &c. From this view of its action it would
seem decidedly antipathic to maniacaliexcitements, and homeopathic to melancholy, hypochondria, &c. Still WOODWARD, of
the Worcester Asylum, tells us that Conium is worthy of but
little confidence as a means of removing maniacal excitement,
but for some forms of melancholy, especially if combined with




CONIUM MACULATUM.                  351
dyspepsia or neuralgia, it is often very useful; also against melancholy, with disease of stomach, torpor of liver, uneasiness,
restlessness and nervous pains.
Cox says that Conium gradually introduced into the system
has certainly been of service in some cases by diminishing excitement and irritation and causing sleep; but some systems or
cases resist its influence for a length of time, and others are. not
affected unless administered in enormous doses. Mead says
Conium is a more powerful soporific than Opium; in somecases
it will fail; has known it to purge, and to constipate. In the
McLean Asylum, S. C., Conium is considered a useful medicine; in recent cases is alterative and slightly narcotic, produces
calmness after it has been taken some time. Dose seven to eight
grains, three times a day. Dr. Woodward, of the Worcester
Asylum, regards it as a valuable remedy and useful in some
forms of insanity; but as a means of removing maniacal excitement it is worthy of hut little confidence; however, for some
forms of melancholy, and especially in chronic diseases of the
digestive organs, with melancholy or neuralgia, it is often useful; also in cases of melancholy complicated with disease of the
stomach and torpor of the liver, attended with uneasiness, restlessness, watchfulness and nervous pains, it often affords great
relief and is auxiliary in accomplishing a cure. In any case is
useful in large doses only-smallest dose ten grains; largest,
two or three or four drachms, three times a day —rarely found
any benefit from doses less than fifteen or twenty grains, three
or four times a day-unless it produced temporary vertigo, and
a heavy dull pain over the eyes or across forehead, thought the
dose too small, or the medicine of poor quality.
In Bloomingdale and other Asylums, Conium is given with
Iron, when the mucous membranes are disordered, the circulation unequal, secretions depraved, and digestion imperfect, often
used in mania after the excitement is subdued, frequently give
it in melancholy, and still more frequently in dementia. Kuk-'
bude also uses Conium and Iron in the debility of old cases.
Fisher did not obtain much benefit from Conium and Iron, except when the secretions were unhealthy, then found it useful
in correcting them.-PETERs.
The action of Conium on the brain, and its circulation seems




352  NERVOUS DISEASES AND MENTAL DERANGEMENT.
almost antagonistic to that of Bellad.; the latter generally causes
delirium and high fever, with active congestion and dilatation
of the pupil, while Conium generally causes a torpid condition of the brain so that the patient falls asleep while conversing, great weakness of the intellectual faculties with loss of
memory, want of mental energy, unfitness for exertion, confusion of ideas, as if from drowsiness, slow conception, ready forgetfulness, hypochondriacal indifference, aversion to labor,
headache with taciturnity and profound melancholy, &c. It
rarely causes fever, but is apt to render the pulse slow, even as
low as thirty, the skin cool and pale. It does not cause active
congestion, but rather a passive stagnation of blood in various
organs, especially in the head and liver. It does not often dilate the pupil-still Christison says in some cases all this is reversed, and it may cause frantic delirium, the patient running
about the house, knocking against everything, or plunging into
the water, under the supposition that he is changed into a goose,
&C.-PETERS.
CASE 32.-A strong, previously quite healthy lad, aged 16,
became deranged; he was treated allopathically for two years
without benefit; his case was peculiar, from his being alternately
dejected for ten days and then excited for ten other days.
Symptoms. —During ten days he is silent, dejected and loaded
with care, picks his fingers, generally keeps his bed, speaks and
answers unwillingly. Vacuity of thought, weakness of memory, and frequently sits as if in a reverie; he eats and drinks;
has a movement from the bowels only every three days, but
passes urine frequently at night. Is timid, cannot be induced
to work, and his sleep is extremely disturbed.
Then for ten other days he is very excited, violent, arbitrary,
quarrelsome and scolds readily. Puts on his best clothes, buys
unnecessary things, which he then undervalues, or wastes or
destroys. Will not work, games, disputes, -and will not bear
contradiction. He picks his nose constantly, and it bleeds easily.
Treatment.-Several doses of Bellad, were given without effect; then Conium 8- was used, two drops per dose, every fourth
day. Soon after taking the second dose he was cured, but for
precaution sake the remedy was continued for several months
in smaller doses and at longer intervals.




CONIUM MACULATUM —CANNABIS INDICA.         353
General Horn. Journal, Vol. 9, p. 196.-Elwert.
CASE 33.-An intellectual and vivacious lady, with enlargement of her spleen, fell into a melancholic condition every fourteen days.
Symptoms.-Very unhappy state of mind, occurring every
fourteen days; she loses all desire to speak, to dress herself, to
take food, or to see her children. Great sluggishness of the
bowels.
Treatnzent.-Conium v, one drop twice a day cured her completely.
General Hom. Jour. Vol. 8, p. 198.-Elwert.
REVIEW.-The doses used were Conium 6 and v, repeated
more or less frequently.
In both cases there was dejection, disinclination to talk and
indifference to everything. The alternation of excitement and
dejection in case 29 was remarkable, see symptom 866. Dreams
full of vexation and fighting.
C A N N A B I S-I N D I C A.
This should prove a most important homeopathic remedy; its
action throws much light upon mental derangement in general.
A marked correspondence may be traced between the phenomena of insanity and those which are induced by the introduction
of Alcohol, Opium, Cannabis-indica, Nitrous-oxide, or laughing
gas, Agaricus-muscarius, Belladonna, Stramonium, &c., into
the system and blood. There can be no doubt that the properties of the blood may be perverted by unnatural changes going
on within the system, as well as by the direct introduction of
poisonous substances from without. Schoenlein, we believe, was
the first to suggest that absolutely narcotic substances were
sometimes formed de novo in the blood and system; prussic-acid
always exists in the saliva; the narcotic properties of Urea are
well known; the drowsiness, heaviness, and low spirits produced'
by bile circulating in the system are familiar. Hence mental derangement is often a blood disease-the presence of a minute portion of any of these substances circulating in the blood,
which is passing through the capillaries of the brain, may excite
delirium, illusions, fury, or melancholy, &c., &c.
But to return to the action of Cannabis-indica, Moreau found




354  NERVOUS DISEASES AND MENTAL DERANGEMENT.
that a small dose generally had no other effect than a moderate
exhilaration of the spirits, or at most a tendency to unseasonable laughter; some quickness of pulse, a little slowness of respiration, a general warmth through the body, with the exception
of the feet, which are generally cold; the wrists and forearms
seem as if loaded with a weight, and movements are performed
involuntarily to set them free. At the same time vague muscular sensations of inquietude in the legs are felt, prompting
one to continual restlessness, corresponding to what is called the
fidgets. A very common feeling is that of the brain boiling
over, and lifting the top of the skull like the lid of a tea-kettle.
The region of the stomach is very often the seat of similar odd
feelings; or the motions of the heart may seem to be performed
with unusual violence. Slight or severe twitches of the limbs
may take place; there is usually an inclination to lie down, and
then the limbs and trunk may be all brought together by this
spasmodic action; or the muscles of the face, especially those
of the jaw may be effected with these spasmodic twitches and
even a temporary state of lockjaw may supervene. These
physical effects of Cannabis-indica are however usually of but
short duration; still they often cease only to return again after
an interval of variable duration.
"The first result of a dose of Cannabis-indica sufficient to
produce the Fantasia, as this remarkable condition is termed in
the Levant, is usually an intense sensation of happiness; it
seems to be really happiness, an entirely mental enjoyment like
that of one who hears tidings which fill him with joy, like the
miser who is counting his treasures, the gambler who is successful, or the ambitious man who is intoxicated with success. A
peculiar state of general exhilaration or joyous excitement,
closely analogous to that which is the first result of Cannabisindica, is often the precursor of an attack of insanity, showing
even in the mode of access of the disordered mental state a
close correspondence between the two conditions.
"One of the first appreciable effects of the Cannabis is the
gradual weakening of that power of controlling and directing
the thoughts which is characteristic of the vigorous mind. The
person feels himself incapable of fixing his attention upon any
subject, his thoughts being continually drawn off by a succes



CANNABIS INDICA,                  355
sion of ideas which force themselves into his mind, without his
being able in the least to trace their origin. These speedily oc
cupy his attention and present themselves in strange combinations, so as to produce the most fantastic and impossible creations. By a strong effort of the will, the original thread of ideas
may still be recovered and the interlopers may be driven away,
their remembrance however being preserved, like that of a dream,
recalling events long since past."
"Under the full influence of Cannabis one becomes the sport
of impressions of the most opposite kind; the course of ideas
may be broken by the slightest cause; one is turned by every
wind; by a word or a gesture the current of one's thoughts
may be successively directed to a multitude of objects, with a
rapidity and lucidity which is truly marvellous. The mind becomes exultant in correspondence with the increase of its energy and power. But now it will entirely depend on the circumstances in which we are placed, the objects which strike the
eyes, the words which fall on our ears, whether the most lively
sensations of gaiety or of sadness shall be produced; or passions of the most opposite character shall be excited, sometimes
with extraordinary violence; for irritation may rapidly pass into
rage, dislike to hatred and desire for revenge, and the calmest
affection to the most transporting passion. Fear may become
terror, courage be increased to rashness, which nothing checks
and which seems not to be conscious of danger. The most unfounded doubt becomes a certainty, for the mind has a tendency
to exaggerate everything, and the slightest impulse carries it
along.
"Remarkable illusions of perception as to time and space are
apt to occur. Minutes seem hours, and hours are prolonged
into years, and at last all idea of time seems obliterated, and the
past and present are confounded together." Moreau mentions
as an illustration, that on one evening he was traversing the
passage of the Opera while under the influence of a moderate
dose of Cannabis; he had made but a few steps when it seemed
to him as if he had been there two or three hours; and as he
advanced, the passage seemed interminable, its extremity seeming to recede as he pressed forwards. In walking along the
street, Moreau frequently saw persons and things presenting the




356  NERVOUS DISEASES AND MENTAL DERANGEMENT.
same aspect as if he had viewed them through the large end of
an opera-glass, that is, diminished in apparent size and therefore suggesting the idea of increased distance. This erroneous
perception of space is also one of the effects of the Agaricusmuscarius; a person under its influence is apt to take a jump
or stride sufficient to clear the trunk of a tree, when he only
wishes to step over a straw or small stick. Such erroneous
perceptions are common enough among ordinary lunatics, and
become in them the foundation of fixed illusions; whilst in a
person intoxicated with Cannabis-indica there is still a consciousness of their deceptive character.
Gaultier, an artist of celebrity, found the slightest deep sound
to produce the effect of rolling thunder; his own voice seemed
so tremendous that he did not dare to speak out loud for fear of
throwing down the walls, or of bursting himself like a bomb;
the striking of one or a few clocks seemed to be exaggerated to
the noise of more than five hundred striking with a great variety
of tones.
It is seldom that the mental derangement caused by Cannabis fixes itself upon any particular train of ideas, and thus gives
rise to a settled delusion; for in general one set of ideas chases
the other so rapidly, that there is not time for any to engross the
attention of the intellect, especially as the patient also preserves a
certain degree of self-consciousness. But once MOREAU thought
himself poisoned by the friend whom he induced to administer
it to him, and persisted in this idea in spite of every proof to
the contrary, until it gave way to another more absurd one,
viz, that he was dead and about to be buried; still he had
consciousness enough to believe that his body only was defunct,
his soul having merely quitted it. All this has its counter-part
in the different stages of natural insanity; the illusive ideas and
erroneous convictions being in the first instance capable of
being dissipated by a strong effort of the wvill, but gradually
exerting more and more influence on the general current of
thought, and at last acquiring such complete mastery over it,
that the reasoning and controlling process can no longer be
called into effectual operation.
It would seem to be an antipathic remedy to monomania.PETERS.




CUPRUM-ACETICUM.                357
14. CUPRUM-ACETICUM.
GENERAL REMARKS.-Cuprum is very useful against attacks
of anxiety in which the patient cannot control himself, weeps,
is in despair, &c. while his body is chilly, the whole being but
slightly relieved by external warmth.
Hygea, Vol. 12, p. 122.-SCHMID.
CASE 34.-A robust man, wet. 38, had been overpowered
for several months by great melancholy and restlessness.
Symptoms. — Invincible dejection has oppressed him for
several months and an incessant restlessness annoys him, as if
some misfortune were going to happen to him; he weeps easily,
and is fearful of losing his reason. Sensation upon the vertex
as if some thing like worms were moving in the brain (see HAHN.
Chron. Dis., Symptoms 39 and 40). His head was heavy and
confused; bowels moved only every three or four days; had
difficulty in falling asleep before two, A.M., and was often
sleepless.
Treatment.-Seven days after Cuprum 8 0-  he was improved,
and Sulph. ~-i- finished the cure.
Gen'l. Hoirn. Journal, Vol. 34, p. 338. —CRosERIo.
CASE 35.-A  consumptive man fell into paroxysms of
anxiety when the lung-disease was checked.
Symptoms.-He was rendered particularly anxious by a fixed
idea that he saw police-officers, who intended to deliver him up
to justice; this caused him to weep and lament like a child. He
imagined that he saw thieves, ghosts and various lifeless things
in the room. Some of his disorders hefelt and:described rightly,
but of others he had no or else extremely false notions; he
maintained a sitting position, acted like one in despair, had extreme difficulty of breathing, a fearful anxiety and paroxysms of
syncope. His pulse during the attacks was variable and weak,
and his skin cool and covered with cold sweat.
He was soon cured by Cuprum-acet.
CASE 36.-A student was reduced bodily and mentally to
a state of great debility, in consequence of excessive study in
preparing for his examination; paroxysms of anxiety were added.
Symptoms.-Pulse weak, but little quickened, and irregular;
skin moist and not hot; feet more frequently cold than warm;
he has attacks of anxiety which he cannot overcome; his head




358   NERVOUS DISEASES AND MENTAL DERANGEMENT.
is dizzy and so painful internally that he fears he will lose his
senses; his sleep is disturbed and not refreshing, and full of
confused and distressing dreams.
Treatment. —Cured by Cuprum-acet. in three days.-SCHMID.
CASE 37.-A woman about eight days after delivery, fell
into a state of anxiety.
Symptoms. —The usually retiring, anxious, timid woman exhibited a remarkable activity in all her thoughts, which were
of an anxious character-her eye and expression were generally
fixed abstractedly upon one object-she had profuse and debilitating perspirations, and her pulse was quick, weak and irregular.
Sometimes when it was supposed that she would be tranquil,
she suddenly jumped out of bed, and it required great force to
return and keep her there.
Treatment. -She recovered rapidly under the use of Cuprumacet. —ScHMID.                                  t
CASE 38.-After the retrocession of erysipelas of the face,
an attack of mania occurred in a woman, and was attended with
excessive anxiety.
Symptoms. — Pulsation in the prwecordia, and remarkable
anxiety, so that she could not control herself. She did not'recognize her husband or son; began to talk a great deal of con.
fused stuff, part of which was really ludicrous; then she would
sink into a state of apathy, from which however she could be
aroused by interesting her. The most violent attacks occurred
at night; when she was urged to take medicine she gnashed
her teeth and resisted violently.
Treatment.-Bellad. and Hyosc. were used without benefit;
but Cuprum in alternation with Stramon. cured her.'Hygea, Vol. 12, p. 120.-ScHMID.
REvIEw.-The deranged states, which were cured by Cuprum,
were marked by confused talking, seeing ivarious imaginary
things, and erroneous illusions, but invariably attended by
anxiety; by restlessness from fear of misfortune, despairing
anxiety, with weeping and wailing.
Various decided bodily ailments were associated with the above,
viz., irregular pulse, pulsation in pit of stomach, cold sweats, &c.
Like in the Bellad.-case No. 24, we find that one patient did
not recognize her own husband and son.




CUPRUM-ACETICUM.-HEPAR-SULPH.-CALC.          359
DoSeS. -SCHMID used three or four grains of the Path or 200th of
Cuprum dissolved in a tumbler of water, one table-spoonful per dose
every quarter, half, one or two hours, according to circumstances. In
case 34, Cuprum'0-~ was used.
The anxious state of the patients pointed to an affection
of the organ of Caution; and the seeing of lifeless figures indicates an increased activity of the organ of Form.
DNOTE.-I have always entertained a decided disbelief of the
homieopathicity of Cuprum to maniacal affections, but find
in five cases of poisoning by copper, observed by BEER of Vienna,
that nervous symptoms were present, of which the chief were
very severe headache, slight delirium, convulsive movements of
the legs, great exhaustion and somnolence, which in three cases
amounted to coma, Brit. Journ. Hom. Vol. 1, p. 98. CHRISTISON
also states that Lbe first symptom is sometimes violent headache, and that in many cases signs of some injury done to the
brain are very generally present, while in other instances it
would appear that the narcotic symptoms form the commencement, and irritant symptoms the termination of poisoning with
Copper.-On Poisons, p. 363.  CHAPMAN also used it with
benefit in a case of scarlet fever with delirium.-PETERS.
15. HEPAR-SULPH.-CALC.
CASE 39.-A man met. 36, of powerful frame and phlegmatic
temperament, having had the itch for half a year, became deranged after taking cold.
Symptoms.-Threatens his relatives, attempts to kill them, to
set the house on fire, requires eight men to restrain him. Afterwards sits speechless and motionless in the corner of the
room —passes urine and fweces involuntarily-his whole body is
covered with an itch-like eruption, with occasional open ulcers.
Treatment.-Hepar-sulph. T, cured him in a few days.
Archiv, Vol. 19, part 1, p. 89.-Szatar.
16. HELLEBORUS-NIGER.
General Remarks.-a) Hellebore is most adapted to those
states which verge on the boundary line between melancholy
and mania; and in actual conditions of depression and debility, in
which at times fixed ideas are predominant.
The influence of Helleb. seems to irradiate from the abdomi24




360   NERVOUS DISEASES AND MENTAL DERANGEMENT.
nal nervous system to the spinal marrow, medulla oblongata,
and brain. Hence many sympathetic affections of the brain
are cured by it.
Hygea, Vol. 23, p. 262.-GRIESSELICH.
b) From various experience I infer that a primary and principal effect of Helleb., is to produce a kind of stupor, or blunting
of the internal consciousness, or a state in which one with good
eyesight does not see perfectly, or does not attend to that which
he sees; with good hearing does not hear plainly, or does not
understand; with good organs of taste, does not taste well; is
always, or frequently absent-minded, remembers the past or
lately transpired things either not at all, or but indifferently;
takes pleasure in nothing; slumbers but lightly, without sleeping
soundly or refreshingly; wishes to work, but has not the power,
or does not give the necessary attention.
HAHNEMANN, Mat. Med. Pur.-B. 205.
c) GRIESSELICH remarks on the above, that in it we find a
condensed description of the state of many melancholic persons; anaesthesia, want of memory, loss of the power of will,
and of action are all extremely well marked, and present a,
marked antagonism to the action of Stramonium and other narcotics.
d) Hellebor.-nig. is very useful in some cases of mental dejection bordering on melancholy, and occurring in females about the
time of puberty, either before or shortly after first menstruation,
which has again become checked.
KNORRE, General Hornm. Journal, Vol. 19, p. 25.
e) Every Homceopathist should read carefully the learned article by Hahnemann, on the Helleborism of the Ancients, see
"LEssER WRITINGS, published by RADDE. Hellebore in small
doses causes increased secretion of the gastric fluids, of thin
bile, more active circulation in the portal system, in the liver
and spleen, and it even renders the blood of these parts thinner
and more fluid. Although it seems to act most promptly and
decidedly upon the gastro-hepatic system, and upon the solar
plexus of nerves, still it also promotes in a marked degree the
menstrual and hoemorrhoidal discharges; it is apt to cause inflammation of the rectum, and MEAD esteemed it as the most
certain emmenagogue. CHRISTISON asserts that in excessive




HELLEBORUS-N1GER — HYOSCIAMUS-NIGER.         361
doses, it causes vomiting, followed by delirium, succeeded by
violent convulsions; while DIERBACH informs us that it has been
used successfully in epilepsy, which passes over into mania, a
form of disease regarded as incurable from the time of Hippocrates.-PETERS.
CASE 40.-After typhoid fever, there remained a kind of
melancholy in a girl, aet. 20.
Symptoms. —She does not speak a word, is dull and indifferent
to external impressions. Sits still upon her bed, apparently
sunken in gloomy thought; face pale and distorted; look dull
and unsteady; pupils dilated; pulse slow and weak; she eats
proffered, food, but never desires any; sleep scanty and restless;
constant desire to run away, but without wildness of manner; without speaking a word she silently clambers up to the
window and attempts to escape through it; whenever she did
escape she always made her way towards the river; finally she
threw herself into a privy, but was rescued from it.
Helleb. cured her quickly.
KNORRE, General Hom. Jour., Vol. 19, p. 24.
CASE 41.-A maiden, wet. 19, fell after typhoid fever into a
dull state, which had lasted five weeks.
Symptoms.-She stares around her fixedly, even when spoken
to, with a strange, or stupid, or wild look, and at times grasps at
her head; she staggers while walking and hangs down her head;
this thoughtless dullness or reverie, with staring at one point, alternates at times with incoherent muttering-constipation.
Treatment. —Ext. Helleb., two grains per day cured her in a
few weeks.
General Hom. Journal, Vol. 19, p. 25.-KNORRE.
REvIEw. —The above cases fully substantiate the correctness
of the views expressed in the general remarks.
17. HYOSCIAMUS-NIGER.
GENERAL REMARKS. —Hyosciamus is apt to excite erotic hallucinations, and jealousy stands in close connection therewith.
Hygea, Vol. 23, p. 254.-GRIESSELIIH.
Dr. SCHNELLER experienced from 1~ grains of the Extract of
Hyosciamus, confusion of senses, weakness of sight, and some
difficulty of speaking, also a by no means disagreeable state




362  NERVOUS DISEASES AND MENTAL DERANGEMENT.
like that of slight intoxication; from two grains, confusion in
head, then of sight and hearing, restless sleep, &c.; from three
and a half to four grains, dull frontal headache, cloudiness and
weakness of sight, with slowness of the pulsoe from four and a
half to five grains, confusion of head, frontal headache on the
left side, dimness of vision, frequent inclination to yawn, and
sleepiness; from eleven and one-fourth grains at one dose, giddiness, reticulated vision. frontal headache on right side, and
sleepiness. CHRISTISON says, in medicinal doses it induces
pleasant sleep, while CHOQUET reports the cases of two soldiers,
poisoned with young shoots, who soon became dizzy, stupid,
speechless, dull and haggard; their pupils were dilated, and
eyes so insensible that the lids did not wink, even when the
cornea was touched by the finger; their pulse was small and intermitting; breathing difficult, jaws locked, and mouths distorted by risus sardonicus. PEREIRA says, in persons with great
nervous irritability, and too active condition of brain, it frequently causes calmness, and an inclination to sleep, also frequently allays irritations and morbid sensibility of one or the
other organ. In one case, a man, Aet. 40, was suddenly attacked
with severe toothache, and fumigated his mouth with the smoke
from the burning seeds of Hyosc.; the pain instantly vanished,
but from that moment he became perfectly impotent, and the
impotency lasted eight months. —Brit. Jour. of Horn., Vol. 1,
p. 412.
Judging from effects similar to the above the antagonistic
school have felt themselves justified in using Hfyosc. in mental
derangement and excitement, but FOUQUIER tells us from his own
experience, that it never causes positive sleep, only a greater or
less tendency thereto, always attended with headache, painful
delirium, feverishness, &c.; CHRISTISON says it causes that singular union of delirium and coma which is usually termed Typhomomania; and that when the prostration and somnolency of
this state abates, the delirium becomes extravagant and the
patient quite unmanageable. WIBNER cites six cases of poisoning with it; several subjects were delirious, danced about the
room like maniacs; one appeared drunk, and another became
profoundly comatose. CHRISTISON concludes that it is very apt
to cause loss of speech, delirium, commonly of the unmanage



HYOSCIAMIUS-NIGER.                 363
able, sometimes of the furious kind, followed by coma, and'
when the coma passes off the delirium is apt to return for a
time. It has caused intense thirst, watchfulness, delirium, depraved vision, and a crowded eruption of dark spots and vesicles
like the petechike and sudanima of typhus fever, or malignant
small-pox. NELIGAN says there are many persons in whom~ it
causes great excitement, headache, and even delirium. VOGT
admits that in large doses it causes vertigo, heaviness in the
head, sleepiness, confusion of head, and headache, anA various
traces of commencing distraction of the mind; for the senses
commence to deceive one; taste and smell are diminished,
noises are heard in the ears, flimmering before the eyes and
double vision, &c., occur. CULLEN says in full doses it is more
apt to cause delirium than Opium;'in many cases it induces
turbulent and unrefreshing sleep. —PTERs.
CASE 42. —A lady, aet. 25, of a quiet, peaceable disposition,
but readily attacked with epilepsy after violent mental emotions,
became deranged on the 5th Sept., after having several epileptic
attacks on the fifth day after her second confinement. She was
treated allopathically for eight days without benefit.
Symptoms. —Violent paroxysms of rage, maltreated her friends,
and tore everything to pieces; turns of anxiety; then she would
sing, whistle, laugh, kiss every one, assumed that she was
pregnant, and had labor-pains, &c.
Treatment.- Bellad. 30 excited, without benefitting her.
Hyosc. acted better. Verat. 12 and 15, produced sleep and
allayed the most violent symptoms; but from April 16 to May
16, Verat., Acon., Helleb., Stramon. and Bell. were given without permanent benefit, and the following condition remained.
Symptoms.-She is extremely excited, rages when one attempts to restrain her, scolds and strikes every one without regard to person; is talkative, and speaks irrationally; weeping
in alternation with joyous mood; anxiety and trembling of the
limbs-excessive secretion of milk.
Treatment. —Hyosc. was given again, and her malady was arrested instanter; she was, and remained well.
Annals, Vol. p. 67. —MARTINI and SPOHR.
CASE 43. —A woman aet. 37, given to drink, became deranged.




364   NERVOUS DISEASES AND MENTAL DERANGEMENT.
Symptoms —Face red, hot; look wild; breathing quick and
oppressed; she scolds and swears incessantly, tears the clothes
off her body, walks about her room at night, strikes powerfully
at those around her, and can scarcely be controlled; will neither
eat nor drink.
Treatment.-Hyosc. 2, one drop cured her in twenty-four
hours.
Archiv, Vol. 19, part. 1, p. 84.-SZOTAR.
CASE 44.-A maiden, aet. 14, not yet menstruated, became
deranged after sleeping in the sun.
Symptoms. -- Great lasciviousness in words and actions;
quickly becomes enraged and strikes at every one; paroxysms
of fearfulness and fright, from fear of an imaginary wolf, and of
being burned alive.
Treatment.-Bellad. —,- in solution, and Hyosc. 3-  in solution,
followed by Sulphur cured her in six weeks. After taking
Hyosc. itching over the whole body especially about the genitals occurred.
New Archiv, Vol. I, part. 1, p. 80.-HAHNEMANN.
CASE 45.-A youth, aet. 23, showed signs of mental derangement quite unexpectedly in the midst of previously uninterrupted good health.
Symptoms. —Unusual restlessness; piercing fixed look; jerking movements of the head, with staring rapidly first here, then
there; face pale; pulse quick, but weak; wishes to get out of
the room; sees appearances which frighten him; figures which
want to carry him off; fowls which are fastened with chains;
a great number of large crabs which are driven into the door;
general epileptic convulsions for the first time.
Treatment.-Two doses of Bellad. -—, without benefit; then
Hyosc. 12, and recovery in eight days.
Practical Observations, Vol. 4, p. 4.-THORER.
CASE46.-A man, wet. 48, deranged for three weeks and
treated allopathically without benefit.
Symptoms.-His cadaverous face has a wild, strange look;
he speaks incessantly, mostly about religious things; imagines
that he is poisoned, or that his mouth smells badly.  Occasionally he scolds or weeps, and says that he hears great noises.
Treatment. —After taking eighteen doses of Hyosc. 2, one




HYOSCIAMUS-NIGER.                  365
dose night and morning, he again became rational and able to
work. The remaining bodily ailments were cured by Sulphur.
General Hom. Journ., Vol. 34, p.. 323.-HAUSTEIN.
CASE 47.-An unmarried man became deranged.
Symptoms.-He rages, scolds, sings, and babbles night and
day, without eating, drinking or sleeping; he attempts to escape
and breaks the window to effect his object; required the
straight-jacket.
Treatment. —Hyosc. 3-, one drop. Speedy recovery.
General Hom. Journ., Vol. 39, p. 31.-WEBER.
Besides in these cases Hyosc. was given in cases No. 5, 38,
66, 99, 112, 113.
REvIEw. —The published experience of our school is still too
limited to enable us to give positive deductions about the action
of Hyosc. in mental diseases.
We see it cure an excited state in cases No. 42, 43, 44 and
45; and fail in others, viz., No. 66, 112 and 113.
It cures a state of depression marked by weeping and sobbing
in alternation with laughing, restlessness, fear of imaginary;
animals in cases No. 44 and 45; while in internal anxiety and,
brooding suspicion, in cases No. 5 and 38, it does not help.
It cures lasciviousness in case No. 44, and leaves shameless
ness uncured in case 66.
It removed the inclination to dance, hop, and speak irrationally in cases 42 and 113.
As a general thing the remedy cured when several of the
above states occurred in alternation, or in connection with epileptic attacks, or in persons subject thereto.
DoSeS. —Hyosc. 2 in single and repeated doses.
"   6 in  single doses.
"  12 in    "     "
"  30 in solution and repeated doses.
It is also doubtful upon which organs of the brain Hyosc.
acts in particular, still it seems to act upon those of combattiveness and destructiveness, amativeness and caution.




36~  NERVOUS DISEASES AND MENTAL DERANGEMENT.
18. IGNATIA.
GENERAL REMARKS.-Ignatia will rarely or never effect a
cure in those who are of an unchangeable disposition, neither
disposed to fright or vexation.
Organon, p. 237.-HAHNEMANN.
CASE 48 —A modest maiden, at. 20, occasionally exhibited
signs of mania after the otherwise regular menstrual flow;
finally, she lost all consciousness, and was possessed with
various fixed ideas.
Symptoms.-She imagines that she is married and. pregnant,
is tortured in her conscience by imaginary misdeeds  frequently
attempts to escape and drown herself; anxiety and fear of death
from congestion to the head and. heart; she is only quiet when
allowed to lie and to indulge in her fancies, and permitted to
give vent to them in a complaining tone; whenever disturbed
she screams, strikes, and tears whatever she can reach, and constantly vociferates that "she has neglected her duty, broken her
oath, &c." Face distorted and death-like; relish for sour things;
it is difficult to get her to eat, and after she has eaten she has
stings of conscience about it.
Treatment.-Various remedies, viz., Bellad., Hyosc., Stramonium, Aurum, Platina, Verat. were given without benefit; Gratiola effected some improvement for a time, but was followed by
such paroxysms of rage that it was difficult to control her;
these subsided and again gave place to the former fixed ideas.
Finally, from the continued use of Ignatia for several weeks,
at first in the first, then in the sixth, and finally in the ninth dilution, she was entirely restored. Her menses which had been
suppressed during her illness returned again.
Archiv, Vol. 15, part. 3, p. 30, and
Ibid. Vol. 16, part. 2, p. 100. —GRoss.
CASE 49.-A maiden, met. 19, of strong, robust constitution
and sanguine temperament, fell into a state of hysteric laughing
and crying, which passed over into delirium, and which returned
paroxysmally.
Symptoms.-Does not know those about her, speaks to them
as to imaginary persons, and calls them by strange names; imagines that she stands upon a fearful heighth, from which she
cannot descend,




IGNATIA.                     867
Treatment.-Two doses of Stramon. 9, followed by Ignat. 8,
restored her.
General Hornm. Journ., Vol. 17, p. 376.-GRoss.
CASE 50.-A youth, aet. 20, of sanguine choleric temperament, active imagination, but otherwise strong and well-conditioned, suffered from undeserved but bitter vexation of spirit;
he fell into a gastic fever and subsequent melancholy.
Symptoms.-Head heavy; extreme weakness of memory, forgets every thing except his dreams; hears with difficulty, sees
as if through a mist; sits staring quietly before him, constantly
thinking of his wrongs, and is unconscious of what transpires
around him; wishes to be alone; falls asleep late; restless
sleep with starting up in fright, and many dreams; pain in the
left hypochondrium (spleen), increased by pressure and slow
walking; his hair falls off profusely; face cadaverous and sunken; voice trembling, low and attended with distortion of the
facial muscles; does not speak willingly; no desire for food
or drink; is quickly satisfied and satiated; always cold especially in the evening; very weak and dejected; walks unsteadily
and with great caution; bowels and urine rather free.
Treatment. —Ignat. -i, one dose cured him perfectly in the
course of fourteen days, after being preceded by a visible
aggravation lasting five days.
Archiv, Vol. 10, part. 3, p. 104. —ATTOMYR.
CASE.51.-A maiden, aet. 20, of sanguine temperament,
excessively sensitive to joy and sorrow, fell into a state of melancholy after suppression of her menses.
Symptoms.-Indifferent to every thing previously most dear
to her; sits still and weeps, imagines various things, especially
that she will become deranged; complains of a sensation and
crawling all over, as if her limbs were asleep; the pit of her
stomach seems insensible to her; sleep dreamy and not refreshing; menses suppressed for two months.
Treatment. —Ignat. 2, repeated daily, cured her in the course
of several weeks.
Archiv, Vol. 19, part. 1, p. 56.-GRoss.
CASE 52.-A delicate maiden, aet. 17, was attacked with
spasms and mental derangement after a fright; she was treated
allopathically for fourteen days without benefit.




368   NERVOUS DISEASES AND MENTAL DERANGEMENT.
Symptoms. —Does not think that she can be saved; weeps
much; has paroxysms of rage, in which she tears her clothes
and can scarcely be held by four strong persons.
Treatment. —Ignat. 6, one dose daily, cured her in six days.
Archiv, Vol. 19, part. 3, p. 33.
CASE 53.-A woman, set. 40, had two attacks daily of the
following state.
Symptoms.-Anxiety, restlessness as if she had committed
some crime, or feared some great misfortune; is overpowered
to such a degree that she can scarcely keep from weeping;
oppression of her breathing, which seems to come from her
stomach up into her throat; lassitude, inability to work; shyness for all persons; these paroxysms lasted several hours.
Loss of appetite, scanty stools, and when most constipated, she
was most indisposed.
Treatment.-Ignat. first trit. (2: 100), ten grains in four oz.
of water, taken in five doses in the course of twenty-four hours.
The paroxysms returned only on the second and third days,
then absented themselves, and she recovered perfectly.
SCHMID, H. A. and G. p. 126.
REVIEW. —Ignatia is undoubtedly useful in mental derangement, when single notions become fixed ideas. The patients are
quiet when not disturbed in their reveries about themselves or
other things,:and then are in a dejected state, which rapidly
changes to excitement when they are disturbed.
Dioses.-The lower preparations were generally used in repeated
doses.
The action of Ignatia upon the organs of conscientiousness
and self-esteem is decidedly evident in the above cases.
19. LACHESIS.
CASE 54. —A youth became deranged from excessive study.
Symptoms.-Extraordinary loquacity, which was quite uncommon for him-carries on incessant prologues in the choicest
expressions, but changes rapidly from one subject to another,
and treats of the most heterogenous matters. He is proud and
suspicious of his friends.
Treatment.-Lachesis 3 — cured him quickly.
Archiv, Vol. 14, part. 1, p. 7.-GRoss.




LYCOPODIUM. —NUX-VOMICA.               369
20. LYCOPODIUM.
GENERAL REMARKS.-It is useful against melancholy, sorrow,
anxiety with dolefulness, lachrymose state, and fear of being
alone.
HAHNEMANN, Chron. Dis. Vol. 4.
CASE 55.-A woman, aet. 30, suffering for several years
with excessive conscientiousness, received Verat., Ac.-phosph.
and Pulsat. without benefit.
Symptoms.-Scrupulous anxiety and conscientiousness, which
rob her of all peace of mind; the anxiety occurs regularly every
afternoon at 4 o'clock, and lasts until 8 P. M.
Treatment.-Lycopod. V-, effected a cure in fourteen days.
Archiv, Vol. 18. part. 2, p. 12.-B. in D.
21. NUX-VOMICA.
GENERAL REMARKS.-a) Nux often proves more useful than
Aurum against the peculiar melancholy with disgust for life,
which leads to suicide; its good effects are often visible in a few,
always in ten days; dose, from first to sixth dilution.
Hygea, Vol. 2, p. 33. —EGIDI.
b) It is most suitable in melancholy depending on abdominal
derangement; especially when the signs of bodily derangement
continue unchanged, notwithstanding the active condition of the
mental trouble; or when the depressed state of the ganglionic
system occasions a still greater disturbance of the abdominal
organs than was present at first.
HARTMANN, upon use of Nux-vom. p. 132.
c) There is a remarkable resemblance between the action of
Nux-vomica and Strychnine, and that of the electric or galvanic
influence; thus it is very apt to cause convulsive motions or
twitchings similar to electric shocks, when given in large quantities; also prickling as if from needles, or as if sparks were drawn
from the skin, or jerks like those produced by electricity; and
if an animal under its full influence be touched, it will experience a
commotion similar to that of a strong electric shock. In smaller
quantities it produces an increase of the irritability, contractility
and tonicity of the motor nerves, muscles and contractile tissues
of the parts with which it comes in contact, or to which its




370 NERVOUS DISEASES AND MENTAL DERANGEMENT.
influence extends; thus if taken before meals it does not interfere with digestion, but probably increases that peculiar peristaltic movement of the stomach, which has for its object the
production of a thorough intermixture of the gastric juice with
the alimentary mass. This is a very important part of digestion.
The fasciculi composing the muscular wall of the stomach
are so disposed as to shorten its diameter in every direction,
and by the alternate contraction and relaxation of these muscular bands a great variety of motion is produced in the stomach
and its contents, sometimes transversely, at others longitudinally;
if these movements be checked or lessened materially it has
been found that the food lies still and heavy, and that surface
only which is in contact with the walls of the stomach undergoes digestion; the residue of the alimentary mass remains as
undigested as when it was first taken into the system.-After a
few days' judicious use of Nux the appetite becomes increased,
and in some cases extraordinarily great; the stools of those suffering from constipation become more free and easily expelledbut if too great a quantity be used, obstinate constipation from
excessive contraction of the bowels ensues, and dyspepsia,
from a tetanic rigidity, and want of motion of the stomach. Judiciously used, it facilitates the secretion and excretion of bile;
wrongly used, the liver becomes small, hard and contracted, its
blood vessels and gall bladder empty, and the spleen is diminished in size and rendered paler. Rightly used, it renders the
mind more clear and joyous, and it actions more vivid; improperly used, it induces an altered state of the intellect, marked by
excitement like that of intoxication, confusion of mind, restlessness, despondency, love of solitude and darkness, an inclination
to keep quiet, but an internal irritation of the sensori-motor apparatus, accompanied with anxiety, oppression and uneasiness,
agitates the patient, and frightens him into a state of restless nervous activity. Persons under its full influence become extremely
irritable and sensitive to all external impressions, so that the
slightest causes will often excite excessive petulance; or they
may be restless, dejected, languid, chilly and anxious, with a
great tendency to drowsiness.-PETERS.
CASE 56.-A lad, aet. 15, excited by disappointed ambition,
began to speak and act in all kinds of strange ways.




NUX-VOMICA.                    371
Symptoms. -He is abashed, says irrational things and does
every thing wrong that he undertakes; complains of heaviness
of the head, pain in back and abdomen; feels weak and cannot
stand up; face alternately red, then pale, with sharpened features; pulse irritated.
Treatment. —After taking Nux I-, perfect health returned in
thirty-six hours
Annals, Vol. 1, p. 50.-C. HARTLAUB.
CASE 57.-A weaver's widow, aet. 77, came under treatment
on Sept. 21. She had had a shock of palsy one and a half years
before, and anotherten week's ago so that she was scarcely able to
crawl around. For six weeks she has without other known cause,
fallen into an anxious state of mind, with fear of recovery-; is
weak, chilly, sleepless; has scanty hard stools, but great appetite; urinates often and suddenly, at times involuntarily, which
is however an old trouble of hers.
Treatment. —Nux-vom. 3-, one-third of a drop.
Result. —Four weeks after she informed me that after taking
the powder her appetite was increased excessively, and all
other symptoms diminished in proportion, except her urinary
trouble, which still remained in a lesser degree.
H. HARTLAUB, Private cases.
CASE 58.-A lad, aet. 18, previously always healthy, after
suffering for a long time with a decayed tooth had it extracted, and then although free from pain, fell into a state of
melancholy, in which he constantly spoke about his tooth.
He was treated allopathically for two months, and had an
artificial tooth inserted, without benefit to his state of mind.
Symptoms.-Dec. 10, the patient has locked himself up in a
room, and only opened it after much entreaty, but immediately
took refuge in the farthest corner of the room, on perceiving a
physician; eyes cast down, answered but few questions, and
constantly spoke about his tooth; all noise and every kind of
employment is distasteful to him; he sat about the whole day
without employment, weeping and complaining of anxiety; he
had some appetite, and his bodily functions were well performed.
Treatment. -Arsen. -30, one dose every evening, for five days
without benefit; then Nux-vom. -72, six doses, one to be taken
every evening.




372  NERVOUS DISEASES AND MENTAL DERANGEMENT.
Result. — Improvement sat in at once; the anxiety and dejection were entirely gone by Dec. 19, and he commenced. to work
again. After taking six doses more of Nux, one dose every
other day, he was entirely restored.
Records of the L. Society. —SCHULZ.
N. B. —See case 113. Several remedies were required to
complete the cure, but Nux removed the following
Symptoms: —Confilsion of the head, sensation as if the brain
would be pressed asunder; slight movements of the bowels
every other day, in place of previous obstinate constipation;
morning erections and excessive sexual desire, together with irritability, rudeness, and crossness.
REVIEW.-The most common causes of disorder in the
above cases were: mental influences, especially, continuous men
tal employment, night watching, &c.; also excessive coffee
drinking.
The groups of symptoms against which Nux was used with
benefit in the above cases, as well as in cases No. 107, 108, 110,
112, 113, are marked by a depressed state of mind, with selftorture about fixed ideas; the patients torment themselves about
injured honor, scruples of conscience, household. cares, and
speak constantly of one thing. To these are added absurd actions and sexual excitement.
The disorder is present not only in the mind, but various
bodily ailments occur in connection.
Doses used.-Nux was used successfully in both high and low
dilutions; in single doses, and repeated. In case 108, it was
given in alternation with Verat.; in No. 112, between Opium
and Stramon.
It seems to act upon the organs of Amativeness, Acquisitiveness, Caution, and Conscientiousness.
22. NUX-MOSCHATA.
GENERAL REMARKS. —This remedy was more used in olden
times than at present. Notwithstanding, HELBIG'S labors, (see
Heraklid I.) which have made us well acquainted with both old
and new observations about its action, still it has been but little
usedin the new practice. Its great relation to the activities of
the brain are quite remarkable, and it is evidently most indicat



NUX-MOSCHATA —OPIUM.                373
ed when no decided pathologico-anatomical changes are connected with.the brain-disorder, and especially in weakness of
memory and vision.
Hygea, Vol. 23, p. 256.-GRIESSELICH.
No cures of mental diseases with it have been reported; may
our departed colleague's words induce some one to use it in appropriate cases.
23. OPIUM.
GENERAL REMARKs.-The effects of Opium have so great a
similarity with some states of mental derangement, that it must
be evident even to the most bigotted, that it cures mental diseases in consequence of its power thus to influence the brains of
the healthy.
It requires but a hasty review of the actions of Opium, to become convinced that it acts quite decidedly and peculiarly on
the central organ of the nervous system as the source of the
mental powers.
Opium produces all the signs of mania; the patient becomes
excited, lively, and courageous; a feeling of increased power carries him upwards towards heaven, and heaven seems to descend
to him by means of the most pleasant hallucinations and visions;
a state of delectable intoxication surrounds the patient with
the most fascinating phantasies. All this must be followed by
its opposite; dejection follows ecstasy; from misuse of Opium there ensues a state of apathetic idiotcy, with loss of power
of will, &c.
Undoubtedly, Opium is most indicated against states of mental excitement and exaltation, and maniacs are more readily
cured by it than others, provided it is suited to the whole state
of the patient.
Still it may prove useful in states of mental depression; the
individuality of the case will decide the matter.
Hygea, Vol. 23, p. 257. —GRIESSELICH.
NOTE. —According to WooD and BACHE, Opium is a stimulantnarcotic, which when taken by a healthy person in a moderate
dose, increases the force, fulness, and frequency of the pulse;
augments the temperature of the skin, invigorates the muscular.system, quickens the senses, animates the spirits, and gives new




374 NERVOUS DISEASES AND MENTAL DERANGEMENT.
energy to the intellectual faculties, which it may excite even to
intoxication or delirium. In a short time, however, this excitation subsides, a calmness of the corporeal actions, and a delightful placidity of the mind succeed, and the individual insensible
to painful impressions, and forgetting all sources of care or
anxiety, submits himself to a current of undefined and unconnected, but pleasing fancies; in short, is conscious of no other
feeling than that of a quiet and vague enjoyment, and finally in
one-half or one hour, all consciousness is lbst in sleep. In some
persons it produces very peculiar effects, differing from its ordinary actions; thus it may cause even in small quantities, restlessness, headache, and delirium, and even in large doses, it may
cause obstinate wakefulness. TROUSSEAU and PIDovx state that
the Opium-sleep may be accompanied or interrupted by painful
dreams or reveries, and at times, after it has been used for
several days, and its use is then stopped, the patient may be exhausted by the most rebellious sleeplessness, and find it impossible to sleep for several weeks. CHRISTISON says, the effect of
a small dose of Opium seems generally to be stimulating in the
first instance; the action of the heart and arteries is increased,
and a slight sense of fulness is caused in the head. In most
persons, the stimulant effect is quite insignificant, still CHRISTISON reports the following experience, repeatedly occurring to a
friend of Dr. LEIGH. If in the evening when he felt sleepy, he
took thirty drops of Laudanum, he was so enlivened that he
could resume his studies; and if when the usual drowsiness
again approached, which it did in two hours, he took one hundred drops more, he soon became so much exhilarated, that he
was compelled to laugh, sing, and dance, the pulse being full
and strong, the temples throbbing violently; but in no long time
the customary torpor ensued. By small doses frequently repeated, the stimulus may be kept up for a considerable time in
some people, even jaded horsemen and horses may be made to
finish fatiguing journeys with great apparent facility, the rider
becoming absolutely more active and intelligent. According to
VoGT, in the second degree of the action of Opium, there is an
enlivening of mental faculties, especially of the passions and
imagination, varying according to the character of the individual; the dejected becomes gay; the timid, courageous; the en



OPIUM.                       875
terprizing, wild and venturesome; the religious becomes a fanatic, or enthusiast; the imaginative are surrounded by numberless beauteous reveries; the lover is lost in sweet dreams, and
the gay, dance and sing, &c. According to SCHMID, much depends upon the mental state of the person before taking Opium,
if he be melancholic, quarrelsome or enraged, these passions are
increased to the highest degree after a slight inebriation from
Opium; but if previously contented or gay, it produces an increase of these feelings, and an imperturbable state of dreamy
happiness; still the pleasurable feelings are very transitory, and
followed by a state of depression and uneasiness, so that the
Opium-eater, in order to renew his pleasurable sensations, becomes a very slave to this drug; finally, no refreshing sleep ever
visits his eyelids, he never experiences an agreeable dream, everything excites disgust in him, even his Opium, which alone can
produce a remission of his sufferings, is taken with repugnance.
According to TRINKS, the effects of Opium on the mind, and especially upon the imagination, can hardly be described with
words; it is a state of the clearest inward contemplation, which
can be carried to the highest degree of clairvoyance, the imagination producing the most delightful and enchanting ideas in
quick succession, while the external senses are inactive, and one
imagines himself transported from earth to the realms of everlasting bliss. DE QUINCEY, the English Opium-eater, always
found Opium to excite or stimulate him for upwards of eight
hours; it was a steady, equable glow of pleasure, introducing
in his opinion, the most exquisite order, legislation and harmony
of the intellectual faculties, communicating serenity and equipoise to all the powers, both active and passive, a healthy restoration to that state which the mind would naturally recover
upon the removal of any deep-seated irritation, or pain that had
disturbed and quarrelled with the impulses of a heart originally
just and good. Opium at first seemed to De Quincey to compose what had been agitated, and to concentrate what had been
distracted, to render the diviner part of his nature paramount, to
put the moral affections in a state of cloudless serenity, and to
shed over all the great light of the majestic intellect; it often
led him abroad in delight to public places and theatres, but he
admits that these are not the appropriate haunts of the Opium25




376   NERVOUS DISEASES AND MENTAL DERANGEMENT.
eater, when in the divinest state incident to his enjoyment. In
that state, crowds became an oppression to him, and music even
too sensual and gross; he naturally sought solitude and silence
as indispensable conditions of those trances or profoundest reveries, which he thought the crown and consummation of what
Opium can do for man; it happened more than once that he sat
from sunset to sunrise, motionless, and without wishing to move.
Ultimately, he took as much as eight thousand drops of Laudanum per day, with the most direful effects, and when he reduced
the quantity to one thousand drops, instantaneously as if by
magic, the clouds of profoundest melancholy which had rested
upon his brain like some black vapors, drew off in one day.
Previously, when he lay awake in bed, vast processions passed
along in mournful pomp; whatever he did but think of in the
darkness, immediately shaped themselves into phantoms of the
eye, and were drawn out into insufferable splendor; all these
visions were accompanied by deep-seated anxiety and gloomy
melancholy, such as are wholly incommunicable by words. He
seemed every night to descend into chasms and sunless abysses,
depths below depths from which it seemed hopeless that he
could ever ascend. Nor did he by waking, feel that he had reascended; the state of gloom which attended these gorgeous
spectacles, amounted at least to utter darkness, as of some suicidal despondency. The sense of space, and in the end, the
sense of time, were both powerfully affected; buildings, landscapes, &c., were exhibited in proportions so vast, that the bodily eye was not fitted to receive them; space swelled, and was
amplified to an extent of unutterable infinity; he seemed to have
lived for seventy or one hundred years in one night; the minutest incidents of childhood, or forgotten scenes of later years
were often revived; scenes from history or romance, crowds of
ladies, festivals, dances passed before his eyes, companies of
centurions and roman legions, &c. Dreams of lakes, and silvery expanses of water troubled him, and finally the waters
changed their character, from transparent lakes shining like
mirrors, they became seas and oceans. Again, a tremendous
change, unfolding itself like a scroll through many months, became an abiding torment, and never left him until the winding
up of his case. Hitherto, the human face had often mixed up




OPiUM.                      377
in; his dreams, but not despotically, but now what may be called
the tyranny of the human face, began to unfold itself; upon the
rocking waters of the illusory ocean, the human face began to
appear; the sea appeared paved with human faces upturned to
heaven; faces imploring, wrathful, despairing, surged upwards
by thousands, by myriads, by generations, by centuries, until
his agitation was infinite, and his mind tossed and surged with
the ocean. Again, his studies of Eastern literature made him
tormented by dreams of oriental imagery and mythological torture; tropical heat and sunlight, all creatures, birds, beasts, reptiles, all trees, plants, all usages, appearances and ceremonies
common to the East, were crowded into his illusions; he was
stared at, hooted at, grinned at, chattered at by monkeys, paroquets and cockatoes; he ran into pagodas, was fixed at the summit, or in secret rooms of temples, for centuries; was transformed into an idol, or priest; was worshipped, or sacrificed; he
fled from the wrath of Brahma, and was waylaid by Seeva, or
Vishnu, or Isis, &c.; he seemed to have done a deed which the
ibis and crocodile trembled at; was buried for a thousand years
in stone coffins, with mummies and sphinxes; was kissed by
crocodiles; or laid with all unutterable slimy things at the bottom of the Nile. Over every form of delirium, there seemed
attached a sense of eternity and infinity, which drove him into
an oppression as of madness. The form of the crocodile became
as constant as formerly his torture from the human face; he
was forced to live with crocodiles; if he escaped, he found himself in Chinese houses with cane tables, sofas, &c., and soon all
the feet of the tables and sofas became instinct with life; the
abominable head of the crocodile, and his leering eyes looked
out at him, multiplied into a thousand repetitions, while he
seemed to stand loathing and fascinated, &c., &c. For farther
information, the "Confessions" themselves must be consultedenough has been quoted to give an outline at least, of what may
be called Opium Dream-, or Reverie-Insanity.
On account of the close relation between sleeplessness and
insanity, Opium has long been used in the cure of this disease;
but of course the experience of different physicians varies. Dr.
WOODWARD says that Opium must be used from a few weeks to
some months; that single doses at night are rarely useful, for




378   NERVOUS DISEASES AND MENTAL DERANGEMENT.
the system must be kept under the influence of it, in doses repeated every four or six hours. Dr. GALT cured twelve out of fourteen recent cases, with enormous doses of Opium, viz.: from six
to twelve grains per dose, two or three times a day, or from one
to three grains of morphine, three times a day-he also had Opium mixed with tobacco, smoked in pipes by his patients; he regards his success as unexampled; still in the same year, he cured only fifteen cases of twenty-seven recent admissions, or but
little more than one-half. Dr. STRIBLING also gave large doses,
viz., one hundred drops of Laudanum every six hours, and cured nineteen cases out of fifty-two new admissions. According
to VOGT, in olden times Opium was lauded in mental derangement by VAN SWIETEN, but Cox soon proved it to exert a beneficial influence in a few particular cases only, so that justifiable
doubts are now indulged against the reputed experience of
WENDELSTADT, REIL and others, who claim to have cured mania by large doses of Opium, sufficient to produce sleep. Lately, NEUMANN has advised it in the second period of mental derangement, marked by melancholy rather than frenzy; it is most
useful in recent cases not connected with organic changes; in
deep-seated cases of hypochondria, hysteria and melancholy, it
only affords palliative relief. Dr. WooD says, want of sleep is
the most common cause of insanity, although this in its turn is
generally caused by mental emotions; all authors agree that
inability to sleep ought never to escape careful observation; excessive watchfulness by day, and restlessness at night, are
fraught with danger of insanity to most persons, especially to
the already predisposed, and when mental derangement has already occurred, want of sleep is one of its most distressing accompaniments, and contributes greatly to aggravate and sustain
insanity, and hence should never be neglected. WOOD says,
nothing on the whole is so effectual as Opium; it will often most
happily control the maniacal paroxysms, but must be given
more freely than in the healthy state of the brain to produce
its legitimate effects, viz., quiet and sleep; he has known patients in states of the most violent maniacal excitement, after
being put to sleep with Opium, to awake in the morning quite
composed and rational; mere nervous irritation, or mental disorder, however violent, is often relieved by it. Still another




OPIUM.                      379
class of physicians think that narcotics with the insane, generally if not always, act as stimulants, and exercise little or no
influence over the sleeplessness of insanity, which they think
generally resists all remedies, and only fairly yields when nature fairly tired out by long exertion, sinks exhausted. They
would not dare press Opium, Conium or Hyosciamus to the point
of producing sleep, as they imagine it would require enough to
prove fatal.-PETERS.
CASE 59. —A man fell into a state of mental derangement,
with frenzy, from the effects of fright and vexation.
iSymptoms.-Great fear of death, and all kinds of fancies annoy him; he sees ghosts and devils, who seek to murder him, in
alternation with a comatose state in which he lies unconscious,
breathes deeply, and sweats greatly.
Treatment.-Bellad. quieted him  speedily, but only transiently; Opium cured him quickly.
Archiv, Vol. 5, part. 1, p. 97.-SONNENBERG.
CASE 60. —A man, aet. 84, suffered without known cause,
from a peculiar kind of mental derangement.
Symptoms. —He imagined that he no longer lived in his own
house and village, but at a place some six miles'distant; he
stopped all passers by, and wished to go with them to his residence; force he met by force, so that two persons could not prevent him from his purposes; his face glowed from rush of blood
to the head, and at times he did not know some of his friends in
consequence of a comatose kind of unconsciousness; anxiety,
wildness; inclination to sleep without the ability to do so; constipation of several days duration, with meteoritic distension of
abdomen; retention of urine from a kind of paralytic condition
of bladder; when smoking, he often forgets to draw upon the
pipe; with all his disposition to sleep, he had the most active
wakefulness. Allopathic treatment had been used in vain.
Treatment.-Opium, one-fourth grain in tincture form, produced quiet night sleep, from which he awaked in full possession
of his consciousness.
Annals, Vol. 4, p. 331.-SCHUELER.
CASE 61. —A man, set. 38, given to onanism since his twelfth
year, fell into the extremest despair, on account of his shattered
health, followed by perfect idiotic apathy.




380 NERVOUS DISEASES AND MENTAL DERANGEMENT.
Syzymptoms.-Cannot be induced to rise from his bed, lies
quietly there, and pays so little attention to questions, that he
must be shaken and pulled to arouse him, when with an expression of perfect mental apathy, he always answers "yes," be it
right or wrong; entire want of appetite,!no desire for food or
drink; whitish coating of tongue; skin moist, pulse normal;
urine scanty and high colored, only passed once in twenty-four
hours. Attempts to jump out of the bed at times, is refractory
and abusive in the evening; at others, can only be made to sit
up in bed by much shaking, but cannot be induced to dress himself; must be pushed along; perfect expression of idiocy; trembling of arms and legs.
Treatment —Cold sitz-baths, aided by Sepia and Bellad., were
given without effect; then Opium-tinct.-fort, in the proportion
of two drops, divided into five powders, was given, one dose
every evening, from the 16th Sept. to 10th Oct., when he was
perfectly restored.
CASE 62.-A woman, in the climacteric years, of powerful
constitution, and subject to nodous gout, fell suddenly into a
delirious state during the desquamative stage of erysipelas of
face.
Symptoms. —She sits up in bed with disturbed features, pale
face, glistening eyes, and dishevelled hair; she speaks incessantly, first in connected, then in an unconnected manner, at
times in a low, and others in a loud, strong voice; first she sings,
then laughs, or cries, or expresses herself in beautiful or obscene
speeches; when she becomes quiet, she either stares fixedly before her, or buries her head under the bed-clothes; she rumples
or tears the pillows, so that her hands and arms are in constant
activity.
Treatment.-Hyosc. and Stramon. in repeated doses did not
help; Morph.-acet. one-sixteenth grain, every two hours, produced quiet in two hours, and the patient awoke the next morning with perfect consciousness.
General Hom. Jour., Vol. 3, part 6, p. 40. —TRINKS.
REVIEW.-Besides in the above cases, Opium was given in
cases No. 101 and 112, and relieved the following symptoms, viz.
Rapid flow of ideas, sleeplessness, with a kind of stupefaction,
(coma vigil,) especially in the evening, and attended with red



OPIUM- PETROLEUM-PHOSPHOR.               381
ness of the face and eyes; constipation; speaking confused stuff;
pointing at, and fear of imaginary animal forms; anxious starting;
jumping up; frenzy, with red face; rigid, glistening, upturned
eyes, &c.
The general remarks by GRIESSELICH are corroborated by the
individual cases.
Doses.-It was used in the - dilut.; strong tinct.: and Morph.-acet.
one-sixteenth grain, every two hours.
To obtain a clear view of the,curative action of such an important medicine as Opium, especially of the organs upon which
it acts, it will be necessary to obtain more facts than are included in the above cases. Still the alternations between anxiety,
fear and wild excitement, point to the organs of Caution, Destructiveness and Combativeness, being in state of alternating
excitement and depression.
24. PETROLEUM.
GENERAL REMARKS. —In anxiety, fearfulness, excited state
of mind, scolding, want of memory.
Chron. Diseases, Vol. 4. —HAHNEMANN.
-CASE 63.-A plethoric, corpulent man, aet. 50, had been for
several months in the following state.
Symptoms.-Irritable, fretful, constantly silent, dejected,
close, without pleasure in his previous occupations; heaviness,
heat and pain in the head every morning; violent pain in back
and sacrum also in the morning; spasmodic eructations; thin,
slimy stools, with cutting pains in abdomen; paleness of face,
emaciation, profuse night and morning sweats.
Treatment.-Petrol 3 —), one drop daily for several weeks, restored him perfectly.`General Hom. Journ. Vol. 5, p. 306.-KNORRE.
25. PHOSPHOR.
GENERAL REMARKS.-Dejection; fear of being alone-; anxiety
for the future; disinclination to work.
HAHNEMANN, Chron. Dis. Vol. 5.
CASE 64.-A woman, aet. 49, of choleric sanguine temperament, who had been in an asylum nine years before, on account




382 NERVOUS DISEASES AND MENTAL DERANGEMENT.
of mental derangement, had again suffered in like manner for
four weeks.
Symptoms.-She destroys whatever she can reach; speaks
in a violent, authoritative manner; spits at her attendants; lifts
up her clothes without shame, and kisses passionately any one
who approaches her; performs foolish actions, and speaks in an
unconnected manner; pulse but slightly quickened; tongue
whitish; almost sleepless; menses quite scanty, pale and watery.
Treatment.-Acon. Bellad. and Hyosc., were given without
benefit; after smelling Pyosphor 3-0 repeatedly, she was entirely
restored in four weeks.
New Archiv, Vol. 2, part. 3, p. 103.-SCHMIDT.
CASE 65.-A cadet was attacked with frenzied somnambulism and had been treated in an asylum for fourteen months
without benefit.
Symptoms.-The paroxysms occur in his sleep and last for
two or three hours; he goes about with closed eyes, destroying
whatever is in the room; no one dared approach him; when the
frenzy is over he lies down, sleeps a few minutes and on waking
knows nothing of what has transpired.
Treatment.-Several remedies and magnetism did not benefit
him; then Phosphor 3-i- was given, one drop morning and evening, and he was cured in fourteen days.
General Hom. Journal, Vol. 16, p. 79. —HARTUNG.
REVIEW.-In both cases the organ of destructiveness was
excited, and in the first case that of amativeness also.
26. PLATINA.
GENERAL REMARKS.-The timid, silent, and anxious condition which it causes, with fear of death, &c. points to its use
in certain forms of melancholy. If to this we add its action
upon the uterus, upon the sexual functions, in neuralgia, &c., we
can easily divine its adaptation to mental derangement in females,
especially in nymphomania and puerperal mania.
CASE 66.-A delicate maiden, aet. 19, who had suffered four
years before with eruptions on the head and from fever and
ague, had exhibited signs of mental derangement for three years,
but for the last half year had menstruated regularly and grown
stronger. She had again become deranged for sixteen days.




PLATINA.-PULSATILLA.                383
Symptoms.-She speaks almost incessantly of various things,
at times irrationally, at others of things which came before her,
of untrueness in love, of her teacher, and of her school-years;
she laughed, cried, danced, made faces, gesticulated with her
hands, persisted obstinately in her own notions, but without becoming frenzied. Her features were distorted, her eyes fixed,
and directed upon one object; she had no desire for food or
drink, but devoured whatever was given her in haste.
Treatment.-Ignatia was given without benefit; on the third
day she took Platina, which was repeated on the eighth day, after
which no sign of derangement occurred until the eighteenth day;
but she remained quiet and taciturn; Crocus was given without
benefit; on the twenty-ninth day she took Sepia, with improvement on the very next day, and could be dismissed cured
on the thirty-sixth day.
Annals of Hom. Hospital, Vol. 2, p. 112.
In another case (see No. 113), Platina relieved the following:
Symptoms.-Griping pain about umbilicus especially in the
evening, as if one had drank unfermented beer; notwithstanding frequent urging and pressing in the rectum he did not have
a passage every day; was obliged to expel the faeces with
much straining; he was forgetful, distracted, often listened attentively to what was said, but in the end knew nothing about it; was dejected, reflective, and had great fear of death;
thought himself superior to his wife.
REvIEw.-The organ of self-esteem seems to be affected by
Platina, as is evident from the cases and symptoms.
27. PULSATILLA.
GENERAL REMARKS.-It is most useful in persons of a
bashful, lachrymose disposition, disposed to internal disquiet,
and to silent vexation, or at least in those of a mild and
yielding temper.
Mat. Med. Pur. Vol. 2, p. 274.-HAIHNNEMANN.
CASE 67.-A woman, met. 45, a-menstrual, had suffered for
several weeks with mental derangement from vexation.
Symptoms. —She is in constant anxiety, has palpitations, is
afraid of every one, and will be seen by no one, regards every




238.4   NERVOUS DISEASES AND MENTAL DERANGEMENT.
body as her enemies, despairs of every thing, weeps readily, and has -no faith in any one.  Her face was pale and
sallow; her look dull and desponding; she had no appetite,
but much thirst; her limbs seemed asleep; she was tired and
weak, and could not sleep at night for anxiety and timidity..Treatment.-Pulsat. a-, one dose, restored her in a few days.
Annals, Vol. 1, p. 62.-RUECKERT.
CASE 68.-A man, -et. 30, strong, choleric, and inclined to
drink.
Symptoms.-Throbbing pain in the brain; dimness of vision
as if he were looking through a sieve; when in the dark, or
when he closed his eyes every variety of frightful forms appeared to 1hind and at which he struck as if they were evil
spirits, or made the sign of the cross to protect himself.
Treatment.-Pulsat. cured him in ten days.
Archiv, Vol. 19, part. 1,:p. 89.-SZTAR.,CASE 69.-A youth, -et. 16,:had suffered for ten days with
a kind of religious mania.
Synmptoms.-Eyes unsteady; lips bluish-red, memory weak:;
stings of conscience with regard to -religion and women; he
has violent palpitations whenever he sees a woman, but is filled
with anger and disgust for them, so that he must fly in order to
-keep from injuring them:; he regards all women as bad, and
thinks that his soul is in danger in their presence; breathing
short and oppressed, painful pressure on chest.
Treatment. —He was icured in fourteen days by Pulsat. I.
General Hom. Journ. Vol. 13, p. 286.-MALAISE.
CASE 70.-A woman, set. 40, had suppression of her lochia
ten days after her fifth fortunate delivery, and mania set in.
-Symptoms. —She is shy and fearful, and looks constantly
about her; as often as she sees a -man, she hides herself under
the bed-clothes, or jumps out of bed and hangs the sheets and
quilts over her head; glistening eyes, rigid look; excessive sensitiveness of the uterine region to the slightest pressure; the
suppressed lochia returned at the end of eight days.
Treatment. —Eight doses of Pulsat., restored the lochia and
perfect health in the course of a week.
CASE 71.-A young woman, set. 19, naturally, large, strong,
active, lively and good natured, became desponding, suspicious




PULSATILLA.                    385
and taciturn during the eighth month of the first pregnancy, had
disturbed features, and entire sleeplessness.
ASymptonms.-She looked about in the yard for her bed; hid
herself -in a corner to escape a little gray man who wished to tear
off her leg.
Treatment. —Bellad. -30 was given with transient benefit
only, but Pulsat. -T- quickly and permanently removed the whole
trouble.
Archiv, Vol. 9, part. 1, p. 113.-BETHMANN.
CASE 72.-A maiden, aet. 18, of sanguine temperament, but
who had been chlorotic several years before, and still had not
yet menstruated, although she often had various kinds.molim.
menstrual., became dejected and tired of lift after a fit of
vexation.
Symptoms.-Frequent frontal headache; sallowness of face,
dark rings around the eyes; bitter bad taste in the mouth,; disgust for meat and bread; nausea, with pain in stomach, at times
vomiting of bilious slimy substances; frequentprofuse bleedings
from nose; piercing pain in the side when coughing, with expectoration of frothy blood; palpitation, difficult respiration;
few and scanty stools  frequent cutti:ng pains in abdomen;
heaviness of the legs; feeling as if all the limbs were bruised;
swelling of the backs of the feet; anxious dreams; thinks with
much pleasure of drowning herself; desponding, and often
bursts into tears; dissatisfied with every thingI; easily angered;
abusive; very fearful, anxious and tired of life.
Treatment.-Pulsat. -T  brought on menstruation in:a few
days, and restored her former hilarity.
Archiv, Vol. 12, part 8, p. 99.-ATTOM:VR.
CASE 73.-A robust woman, met. 20, of quiet gentle cdisposition, had suffered for several years after her first confinement,
with irregularity of the menses, and anxiety and intternal Xestlessness, so that she did not know what:to do.
Symptoms. —-Heat and:congestion to -the face'and head;
headache, oppression of the heart, and pain in the small odf-the
back; sleepless nights in consequence of great anxiety, and
anxious uneasiness, in head; does not believe -that she can be
saved and thinks that her only salvation is in constant prayer.
Treatment.-Pulsat. in small doses relieved her in a few days.




886   NERVOUS DISEASES AND MENTAL DERANGEMENT.
Annals, Vol. 2, p. 243.-BETHMANN.
REVIEW.-In all the cases in which Pulsat. was of essential
benefit, we find a decided state of depression, a form of melancholy marked by an anxious, scrupulous, lachrymose condition;
or the patient sees frightful figures, which frighten him, or believes that he cannot be saved; is tired of life, thinks about
drowning, and dislikes society.
The stings of conscience in case 69, when one approaches as
female are peculiar and characteristic.
In several cases the mental disease was connected with pregnancy, confinement, or irregular menstruation.
In Case 27, Pulsat. was not beneficial against symptoms
which seemed to indicate it, but the mental disorder consisted
in an anxious state about her affairs, belief that she must starve,
and inclination to run away.
Doses.-In several instances the quantities are unfortunately not
mentioned.
The organ of caution is the one upon which Pulsat. seems to
act most decidedly.  Its relations to other organs, such as conscientiousness, hope, marvellousness, &c., can only be settled
by more numerous observations.
28. PLUMBUM.. The Lead mental- or cerebral-derangement has been so fully
elaborated by TANQUEREL, and the remedy according to homceopathic principles promises so much in the cure of many of the
most intractable cases of insanity, that I [PETERS] have deemed
it advisable to include Plumbum among the articles here treated
of; it being expressly understood that the whole is but a transcript and condensation from TANQUEREL.
"The cerebral lead-disease may occur in a sudden and unforeseen manner, or be announced by some functional trouble of the
brain, such as violent headache, either general or partial, and
often limited to the forehead; these pains in the head may
vary in their nature and intensity, and are generally accompanied by dizziness and sense of intoxication.
"Sometimes it is preceded by wakefulness or by disturbed
sleep, agitated and interrupted by dreams and fanciful imagin



PLUMBUM.                      387
ings; the unfortunate patients often awake suddenly full of fear,
leap from their beds, and escape or injure themselves.
" At other times the approach of the disease is preceded by
dimness of sight, tingling in the ears, blindness, squinting, dilatation, or contraction of the pupils; or by a strange, astonished,
dull or pensive look. Some patients have a great fullness or
heaviness, with great pain in the orbits of the eyes.
" In another class of patients the moral sensibility is deranged,
many have presentiments of sickness, sadness, an extraordinary
and causeless uneasiness, or become silent and indifferent to all
the objects which surround them. Others become morose and
weep without cause, some have their minds agitated, and change
their place without ceasing, trying to divert their thoughts, and
to remove themselves from the sudden and great terrors which
beset them. Some have a stupor, an undefinable uneasiness
from embarrassment, and slowness of ideas and motions. About
one case in three and a half of lead mental derangement have
some of these precursive symptoms; still, an unusual, strange,
astonished, dull or pensive look, taking.place suddenly is the
most common phenomenon which announces the approach of this
disease.
" Lead paralysis precedes the cerebral disease about once in
four times; severe pains in the limbs or lead colic sometimes
cease suddenly and the lead mental disease then sets in; it
oftener commences in the night than the day.
"The symptoms of lead mental disease vary very much, delirium, coma, or convulsions may recur separately or combined;"
in short TANQUEREL prefers a mode of describing it similar to
that which has been adopted by authors who have written on
mental alienation.
1) DELIRIOUS FORM.
This occurred eighteen times in seventy-two cases; the delirium may be light or profound, partial or general, continued
or remittent, and even intermittent, and be accompanied or
not by loss of one of the senses. Finally and especially, the
delirium may be tranquil or furious.




388'NERVOUS DISEASES AND MENTAL DERANGEMENT.
A) TRANQUIL DELIRIUM.
" Sometimes the patient seems astonished, his features being
at the same time immoveable and his eyes fixed; or he seems
absorbed in profound thought, with composed features. TANQUEREL has seen three persons whose eyes were turned upwards, with open mouth and every feature immoveable, as if
fallen into a trance.
"Some have a sardonic smile, or laugh without ceasing and
without cause; others weep frequently and have an air of sadness and melancholy impressed on the whole person. In many
the face is gentle and benevolent, or hard and discontented;
some have an air of stupor, with their features. weighed down
and their eyes fixed and haggard. This state of countenance
often varies with prodigious rapidity, so that a single person
may offer in a few hours all the varieties of expression first
mentioned.
" If they be questioned about the thoughts which they have
in connection with so varied a physiognomy, they will answer
at random; it will be seen that their words, and consequently
their thoughts, are entire strangers to the expression of their
countenances.  At first the patient may reply like a sane
man, and in such a way that one is often in doubt whether there
is really any mental disease. But let the physician pursue
the conversation, passing rapidly from one idea to another, and
the patient will suddenly become wandering, and put together
words and phrases without meaning; but soon he returns, especially if aided, to a succession of rational ideas, still byand-bye the delirium will return again. Sometimes the patient
wanders every few moments; at others not for hours, or even for
a day, and in the interval is perfectly rational." These variations of physiognomy and speech, and singular union of reasonable and wandering ideas are so frequent that it occurred to
TANQUEREL to establish the diagnosis of lead mental disease
upon them, and with success.
" Some patients, when questioned, do not reply immediately;
they seek for expressions, use one word for another, or again
their reply may be correct; they do. not always look towards the
questioner; sometimes they do not appear to understand what is
said to them, and it may be necessary then to speak very loud,




PLUMBUM.                      389
to arouse them  gently and fix their attention; sometimes- they
use the same word or words in answer to the most varied'
questions.
" If left alone they very often speak to themselves, call their
neighbors or absent persons; some reply to all that speak, or
all that they imagine they hear speak around them. Their speech
is very often free and the voice clear; but some murmur unintelligible words between their teeth, or else their voice is so much
weakened, that their words cannot be understood. They have
periods of entire silence, and some of talking; alternately gayor sad, loquacious or silent, or delirious. The subject of the
delirium varies much, and often has no predominant character,
still it often has been observed that the same idea returns with
several fits of talking, and then the subject of the wandering;
changes.
"Some patients throw about their arms, uncover themselves,
wish to go away, not recognising the place in which they are;
leave their own beds to lie in another's; throw themselves against
the furniture which they meet, and know but imperfectly the
persons around them, although they generally return to their
beds with the aid of their keepers, and without resistance.'" Some have a slight trembling of the arms and muscles of
the face, find difficulty in using their limbs, or in speaking and
stutter.
"Hallucinations of sight and hearing, have been observed in
some; many think that they see frightful objects which cause
them to leap from their beds; others hear delightful music,
which charms away their weariness; one patient imagined that
he saw a woman come every morning to provoke him, placing
herself sometimes before, sometimes behind him, and saying the
most insulting things to him; one day he impatiently seized the
poles which supported his curtains, thinking to catch this woman; all this he related with a tone of calm assurance and belief."
B) FURIOUS LEAD DELIRIUM.
"In this variety, the eyes are often wide open, threatening,
furious, or haggard; the features contracted, and excitement
marks every act of the patient.




890   NERVOUS DISEASES AND MENTAL DERANGEMENT.
"They cry, vociferate, swear, threaten, storm, tear their garments, break the bonds which hold them in bed, run in other
rooms, attack the people they meet on their way, try to beat,
tear, and bite them, and address them with the grossest invectives. If they are not restrained, they continue to enact the
most violent manoeuvres; some cast themselves from the windows
or throw themselves against the walls or furniture with such violence as to destroy life. If a straight-jacket is put on, their fury
is redoubled, they stamp their feet, agitate their limbs, suddenly
rise in a convulsive, or tetanic manner, stiffen themselves, and
display a strength which can only be overcome by three or four
men.:" Once chained, they often grind their teeth: spit at their assistants, call for scissors or knives, tear at their bonds, and exhaust themselves in vain efforts. Constraint agitates and enrages some, who become calm when unbound; sometimes the pain
produced by blisters, produces the same excitement. In many,
this furious delirium is accompanied by a spasmodic contraction
of the muscles of the face, rolling of the eyes, grinding of the
jaws, jerking of the tendons, or trembling of the limbs.
"Terrors, visions, and hallucinations, often besiege the minds
of these persons; some cry, weep, lament like children, because
they imagine they see pistols pointed at their heads to kill them;
they supplicate and implore help to remove these causes of despair. Some abuse the nurse, whom they imagine has been sent
to poison them, they then may touch the medicine, but suddenly
repulse it with great violence. An old soldier thought he saw a
regiment of cavalry ready to attack him; some think they have
destroyed themselves, by throwing themselves'from a more or
less elevated place, &c.
"These patients in general talk much, have an incoherent association of words and ideas, and their speech is reprimanding,
abrupt, stuttering, and often unintelligible. They may have
convulsive agitation of the muscles of the larynx; talking and
fury generally return in simultaneous fits; from some minutes
to hours, or days and nights may pass in this furious state; then
a short calm ensues, but the fury soon returns.
"'The face is usually of an earthy yellow, and is sometimes
slightly flushed, but has not that warm coloring which is gene



PLUMBUM.                       391
rally remarked in inflammations of the brain.  Sometimes the
tongue and teeth present appearances which might be thought
to indicate typhoid fever; the mouth may become dry, the tongue
furred, chapped, or:trembling, while blackish sordes cover the
teeth and gums; if the pulse be accelerated and irregular, and
the body be covered with sweats, it would be easy to mistake
this state for that of a grave fever of bad character.
-"The delirium may remain incomplete for some hours or days,
and then consist only of an illusion of the external senses, and
an incoherence:of ideas, which produces a singular confusion in
the names of persons and places; but as soon as the delirium is
completely developed, it proceeds with an incredible irregularity; it exalts and increases, then diminishes in intensity from
one moment to another, without any order; there may be:remissions marked by a certain lucidness of ideas, but a sudden attack of violent delirium is apt to return. From time to time,
the patients are affected with drowsiness, as if asleep, but this
somnolent state does not last long, usually after a few minutes
or an hour, the delirium returns; the disease is characterized by
this alternate delirium and drowsiness; a long duration of somnolency, if it does not become comatose, is of good augury.
The whole disease is apt to commence with tranquil delirium;
soon fits of fury are added; finally somnolency occurs, and delirium succeeds it at longer or shorter intervals; at length true
sleep follows, and the patient is almost restored to reason-from
this time on, the tendency to sleep is strong, and.almost irresistible; finally he seems merely fatigued, his limbs ache, and
he has an expression of surprise."
Enough has been quoted to convince every Hom.ceopathist of
the great importance of lead as a remedy against insanity-and
DANA'S translation of TANQUEREL on Lead-diseases is easily
to be obtained by every American and English physician.  It
only remains for me to add, that Plumbum should be faithfully
tried in obstinate and chronic cases of mental derangement;
there is literally little or no hope from the ordinary allopathic
and homoeopathic remedies. The best old school authorities
concur in admitting, that in cases of insanity of more than
twelve months' standing, the probability of recovery is less than
onein four. The mean of recoveries from mental derangement of
26




392   NERVOUS DISEASES AND MENTAL DERANGEMENT.
all ages, is from thirty-three to forty-seven per cent., leaving
fifty-three to sixty-seven per cent. to become incurable and
chronic-here is a large field for the use of Plumbum. ESQUIREL in 2005 cases, had 604 recover during the first year; 497
during the second year; only 86 in the third year, and only 41
cases in the seven following years, leaving 777 cases, or about
30 per cent., entirely and hopelessly uncured. In March, 1844,
in the Hanwell Asylum, of 984 cases, only 30 were regarded as
curable. Shall nothing be done for these numerous sufferers?
If there be some or any truth in the homoeopathic law, Plumbum should prove useful in some of these chronic intractable
cases, especially as no organic disease is generally present in
them, for it may be asserted without fear of contradiction, that
no pathologist could in nine-tenths of the cases of mental derangement which prove fatal, take upon himself to say whether
the person examined had been of sound mind during life, or not.
Again, the Paralysis of the Insane is generally regarded as
incurable. Plumbum is also homoeopathic here.
Again, Epilepsy is the most common form of convulsions by
which the brain manifests the deleterious action exercised upon
it by lead. TANQUEREL has observed thirty-six cases of lead
epilepsy-the connection between mental derangement and convulsions is well known, and the difficulty of effecting cures in
such cases is equally public. WOODWARD says, that- "Stramonium is most useful in cases of insanity, coupled with epilepsy;
it does not cure, but often the symptoms are greatly diminished
in force and frequency by it; in some cases, the epileptic attacks
are entirely suspended by it." From the known tendency of
Lead to produce paralysis, and its consequent antagonism to
convulsions, it has often been a source of astonishment, that old
school physicians have not more frequently tried it in convulsive
disorders.
Finally, Lead produces a form of idiocy similar to that which
succeeds mania or monomania; but lead-idiocy has this peculiarity, that its intensity varies in an extraordinary manner,
from moment to moment, from day to day. To-day the patient
is careless and indifferent to all that passes around him, lies immovably in his bed, his face dull and without expression; to-morrow he will be bright, pleased, and grateful; but on the third




RHUS-TOXICODENDRON- SECALE-CORNUT.           393
day, this amelioration disappears, and the patient returns to his
vegetative life. Hence it might render a fixed idiocy, mobile
and transient.
28. RHUS-TOXIC ODENDRON.
CASE 74.-A maiden, aet. 18, rather short and thick set;
somewhat crooked, with the spine bent to the right side, in consequence of a fall, when a child of nine months old.
As a child, and occasionally now, she had eruptions upon the
scalp; had had measles, scarlet fever, and small pox; learnt
rapidly in school; had not yet menstruated. Three years ago,
after a fright, she was taken with heaviness in the forehead, and
eight days after, showed signs of mental derangement; did not
wish her mother to look at her, was mistrustful, and had a di'slike for all company; at times would come in from the street,
thinking that everybody looked at her very strangely or curiously; then would sit quite alone; her eyes were dim and sensitive
to light.
This kind of attack had occurred three times, had always
lasted six weeks, but this time had already continued eight
weeks, but without being attended with the affection of the eyes.
Symptoms.-She often weeps without cause, imagines that
people talk about her, that she does not earn or deserve anything; acts childishly; heaviness of the head; if she lies with it
low she has throbbing in the temple of the side on which she
lies; diarrhcea easily excited by cold; cough for eight days, especially on lying down, with piercing pain in epigastrum; coldness of hands and feet; frequent rumbling in the bowels.
Treatment. —Bellad. 0v was given for fifteen days without
benefit; then Rhus 3-0, and in six days more, her mother reported her as entirely different, as almost well; she was only somewhat reflective after going to church. During the three months
more that she was under observation, she remained quite well.
H. HARTLAUB.-Private cases.
29. SECALE-CORNUT.
GENERAL REMARKS.-The very numerous observations which
have been made with Ergot, leave no doubt but that it is a very
powerful remedy, which may prove very useful in mental disorders.




394  NERVOUS DISEASES AND MENTAL DERANGEMENT.
Secale is a decided spinal remedy, and may effect great good
in mental diseases, when connected with paralysis and paralytic
states, intermixed with cramps, especially where corresponding
disturbances are found in the sexual system.  GUISLAIN regards
it as a remedy against nymphomania; it should also be borne in
mind in those mental derangements of men which arise from excessive losses of semen, in the melancholy of onanists, and of
those who suffer from diurnal pollutions.
Hygea, Vol. 23, p. 263.-GRIESSELICH.
30. SEPIA.
GENERAL REMARKS.-Dejection of spirits, and weeping;
melancholy and sadness; anxiety, in the evening in bed; disinclination to labor, indifference towards his family.
HIAHNEMANN, Chron. Diseases, Vol. 5.
It was given, but without farther remarks, in cases No. 66,
100, 105, 106.
In case 66, after using Platina, the following state remained:
Symptoms.-She is taciturn, scarcely speaks a word without
being aroused to it; sits for hours with her knitting; always answers correctly, but very abruptly.
Treatment.-After taking  Sepia, she was better, ev;en on
the next day, and was soon completely restored.
31. DATURA-STRAMONIUM.
GENERAL REMARKS.-a) I speak from experience when I
proclaim the great virtues of Stramonium, when used homweopathically against natural mental diseases, similar to those excited
by it.
HAHNEMANN, Mat. Med. Pur. Vol. 3, p. 288.
b) From the effects of Stramonium, the illusions before the
eyes always appear dark colored, while from the full effects of
Bellad., they are always fiery and shining. Finally, and which
I regard as most important, and hitherto too much neglected,
the patient under the influence of Bellad., in the majority of instances, is in a joyous state of mind; or even when he is depressed, the illusions do not strike him with fear and fright, as
those excited with Stramon., do.
Hygea, Vol. 4, p.115.-KURTZ.




SEPI —-DATURA-STRAMONIUM.              395
c) The excitement of fear: is undoubtedly a predominant effect
of Stramon..
The remarkable mobility, haste, and precipitancy which is
manifest in the Stramonium disease, is worthy of attention; the
mental disorder is marked by an unusual agility.
Hygea, Vol. 23, p. 254. —GRIESSELICH.
NOTE.-d) A man was induced to drink some wine in which
Stramonium seeds were steeped; he was then robbed, and became
unconscious- for twenty-four hours; he was found wandering in
the woods, delirious and incoherent, with staring eyes and oppressed breathing, and was regarded as a madman for some time.
In another case, observed by Dr. TRAILL, the patient had a
flushed face and glistening eyes, with incoherent speech, so that
his friends supposed him to: be intoxicated; subsequently he fell
into a strain of incessant, unconnected talking, like one demented. Dr. DROSTE, from infusion of 125 seeds, saw delirium followed by fatal coma. DUGUID reports the case of a man who
drank a decoction of three thorn-apples; he was seized with
great vertigo almost immediately, with stammering, and general
torpor for seven hours, from which he aroused in a furious delirium. FRANK saw a man become deranged for eighteen days,
after taking a large quantity.
The effects of Stramonium on children, have been more frequently observed. FOWLER saw a little girl, who had swallowed
one and one-half drachms of the seeds, become maniacal in less
than two hours, with spectral illusions, interrupted by some intervals of lethargic sleep. Another child, besides other symptoms, was remarkable from assuming an attitude and expression
as if about to tumble into a fit. VICAT and SWATNE observed
furious delirium in two cases. In three children treated by
ALIBERT, there was delirium, restlessness, constant incoherent
talking, dancing and singing, attended with fever, and flushing
of the face. YOUNG witnessed some convulsions in one case.
KAAUW BOERHAAVE has reported with great minuteness, the
case of a young girl, who was induced by a human fiend to take the
powder of Stramonium in coffee, in order to seduce her; the effects were, redness of the face, delirium, nymphomania, loss of
speech, fixing of the eyes, tremors, convulsions, and coma. RUST
gives a case of a child with spasmodic closing of the eyes and




396 NERVOUS DISEASES AND MENTAL DERANGEMENT.
jaws, spasms of the back, and complete coma. Dr. DUFFIN'S
child, aet. 2 years, swallowed about 100 seeds without chewing
them; she soon became fretful, like a person intoxicated, her face
was flushed, pupils dilated, speech incoherent, she had wild spectral illusions, and furious delirium, followed by spasms of the
throat, and croupy breathing, coma, with violent spasmodic agitation of the limbs, occasional tetanic convulsions, &c. A girl,
fat. 4 years, ate a few seeds; soon had noises in her ears, and
sleeplessness; she sang, wept, and spoke confused nonsense incessantly; her eyes were lively; pupils dilated and insensible
to light; she snatched continually in the air as if to grasp
something; she was unable to stand, her knees knocked together,
and she staggered and fell about like one drunk. A boy, aged 5
years, ate more than a drachm of the seeds; in an hour he was
much excited, and rather delirious, clinging to the woman who
had him on her lap, under the seeming fear of some pressing
danger; his pulse was 120. face flushed, eyes brilliant, pupils
dilated, and he had convulsive movements of the limbs and neck,
with frothing at the mouth. After evacuant treatment, the
symptoms were relieved, except the tossing of the limbs, which
increased, with great flushing of the face; his skin was intensely
red; a state of extreme vigilance succeeded that of terror, and
lasted for a day or two. Ten children, from seven to fourteen
years of age, ate of the seeds; they all became deranged and
furious, and fell into a state of persistent insomnia; at first they
had an extreme aversion to liquids, but afterwards drank with
avidity. MEIGS observed a girl, set. 2 years, who had taken a
large quantity of the seeds; very soon, singular symptoms set
in, viz., gaiety, delirium, hallucinations, disordered vision, redness of the face, more intense than that of the most confluent
scarlet fever, &c.
WooD and BACHE say, that it causes vertigo, headache, dimness or perversion of vision, confusion of thought, delirium, and
a kind of intoxication; inclination to sleep is sometimes but not
uniformly induced; the delirium is sometimes of the furious, and
sometimes of a whimsical character. VOGT asserts that it causes a similar affection of the brain and senses, with the same
great congestion towards the head, like that caused by Bellad.,
but that the Stramonium delirium is much more apt to be at



DArTURA-STRAMONIUM.                 397
tended with spasms. TROUSSEAU and PIDovx state, that large
doses caused vertigo, slight stupor, disordered vision, agitation,
spasms, furious or gay, or sad delirium, continual hallucinations,
obstinate insomnia, and high fever; the delirium and blindness
may last for some days or weeks; the delirium is at times gay,
at others sad, but is always accompanied by singular hallucinations, and fantastic visions-hence in old times, Stramonium received the name of Herbe aux sorciers, or Herbe au diable, and
because it was used by pretended magicians to intoxicate, and
produce fantastic illusions in those superstitious persons who
wished to witness their incantations, or assist at the so-called
witches-SABBAT. CHRISTISON says, on account of its intoxicating properties, it was once used extensively in Germany, to
cause loss of consciousness and lethargy, preparatory to the commission of various crimes.  GMELIN informs us that it was
used by prostitutes and thieves to put persons asleep, in order
to violate or rob them; by procuresses to take away from their
noviciates all sense of natural shame; by old whore-mongers, to
seduce young maidens; by criminals, to render their watchers
insensible; by false wives, to prevent their husbands from detecting their misdeeds; in short, for exactly the same purposes
that gin, whiskey and Opium are used in England and other
countries. On account of its specific action on the sexual system, it was also used to cause illusory pleasures in silly lovers,
and in the composition of love-philtres. Finally, in the French
law annals, there is the record of a band of thieves, called Endormeurs, who operated by mining powdered seeds of Stramonium with tobacco, to be smoked in pipes, with which they plied
their victims until stupid and delirious.
It seems very singular in the face of the hot opposition to
Homceopathy, that a drug like Stramonium should be used in
mental derangement by old school physicians; still it was introduced into general practice by the celebrated STORCK of Vienna,
as particularly beneficial in mania; his original recommendation
in 1762 was founded upon two cases:
1st CAsE.-A young girl, eet. 12, had been deranged for two
years; she took one demi-grain of Ext. Stramonium, night and
morning, with improvement in the course of three weeks; it
was continued for two months more, and the dose very slightly




398   NERVOUS DISEASES AND MENTAL DERANGEMENT.
increased; she gradually and perfectly recovered her reason in
that time.
2d CASE. —A woman, ret. 40 odd years, had had vertigo for
two years, and gradually became deranged, with occasional paroxysms of frenzy. Dose, one grain of Extract, gradually increased to three grains, once a day; decided improvement in
four days, and perfect restoration of intelligence in a month.
She died some time after, and the brain was found infested with
hydatids, yet she had had no return of mania after taking Stramonium.
These cases led STORCK to use the memorable words which so
often have given comfort and courage to IIAHNEMANN and his
disciples:  "Si Stramonium turbando mentem adfert insaniam
sanis, au non licet experiri, nun insanien tibus et mente captis
turbando, mutandoque ideas, et sensorium commune adferret
mentem sanam et convulsis tolleret contrario motu convulsiones.
See STORCK libell. de Aconito, Stramon. et Hyosciam. VINDOB.
WOOD and BACHE say that, subsequent observations have confirmed STORCK'S estimate of Stramonium in mania, and that
numerous cases are on record, in which benefit has accrued from
it. VOGT says it was found useful by STORCK, SCHMALZ and
BARTON, especially when the attack of mania was caused by
mental influences, and appeared in paroxysms, separated by lucid
intervals-said to be more frequently useful than Bellad. TRousSEAU says, a sufficiently great number of facts confirm the utility
of Stramon. against mania; SCHNEIDER slowly cured a lady,
at. 50, with demonomaniac melancholy; also a lady deranged
after confinement; BERNARD saw an accidental cure of a chronic
mania, also, in a lady after confinement; she took some of the
seeds through inadvertence, had all the signs of severe poisoning, and was thus cured. AMELUNG cured four cases of acute
mania after the first violence of the symptoms had been subdued
by other means. The experience and reasoning of MOREAU Of
Tours, is similar to that of STORCK and HAHIN EMANN, he says
he uses it in monomania with hallucinations, because Stramon.
causes hallucinations, and imagines that it cures these in the
same manner as many local irritating remedies cure irritations of
the eye, skin, urethra, &c. BAYLE collected fifty-five cases of
mania, treated by STORCK, SCHMALZ, RAZOUX) REEF, MEYER,




DATURA-STRAMONIUM.                  399
OBDELIUS, DURANDE, MARFT-, B:ERGIUS, GREDING, SCHNEIDER, BERNARD, and AMELUNG; a considerable majority were
either cured or relieved; still PEREIRA thinks that the cases in
which it proves of service are- very rare, while those: in which it
will prove injurious, will be found very common; while CULLEN
admits that he has not, and doubts if any other person has
learned to distinguish the cases in which it is proper to use it.
With the hints derived- from STORCK, HAHNEMANN, and MoREAU, we add those derived from WOODWARD, of the Worcester
Asylum; he says that Stramonium  acts favorably in some cases, and disappoints in others, but it is most useful in cases complicated with epilepsy; it may not cure, but often the-symptoms
will be greatly diminished in severity and frequency, while in
some cases, the epileptic attacks will be entirely suspended;
still we have' seen that VOGT says Stramon. is more apt to cause
convulsions than Bellad., and: in the cases of poisoning, we have
quoted, attacks of convulsions were quite frequent. Again, according to WENDT, Stramon. stands in a near specific relation
to the nerves of the sexual organs, and in large doses, causes
insatiable increase of lust and shameless lasciviousness, which
effects may be regarded as characteristic of its action, as that of
Phosphor, or Cantharides; still WENDT, who was no homoeopathist, found it especially useful in mental diseases, arising from
disorder of the sexual functions, from onanism, excess in sexual
congress, &c., actually cured a case of nymphomania with it.
-PETERS.
CASE 75. —A woman, set. 62, had been deranged during her
confinement with her first child, and had had four more repetitions of mental disease; the last time after an interval of health
of six years' duration; eight days before her last sickness she
had an attack of chills, which were repeated on the outbreak of
the mental disease, six days ago.
Symptoms.-She sits in bed and speaks incessantly and vehemently, sometimes for a quarter of hour at a time; wishes to
escape; then she will sit perfectly quiet for three or four hours
together; occasionally she supports her head upon her hand, as
if she had pain in it; complains of her abdomen; costive; urine
passed unvoluntarily at times; sleeps but little; but eats and
drinks.




400   NERVOUS DISEASES AND MENTAL DERANGEMENT.
Treatment.-She received two doses of Bellad. I, one-third
of a drop per dose, in the course of forty-eight hours, without
evident benefit; the paroxysms of mania became so violent that
she was put into a straight-jacket, and required several men to
watch her. Then Stramonium was given in like doses, four
times, at intervals of four days. The first dose was soon followed by an aggravation lasting three and a half hours, succeeded
by perfectly clear, healthy understanding for two hours; the
next day, there were several violent paroxsms of no long duration, but interrupted by quiet sleep and lucid intervals; actual
complaints about pains in the head and abdomen now occurred,
also cough with pain in the epigastrium. After the second dose
there only remained hastiness, timidity, anxiety, and timid
look. After the third dose, she was able to go out, and several
days after the fourth dose no trace of the disease remained.
H. HARTLAUB, Private communications.
CASE 76.-A man, ret. 42, previously affected with Lues,
was attacked with erysipelas of the face, after taking cold,
and this was succeeded by congestion to the head, obstinate
costiveness and mental derangement.
iSymptoms.-In the evening he becomes restless, and busies
himself with spirits which seem to come to his bed; he grasps
after a sword, strikes about him with it, in order to drive a devil
out of the room who is seeking to attack him; this conduct lasts
the whole night; but early in the morning and during the day
he is rational. His face is red, eyes glistening, thirst very
great, abdomen moderately distended, and sexual desire much
aroused.
Treatment. —Hyosc. was given without benefit; after taking
Stramon. he was restored to quiet sleep and to his previous
mental powers.
Annals, Vol. 1, p. 230.-TRINKS.
CASE 77.-A man, met. 26, of sanguine temperament, fell
into mania, after a fright.
Syymptoms. —He speaks incessantly of incomprehensible and
foolish things; first he sits down, then he stands up; or kneels
down, and braces himself with great power against the wall; extends his hands alternately, directly before himself, or puts
his finger upon his mouth; he tears his clothes, and breaks




DATURA-STRAMONIUM.                 401
his bonds with inconceivable rapidity; does not answer questions, and avoids the eyes of others; his pupils were contracted, his eyes dull and sunken.
Treatment.-Stramon. 3 and 6 cured him in three weeks.
Archiv, Vol. 19, part 1. p. 92.-SZTAR.
CASE 78.-A puerperal woman, with natural flow of lochia,
and regular state of all her functions. with the exception of
an excessive flow of milk, became perfectly deranged; she talked
of the most silly and confused stuff, which no one could understand, &c.
Treatment.- Stramon. 9, taken for many days, both night and
morning;,cured her radically.
General Hornm. Journ., Vol. 2. p. 114.-KRETZSHMAR.
CASE 79.-A miss, set. 30, of delicate frame and timid,
desponding nature, became melancholic after a fright.
Synmptoms.-She was exceedingly concerned and dejected;
believed that she was not worthy of eternal salvation, because
she could not accomplish the tasks she undertook in the evening;
she wished to have several lights in the room, and begged earnestly that she might not be left alone; her nights were sleepless, and spent in praying and weeping; sometimes she answered
questions, at other, she did not speak, but brooded silently, and
was frightened by the slightest noise; when urged, she took
food; her head and forehead were hot, pupils dilated, pulse
weak and quick.
Treatment. —Stramon. 3, at first one drop per dose, night and
and morning; then one dose at night only, cured her in fourteen days.
Hygea, Vol. 20, p. 231.-MAYERHOFER.
CASE 80.-A young, volatile man, aet. 22, had already had
three attacks of mental derangement, which lasted under allopathic treatment, from five to eight weeks.
~Symptoms.-Great bodily restlessness; confusion of memory;
alternations of heat of the face and coldness of the body, then
anxiety and thirst; frequent flushing of the face, with fixed
look; dejection, weeping and fear of death; stuttering and
lisping before he could-utter a few words; constant coldness
of the feet; restless anxious sleep, with wonderful illusions;
fear of mad animals and black dogs.




402   NERVOUS DISEASES AN-D MENTAL DERANGEMENT.
Treatment. —This- fourth attack, was cured by Stramon. 15,
in the course of twenty-four hours.
Annals, Vol. 3, p. 270.-BETHMANN.
CASE 81. —An emaciated man, aet. 48, awoke- from sleep
three weeks ago with signs of mania.
iSymptoms,.-Loud laughing; he makes leaps like those of
a rope-dancer, it seemed as if he floated upon the tips of his
toes; is irritable- like one who: has not slept enough.
Treatment.-First Camphor, as antidotal to previous allopathic treatment; then he was cured with Stramon. 3) in four
weeks.
Archiv, Vol. 19,' part. 1, p. 88.
CASE 82.-A man, met. 36, had been deranged for several
months.
Symptoms. —He- imagines that he lies in a vault, confesses,
prays, and wishes to be killed; laughs as if he were tickled;
wishes to be kissed by every one; accuses his wife of unfaithfalness to him; he scolds, strikes furiously about him, and cannot be held by his watchers; he looks upon his attendants as
dogs, and barks at them in order to make himiself understood
by them; he speaks Jewish-German, which he never did before,
and believes that his house is surrounded by wagons full of Jews
and geese, who expose their posteriors to him, and thus render
him furious. He is pale, eats nothing, and does not sleep; constant twitching of the facial muscles; he pushes his thumbs
between his fingers.
Treatment.-Was treated allopathically without avail, and
then cured by Stramon. - in a few days.
Archiv, Vol. 16, part. 2, p. 81. —SCHELLHIAMER.
Besides in the above cases, Stramon. was used in cases No. 14,
38, 94, 98, 101, 102, 103, 109 and 110.
An old lady, had restless nights for six weeks, with visions;
it seemed as if strange persons entered the room, commenced
various indifferent employments, and came so near to her that
she became very much frightened and could not stay in bed.
Well in six days.-BECKER.
A man of 60, of maniacal family, hypochondriacal for several
years, always preceded by great excitement, in which he effected his business with great haste, would not bear contradiction,




DATURA-STRAMONIUM.                  403
had no rest, made disturbance and lost his sleep-this state
generally lasted two-months, and was then followed by, great relaxation, inactivity, grief about his affairs, which were quite
brilliant-excitement attended with full quick pulse, strong
palpitation and congestion to the head.
Stramonium continued for several weeks, relieved the excitement, and the depression did not follow,:he remained well for a
year, when a slight renewal was quickly relieved by Stramonium.-SOBERNHEIM.
REVIEW. —Of thirteen cases, treated by Stramon, seven were
males and six females, of various ages. Among the causes of
the attacks relieved by Stramon. were the puerperal state, in
cases No. 75 and 78; previous facial erysipelas in No. 76; and
fright in cases 77 and 79.
As to the form of mania cured or relieved by Stramon., that
with much excitement is the most common; but attended with
scolding and endeavors to destroy, in cases 77 and 82 only;
mnre frequently we find constant talking, preposterous laughing, silly actions, disquiet, inclination to run or go away, but
differing from the constant impulse to escape on account of
anxiety; visions of spirits and ghosts, and contests with them, or
of animals; sexual excitement: the patient wishing to be kissed,
and making improper speeches; great muscular activity, hopping and jumping.
A  depressed state of mind occurred only in cases No. 79
and 80, in the form of dejection, fear of being alone, brooding
and feeling unworthy of salvation.
B.oth these states of excitement and depression occurred in
alternaticn in case No. 75.
Erroneous impressions about oneself, and others occurred
in No. 82.
But few physical derangements occurred in connection with
the mental disorder.
In several of the cases Bellad, or Veratrum had removed
the state of great excitement, after which Stramon. was given
with great benefit.
It was useless, or only transiently useful in cases marked
by great anxiety, fear, suspicion,, and against melancholy
from mortified self-esteem.  See cases No. 90, - 72 and 6.




404   NERVOUS DISEASES AND MENTAL DERANGEMENT.
Of the fourteen cases, five were cured by one dose of Stramon.; nine required repeated doses.
The size of the curative dose varied very much, from the
second to the thirtieth potency.
The action of Stramon. extends to several organs of the
brain, although but traces of this are to be found in the above
cases; it acts upon amativeness; destructiveness; caution;
wonder, and imitation.
32. SULPHUR.
GENERAL REMARKS. —a) Against timidity; inconsolableness
about every action, which is regarded as wrong; religious fixed
ideas; paroxysms of anxiety.
HAHNEMANN, Chron. Dis., Vol. 5.
b) This much we can assume from what is known of the
action of Sulphur, that it will not prove curative against mental disorders originating in the brain —and that it will prove
most useful in chronic cases.
Experience has taught many of us that Sulphur is exceedingly useful in chronic affections in which the mental powers
are clouded and perverted, without there being actual mental
derangement, but much fear of company, despair of recovery,
fancies about disease, calamity, care and want; Sulphur seems
to unbind the chains of despondency and false fears in which
the mind has been cramped.-GRIESSELICH.
CASE 83.-A woman, met. 40, a brunette, tall, thin and frequently the subject of melancholy, which had increased very
much for the last few months, during which her menses had
been suppressed.
Symptoms.-Violent headache, severe pressure as if the brain
were walled in; eyes dull, face pale, oppression in the epigastric region; stools white and hard; anxious state of mind
and fears about her condition; imagined that she must starve,
fears the ruin of her household, goes about wringing her hands,
and seeks to escape; frequent chills.
Treatment.-Pulsatilla was given without benefit; after
taking Sulph. -I-, the melancholy soon passed away and her
menses returned again. Calc. was given to complete the cure.
Annals, Vol. 3, p. 156.-TIETZE.




SULPHUR.-TABACUM.- VERATRUM-ALB3UM.    405
33. TABACUM.
GENERAL REMARKS.-Whoever studies the effects of Tobacco
will not fail to perceive that this drug, almost entirely neglected
as it is by physicians of present times, must possess unusual
powers in mental diseases, for its relations to the brain are both
striking and characteristic.
The Tobacco mental derangement commences with simple
hypochondriac mood, increases to melancholy and dejection,
passes over into mania in which the patient acts without control, sings, cries and appears almost frenzied.
It is remarkable how deranged persons long for Tobacco;
each morsel is a god-send to them.
Hygea, Vol. 23, p. 252. —GRIESSELICH.
34. VERATRUM-ALBUM.1
GENERAL REMARKS.-a) The powers possessed by this remedy of benefitting or curing almost one-third of all the deranged confined in asylums, has not been suspected by physicians, because they did not know which particular forms of
mental derangement to treat with it.
Mat. Med. Pur.. Vol. 3, p. 326.-HAHNEMANN.
b) It is useful against great restlessness and- excitement,
screaming and constant laughing in the midst of irrational and
mostly incomprehensible talking, fear of strange persons, running about, attempting to escape, &c.
General Hom. Journ., Vol. 19, p. 21.-KNORRE.
CASE 84.-A [woman, ret. 30, fell into such a state of
frenzy, fourteen days after confinement, that she had to be
bound.
Sy mpto'ms. —She did not sleep, but babbled incessantly;
when she heard the clocks strike, or similar noises, she became
quite silly, and danced about until she was obliged to keep
quiet; slept but little and awoke in fright; wild look, and a pe
culiar irregular quickness of speech.
Treatment.-Veratrum, at first three doses, and then one per
day, cured her; various new symptoms arose during the treat
ment.
RADMACHER, Vol. 10, p. 823.
CASE 85.-A man, aet. 60, of quiet melancholic tempera



406   NERVOUS DISEASES AND MENTAL DERANGEMENT.
ment, had one or two attacks of mental derangement per year;
two of his brothers were subject to like attacks.
Symptoms. —He drives all his family out of the house; imagined that the sun turned around the earth; had paroxysms
of fear of death, groaning, restlessness and despair; also of
confusion and absence of mind, and which led him into the -most
senseless actions.
Treatment. -Verat. I-r, one drop soon restored him to health.
-KNORRE.
CASE 86.-A woman, aet. 38, who had had previous attacks
of mental derangement, became so bad that she was obliged to
be confined.
Syymptom.s. —Speaks excitedly and incessantly, with unsteady
and wild looks and constant smiling face, with alternations of
loud laughter; she distorts her face hideously and seeks to
keep off all who approach her; does not answer questions, takes
refuge behind the table, then laughs and scolds; color of face
natural; preferred food she rejects.
Treatment.-Tinct. Verat. from five to twenty or thirty
drops given in coffee, restored her in the course of fourteen days.
General Hornm. Journ., Vol. 19, p. 21.-KNORRE.
CASE 87. —A case of religious derangement in a farmer, induced in part by hard drinking, and which occurred more
severely every other day and was attended with such qonsid'erable lateness of the back that he walked with difficulty, was
cured by two doses of Veratrum T-, aided by an intermediate
dose of Sulph.
General Horn. Journ., Vol. 2, p. 114.-KRETZSMAR.
CASE 88.-A woman, Iet. 36, had been for eight days in a
state of anxiety and despair, which had not been relieved by
allopathic treatment.
Symptoms.-Very red, glowing face; great agony, dejection
and despair; she wailed and cried incessantly, but could give
no reason for doing so; she did not eat or drink, neither could
she sleep.
Treatment.-Veratrum  1st, two drops, divided into four
doses, one dose night and morning quieted.the patient in twenty-four hours.
Annals, Vol. 4, p. 330.-ScHUELER.




VERATRUM- ALBUM.                 407
CASE 89.-In mental derangement marked by indecent
speeches and lasciviousness, Veratrum often affords the most
marked relief. A widow, who had fallen into the above state
was quickly cured by Veratrum -r-2, one drop, after bloodletting,
Tart.-emet. and blisters had been used without avail for eight
days. She is now married and is quite well.
General Homrn. Journ. Vol. 2, p. 113.-KRETZSCHMAR.
CASE 90.-A woman-became melancholic after an attack of
typhoid fever.
Symptoms.-She is unhappy about the death of her grown
up daughter deceased several years ago; reproaches herself
that she made her unhappy by the sad tone of her own mind;
she attempted to drown herself, but was rescued.
Treatment. -Verat. 6, in repeated doses, soon cured her.
ENGELHARDT, Record. of L. Society.
CASE 9 1.-A melancholic patient became frenzied, he sang
and whistled the most beautiful melodies, of which he knew
nothing when he recovered.
Treatment.-Bellad. and Stramon. were given without benefit; but after taking Veratrum 1, one drop every eight hours,
he soon improved and recovered.
This led HARTLAUB to remark that Veratrum was the main
remedy in the mental derangements of that neighborhood,
especially when they verged upon insomnia and mania.
ENGELHARDT, Record of L. Society.
CASE 92. —An old maiden, wt. 32, had suffered for twenty
years with an alternately healing and again outbreaking sore
upon the left leg; for the last three weeks she had shewn
signs of mental derangement. On the 30th August she became
frenzied; her pale distorted face, wild threatening look, her
dishevelled hair, her grinning, and utterance of almost beastly
noises made a dreadful impression upon spectators.
Symptoms.-She struck, bit and spit about her; she constantly moved her head and body to and fro, muttering and
groaning all the while; attempted to jump out and run away;
alternately she sang in a broken and wild manner, then sank
into quiet and hung down her head; she does not understand,
or answer questions.
Trieatment. —Sept. 5th, she received two drachms of Tinct.
27




408   NERVOUS DISEASES AND MENTAL DERANGEMENT.
Veratrum, twenty-five drops to be taken per dose, twice a day;
this was followed by quiet sleep, desire for food, and she could
be released from her bonds; on the 9th Sept., she received
fifty drops of Tinct. Veratrum, followed by sound sleep; subsequently she took ten drops, twice a day; she was entirely relieved of her mania but remained taciturn and reserved and
finally died of dropsy.
General Hom. Journ., Vol. 19, p. 23.-KNORRE.
Besides, Veratrum  was given in cases No. 3, 42, 95, 96,
98, 99, 100, 101. 102.
REvIw. —Of eighteen cases treated by Veratrum, five were
males and thirteen females.
The causes of the mental derangement whenever they were
mentioned and whenever the remedy cured without other aid,
although very differing, were always of a purely somatic or
material nature.
Still but few physical symptoms were met with; sleep however was almost always entirely absent, and food was only
taken when urged upon the patient.
As regards the form of mania in which Veratrum was most
useful we find first: a state of excitement characterized by
rioting, noise-making, laughing, singing, and whistling (see
cases No. 42, 84, 86, 91, and 105); or by incessant talking (see cases No. 84 and 86); especially of an indecent character, with sexual excitement (see cases No. 42 and 89); or by
senseless actions, (see cases No. 84, 85 and 86).
Second: also a state of depression marked by restlessness,
anxiety, despair, imagining an unhappy state, fear of fancied
forms (see cases No. 42, 88, 90, 95); and by deficient sexual inclination in case 95.
The religious mania in case 87 has not been accurately described.
These two forms were found in alternation in cases No. 42,
92, 100, 105 and 112.
The Veratrum did not prove useful against perverse actions
and speeches, with inability to understand questions and the
epileptic cramps which occurred in case No. 95; nor against
anxiety and reproaches of conscience in case 103; nor in inclination to abuse others in No. 97. Again, in case No. 105,




VERATRUM-ALBUM. —ZINCUM.              409
the inclination to destroy was only lessened and changed
into loud laughing and active jumping, which were removed
by' Stramon. The increased state of self-esteem in cases No.
55 and 112 Were not removed by Veratrum; while in No. 42,
the rage, abuse, desire to run away, and indecent speeches
were merely lessened, not removed.
Dose —In twelve cases, the doses were repeated in nine; in three
cases one dose sufficed to effect a cure, from the Tincture down to
the fifteenth dilution was the most useful strength; the thirtieth dilution was given without benefit.
Organs of brain.-That of amativeness was excited in some
cases and depressed in others; those of destructiveness and
combativeness when in a state of excitement were calmed by
Veratrum; that of hope was also influenced by it, for we find
the unhappy and despairing rendered cheerful.
35. ZINCUM.
GENERAL REMARKS.-The action of this remedy in brainfever attended with the violent mental derangement is very
striking; it is also homoeopathic to dulness of the head, difficult
flow of ideas, absence of thought, forgetfulness, dulness of
memory, dizziness, drowsiness, manifold pains in the head,
paralytic-like oppression of the mental faculties, thoughts of
death, disinclination to work, irritability, capriciousness and
moroseness. GRIESSELICH.
CASE 93. —.A single woman, a-t. 46, a-menstrual for ten
months, fell into the following state two months ago, in consequence of vexation and passion.
Symptoms,.-She fears that she will fall into hands ofjustice,
because she supposes that it is believed that she has committed
some crime. Timid expression; believes that she is watched
and followed by her neighbors; that the: devil is in pursuit of
her, and comes up from under the floor. Restless sleep at times,
during the day; fever at night, with only one or two hours
dreamy sleep; believes that she is about falling down a precipice, and that she is pursued, hence she runs away with all her'
might. Afterwards she feels exhausted, feeble and inclined to.
weep. She takes an antipathy to ally one who attempts to con —
vince her of her errors. She has headache, heat of the head.




410  NERVOUS DISEASES AND MENTAL DERANGEMENT.
and face, dusky redness of the cheeks, emaciation of the face.
Is dizzy and walks unsteadily; has alternations of moderate
heat and coldness of the body; constipation; brick red deposit
from the urine. She had already been bled.
Treatment. -Oxide of Zinc, one-sixth grain, per dose, six
times every twenty-four hours; with improvement on the
second day, and recovery by the eighth; still the remedy was
continued for several days longer.-Sc HMID.
CASE 94.-RADElM-ACHER says, that he once cured a deranged
girl in five days, with acetate of Zinc.
CHAPTER  II,
CASES IN WHICH SEVERAL REMEDIES WERE REQUIRED.
CASE 95.-A woman, wat. 50, formerly always healthy, had
been indisposed for four weeks; there was an alteration in her
mental state; she often could not recollect herself; was somewhat childish; repeated the same thing several times, and often
laughed without cause.
On the 4th of September, at eight, A. M., she was attacked.
with an apoplectic seizure; she lay quietly upon the bed upon
her back, with closed eyes, compressed mouth, very slow and
somewhat small pulse, natural warmth of the body without perspiration, appeared constantly in a deep sleep, still she turned
over occasionally, and put out her tongue when loudly requested
to do so; her tongue was dry and brown, especially in the
middle, but was not drawn to one side.
Treatment and Result.-Bellad. was given without effect;
two doses of Arnica were followed by some vomiting of dark
mucus, the tongue became moist, and some perspiration shewed
itself; otherwise her condition remained the same. On the
following day she was somewhat more conscious; her eyes
were constantly open; but frequently spoke quite erroneously,
and this wandering of the mind increased towards evening.
Thought that her ears were in the wrong place and ought to
he cut off; great restlessness, inclination to run away, heat of
skin, much perspiration, whiteness of the tongue, constipation.




CASES CURED BY SEVERAL REMEDIES.          411
Bellad. was again given in the evening, but on the next day the
following symptoms were present:
Constant inclination to run away; great exhibition of strength,
when she was opposed; threw her bed and other things out of
the window; spoke a great deal, but always foolishly, with
much laughter; if she was spoken to, she appeared to understand nothing, and looked quite stupid; pulse slow, somewhat
full; tongue white and dry.
She received Verat 30, one-third of a drop per dose; f1llowed by more quiet during the day, but increased restlessness
at night, succeeded by violent epileptic-like cramps, lasting
about five minutes, recurring every hour for three'times, an-d
then every an half hour for six hours.
Symptoms.-At first she fell down suddenly, and commenced
to grasp with her fingers; attempted to scream, but could not
make a loud noise, but only rattled in the throat, with frothing
at the mouth; bent her body backwards; struck out with one
arm, and grasped with the other; her legs were quiet; face
pale; consciousness lost. Between the paroxysms she was in
the same state as the day before, only more languid; but she
never entirelyrecovered her consciousness.
Treatment. -In the afternoon she -received Stramonium 30,
one-third drop; no more spasms occurred, but she still attempted
to escape; this finally subsided and she partially recovered her
consciousness. On the next day she had two stools, and was
able to attend to her, household duties.  After the elapse of
several days something foolish could be observed in her manner;
she laughed while speaking, without cause, turned around her
body round and around, &c. But all this subsided in a:few
days, after the Stramonium had been repeated.  She then remained well.-H. HARTLAUB.
-CASE 96.-A womian, awt.33, small in stature and of delicate
constitution, had suppression of the menses, and fell into a state
of melancholy; her sexual inclinations which had never been
very active, now seemed entirely extinct, yet she labored under
the fixed idea, that she had been inconstant, and was possessed
of the devil.
Treatment. —Sulphur 30, followed by four doses of Verat. 15,
one every six days. After the third powder menstruation sat




412 NERVOUS DISEASES AND MENTAL DERANGEMENT.
in and lasted for eight days, followed by evident improvement
in four weeks.  A few doses of Ignat. 2, every forty-eight
hours, restored her entirely.
Archiv, Vol. 19, part. 1, p. 48. —GRoss.
CASE 97.-A delicate woman, awt. 30, fell during her confinement, in consequence of fright and vexation, into a state of
mental derangement, marked by boundless suspicion and jealousy. She had been treated without benefit for three months,
when she was restored by six doses of Ignat. 3 and Hyosc. 2,
in alternation, one dose every day.-GRoss.
CASE 98.-A lady, at. 48, of melancholic sanguine temperament, fell, after an attack of gout into a deep melancholy;
her menses were suppressed and all allopathic means proved
useless; organic disease of the heart was suspected.
Treatment.-She was entirely restored in a few months by
Verat. 3 and Bellad. 3, and Coccul. 2 in alternation.
Hygea, Vol. 20, p. 237.-DR. MAYERHOFER.
CASE 99. —A man, met. 30, delicate and of a phlegmatic
temperament, became deranged without any evident cause.
Symptoms. —He believed that he was bankrupt; had lost
his chance of salvation; saw phantastic shadows and. figures,
of which he was afraid; expected evil from every thing and
seemed tortured with anxiety.
Treatment.-Several doses of Stramon. were given without
benefit; then excessive anxiety and. restlessness were relieved
by Bellad. 30 and Aconit. 30. Nux, Bryon. and Verat., finally
restored him entirely, after eight days' treatment. —TiioRER.
CASE 100.-A  lady, aet. 32, delicate and sensitive, but
choleric became deranged after an attack of nervous fever.
Treatment.-She was quieted and relieved by Verat. 18 in
solution, but a state of groaning, crying and sighing remained;
Hyosc. 6 in repeated doses, Opium 3 in solution, and Chamomilla and Sulphur restored her entirely.-DR. GASTFREUND.
CASE 101.-A spinster, aet. 30, suffering with Amenorrhea,
and derangement of the stomach and liver, fell into a melancholic state, from which she was entirely relieved in three
months, by Verat., Ignat., Caust., Sepia, Puls., and Cocculus.
- RUMMEL.




CASES CURED BY SEVERAL REmEDIES.        413
CASE 102.-A young man, et. 20, of placid and impressible
disposition, fell suddenly into a state of mania.
Symptoms.-He answered no questions; spoke much irrational stuff; tore his clothes; was noisy and destructive; his
eyes were red, and he took no food.
Treatment.-Verat. 6, was followed by sleep, and in the
morning he asked for food. He had no stool for four days after
taking Veratrum, but Opium 9, was followed by a copious discharge. Still he was very suspicious, mistook his physician for
an evil spirit. He was finally restored in six weeks by Bellad. 30,
Stramon. 6, Verat. 12, and Phos.-ac. 2, given at rather long
intervals.-SZTAROV.
CASE 103.-A young man, aet. 18, fell into a kind of mania,
after dancing all night and drinking a good deal, during which
he became engaged. in a quarrel.
Symptoms.-He spoke unconnected stuff about bad treatment and of revenge; spoke to persons by name who were not
present; was very restless, brooked no opposition; had gastic
derangement from vexation.
Treatment.-Stramon. 6, was followed by some quiet, even by
sleep and some appetite; at the end of a few days more he
was in the following condition.
Symptoms. —His look was disturbed; face pale and sallow;
he sprang up, wrung his hands, complained bitterly that no one
would forgive him; sought out dark places, and covered his
face with his hands. Bellad. 15 was given, and in three days
he was in the following state:
Symptoms. —Dejected look; emptiness in the head; restlessness; inability to collect his thoughts; at night as soon as
he shut his eyes, frightful figures appeared to him, he wept,
spoke of confused stuff, of being placed in chains and bonds,
where neither the sun or moon would shine upon him; that he
could not be forgiven; that he had no merciful God.-His
urine was pale; skin dry and parched; yawning and shivering;
he scratched himself here and there, and an unusual redness
appeared at the irritated spot.
Treatment.-Dulcamara 18, one drop, followed by perspiration, and irruption of red spots upon the skin; he no longer
spoke irrationally, although his head was still confused, and he




414   NERVOUS DISEASES AND MENTAL DERANGEMENT.
had occasional paroxysms of anxiety. Bellad. 24, completed
the cure, which required twenty-one days in al.-SPOHR.
CASE 104.-A wealthy countryman, aet. 22, fell, from inju-dicious treatment in consequence of a suspicion of guilt, into a
state of perfect mania, so that he had to be confined. Bellad. 30,
three doses, one every day, removed the mania, and quieted
the patient very much, so that the straight jacket could be
taken off.
Symptoms.-He lay quietly in bed, declared that he was
bodily well, but did not know what he was doing at times, and
spoke irrationally occasionally.
Treatment.-One dose of Stramon. 9, was given each day,
with progressive improvement; then two doses of Nux-v. 3,
removed the somatic symptoms; finally a lachrymose condition
was relieved by Pulsat.-THORER.
CASE 105.-An active lad, met. 12, with an extremely irritable
nervous system, and who had suffered while an infant with abdominal obstruction and latterly also with congestion to the
head, fell into a state of mania. The paroxysms occurred
every day, and sat in two hours earlier each time.
Treatment.-Verat. 12, followed by later appearance of the
maniacal paroxysms, and shorter duration of them; religious
excitement ensued, with declamation of hymns, &c. Verat.
was repeated, and on the following day paroxysms of laughing
occurred in place of maniacal excitement, with rope-dancer-like
agility. These attacks subsided entirely under the use of Stramonium 18;-remaining nervous irritability and constipation
were removed by Nux and Lycopod.-FIELITZ.
CASE 106.-A lady, et. 50, of delicate constitution fell
into a state of melancholy after much care and grief, so that
she had entirely withdrawn from all society for several years.
Treatment.-She was cured in the course of six months by
Ignat., Nux, Arsenicum and Sepia.-THORER.:CASE 107.-A man, met. 40, tall and thin, had suppressed an
attack of itch three years ago,' and gradually became deranged.
Treatment.-Nux 4, Verat. 12, Sulph. 6, Psorin 30, Sepia
and Carb.-v. 6, were used in effecting the cure. —THaoREa.




CASES CURED BY SEVERAL REMEDIES.        415
CASE 108. —A lady, wet. 30, got rid of an impetiginous
eruption, during her last pregnancy, and then after weaning her
child, fell into a melancholic condition, preceded by fright.
Treatment.-Pulsat., Verat. and Bell., at intervals of two
days, produced a marked improvement in four weeks; then
Arsenicum 30, at intervals of two and four days, and finally
Sulphur 6, completed the cure.-THORER.
CASE 109. —A man, aet. 38, had been in a melancholic condition for twelve years in consequence of the unfaithfulness of
his wife.
Treatment.-He was entirely cured in three months, by
Pulsat. 12, Ignat. 9, Nux 4, Verat. 12, and Arsen. 30 and
Calc. 30.-THORER.
CASE 110.-A woman, aet. 30, became deranged after the
death of her child.
Treatment. —She was cured in six weeks, with Bellad. 2,
Verat. 12, Stramon. and Hyosc. 6. —SZATAR.
CASE 111.-A teacher, et. 27, who had a great opinion of
himself, became deranged after dismissal from his situation.
Treatment.-He was cured in one month by Opium, Nux,
Stramon., Hyosc. and Aurum.-SZATAR.
CASE 112.-A learned person, aet. 30, had weakened himself considerally while at the university, by long-continued
study, late hours, and coffee drinking. He had scarcely recovered somewhat at home, when in order to forget a disgraceful vexation, he began to apply himself anew to study, and drank
large quantities of coffee, in order to keep awake at night.
Mental derangement followed, attended with various bodily infirmities.
Treatment.-Nux 30, removed his headache, constipation, excessive lasciviousness and irritability. Verat. 12, only produced
transient relief. Ferrum removed the remaining debility, and
Platina 3, one-half grain per dose, restored him entirely.SCHROTER.




416  NERVOUS DISEASES AND MENTAL DERANGEMENT.
GENERAL REVIEW
OF THE TREATMENT OF MENTAL DERANGEMENT.
In the preceding cases, Bellad. was administered 32 times;
Veratrum, 19 times; Stramonium, 17 times; Hyosc. in 12
cases; Pulsat. in 7; Ignatia and Opium, each 6 times; Cuprum,
5 times; Anacardium, Arsenicum  and Nux, each in 3 cases.
While Aconite, Aurum, Conium, Helleb., Phosphor and Platina
were each used in two cases, and Calc., China, Crocus, Hepar,
Lachesis, Lycopod., Petrol., Rhus, Sepia, Sulphur were given
each in one case. Besides, Baryta, Bryonia, Causticum, Coccul., Nux-mosch., Secale and Tabacum are recommended in
general terms.
In states of Exaltation we find: An excited and mild state
cured by Opium and Phosphor; (see also GRIESSELICH's remarks
on Acon. and Tabac. Raging, shouting, laughing and singing
have been removed by Verat.)
Scolding and inclination to destroy, by Hyosc.  Ready inclination to anger, to strike, or to tear one's clothes by Stramon.
Mania in the highest degree, with attempts at destruction and
murder, by Bellad.
Foolish imaginations, by Anacardium. Great talkativeness,
confused talking of complicated things, by Cuprum, Opium and
Verat.; when attended with active muscular motions, by Stramon. Talkativeness, with delivery of speeches, by Lachesis.
Thoughtless actions by Verat. and Hyosc.; occasionally by
Bellad.
Shameful conversation, with sexual excitement, by Veratrum
and Stramon.
Religious mania has been cured by Verat. and Aurum. Seeing of ghosts and devils, by Opium and Cuprum; of animals,
by Hyosc.
False impressions about one's-self and body, by Stramon. and
Anacard.




GENERAL REVIEW.                 417
Among the states of Depression, we find: Loss of will, and
power to decide upon any action, have been cured by Coccul.
and Helleb.
An apathetic state, with dullness, indifference brooding, and
stupid expression, by Baryta, Hellebore and Opium.
The most numerous observations and cures have been made
in the forms of melancholy, from dejection of spirits to the
highest degree of anxiety and despair.
Dejection has been cured by Conium and Petrol., with fear
of death, by Platina.
Depression of spirits by Stramon. and Sepia.
Anthrophophobia, by Anacard.
Melancholic condition by Aurum, Ignatia, Sepia and Rhus;
when attended with weeping and occurring in connection
with pregnancy and confinement, by Pulsat.-with desire for
solitude, and fear of coming to want, by Nux and Calcar.
Feeling of being unfortunate, by Veratrum; when occasioned
by child-bed and Misfortune, by Bryonia.
Melancholy from care and grief, by Causticum.
Anxious solicitude and fear of starving, by Sulph. and Calc.
Fear of being alone, by Stramon.; —of frightful forms and
figures, by Pulsat.;-anxious conscientiousness, by Lycopod.
Anxiety about phantoms of the imagination and constant endeavor to fly from them, by Bellad.
Restlessness and desire to escape, by Stramon. and Helleb.,
and other remedies.
Despair about shattered health and fear of death, by Calcarea.
Despairing anxiety, with fear of approaching misfortune,
attended with complaining and weeping, by Cuprum; —on
account of an unhappy position, by Veratrum.
When the mental derangement assumed the form of fixed
ideas, we find:
Expectation of approaching death, during child bed, cured
by Aconite.
The idea of having commnitted a crime, with fear of the




418  NERVOUS DISEASES AND MENTAL DERANGEMENT.
officers of justice, by Cuprum and Zinc. —when the physician
is mistaken for a police-officer, by Bellad.
The illusion of not being in one's own house, by Opium;the belief of never being able to be happy more in one's own
house, by Arsenicum.
Notions about supposed intentional insults, with scruples of
conscience, bIy Ignat., Nux, and Pulsat.
Fear of not being saved, by Ignat., Sulph., and Calc.
Fear of coming to want, by Bryon, Nux, and Calc.
Notion that one is composed of two persons, by Anacard.
The inclination to suicide and disgust for life, require particular attention.
1) Arsenicum has cured the inclination to suicide, with clear
consciousness, from an internal frightful anxiety; although the
patient was not tired of life, but wished to be watched and
restrained.
2) Aurum, has cured persons who thought seriously of taking
their own lives. zEGIDI says that Nux, not Aurum, will cure
the melancholy, with disgust for life, which drives one to commit suicide. Aurum is-most useful when there is a state of
discontent with one's-self, from supposed bad behavior; or when
there is excessive conscientiousness, with anxiety, agony of
heart, with longing for death.
3) Hellebore, has cured a girl who attempted to drown herself;
it is homoeopathic when one is tired of life, feels unhappy
when he sees others enjoying themselves, and is very anxious.
4) Nux is homeopathic when there is anxiety, as if from a
bad conscience; or anxiety with palpitation of the heart, driving
one to commit suicide; or when one regards his condition as
insupportable, so that he would rather die.
5) Pulsatilla is homoeopathic to disgust for life, with inclination to drown herself; anxiety in the region of the heart,
with inclination to commit suicide.




GENERAL REVIEW.                  419
6) Veratrum has cured a woman who was about to drown
herself on account of her unhappy position.
Forty-six different physicians have furnished the above cases.
In twenty-nine cases, doses of the crude drugs or low dilutions
were used; while the higher potencies were given in seventysix cases.
We may infer, that.
1) The organ of Amativeness is influenced by Hyosc., Nux,
Phosphor, Stramon., and Veratr.
2) That of Adhesiveness, by Bellad.
3) Combativeness, by Bellad., Hyosc., Op., and Verat.
4) Destructiveness, by Bellad., Hyosc., Op., Phosph.,
Stramon., and Verat.
5) Acquisitiveness, by Bryon., Calec., and Nux.
6) Self-esteem  by Ignat., and Platina.
7) Caution, by Aconite, Arsen., Cuprum, Hyosc., Nux,
Op, Puls., and Stramon.
8) Benevolence, by Anacardium.
9) Conscientiousness, by Arsenicum,Ignat., Nux, and Aurum.
10) Hope, by Calc., Verat., and Sulph.
11) Marvellousness, by Stramonium.
12) Imitativeness, by Stramon.
13) Form, by Bellad., Cuprum, and Hlyosc.
14) Causality, by Anacardium,








A P P E N D I X,
ON  HASCHISCHI
This composition is a distillation of the pistils of the Hemp.
In one patient it produced dryness of the throat and twitching of
the limbs; the pulse was ninety-six, and face flushed; his ideas
appeared to develop with extreme rapidity; at one moment he
offered the singular phenomenon of a double man; he heard music
on one side, and conversation on the other; but this symptom did
not continue. His pupils became much dilated, he felt particularly gay and happy wished to be alone in a quiet place;
he had great repugnance to speak or move; all faces seemed
ridiculous to him. He then moved about, sometimes laughed
violently, but suddenly threw himself upon a couch, refused
to answer any more questions, and begged to be left alone,
and not disturbed in the voluptuous and delicious sensations
he experienced; he had spasmodic movements of limbs and diaphragm; sighed, moaned, laughed and wept by turns; pulse increased to one hundred and twenty per minute; face much flushed.
His friends began to feel uneasy, but the experimenter assured
them that he did not suffer, but felt happy. He had the most
agreeable sensations proceeding from the pit of the stomach;
he seemed in ecstasy, his features bespoke the greatest happiness; he could not find language to express his feelings; he
would not wish to leave his present condition, he felt so happy.
Often said, how much I thank those who gave me that delicious drink. His sense of hearing became exceedingly acute;
he heard very distinctly what was said far off, and in a low
voice. In the midst of his ecstasy he neither lost consciousness of persons or things. He felt no distress on the following days, but on the contrary a great sensation of happiness.
Another experimenter, naturally very serious, and who rarely laughed, in two and a half hours after taking Haschisch,




422                    APPENDIX.
suddenly exclaimed that he was delirious, began to sing, took
out his pencil and endeavored to write down what he felt;
but threw away his paper as his delirium increased; his features became very flexible; he laughed sardonically, his eye
was animated, face red, pulse one hundred and twenty, pupils
dilated, looked extremely happy, laughed, sang, gesticulated
and spoke with great volubility; his ideas followed each other
with rapidity; he was deranged, as in Gay mania.  But in
the midst of this abundance, mobility, and variableness of ideas,
his naturally serious character and studies obtruded themselves,
intermixed with pleasantries, bonmots and puns.  His tongue
became dry, he spat frequently, his legs became slightly convulsed; his hearing and sight became very acute; he had no
notion of time or space, but recognized every one present and
answered questions correctly. A multitude of ideas seemed to
fill his head, which he could not put in words; expressed his
willingness to lose an ear or eye, if he could only have another
tongue to make known what he experienced. His pulse fell to
ninety, but his delirium still continued; incoherent sentences
followed with inconceivable rapidity; when water was given
him, he exclaimed that will make tile frogs come, who will
drink up the liquor. Then the character of his delirium changed: He sat himself in a corner, closed his eyes, talked to himself and seemed inspired; spoke of sciences, gave definitions,
then pronounced a few broken words, and immediately recited
some twenty very harmonious impromptu and original verses.
His countenance expressed gaiety and satisfaction; his skin'became very pallid; pulse rose to one hundred. Then left off improvising to speak of foreign countries; described countries and
cities which he had visited; but although Haschisch is supposed
to cause second sight he could not describe places with which
he was unacquainted; he himself finally said that a livelier impulse was given to his ideas, but nothing was added to his
knowledge. Finally, the delirium, which had for a long time
been confined to a series of ideas, became general again; he
sang, laughed, and talked with great vivacity; said he was
happy, &c.
Individuals under the influence of Haschisch feel a maniacal
exaltation; ideas succeeded each other with rapidity and




'ON HASCHRIScIn                42 
Incoherence; the mind was under the empire of hallucinations
and illusions; recollection could be evoked and vivified as if
they were real; as in dreams there was a loss of time and
space.
An other experimenter saw stars in his plate, and the firmament in the soup dish; turned his face to the wall, talked to
himself; and burst into fits of laughter, with eyes flashing and
in the highest glee.
A fourth, first saw the pupils of the eyes of his friend sparkle
strangely and acquire a most singular turquoise blue color; in
a few minutes a general lethargy came over him; his body appeared to dissolve and become transparent; he saw the haschisch which he had eaten distinctly within him, in the form of
an emerald,: from which thousands of little sparks were emitted;
his eyelashes seemed to lengthen indefinitely, twisting themselves like golden threads around little ivory wheels, which
whirled about with inconceivable  rapidity.  Around were
figures and scrolls of all colors, arabesques and flowery forms
in endless variety, which he could only compare to the variations
of the kaleidescope.  He still occasionally saw his companions,
but they appeared disfigoured, half men, half plants; now, with
the pensive-air of the ibis, standing en one leg; and, again as
ostriches flapping their wings and wearing so strange an appearance that he shook with laughter; and as if to join in the
buffoonery of the scene, he tossed up the sofa cushions, catching
thern as they descended, and twisting them around with all the
dexterity of an Indianjuggler. One of the gentlemen addressed'the experimenter in Italian, which the haschisch, by its extra-'ordinary power, delivered to him in Spanishi.
After some minuteshe recovered his calmness, without headache or other unpleasant symptoms, but felt much astonished at
what had passed. In a half hour more he again fell under the influence of the haschisch and his visions were still more complicated
and extraordinary. Millions of butterflies, whose wings rustled
like fans, flew about in the midst of a confused light; gigantic
flames with crystal calyces, enormous hollyhocks, gold and
silver lilies arose and burst into flowers around him, with a
crackling sound like that of a bouquet of fireworks. His hearing was prodigiously.developed; he seemed to hear the sound
28




424                     APPENDIX.
of color, green, red, blue and yellow sounds struck him with perfeet distinctness; a glass upset, the creaking of a chair, or a
word spoken, however low, vibrated and resounded  like rolling
thunder; his own voice appeared so loud that he dared not
speak for fear of throwing down the walls, or bursting like a
bomb; every object gave forth a note of the harmonica or yEolian harp; he seemed to swerve in an ocean of sound. Never
before was he bathed in such beatitude; he was so encircled by
its waves, so transported fiom  all things earthly, so lost to
self, that he comprehended for the first time what might be the
existence of elementary spirits, or angels, or souls released from
this mortal coil. He was as a sponge in the midst of the sea;
every instant waves of happiness washed over him, entering
and departing through the pores; for he seemed to have become permeable, even to the smallest capillary vessel; his
whole being was filled with the color of the fantastic medium
in which he was plunged. Sounds, perfumes and light reached
him  by multitudes of beams, delicate as hair, and ihrough
which he seemed to hear the magnetic current pass.
What is very curious in the intoxicating effects of haschisclh,
is, that it is not continuous; it cones and goes suddenly; raises
you to heaven, and places you- again on. earth, without any
gradual transition; like madness too, it has its lucid intervals.
A third attack, the last and strangest terminated the experience
of the last experimenter.  His sight became doubled; but soon
he became completely insane for an hour.  All kinds of Panta(gonetic dreams passed through his fancy; goat-suckers, storks,
stupid geese, unicorns, grifins, nigohtmares, and the menagerie
of monstrous dreams trotted, jumped, flew or glided through the
room., He saw horns terminating in foliage; webbed hands;
whimsical beings with the feet of the arm-chair for legs, and
dial plates for eyeballs; enormous noses danced the Cachuca,
mounted on chicken legs. He imagined that he was the parroquet of the Queen of Sheba, and imitated to the best of his
ability, the voice and actions of that interesting bird. Th'le
visions became so grotesque, that lhe was seized. with a desire
to sketch them, which he did with inconceivable rapidity. A
friend seated at the piano seermed dressed like a Turk, wEith




ON HASCHISCH.                 425
a sun painted on the back of his vest; the notes of the piano
seemed escaping in the form of guns and spirals,. curiously
intertwisted. A fancy animal represented a living locomotive,
with a swan's neck terminating in the jaws of a serpent,
whence issued jets of smoke; two monstrous paws were composed of wheels and pulleys, and each pair of paws had a pair
of wings; on the tail of the animal was seated the Mercury of
the ancients, confessing himself to be conquered, notwithstanding his heels.-Du BOISMONT.








A
T RlEt] A T I S FE
ON THE
INFLAMMATORY AND ORGANIC
DISEASES OF THE BRAIN.
INCLUDING:
IRRITATION, CONGESTION AND INFLA) MATION OF THE BRAIN, AND ITS ME?BRANES, TUBERCULOULS-MENINGlITIS, HYDROCEPHALOID DISEASE, HYDROCEPIALTUS ATROPHY AND HYPERTROPHY, HYDATIDS, AND
CANCER OF THE BRAIN








ON THE
NATURE AND CAUSES
OF
IRRITATION, CONGESTION, INFLAMMATION, AND
DROPSY OF THE BRAIN, AND ITS MEMBRANES.
I.- IRRITATION OF THE BRAIN.
IN CHILDREN.
DR. W. NICKOLL has thus designated a state of brain occurring in children, which appears to hold an intermediate
place between hydrocephaloid disease and that of inflammation.
It may on the one hand run into inflammation if neglected; and
on the other hand is apt, if treated too actively and allopathically, to be followed by symptoms of exhaustion, and of the
Hydrocephaloid disease of Gooch and Hall.
In simple irritation of the brain the child is wakeful, scarcely
ever sleeping, irritable, highly sensitive to every object of sight
and sound; the pupil is in many instances more or less contracted, the limbs are in action, the head tossed about; the
child cries without any apparent cause; there is unusual liveliness and animation; it wakes suddenly from sleep, and starts
at the least noise when awake; the fists are generally clenched,
with the thumbs turned in, and the forearms bent upwards on
the arms; and sometimes a degree of opisthotonos is observed,
the legs being drawn up, while the head is thrown back. This
state of things is usually, though not always, accompanied by
increased temperature of the head and of the skin generally,
and by an accelerated pulse.
29




428             IRRITATION OF THE BRAIN.
Some children seem to be much more prone than others to
this affection, and it is in the nervous, weakly and scrofulous
that it is most frequently seen. There is apparently an original difference or excitability of the nervous constitution, which
predisposes them to be thrown into this state of Erethism; and
when this natural predisposition is not present, defective nourishment, and a debilitated state of the system are apt to induce
it. Any long continued irritation of the nervous extremities,
particularly of those distributed upon the mucous membranes,
may be the exciting cause of this affection; hence, painful dentition, worms, an unhealthy state of the stomach, bowels or
liver, or chronic and troublesome eruptions, or sores, or some
disease or impurity of the blood, may prove the exciting cause
of irritation of the brain or nervous system. When this state
obtains, convulsions, it is well known, are apt to occur.
The most deceptive part of the disease is, that the preternatural excitement and mobility of the nervous system is apt to
give rise to excitement of the heart and arteries, and determination of blood to the head, from the excited condition of the
brain. If the case be regarded as one of active congestion or
commencing inflammation of the brain, and treated allopathically and antiphlogistically, irrespective of the peculiar state of
the nervous system, exhaustion will speedily follow, and the
symptoms of reaction and excitement from loss of blood will be
added; if the same treatment be still pursued, the case will
soon end fatally, and probably be attended with effusion of
water into the ventricles of the brain. If the body be examined
after death, the effusion will of course be detected, and will be
presumed to have been the cause of death; but the real truth
is, in certain states of the nervous system, unpreceded by any
great cause of exhaustion, an increased quantity of blood may
be thrown to the brain, and give rise to all the symptoms of the
first stage of an inflammatory affection, but which cannot be
removed by the ordinary allopathic antiphlogistic means, as
these will aggravate the original excited condition of the brain
and nervous system, inducing new and still more dangerous
symptoms, causing the case to terminate fatally, with all the
signs of an advanced stage of dropsy of the brain.
In older patients these cases are apt to be attended with




IRRITATION OF THE BRAIN.               429
much delirium; WATSON says they seem to be, but are not,
cases of Meningitis of any kind. ABERCROMBIE refers to them
as instances of a very dangerous modification of inflammation
of the brain, which shows only increased vascularity, without
any of the other signs or effects of inflammation. WATSON
very decidedly asserts that he entertains no doubt whatever,
about the nature of these cases, viz.: that they are not examples of inflammation at all, for they neither show the anatomical
characters of inflammation, nor do they yield to the remedies
for inflammation. In short, they were made to terminate fatally
by Abercrombie's outrageous system of extravagant bloodletting. Apoplexy according to Abercrombie, may also arise
from exhaustion, and terminate fatally, when treated actively
by blood-letting, &c., without any morbid appearance being
found in the brain after death, or with appearances so slight as
to be altogether inadequate to account for the symptoms, or
fatal termination of the case.  (See treatise on Apoplexy.)
ABERCROMBIE himself admits that in four fatal cases of
Apoplexy, all the usual allopathic remedies were used in the
most active manner without the least effect in alleviating any
of the symptoms, and on inspection after death, either no vestige of disease could be discovered in the brain, or at most there
was but slight fulness of the blood-vessels, insufficient to account for death, which was doubtless caused by the too active
treatment.
Treatment.-NICHOLLS says that judicious treatment will
throw muchl ight on the pathology of these cases. If there be
any manifest cause of irritation present, either from teething,
or a disordered state of the bowels or liver, and this be removed
and the child then placed in as quiescent a state as possible, by
excluding it from light and noise, and every source of excitement, giving a dose or two of some sedative, and nourishing but
unstimulating diet, and subsequently a gentle tonic, all the
symptoms of brain disease will vanish.
The most homoeopathic remedies are: Coffea, Cannabis,
Thea, Ignatia, Nux. If these fail to afford relief;  Conium,
Hyosciamus, Opium, Asafcetida, Chamomilla or Valerian may
be tried.
COFFEA, THEA- and CANNABIS may be used when the attack




430            CONGESTION OF THE BRAIN.
has been brought on by excessive and pleasurable excitement,
when the child is so excited and lively as to be almost uncontrollable, with sleeplessness; i. e. when the grey substance of the
brain, and the senses or intellectual faculties are principally
aroused, and stimulated.
Nux and IGNATIA are the principal remedies, when the
white substance of the brain, and the motor track and nerves
are implicated; when there is a tendency to twitching, starting,
&c., especially if the attack has been brought on by a fit of
passion, vexation or disappointment.
HYoscIAMUS and OPIUM are the antagonistic remedies for
COFFEA and THEA, and may be used when these remedies seem
indicated but fail to afford relief.
CONIUM is the antagonistic remedy for Nux and Ignatia,
and may be given when these fail to afford relief.
II.-CONGESTION  OF  THE  BRAIN.
IN CHILDREN.
ACCORDING to WEST, Congestion of the Brain is a very frequent disorder in young children; he quotes Dr. MAUTHNER
in proof, who on examining the bodies of 229 children, dead of
various diseases, found a congested state of the blood-vessels of
the brain, in no less than 186. WEST assumes that the brain
in infancy is much more exposed to congestion and irritation,
than that of the adult, owing to the far wider variations of
which the cerebral circulation is susceptible in early life than
subsequently. Nor is the cause of this difficult to discover.
The skull of the adult is a complete bony case, and the firm
substance of the brain, affords a comparatively unyielding support to the blood-vessels by which it is nourished. The variations in the quantities of blood which the brain of the adult
contains, must needs be circumscribed within far narrower
limits than in the child, whose cranium, with its membranous
fontanelles and unossified sutures, oppose no such obstacle to
the admission of an increased quantity of blood, while the soft
brain keeps up a much slighter counterpressure on the bloodvessels than is exerted by the comparatively firm parenchyma




CONGESTION OF THE BRAIN.               431
of the organ in the adult.  Hence, if the circulation in the
child be disturbed, whether from difficulty in the return of
venous blood, as during a paroxysm of whooping cough, or from
increased arterial action, as at the onset of a fever. or during
the acute inflammation of some more or less distant organ, the
brain becomes congested, and delirium, or stupor, or convulsions
often announce the severity of the consequent disturbance of its
function. The same causes too, which expose the brain to be
over-filled with blood, render it possible for it to be drained
more completely of its blood, than in the adult. This fact
should always be borne in mind, when treating the diseases of
infants, for debility, exhausting discharges, and especially excessive allopathic depletion will often quickly induce a bloodless state of the brain, and all the symptoms of Hydrocephaloid
disease.
Hence, in the treatment of diseases of children, the physician
must be constantly on the watch against congestion of the
brain, as a condition which is very likely to come on, in the
course of the most various diseases, and of affections even of
quite distant organs. But it is not merely as a serious complication of many other diseases, that this congestion of the brain
in children deserves notice: its importance depends still more
on its constituting the first and curable stage of many diseases
of the brain, which, unless arrested at the outset, soon pass
beyond the resources of our art. —-WEST.
Congestion of the brain may arise from irritation; from the
presence in the blood of the poison of some eruptive disease,
such as scarlet fever, measles, or small-pox; or the brain may
become actively congested at the time of teething, or from feverish irritation of the whole system, or from exposure to the
sun, or from a blow upon the head, or from the fever of inflammation of some distant organ, such as the lungs, stomach, or
bowels, &c. Or a state of passive congestion may be induced
by some mechanical impediment to the return of blood from the
head, such as the general spasmodic compression of the bloodvessels such as occurs in general convulsions, or during a fit of
whooping cough; or from the pressure of an overloaded stomach, or liver, or enlarged thymus or bronchial gland. Finally,
passive congestion, may be merely the result of a languid cir



432            CONGESTION OF THE BRAIN.
culation, arising from debility, or exhaustion, or want of pure
air, or of nourishing and sufficient food, such as occurs in diarrhcea or summer complaint, in which the child not only has a
great drain upon the system, but either is unable to take or
does not receive a sufficient of nourishing food, from a mistaken
policy on the part of the physician.
Intense congestion of the brain is not a very unusual consequence of the irritation of the brain and nervous system, from
the presence of the poison of some eruptive disease in the system, or from the acceleration and disturbance of the circulation
at the outset of the eruptive fevers.  Convulsions and apoplectic symptoms then, sometimes, come on suddenly in a child,
previously to all appearances, in perfect health, and may even
terminate in death in less than twenty-four hours. The brain
will be found loaded with blood, but all the other organs of the
body are quite healthy. We may be at a loss to account for
such sudden and severe symptoms unless measles, scarlet fever
or small-pox are prevailing, or some other child in the family
or neighborhood is soon after attacked by one or the other of
them. That this train of symptoms often arises from the presence of some morbid poison in the blood, is still more evident
from the occasional results of repelling eruptive diseases of the
scalp. Thus, GOLDING BIRD relieved a child of Porrigo with
external applications in three weeks; for a time it appeared
in perfect health, but in the act of crying "Papa," it was attacked with a kind of spasm and dropped dead. Dr. DENDY
has seen four similar cases, in which death occurred as suddenly, all in the respectable classes.
When congestion of the brain and convulsions precede the
eruptive diseases, these symptoms as alarming as they generally
are, comparatively seldom end in death; for they generally disappear almost as if by magic, on the appearance of the eruption, except in those few cases in which the quantity of the poison is so
great, that it cannot all make its escape upon the surface; or
in which the congestion of the brain is kept up by the intensely
feverish state of the whole system.
The presence of some irritating substance in the blood, also
obtains in those cases in which convulsions, or irritation of the




CONGESTION OF THE BRAIN.               433
brain arises from suppression of perspiration, scantiness of
urine, deficiency of bile or some other secretion.
Another cause may aid in keeping up or increasing the
pressure upon the brain in feverish disorders, viz.: an absolute
expansion or increase of the volume of the blood; the most
marked instance of this is in congestion of the brain from exposure to the heat of the sun, even though the head has not been
unprotected from its rays. Of this WEST saw a striking instance in the case of a delicate boy, who whei a year old, was
taken out by his nurse, during one of the hottest days of summer. He was quite well and cheerful when he left the house,
but, after being out for some time, began to breathe hurriedly
and irregularly, and his nurse in consequence brought him
home.  He was restless, fretful and alarmed; his surface
generally hot, and his head especially so, the brain pulsating
forcibly through the anterior fontanelles; the pulse too rapid to
be counted; the respiration hurried, labored and irregular,
and there were constant startings of the tendons of the extremities. The child was on the eve of convulsions, but the tepid
bath relieved the heat of the skin, and the expansion of the
blood, the pulse fell and the twitchings diminished. Light and
sound were excluded; he fell asleep and awoke in a few hours
refreshed and tranquillized, and on the next morning a little
languor was all that remained of an illness which seemed likely
to prove so formidable.-WEsT. Cooling and soothing remedies are required in almost all cases of irritation, congestion, or
expansion of the blood.
Disorders of the nervous system are very frequent during the
period of teething. Many of the symptoms which then occur,
are the direct result of irritation of the tri-facial nerve, but
others are the immediate consequence of congestion of the brain.
Febrile disturbance almost always attends upon the process of
dentition, and when the circulation is in a state of preternatural
excitement, a very slight cause may suffice to overturn its equilibrium, and occasion a greater flow of blood to the brain than
the organ is able to bear.  Suppression of perspiration, deficiency of bile and scantiness of urine, often occur during dentition and leave the blood overloaded with effete and irritating
substances.




434            CONGESTION OF THE BRAIN.
According to WEST, congestion of the brain may come on
very suddenly, its symptoms being alarming from the first, and
such as to call for immediate interference; or general uneasiness, a disordered state of the bowels, which are generally,
although not invariably constipated, and feverishness may precede the more serious attack by a few days. The head becomes
hot by degrees, the child grows restless and fretful, and seems
distressed by light and noise, or sudden motion, while children
who are old enouigh sometimes complain of their head. Usually, too, vomiting occurs repeatedly, a symptom which is not only
confirmatory of others, but also may exist before there is any
well-marked indication of the head being affected, and when,
though the child seems ailing, there is nothing definite about its
illness. The degree of fever which attends this condition varies much, and its accessions are irregular; but the pulse is
usually much and permanently quickened; and, if the skull be
unossified, the anterior fontanelle (or soft spot on the top of the
head,) is either tense and prominent, or the brain is seen and
felt to beat forcibly through it. The sleep is disturbed. the
child often waking with a start, while there is occasional twitching of the muscles of the face, or tendons of the wrist. The
child may continue in this state for many days, and then recover its health, with or without medical interference; but, a
slight cause will generally suffice to bring back the former indisposition.  Striking instances of this are often seen while
children are teething; the fever may subside, the head grow
cool, and the little patient appears quite well as soon as a tooth
has cut through the gum, but the approach of each other tooth
to the surface will be attended by a recurrence of the symptoms.
Yet, we cannot always reckon on such a favorable result occurring; for the symptoms above mentioned are sometimes the
indications of the system generally having begun to suffer from
mischief which has been going on for months unnoticed, and
which is now about to break out with all the formidable characters of acute dropsy of the brain.  Or, should they have no
such serious import, yet congestion of the brain is itself a serious and sometimes a fatal malady.  Even though on treatment being adopted, the heat of the head may diminish, and the
flush and heat of the face grow slighter and less constant, still




CONGESTION OF THE BRAIN.               435
the countenance may become very heavy and anxious, the indifference to surrounding objects may increase, and the child finally lie in a state of torpor or drowsiness; from which, however,
it can at first be aroused to complete consciousness. But after
being aroused, it soon subsides intodits former drowsiness; the
bowels generally continue constipated, and the vomiting seldom
ceases, though it is sometimes less frequent than before. The
pulse usually becomes smaller than in the first stage, and
though there is often irregularity in its frequency, no actual
intermission occurs. An attack of convulsions sometimes marks
the transition from the first to the second stage; or the'child
passes without any apparent cause, from its previous torpor
into a state of convulsions, which subsiding, leaves the torpor
deeper than before. The fits may return and death take place
in one of them, or the torpor growing more profound after each
convulsive seizure the child at length dies comatose.
The second stage, if it may so be called, is usually of short
duration, and if relief be not afforded by appropriate treatment,
death is seldom delayed beyond forty-eight hours from the first
fit, though no graver lesion may be discovered afterwards than a
gorged state of the vessels of the brain and its membranes, and
perhaps a little clear fluid in the ventricles and below the
arachnoid.
Occasionally, death does not so speedily follow these symptoms; but they may continue slightly modified for days, or even
weeks, and contrary to all expectation, recovery now and then
takes place, especially in very young children, in whom the
congestion having relieved itself by a copious effusion of water
into the ventricles of the brain, the yielding skull accommodates
itself to its increased contents. This chronic dropsy of the
brain may even admit of cure.
Treatment. —The principal homceopathic remedies are: Glonoine, Opium, China, Ferrum, Belladonna and Stramonium.
If these fail, their antagonistic remedies, Aconite, Digitalis
Conium or Veratrum-viride may be _used. (See Treatise on
Apoplexy.)




436      INFLAMMATION OF THE DURA MATER.
INFAMMATION  OF THE MEMBRANES OF THE BRAIN.,
I.-INFLAMMATION OF THE DURA MATER.
ACCORDING to ROKITANSKY, primary inflammations of the
dura mater to any extent, such, for instance, as would lead to
the formation of matter, are of rare occurrence, with the exception of those which are brought on by injury.
On the other hand, inflammations of slight degree, and usually combined with moderate inflammation of the bones of
the skull, are frequent.  They are characterized by vascularity and rosy-redness of the dura mater, and by softening
of its texture; they give rise to interstitial infiltrations of
the membrane with the products of inflammation, as well as to
exudations upon that surface of it which adjoins the bone; such
exudations become organized into loose cellular, or thick fibrous
tissues, or at length, especially if there be any attendant inflammation of the bone, into bone; and they bring about a preternatural adhesion to the inner surface of the skull.  These
patches of inflammation are often widely spread, especially
along the sutures; but sometimes they are confined within a
smaller compass, so as to form circumscribed islands. Exudations which become converted into bone are generally spread
out into a thin layer like that of puerperal osteophyte; they are
first spongy, but gradually become compact: sometimes they
form a mass of bone which looks as if it had flowed or dropped
upon the membrane, and then coagulated; while, not unfrequently there are circumscribed plates or nodules, which, though
they in course of time become intimately united to the bone,
yet originally adhered firmly to the dura mater.
When the inflammation is more intense, and runs a chronic
course, the dura mater acquires an increase in thickness, sometimes to the extent of three lines, and even more; it becomes
indurated and callous, and usually adheres more closely than
natural to the bone.
When the inflammation is brought on by injury, or extends
to the dura mater from the neighboring tissues, it frequently




INFLAMMATION OF THE DURA MATER.            437
terminates in the production of pus, and in suppurative degeneration of the membrane. These cases are of great importance,
for they are generally secondary to inflammation and suppuration of the bone, or of the neighboring ligamentous structures.
They are especially apt to occur in certain localities; thus, the
dura mater often inflames, suppurates and sloughs from caries
of the bones of the internal ear, and the labyrinth of the ethmoid bone of the nose; from caries of the upper bones of the
spine, and suppuration of their ligaments. In the dura mater
these processes remain limited and circumscribed, but when
they reach the inner membranes of the brain, they usually
spread rapidly into general meningitis.
ASymptoms.-Inflammation of the dura mater according to
WATSON rarely occurs as a spontaneous disease, but is not at
all uncommon as a result of external injury. Its symptoms
have been excellently well described by POTT: A man receives
a blow'Upon the head; the blow stuns him perhaps at the time,
but he presently recovers himself, and remains for a certain
period, apparently in perfect health. But after some days he
begins to complain; he has pain in his head, is restless, cannot
sleep, has a frequent and hard pulse, a hot and dry skin, his
face becomes flushed, his eyes red and ferrety; chills, nausea
and vomiting supervene, and towards the end, convulsions and
delirium. Meanwhile the part of the head which has been
struck becomes puffy, tumid and sometimes tender, and if this
tumid part of the scalp be cut through, the pericranium beneath
is found separated from the skull; and the bone of the skull
itself is observed to be altered in color, whiter and drier than
the healthy bone; and if a piece of the bone be removed, it is
also seen that the dura mater, on the under side of it is detached from the skull, and sometimes smeared with lymph or
puriform matter.  This is a disease which is often met with by
the surgeon.
According to SOUTH and CHELIUS inflammation of the dura
mater may be acute or chronic.
Acute inflammation of the dura mater appears most commonly from the third to the fifth day after the injury; the patient complains of severe oppressive headache, which spreads
from the injured part over the whole head; the heat of the




438       INFLAMMATION OF THE DJURA MATER.
head is increased; the pulse is small, compressed and rather
hard; the patient is heavy and difficult to arouse; his ideas
become unconnected, and quiet delirium comes on; and lastly,
when the inflammation proceeds to suppuration, the patient falls
into a state of continued stupefaction, from which he cannot be
easily aroused; convulsions come on, with continued shivering
and irregular pulse; the pupils are wide and fixed; the breathing snoring and slow; the sphincters are paralyzed and finally
the patient dies.
On dissection, the dura mater is found reddened, covered
with exudations, and separated from the inside of the skull;
pus may be found between it and the skull, and at this part the
dura mater is often gangrenous.
Chronic inflammation of the dura mater, from injury to the
head, often commences only after a long space of time, often
after seven or fourteen days, often after a month; it begins
with headache, mental and bodily depression, heaviness, unsteady walk, derangement of the stomach, quick pulse; and in
its further course a. circumscribed painful swelling of the scalp
commonly arises at the place of injury; or, if there be a wound,
it becomes pale, and secretes a thin, sanious fluid, which sticks
fast to the bandages. The pericranium suppurates around the
wound, and the inflammation soon runs into exudation of a yellowish, ichorous, purulent fluid, which collects either between
the skull and the dura mater, or between the latter and the
surface of the brain. The patients sometimes die twelve or
eighteen months after the injury.  SOUTH has seen several
cases of this chronic inflammation, which is always a serious
disease, and very difficult to control; often indeed entirely unmanageable under allopathic treatment. The patient then goes
on slowly from bad to worse; sometimes with intervals of improvement, and sometimes without, and will frequently live for
many months in a constant state of suffering.
According to WATSON the next most frequent cause of inflammation of the dura mater, after injuries of the head, is disease of the internal ear, and of the petrous portion of the
temporal bone.  Sometimes acute inflammation arises within
the tympanum, when there has been no previous disease of the
ear: the patient has severe earache; at length a gush of mat



INFLAMMATION OF THE DURA MATER.              439
ter comes from the external meatus, but the pain does not cease,
as it usually does in such cases; it continues, or even increases
in intensity; the patient begins to shiver, becomes dull and
drowsy; slight delirium perhaps occurs, and by degree% he
sinks into stupor. In some instances no pus issues externally.
More commonly symptoms of the same kind supervene upon a
chronic discharge of purulent matter from the ear, especially as
a sequel of scarlet fever.  In some of these cases there is no
symptom to mark the extensive mischief going on within the
head, except the intense pain; the pulse may not be quickened,
the skin may be warm but moist, and there may be neither fever, delirium or convulsions. In other cases, besides the intense
pain in the head, there may be vomiting, intolerance of light,
slight and transient delirium, a degree of stupor, and slight convulsions.
In some cases, pus is absorbed from the ear, and diffuse inflammation of the veins with terrible consequences in various
parts of the body may ensue. In such cases the complaint is
marked by pain in the head, fever and chills which intermit;
and so regular sometimes are the intermissions that the physician may be led to believe that he has fever and ague to deal
with; then pain and swelling of some of the joints may come
on, leading to the belief that the case is complicated with rheumatism; but the true and alarming nature of the case will soon
become apparent;  abscesses form in and about the affected
joints, and if they be opened, foul, grumous and dark colored
matter will be let out. The patient will generally have more or
less fever, with dry parched tongue, rapid and feeble pulse, with
more or less diarrhoea.
In short, in these cases the patient has pain in the ear, with
discharge of pus from the external meatus, followed by pain in
the head coming on with fever and chills, and followed after a
short interval by destructive suppuration in several distant
parts; all forming a chain of presumptive evidence that the
fatal mischief finds its entrance into the head and rest of the
system through the porches of the ear.
Although quotidian paroxysms of fever have been noticed in
several cases, still in one case at least the fever bore a tertian
type: A young man previously healthy was attacked with fits




440       INFLAMMATION OF THE DURA MATER.
of shivering, accompanied by pain on the left side of the head;
at first the paroxysms were rather irregular; but they soon
assumed the form of tertian ague, coming on every other day,
at about the same hour; the cold fit commencing at noon and
lasting about half an hour, followed by a hot fit of somewhat
longer duration, and terminating in profuse perspiration. In
the intermissions the pain in the head was trifling, there was no
thirst or fever, but the patient did not sleep. A tumor formed
over the mastoid process, and was opened, giving issue to aquantity of extremely offensive brownish pus, followed by great
relief; but in about ten days the pain in the head and ear became very severe, with violent shivering fits many times a day,
great thirst, heat of skin, vomiting and delirium; his face was
flushed and pulse hard; he soon died.
Suppuration of the tympanum and consequent disease of the
bone, are more common in scrofulous persons than in others;
and they are more apt to occur as sequele of scarlet fever, than
in any other way.
Treatmentz. —The remedies which act principally upon the
sero-fibrous tissues are most specific in this disease, viz.: Aconite, Bryonia, Mercurius, Mezereum, Colchicum, &c.
When it arises from a mechanical injury to the head, the
treatment may be commenced with Arnica, internally and externally; when fever arises, Aconite should be used internally,
and the Tincture of the Root should be applied freely and repeatedly to the external surface of the head, avoiding the cut
or wounded surfaces; if the case progresses steadily, Mercurius should be given in alternation with Aconite; if signs of
effusion of serum and fibrine from the inflamed membrane arise,
Bryonia, Mezereum, Hellebore or Colchicum, should be used in
alternation with Mercurius, or the Iodide of Mercury; if the
symptoms of purulent exudation arise, Tartar-emetic, or Heparsulph., Sabina or Thuya should be given.




INFLAMMATION OF THE ARACHNOID.             441
INFLAMMATION  OF  THE  ARACHNOID.
ARACHNITIS.
THE arachnoid membrane is a shut sack, the parietal layer
of which is attached to the dura mater, while the cerebral or
visceral layer is for the most part blended with the pia mater
of the brain.
Inflammations of the parietal layer of the arachnoid, are on
the whole of frequent occurrence; their pathological import,
however, is according to ROKITANSKY, mostly subordinate;
they are met with, from injuries of the skull, from what is
called a phlogistic state of the blood, in pynemmia, in the course
of acute eruptive diseases, in Bright's disease, and acute biliary
dyscrasia. They are commonly slight in degree; the inner
surface of the dura mater is then found streaked with delicate
red vessels, and is of a clear rosy tint; it is lined with an exudation, that may be delicate or greyish, and soft like a layer of
mucus; or more consistent and membranous, or yellow, loose
and pus-like.
In some rarer cases, this inflammation of the parietal layer
has all the appearance of being primary, and judging from the
amount of its products, also severe. These processes usually
take place, and furnish their products without being accompanied by any similar disease in the cerebral layer: even in the
intense primary inflammation, just alluded to, the change which
takes place in the cerebral layer is limited to cloudiness and
thickening; the false membrane very rarely produces any adhesion between the two surfaces.
Inflammation of the cerebral layer of the araclhnoid presents
peculiar appearances, in respect to the condition of the pia
mater.  We find'on the one hand, that, as arachnitis is not
usually fatal in itself, or at least not in an early stage, it
sometimes leaves traces of its existence, in pretty extensive
thickenings of the membrane; in free exudations on its surface,
which become converted into circumscribed tendinous patches,
or diffused false membranes, &c., whilst very trifling changes
are discoverable in the pia mater, to indicate that an inflam



442        INFLAMMATION OF THE ARACHNOID.
matory process occurred at the same time in it. When, on the
other hand, the pia mater is acutely inflamed, and there is
profuse exudation into its tissue, the subjacent arachnoid is in
no marked degree affected, and its surface is entirely without
any free exudation. Showing that the inflammations of the two
membranes are entirely different and distinct, and that specific
remedies must be found to act curatively upon each.
Purulent exudation on the free surface of the arachnoid takes
place on the parietal layer only when the dura mater is
very acutely inflamed in consequence of injury of the skull and
caries, proving that remedies which act specifically upon the
bones and dura mater, will also probably act specifically in inflammations of the parietal layer of the arachnoid; and on the
cerebral layer, only when a simultaneous acute inflammation of
the pia mater also gives rise to an exudation of pus; proving
that remedies which act specifically upon the pia mater, will
also probably act specifically upon the cerebral layer of the
arachnoid.
It is remarkable that true tubercular exudations do not occur
on the arachnoid; proving that remedies which act specifically
upon the arachnoid may prove antidotal to tubercular disease.
Finally, according to RObKITANSKY, on whichever layer of
the arachnoid these processes take place, that portion which corresponds to the convexity of the hemispheres of the brain is
exclusively affected; and in proportion as they approach the
base of the brain, (which they occasionally do), the intensity of
the inflammation, and the quantity of their products is palpably
diminished; again proving that remedies which act specifically
upon the upper surface of the brain, and upon the arachnoid
are antagonistic, or antidotal to tubercular disease, which acts
principally upon the base of the brain, and upon the pia mater.
Symptoms and Treatmnent. —These are very similar to
those of simple inflammation of the pia mater, and cannot be
definitely given in the present state of our knowledge.




INFLAMMATION OF THE PIA MATER.             443
INFLAMMATION OF THE PIA MATER.
MENINGITIS.
THIS is the true meningitis, and the most important disease
of the membranes of the brain. According to ROKITANSKY it
is impossible to depict its general features without distinguishing two totally different forms of the disease.
a) Firstform. —This is a true inflammatory affection; it usually extends over the convexity of the brain, and diminishes in
intensity as it approaches the base. It rarely occurs at the base
of the brain at all.
The individuals who present this form of disease are generally in the youthful period, the bloom of life; they are usually
strong, at any rate they show no trace of the tubercular dyscrasia.
The disease is usually unaccompanied with acute dropsy of
the brain; at least the exudations and effusions found in the
ventricles are mostly slight; so also, softening of the stomach
does not usually accompany or result from it.
Except at its periphery or convexity, the brain is unaltered
by it, especially no softening of the brain arises or results
from it.
It is a pure inflammatory affection and if any specific remedies against simple inflammation are known in any school of
medicine, it ought to be a perfectly manageable disease. In
fact ROKITANSKY says, although this form of meningitis is
frequently fatal, yet it often terminates in resolution. A chronic form of it is frequently found in mental disease, especially
in cases of secondary imbecility; yet it is frequently acute and
even epidemic.
b) Second form.-This is the most frequent and fatal disease of the membranes of the brain, especially in children. It
occurs according to ROKITANSKY almost exclusively at the
base of the brain, and the peculiar opaline, flocculent, albuminoserous, gelatinous, sero-purulent effusions and exudations which
attend it, accumulate especially between the hemispheres of the
brain on each side, from the optic commissure in front to the
30




444         INFLAMMATION OF THE PIA MATER.
pons, and even over the medulla oblongata behind.  From
thence they may be traced into the fissure of Sylvius, and the
longitudinal fissure of the brain, and so on to the convex surface
of the hemispheres; for the fibrino-tuberculous product accumulates along the vascular trunks which run in the fissures,
viz.: the arteries and veins of the fissure of Sylvius and Corpus-callosum, and the latter often appear completely enveloped
in the exudation.
From these points the inflammation always extends also to
the choroid plexuses and the lining membrane of the ventricles,
particularly the lateral ventricles, and there gives rise to the
effusion and exudation of similar products, from which a distinct
purulent sediment is often deposited; hence it is almost always
combined with acute dropsy of the brain; and very often it is
also associated with softening of the stomach.
The brain itself is always in a state of acute oedema, or serous infiltration, with hydrocephalic swelling. At those parts
where the disease is most intense, and particularly in the fissures of Sylvius, the convolutions of the brain, especially at the
superficial parts, become the seat of red, or yellow softening.
The subjects of this form of the disease are mostly children,
although it is also frequent at later periods of life. The individuals who are attacked with it are generally persons already
suffering with the tuberculous dyscrasia, or those in whom tubercle is actually deposited.
The base of the brain is the chief seat of this form of tuberculosis; from thence it extends towards and over the hemispheres; it is rare to find the convex surface of the brain the
principal seat of its development.-RoKITANSKY.
It is the most frequent and fatal disease of the head; as it is
generally associated with the deposit of tubercles in other, and
often many other organs, with extensive dropsy and softening
of the brain; and with decided softening of the stomach, there
is almost necessarily scarcely any chance of recovery.
Symptoms of primacry menizgitis. —This disease is most
frequent in persons from the age of sixteen to forty-five years;
next, in children from five and a half to eleven years; it is very
rare in infants, and more common in males than females. It is
most frequently caused by exposure to the sun, by excessive




INFLAMMATION OF THE PIA MATER.              445
intellectual labor, by intemperance in drinking, and by depressing mental emotions; in children it is most common during
dentition, or from suppression of eruptions of the scalp.
In the simple, primary form of the disease, the pain in the
head is always very prominent, and sets in at the very beginning of the attack; it is violent and continued, with more or less
severe exacerbations; it often obliges the patient to cry out; it
is complained of spontaneously and unceasingly; the patient
insists that his disease is solely in his head, can point to the
exact seat of it, and complains of it until he falls into a state of
unconsciousness.
The intelligence is very quickly involved in the great majority of cases; there is great mental agitation, soon followed by
active delirium, which is sometimes violent, or even furious.
The patients are apt to get out of bed, and attempt to jump
out of the window, &c. This is soon followed by somnolence,
which alternates at first with the delirium, but finally settles
into a profound coma, or complete loss of consciousness.
The eyes are sensitive to light, the pupils are almost always
dilated, but at times they are contracted or irregular; they
finally become immoveable, and in some cases vision is entirely
abolished; squinting is also firequently observed, especially in
children.
The nerves of motion do not ordinarily present any peculiar
symptoms, especially in the early stages of the disease, except
that the patient is apt to totter and fall if he attempts to rise;
at a later stage, however, we often notice stiffness of the limbs,
or spasmodic contractions, or even convulsions; but these symptoms are not constant. Towards the end of the attack, subsultus, carphologia, and convulsive movements are generally present. It is rare that we observe partial stiffness of one limb, or
paralysis; when these are present, there generally is a simultaneous affection of the brain itself.
Sometimes the nerves of sensation are blunted, either throughout the whole body, or in more or less extensive parts; at times,
however, there is an increase of sensibility, at least for a time.
The countenance is generally animated, the eyes haggard and
brilliant; there are frequent alterations of color, from red to
violet, and thence to pallor, more or less intense. Sometimes




446        INFLAMMATION OF THE PIA MATER.
the features are contracted and grimacing, at others they are
relaxed. The eyes often express astonishment, fright or fury;
at others they seem dull, glassy, and without expression; at
times they are prominent, at others sunken.  An unintelligent
smile often flits over the features.  The nostrils are generally
dry; the lips pale and parched.
Of the symptoms of the digestive organs, the vomitings are
without doubt the most remarkable; they are generally bilious,
and often abundant; they often cease on the second or third
day of the attack, but sometimes persist to the end, although
they may intermit for a time, to be renewed again.  The tongue
is generally dry, often red, or covered with various kinds of
coating. Constipation is also one of the most constant symptoms; it generally sets in from the beginning, and may even
precede the other phenomena.
The breathing is generally remarkably irregular.
Fever is always well marked, the pulse is quick and hard at
first; afterwards it becomes small and irregular. The skin is
hot and remarkably dry.
Secondary meningitis occurs during the course of some
other disease, especially typhoid fever; the headache is apt
to be not very well marked; the vomitings are often absent;
the most remarkable symptoms are the softness, and irregularity of the pulse and respiration, the paleness and expression of
anxiety upon the face, and the extreme agitation which precedes
the delirium.
The course of the disease is onwards, and although there are
some exacerbations, yet the remissions are not as notable as in
tubercular meningitis.  The duration of the disease is very
short; it does not last longer than from three to nine or eleven
days.
Diagnosis.-Inflammation of the pia mater may be mistaken
for tubercular meningitis, or for typhoid fever. But in tubercular meningitis there are generally preceding signs of illhealth, or of tubercular disease; the symptoms of inflammation
of the pia mater set in more suddenly, are more severe from the
onset, and persist more actively; the headache is more violent,
also the heat of the head, redness of the face and intolerance of
light; the delirium is also more intense; the vomitings are




INFLAMMATION OF THE PIA MATER.               447
more frequent and abundant; the fever more severe and con-\
stant. The symptoms progress more rapidly and regularly.
It may be distinguished from typhoid fever by the less frequent vomiting, more frequent pains in and distension of the
bowels, with diarrhoea, which are so characteristic of the latter
disease; enlargement of the spleen may also be distinguished
by percussion; bleeding from the nose and ringing in the ears,
the rose colored spots, sudamina, the regularity of the pulse and
breathing, and absence of rigidity or paralysis of the limbs will
also serve to distinguish the two diseases.
Treatment.-If the symptoms of arachnitis or meningitis
begin to show themselves, or even if the disease be fully developed we may begin the treatment with Aconite; it acts specifically upon the serous and fibrous membranes, and is thought
to be homceopathic to all acute inflammations, while physicians
of the dominant school suppose it to be as antipathic to all
acute inflammations and congestions as Digitalis or Veratrumviride.  According to KREUSSLER it is not a question of fever
or no fever, for an acute inflammation of the brain as well as of
the meningeal membranes requires the use of Aconite, from the
commencement of the disease until the period when essential
changes develop the full characters of the affection. IIe says
it is always safe to commence the treatment with a few doses of
Aconite, even if it be possible to discern the homceopathicity of
another and apparently more specific remedy from the.very beginning of the attack.
Dose. —Of course, in so serious a disease, the remedy should be
used promptly and thoroughly; it should be given not only internally, but also applied externally, and that right freely. I have been in
the habit of applying the Tincture of the Root of Aconite, over a
large portion of the scalp, every 2, 4, 6 or 8 hours, according to the
severity of the symptoms. The Tincture of the Plant may be given.
in repeated doses, every 4, 1, 1 or 2 hours, in acute and rapid cases;
every 2, 4 or 6 hours, in sub-acute and slighter attacks.*
If the case progress, so that it is probable that exudations of
plastic lymph or sero-fibrous effusions have already commenced
to take place, then Bryonia and Miercurius are the most important remedies; if there be much vomiting with obstinate
constipation, great heat of head and much fever. one or two full
* The dilutions and pellets are probably not useful in cases of meningitis of any kind.




448        INFLAMMATION OF THE PIA MATER.
doses of Mercurius may be given so as to bring about free
action upon the bowels.  Small doses of Tartar-emetic may
also serve to allay the irritability of the stomach, to moderate
the fever, tend to produce perspiration and aid the action upon
the bowels; but they must not be continued long, or else too
great prostration may be produced. The Tartar-emetic must
be quickly changed to alternate doses of Bryonia, and small but
repeated doses of Mercurius. If Mercurius be at all indicated
it may also be allowable to apply a weak solution or ointment
upon the scalp, in the immediate neighborhood of the seat of the
disease.
If it becomes apparent that a large effusion of serum, has
taken place from the inflamed membranes, Helleborus, Digitalis, Kali-hydriodicum, and Mercurius-iodatus, become the
principal remedies. If Hellebore and Digitalis, either singly
or in alternation fail to produce an alleviation of the symptoms,
Kali-hydriodicum may be applied over the whole of the scalp in
solution, or in the form of an ointment, and frequently repeated
small doses may be given internally.  If these also fail, Iodide
of Mercury may be applied in the form of an ointment over the
scalp, and small doses of this, or of Mercurius-corrosivus may
be given internally.
If an almost entire suppression of urine occur, Cantharides
will prove the most homceopathic remedy. It is far more homceopathic to inflammations of the membranes of the brain than
either Belladonna, Stramonium or Hyosciamus, which only produce congestion, rarely inflammation of these parts.  Cantharides has caused congestion of the vessels of the brain; thickening of the arachnoid of the brain, but especially of the cerebellum, which is covered with a very thick layer of lymph, while
a large quantity of serum has been found at the base of the
brain. As the suppression of urine in arachnitis and meningitis, does not depend upon an inflammation of the kidneys, but
upon a torpid or semi-paralytic state of these organs from pressure upon the brain, Cantharides which acts far more specifically upon the kidneys, than upon the brain or its membranes,
may arouse the former organs from their torpor, and bring on a
secretion of urine which may relieve the pressure upon the
brain; at the same time it will not exert an injurious or too




INFLAMMATION OF THE PIA MATER.               449
irritating effect upon the brain or its membranes, as the stage
in which it is most indicated, and hence is most useful, is that
in which the profuse exudation of fibrine and copious effusion of
serum  from the meninges of the brain has brought about a
resolution of the inflammatory congestion of these organs, and
left them  in a state of torpor from over-exertion and secretion,
which will not bear debilitating remedies, and may tolerate exciting or stimulating ones; the depressed state of the general
system when copious effusion has taken place, marked by sopor
with complete insensibility to external impressions, with a small
feeble and intermitting pulse, coldness and clamminess of the
skin, calls for the use of stimulants, and Cantharides may prove
the best, from its specific relation to the seat and nature of the
disease, and its marked power over the secretion of the kidneys,
which it is so important to restore.  If the case be not absolutely hopeless, and the internal use of Cantharides does not
produce the desired effect, and the physician and parents are
willing to inflict some suffering in the hope of saving life, which
might otherwise be lost, a blister of Cantharides may also be
applied to the back of the neck, or even to the scalp. But such
an extreme and severe measure should only be used in cases of
pure or simple arachnitis, or meningitis; if it be at all probable
that tubercular meningitis be present, all temptations to severe
and active measures should be steadily rejected by the physician, whose sole endeavors in such almost invariably hopeless
cases, should be directed towards soothing and allaying any
and every painful symptom of the case; narcotic remedies, such
as Belladonna, Conium, Hyosciamus, Opium, or Stramonium, or
Cannabis-indica, or Chloroform should be used freely and without
hesitation.  To save life is next to impossible; to allay suffering is both possible and imperatively demanded.
It may be allowable to mention here that Dr. HAHN has succeeded several times with the cold affusion, in arousing and
curing children, after the supervention of complete coma.  He
has also succeeded in 14 cases, after the patients were in an apparently hopeless state of coma, with frictions of the scalp, with
Tartar-emetic ointment repeated every two hours, until pustulation was established; it is a severe measure and occasionally
induces gangrene of the scalp, yet it is perhaps allowable in the
advanced stages of simple inflammatory meningitis.




450              TUBERCULAR MENINGITIS.
TUBERCULAR MENINGITIS.
IN CHILDREN.
THIS is one of the most common diseases of the brain or its
appendages in children. It is by far the most common cause of
so-called acute- or sub-acute dropsy of the brain, and furnishes
a satisfactory reason why this disease is so frequently fatal
under every variety of treatment, at the same time that it renders it self-evident that any physician or class of physicians who
pretend to cure the majority of their cases of dropsy of the
brain, are either self-deceived, or are absolute impostors.
GREEN says that at least one-fourth of all the diseases of the
brain in children are tubercular in their nature; BECOUEREL
in 30 cases of meningitis, found tubercular granulations in the
membranes of the brain in no less than 28; JACKSON found
them in 4 cases out of 6; GREEN discovered them in 56 cases
out of 60; RILLIET and BARTHEZ in 29 cases out of 33; BouCHUT in 6 cases out of 9. Ience in 138 cases of so called
acute hydrocephalus, tubercles were found in no less than 123
instances.  Hence it is evident that until within a few years,
tubercular meningitis, simple acute meningitis, independent of
tubercularization, and simple dropsical effusion within the
cavity of the skull, independent of inflammation have been confounded together under the single term  of hydrocephalus or
water on the brain.;Symptoms.-Unlike acute simple meningitis there is more or
less of a premonitory stage. According to WEST, in the first or
premonitory stage there are many indications of cerebral congestion, coupled with general febrile disturbance; and presenting exacerbations and remissions at irregular periods.  The
child becomes gloomy, pettish and slow in its movements, and is
but little pleased with its usual amusements.  Or, at other
times its spirits are very variable; it will sometimes cease suddenly in the midst of its play, and run to hide its head in its
mother's lap, putting its hand to its head, and complaining of
headache, or saying merely that it is tired or sleepy, and wants
to go to bed.  Sometimes, too, it turns giddy, as may be known,
not so much from its complaint of dizziness, as from its suddenly standing still, gazing around for a moment as if lost, and




TUBERCULAR MENINGITIS.                451
then either beginning to cry at the strange sensation, or seeming to awake from a reverie, and at once returning to its play.
The infant in its nurse's arms betrays the same sensation by a
sudden look of alarm, a momentary cry, and a hasty clinging to
its nurse. If the child can walk, it may be observed to drag
one leg, halting in its gait, though but slightly, and seldom so
much at one time as at another, so that both the parents and
the physician may be disposed to attribute it to an ungainly
habit which the child has contracted. The appetite is usually
bad, though sometimes very variable, and the child, when apparently busy at play, may all at once throw down its toys and
beg for food; then refuse what is offered, or taking a hasty bite,
may seem to nauseate the half-tasted morsel, may open its
mouth stretch out its tongue, and heave as if about to vomit.
The thirst is seldom considerable, and sometimes there is an
actual aversion to drink as well as to food, apparently from its
exciting or increasing the nausea. The stomach, however, seldom rejects everything, but the same food that occasions sickness at one time is retained at another.  Sometimes the child
vomits only after taking food; at other times, even when the
stomach is empty, it brings up some greenish phlegm, without
much effort, and with no relief. These attacks of vomiting
seldom occur oftener than two or three times a day, but they
may return for several days together, the child's head probably
growing heavier, and its headache more severe. The bowels
are generally constipated from the first; the evacuations are
usually scanty, sometimes pale, often of different colors, almost
always deficient in bile, frequently mud-colored and very offensive. The abdomen is seldom full or distended, but the child
sometimes complains of pain in the belly, which may be tender
to pressure. The tongue is not dry, generally rather red at
the tip and edges, coated with white fur in the centre, which
becomes yellowish towards the root; occasionally WEST has
seen it very moist, and uniformly coated with a thin white fur.
The skin is harsh, but there is no great heat of surface. The
nostrils are dry; the eyes lustreless; the pulse accelerated,
but seldom exceeding 120 in children of four years old and upwards, not full and strong, but often unequal in the force and
duration of its beat.




452              TUBERCULAR MENINGITIS.
The child is apt to be drowsy, and will sometimes want to be
put to bed two or three times in the day; but it is restless,
sleeps badly, grinds its teeth in its sleep, lies with its eyes
partially open, awakes with the slightest noise, or even starts
up in alarm without any apparent cause. At night, too, the
existence of intolerance of light is often first noticed in consequence of the child's complaints about the presence of the
candle in the room.
WEST truly says, that we must not expect to find all these
symptoms in every case, neither indeed, when present are they
persistent, but the child's condition is very apt to vary greatly
in the course of a few minutes; cheerfulness alternating with
depression, and sound sleep being now and then enjoyed in the
midst of the unrefreshing dozes of the night.
HAR TMANN says, the precursory stage does not offer any of
the characteristic symptoms of acute dropsy of the brain. Thus
the child, which was previously able to run about with ease, has
an unsteady vaccillating gait; he raises his feet high from the
floor, or is liable to fall on the level ground, even in the room.
This unsteadiness communicates itself to the whole body. We
observe, moreover, a sudden change of disposition; in the place
of the former cheerfulness and lightness of heart, the child is
apt to become morose and peevish. On moving the head suddenly, or raising it from the recumbent posture, vertigo or a
sense of stupefaction is experienced. In some cases the secretion of urine is scanty, in others it is turbid, flocculent or opalescent. Some authors number a fine, dry, colorless eruption on
the outer side of the upper arm, on the cheeks and lips among
the precursory symptoms of dropsy of the brain.
Besides these symptoms there are others which are more or
less characteristic; such as a loss of the previous blooming appearance; restless sleep during which the child is apt to moan,
groan, start up as in a fright, alternations of creeping chills and
flushes of heat; a pulse of the ordinary rapidity, but one which
intermits at times, or beats irregularly or more feebly.
If many of these symptoms be present, the physician should
be led to suspect the impending approach of dropsy of the brain
and to watch the development of the symptoms with anxious
and redoubled attention. If the child be descended from scrofu



TUBERCULOSIS.                   453
lous or consumptive parents it may already be too late to save
life; the tuberculous dyscrasia may already be so fully developed, or the blood be already so fully overloaded with tubercular matter, or the capillary vessels may have lost their power
and function of- forming or separating healthy materials from
the blood, that it will be impossible to prevent the formation
and deposition of tubercle in the membranes of the brain, or
even in many other organs. Still the trial must be made, late
though it be. But in order to treat the tuberculous tendency
or dyscrasia with the faintest hope of success, we must first understand, thoroughly understand, of what tubercle consists, and
what it really is.
TUBERCULOSIS.
TUBERCLE.
THE physical description of tubercle is well known to every
physician, the chemical is not so. According to HAsSE, who
drew his conclusions from numerous analyses carefully compiled
by CERRUTTI and VOGEL, the organic component parts of tubercle are principally Caseine, with some fat, and a little albumen. According to PREUSS the animal portion of tubercle is
principally made up of Caseine, with some fat in the form of
Cholesterine, and a trifle of Phymatine. GiiTERBOCK found
much Caseine, some Albumen, Phymatine and fat.
Less accurate observers, such as THENARD, found Albumen in
excess; while HECHT and SCHARLAUV who probably did not
separate the cellular and other tissues, or products of inflammation found intermixed with the surrounding tubercular masses,
found nearly equal proportions of Gelatine, Albumen and Fibrine, in their analyses of tubercular substance.
ANCELL, justly says, if we admit that tubercle is a definite
chemical compound, which is very probable, still this compound
must be subject to changes and to admixture with numerous
extraneous and accidental materials, as with those composing
the tissues in which the tubercle is deposited, and which by.
pressure and otherwise, become disintegrated and blended with
the essential constituents of tubercle, or with the products of
inflammation, such as coagulable lymph, or fibrine, or pus from




454                   TUBERCULOSIS.
inflammation of the substance of the tuberculous organ, or with
mucus or pus from the mucous membrane of the lungs, or with
blood itself. It is always difficult, and frequently impossible,
for the chemist to separate these different products, or to estimate their proportions. Tubercle must also, from the same
causes, exhibit differences, according to the nature of the tissue
in which it is seated. Still, he says, chemical analysis leaves no
doubt that tubercle contains a protein compound as an essential
constituent, which appears to bear a close analogy to, if it be
not identically Caseine.  Tubercle has a decidedly cheesy appearance to the naked eye, and tuberculous pus resembles a
mixture of soft cheese and water both in color and consistence.
ANCELL repeats that the caseous quality of tubercle and scrofulous pus indicates the presence of a nitrogenous compound of a
caseous nature in the liquor tuberculi, showing that from the
liquor sanguinis of tuberculous blood a caseous blastema is exuded, differing from the ordinary healthy blastema. Its caseous
quality renders it unfit to nourish the tissues, and gives it a
tendency to solidification.
Another large class of medical chemists think that tubercle is
essentially albuminous in its nature. Thus HECHT found in
crude tubercle: Fibrine 30 parts; Albumen 23; Gelatine 27;
water and loss, 27. BOUDET found: Caseine, Gelatine and a
considerable quantity of Cholesterine; when tuberculous substance was treated with cold water it yielded: Albumen, a substance resembling Caseine, and a fibrinous residue. GfiTERBOCK found: Pyine, Phymatine, Albumen and fat. SCHARLAU,
Albumen, Gelatine, Fibrine, fat and water. VOGEL, Fibrine,
Albumen and Caseine, with fat, a material analagous to Pyine,
&c. GLOVER, Pyine, Albumen, (but no Caseine,) fat, &c.
L'HIERETIER found softened tubercle to consist of Albumen,
very soft Fibrine, fatty matter and lime.
It is easy to account for many of these discrepancies; thus
PREUSS in the most complete chemical analyses of crude tubercular pulmonary substance which has yet been furnished, found
Gelatine in the residue of the pulmonary tissue, which he carefully separated from  the tuberculous substance, but none in
tubercle itself. If other chemists had been equally careful,
they probably would not have found much or any Gelatine in




TUBERCULOUS BLOOD.                  455
tuberculous matter. Again, ANCELL Says that Pyine is by no
means a constant constituent of tubercle; it is a trit-oxide of
Protein, the result of inflammatory action on tuberculous blood
resulting in the super-oxidation of the Protein compounds, such
as Caseine, or possibly Albumen or Fibrine, which make up the
bulk of tubercle. The Fibrine is also probably the result of
inflammation, hence, we can easily narrow down the two essential constituents of tubercle to Caseine and Albumen.
Caseine and Albumen are analagous substances; both are
compounds of Protein; Albumen consists of 10 atoms of Protein, 2 atoms of Sulphur and 1 of Phosphor.; while Caseine
consists of 10 atoms of Protein, 1 of Sulphur and none of Phosphor. Hence it is very easy for careless or not very expert
chemists to mistake one for the other.
TUBERCULOUS BLOOD.
As tubercle is evidently derived from the blood, we have next
to examine the character of the blood in tuberculous subjects.
According to ANCELL tuberculous blood is defective in vital
properties; the red globules are deficient in number and defective in structure; the globulin, hematin and iron are all
deficient.
The serum of the blood is vitiated in quality, the water,
Albumen and lime are in excess, and the Albumen also defective in quality. Caseine does not exist normally in the blood,
and hence the defect in the Albumen may consist in its tendency to be converted into Caseine.
The Fibrine is rather deficient in quantity and defective in
quality, the fats probably deficient; the alkaline and earthy
salts, especially the chlorides and phosphates of Soda and
Potassa decidedly deficient.
DIETETIC TREATMENT OF THE TUBERCULOUS DYSCRASIA.
Hence the indications for the improvement of the quality of
tuberculous blood, are': 1st, to increase the quantity of iron, fat,
alkaline- and earthy-salts and Fibrine, and to improve the quality of the latter; 2d, to diminish the quantity of water, lime and
Albumen, and improve the quality of the latter.




456              DIETETIC TREATMENT OF
As blood is formed from the food by the processes of digestion, chymification, chylification and sanguinification, tuberculous blood may be produced from improper food, by a peculiar
form of indigestion, or by a defect in sanguinification in the
lungs or other parts of the body.
In the first place vegetable Albumen, according to MULDER
is perfectly identical with animal Albumen, and hence it is
probable that the whole quantity of Albumen required for the
purposes of the body is delivered to it already formed, and does
not require to be elaborated by the processes of digestion or
sanguinification.  Great care should be exercised in the selection of the albuminous articles of food for consumptive persons,
that they be of the best quality; as there is already a tendency
to excess of Albumen in tuberculous subjects, articles of food
should be selected which contain comparatively little of already
formed Albumen.  According to PROUT the following quantities
of Albumen are found in the subjoined animal substances.
East India Isinglass,  -    -    7.2 to 13.5 per cent.
White of Egg,                         15.5    "
Yolk    "  -    -    -    -           17.47   "C
Liver of Ox,     -20.19 
Sweetbread,                           14.00
Caviare,    -    -    -    -    -    31.00   "
Hence the above articles are more or less objectionable in
the diet of scrofulous, tuberculous or consumptive persons.
The muscle of Beef contains only,  -    2.2 per cent.
6"     Mutton       "      -    2.6    "
"~     Venison    "        -    2.3'
"  Veal     "      2.6 to 3.2    "
"'   C Chicken'      -    3.0    "
"4     Fish         "      4.4 to 5.2    "
"' /   Pigeon              -    4.5    "
Hence, beef, mutton, venison and chicken form the best animal food for tuberculous subjects.
Again, as the Fibrine of the blood is defective and deficient,
articles of food which contain much Fibrine should be selected.
The muscle of Beef contains      20 per cent. of Fibrine.
"r     Mutton  "          22    "
Chicken "          20    "




THE TUBERCULOUS DYSCRASIA.               457
The muscle of Veal contains     19 per cent. of Fibrine.
Pork    "         19     "4
F lFish    "  from 13 to 15 "     "
Sweetbread, only    8
Again, articles which contain Caseine should be avoided in the
diet of tuberculous persons-milk, curds and cheese are objectionable, cream and whey are allowable. Asses' milk is the least
objectionable as it contains only 1.82 per cent. of Caseine, while
cows' milk contains as much as 4.48. The milk of cows fed on
hay, turnips and potatoes contains only 3.3 per cent. of Caseine,
and is perhaps less injurious than some other kinds.
Vegetable Caseine is chiefly found in the leguminous seeds,
such as beans, peas, lentils, &c., hence these may have to be
avoided.
Vegetable Albumen is present in considerable quantity in
most vegetable juices, such as the juices of carrots, turnips,
cabbages, cauliflowers, asparagus, &c.-Potatoes contain far
less Protein and Albumen than any other vegetable substance
used for food, —only 1 per cent.
Vegetable Fibrine is most abundant in the seeds of the cereal
grasses, such as wheat, rye, barley, oats, maize, rice; it also
exists in buckwheat; the juice of grapes is especially rich in
it, &c.
As the fat is deficient in the tuberculous dyscrasia, the oily
alimentary principles should be used.
Filberts contain   -    -        60 per cent. of oil.
Walnuts  "        -    -    -    50    "
Olive seeds       -    -    -    54    "
Cocoa and Earth-nuts  -    -    47    "
Almonds  "       -    -   -    46(
Maize     "       -   -    -      9    "9
Dates     "      -   -    only.02 " "
Yolk of Eggs     -    -    -    28.75  "
Ordinary meat, with cellular tissue 14.3   "
Liver of Ox      -    -    only  3.89  "
Caviare          -    -     "   4.3   "
Cow's Milk       -   -           3.13  
Asses "          -                     ".11




458             TUBERCULOUS INDIGESTION.
Butter and olive oil, fats, meats and marrow may be used,
suet puddings, salmon, herrings and eels abound in oil, chocolate and cocoa, hashes, stews and broths contain much fat.  As
the fixed oils and fats are difficult and slow of digestion many
physicians may consider them objectionable.  It is well known
that in many delicate persons fat does not become properly
chynified. It floats on the contents of the stomach in the form
of an oily pellicle, becoming odorous, and sometimes highly rancid, and in this state excites heartburn, most disagreeable nausea,
and eructations, or at times actual vomiting. These effects are
owing to the development of volatile fatty acids, and may be
prevented by the use of alkaline and earthy salts, such as the
chlorides and phosphates of Soda and Potassa which are also
required to make up the deficiency of then, which has been shown
to be present in the blood of tuberculous subjects.
As the Iron of the blood is also deficient, a certain quantity
must be supplied to the system.
TUBERCULOUS INDIGES'rION.
Such is the theoretically correct system of diet in tuberculous
dyscrasia and affections; but it is very evident that healthy
animal or vegetable Caseine or Albumen will not be converted
into tuberculous Caseine and Albumen if all the functions of
digestion and sano;uinification be perfectly and healthily performed.  According to BENNETT, many observing physicians
have not failed to notice that tubercular disease is ushered in
with a bad or capricious appetite, a furred or morbidly clean
tongue, unusual acidity of the stomach and bowels, loss of
appetite, constipation alternating with diarrhoea, and a variety
of symptoms denominated dyspeptic, or referable to a deranged
state of the digestive organs. It is probable that tuberculosis
is a disease of the primary digestion, causing, 1st, impoverishment of the blood; 2d, local exudations from the bloodvessels
presenting the characters of tuberculous exudation; and third
the consequent softening, ulcerations and destructive results
which distinguish it. BENNETT also asserts that further observations show, that circumstances which remove the malassimilation of food frequently check further tubercular exuda



TUBERtULOUS INDIGESTION.               459
tions, while those which previously existed become abortive, and
that occasionally more extensive excavations may heal up and
cicatrize.
A healthy nutrition of the body cannot proceed without a
proper admixture and proportion of the albuminous and oleaginous elements. This may be inferred from the physiological
experiments of TIEDEMANN, GMELIN, LEURET, LASSAIGNE, MAGENDIE and others; from an observation of the constituents of
milk, (caseine, butter and sugar,) the natural food of young
mammiferous animals; from a knowledge of the contents of the
egg, (albumen and oil,) which constitute the source from which
all the tissues of oviparous animals are formed before the shell
is broken; and from all that we know of the principles contained in the food of adult animals.
The peculiarity of tuberculosis, however, is that an excess of
acidity exists in the alimentary canal, whereby the albuminous
constituents of the food are rendered easily soluble, whilst the
alkaline secretions of the saliva and of the pancreatic juice are
more than neutralized, and rendered incapable either of transforming the carbonaceous constituents of vegetable food into
oil, or of so preparing fatty matters introduced into the system,
as will render them easily assimilable. In consequence, more
albuminous than fatty matters enter the blood, and the necessary
waste of structure is supplied by the absorption of the adipose
tissues of the body. Hence the emaciation which characterizes
tubercular disease; hence also, as the fatty matters introduced
into the stomach are not digested and assimilated, but are simply taken up into the vena porta and carried to the liver, the
fatty liver which occurs so frequently in the tuberculous dyscrasia. In the meanwhile local congestions occur in various
parts, leading to an exudation containing a super-abundance of
albumen; which in its turn being deficient in the necessary
proportion of fatty matter to form elementary molecules, remain
abortive and form tuberculous corpuscules.
To improve the faulty nutrition which originates and keeps
up the tubercular disease it is of all things important, therefore,
to cause a larger quantity of fatty matter to be assimilated.
The use of alkalies or other solvents or digestives of oil are allimportant, although a mere increase in the amount, or even
31




460             TUBERCULOUS MENINGITIS.
quality of the food will often accomplish this. The treatment
practised some years ago by Dr. STEWART, which consisted in
freely administering beef-steaks and porter, and causing exercise to be taken in the open air, excited considerable attention
from its success. BENNETT has been informed, that in some
parts of America the cure consists in living on the bone-marrow
of the buffalo, and that the consumptive patient gets so strong
in this way, that he is at length able to hunt down the animal
on the prairies. All kinds of food, rich in fat, will not unfrequently produce the same effects, and hence the value long attributed to milk, especially ass's milk, the produce of the, dairy,
as cream and butter, fat bacon, caviare, &c.
But, in order that such substances should be digested or
assimilated, solvents of fat (alkalies) must be used, if the powers
of the stomach and alimentary canal have undergone any great
diminution. Unless this precaution be used, it will be found in
many cases that the patient is unable to tolerate such kind of
food, and that it either lies undigested in the stomach, or is
sooner or later vomited.
Children born of tuberculous mothers should be weaned
early; unless a perfectly healthy and robust wet-nurse can
be procured it is better to feed them with diluted or undiluted
cream.
FULLY DEVELOPED TUBERCULOUS MENINGITIS
Is marked by three important symptoms, viz.: by headache,
vomiting and constipation, to which is added in the great
majority of cases, some acceleration of the pulse; the intelligence may remain perfect, showing that the brain itself is not
yet involved; the strength may not be greatly diminished, nor
the appetite entirely lost, and the thirst may be moderate.
These symptoms usually last but two or three days before
others make their appearance, showing that the attack is confirmed. In some few instances, however, the precursory symptoms last, with irregular intermissions, for several weeks. In
some cases the invasion may be preceded for three months by
occasional cough, irregular attacks of fever, progressive emaciation, paleness, languor alternating with extreme irritability,




TUBERCULOUS MENINGITIS.                 461
disinclination to take exercise, and during the latter part of the
time by partial lameness, and in fact by 11 the signs of general
tubercular disease. In other cases the invasion may be preceded for several months by frequent complaints of intense
headache, especially after taking active exercise, and by unusual
languor, and by no other symptoms; there may be long inter- 
vals of health, and the child then be taken down suddenly.
According to MEIGS, headache is a nearly invariable symptom in children old enough to describe their sensations, and is
therefore very important. In infants its presence is to be inferred when the child frequently carries its hands to various
parts of the head, and presses strongly against it, and when the
head is constantly rolled from side to side. It is usually referred to a point just over one or both brows; in other cases it
extends over the whole head. It is commonly severe so that
the child, when old enough, complains of it spontaneously; they
may even cry frequently and bitterly, beg to have the doctor
sent for, and submit willingly to any remedy suggested for its
relief. It is thought that the acute, shrill cry of the disease
depends upon the acuteness of this pain.  It usually lasts
throughout the first stage, and ceases only as the delirium and
coma of the second stage come on.
As long as the membranes of the brain are alone involved the
headache is not attended with delirium. In truth, the intellectual faculties remain undisturbed in the majority of cases
during the first few days; and this fact, which is so contrary to
what is generally supposed, is apt to mislead the physician in
his opinion and treatment of the case; he is generally too apt
to give remedies which act more specifically upon the brain,
than upon its membranes.
I trust that it has been rendered evident that a correct system of diet is as necessary in tuberculosis as in diabetes or
adiposis.  There is frequently time sufficient to make the trial,
for the healthy and robust are comparatively seldom attacked
by dropsy of the brain, and in many instances the evidences of
declining health, precede for weeks or months the real premonitory symptoms of the disease.  We often observe a gradual
decay of the child's strength and wasting of its flesh, it becomes
subject to irregular febrile attacks, coughs a little, loses its




462             TUBERCULOUS MENINGITIS.
appetite, its bowels are almost always disordered, and generally
constipated, it makes frequent vague complaints of pains in its
limbs, or of weariness or headache.
Medical treatment. —HARTMANN correctly states that one
of the most homoeopathic remedies for the precursory stage
of tubercular meningitis is Pulsatilla; it corresponds more
especially to the derangement of the stomach, to the inability
to digest rich and fatty food, to the gradually failing health,
loss of flesh and ill-conditioned look, to the tottering gait, the
vertigo, and deranged secretion of urine, to the headache, nausea and vomiting. Still it is not positively known to have a
specific curative relation to the albuminous or tuberculous dyscrasia.
Hepar-sulphur. deserves great attention when the albuminous excess, or dyscrasia is fully developed, at least, according
to SOBERNHEIM it renders the pulse softer and slower, the
blood darker and decidedly deficient in albumen,; its powers
in this respect are so decided that HARTWIG asserts, in half an
hour after taking Hepar-sulph. in massive doses, the blood of
horses will be found from three-fourths to four-fifths deficient in
albumen.  When small doses fail, the following prescription
may be used:
Hepar-sulphuris,          grs. 18.
Cocoa Butter,         drachms 2.
White Sugar,             "     3.
Oil of Almonds,          ounce i.
One or more tea-spoonsful per dose.
This prescription will meet many of the requirements in the
tuberculous dyscrasia, viz.: the alkaline, oleaginous and antialbuminous treatment. BUscH of Strasburg, has cured several
cases of confirmed tubercular consumption, with Aconite in the
first stage, and Hepar-sulphuris in the subsequent periods.
Prof. BANG, of Copenhagen, has had similar good fortune; also
Dr. HAREL DE TANCREL.
Treatment of the headache.-If fever and other symptoms
of inflammation be present, Aconite will be the most important
remedy. It may be given internally in the ustal doses; besides, as the seat of the disease is at the base of the brain,
Aconitine ointment, (from 1 to 4 grains to the half ounce of




TUBERCULOUS MENINGITIS.               463
simple cerate,) may be rubbed behind and below the ears, and
on the back of the neck where it joins the head; or Tincture
of the Root may be applied freely in the same localities, every
two, four or six hours, according to the severity of the symptoms. In simple acute meningitis these remedies should be
applied to the top of the head.
The next most important remedy is Belladonna or Stramonium; they may be given internally; and the Extracts or
Tinctures may be used externally, as directed for Aconite.
If these fail to afford relief. Hyosciamus or Opium may be
used both internally and externally; as soon as the physician is
decided in his opinion that the case is one of Tubercular Meningitis, and hence almost necessarily hopeless, his principal endeavors should be directed towards soothing the sufferings of
the patient.
But Glonoine should be tried faithfully before palliative
remedies are given; especially when there is violent congestion
to the head, throbbing in the forehead, temples and vertex, violent beating of the carotids, redness of the face, quickness of
the pulse, &c.
Vomiting is the next most important diagnostic symptom,
and almost a constant one; BARRIER found it absent in only
15 cases out of 80, or in less than a fifth. It generally makes
its appearance on the first day, rarely later than the second or
third, and lasts two or three days, and sometimes longer; it
may, however, last ten or twelve days; the matters ejected consist of food, mucus and bile in various proportions; it is commonly repeated two or three times a day. The vomiting is
often, although not always, of a peculiar character, viz.: projectile, i. e. it occurs without much or any nausea, and the contents of the stomach are propelled suddenly with great force,
often to the distance of several feet from the person of the
patient. The vomiting may arise from irritation of the Pneumogastric nerve at the base of the brain; or from commencing
disease in the Corpus-striatum, (see treatise on headaches,
p. xiv.); or from gelatinous softening of the stomach.
Treatment of the vomiting.-This may subside under the
use of Aconite or Belladonna. If these fail, Cuprum or Zin



464             TUBERCULOUS MENINGITIS.
cum are best suited to the peculiar spasmodic vomiting, attended with little nausea. Zincum is also supposed to exert a
specific action on the brain, (see treatise on Mental Derangement, p. xxiv.) and HARTMANN says it is very useful in the
first stages of the disease, when the children become irritable
in the evening, are somewhat delirious during their sleep, but
become more quiet after midnight, and are quite bright again
towards morning; also when the bowels are costive, violent
headache sets in, the eyes become sensitive to light, the nose
dry, retching, vomiting and insatiable appetite occur, the urine
becomes scanty, turbid and loam-colored, with evening fever,
frequent pulse, heat and anxiety, and twitchings of the muscles.
Zinc has also a well-established reputation against many subacute and chronic inflammations, many nervous and spasmodic
affections, such as asthma, St. Vitus' dance, epilepsy, convulsions of children, constipation, flatulence, &c.
In vomiting from softening of the stomach, Kreosote is the
best remedy.
Constipation is said to be even a more important symptom
than vomiting; according to BARRIER it is absent in only 7
cases out of 87; it generally persists obstinately for several
days; and sometimes is not present at the very beginning of
the disease, but sets in soon afterwards. It generally depends
upon the disease at the base of the brain, more especially seated
in the Corpora-quadrigemina, (see treatise on headaches, p. xiv.)
Treatmrent.-In children predisposed to dropsy of the brain,
the condition of the bowels must be most carefully watched,
constipation must not be allowed to exist even for a day, and
the least indication of gastric disorder must be regarded as a
serious matter. If constipation has already been present for
several days before the physician is called in, some simple but
efficient purgative or injective medicine should be given at once.
When this has been done, Zincum and Opium will probably keep
them regular; at least Dr. STRONG, (allopathic physician) ably
advocates the use of Zinc and Opium in flatulence, and in constipation. WVEST thinks that the value of purgatives in the
treatment of ordinary hydrocephalus can scarcely be overrated;
but he says that they must be given so as not merely to obtain
free action of the bowels, but to maintain it for some days. In




TUBERCULOUS MENINGITIS.               465
tubercular meningitis any very harsh and active measures for
this purpose are entirely misplaced and useless.
The urine is scanty, frequently turbid and cloudy in the first
stage; afterwards it may deposit a chalk-like sediment, and
finally it is passed involuntarily. Other authors say that it is
apt to be of a deep amber hue, of high specific gravity, sometimes milky depositing a slimy sediment, and it is apt to smell
offensively after being passed and to cause pain in the urethra.
In simple meningitis or phrenitis, the urine is of a dark-brown
or porter-color, containing an excess of urea and less of lithates;
the sediment is generally reddish or reddish-brown.
Again hydrocephalus has been known to commence and proceed to the last stage with scarcely any other symptom than
slight fever, with little or no pain in the head, but a constant
and nearly ineffectual desire to pass urine; in one case not above
a gill of urine was passed in twenty-four hours for five days,
and no other symptom of consequence was present. MONRO and
EBERLEE have observed such cases.
On the other hand GUERSENT observed five cases in which
the profuse secretion of urine was quite remarkable, and in
these tubercles were found in the kidneys in every case.
Treatment of the urinary disorder.-Many physicians think
that the peculiar milky urine, with chalk-like or slimy sediment
indicate an endeavor on the part of nature to drain off some
noxious substance from the blood: if this be the case, Phosphoric-acid will prove the most homoeopathic remedy to milky
urine, with gelatinous lumps, or appearing as if flour were
stirred in it. This remedy is also indicated against softening
of thle stomach.
Carbo-vegetabilis, and Iodine when the urine is thick and
milky.
Chin.-sulph., when there are slimy flocculi, and a clay-colored
greasy sediment.
Tart.-emet., when it is pale, with a flour-like sediment.
Rhus-tox., pale urine with a snow-white sediment.
Zincum, when it is turbid and clay-colored.
Jllriatic-acid, when' it is white and turbid like milk when
passed.
China, when it is white and turbid, with a white sediment.




466              TUBERCULOUS MENINGITIS.
Graphite, when it is turbid, with a white sediment.
Dulcamara, when it is turbid and white.
Mercurius, when it is turbid as if stirred with flour; or
clear at first, and then becomes white as if mixed with chalk,
with burning in the urethra.
Zincum, yellow urine, depositing whitish flocculi.
Some physicians think it very important that there should be
a free flow of urine, and erroneously suppose that the brain is
safe as long as the kidneys act freely, (see above).
Among the brain remedies, Belladonna produces a free flow
of urine.  Dr. H. M. GRAY thinks that it exerts a tremendous
diuretic power; is confident that its power over the secretion
of urine is very great, as he passed three pints of urine in the
course of an hour, attended with slight strangury, while under
its influence.
Cantharides is perhaps the most homceopathic remedy to
meningitis, and its action upon the kidneys is well-known; it is
most indicated when the urine is full of mucus, with fiocculi and
filaments, or mixed with sand or clots of blood.
Arnica, when clear urine soon becomes white and.turbid.
Zincum has already been alluded to.
If these remedies fail Digitalis and hydrodate of Potash will
almost certainly produce a free flow of urine, but that will very
often not ward off a fatal termination.
The next most important symptoms are observed in the pulse
and respiration; they do not accord;. the pulse is apt to be
rapid at first and the respiration disproportionably slow; irregularity of breathing is often noticed by an attentive observer,
long before there is any irregularity of the pulse; one, two or
three respirations may be taken at equal intervals, but the
breathing is apt to be quite superficial, the upper ribs only
slightly rising and falling, but then there comes a full deep inspiration, very often attended with a sigh: again, there are one,
two, three or four, superficial inspirations followed by a deep
loud one. At other times the inspiration is quick, hurried and
convulsive, followed by a marked increase in the duration of
expiration and the period of repose; the inspiration is considerably shortened and a deep prolonged sighing often supervenes,




TUBERCULOUS MEN1NGITIS.                467
and considerably diminishes the amount of respiratory movements.
In the first stage the pulse is much accelerated, full but compressible, with a perceptible variation in the rythm of the artery, and in the regularity of the strokes; the pulse sometimes
beating as quick during one-third of a given time as it had previously done during the former two-thirds; thus, in a pulse of
140, one-half, or 70 strokes may be performed in 40 seconds,
and the other 70 in 20 seconds. This is often noticed before
there is any intermittence noticed. Then some slight intermission will be noticed every 7th, 17th or 20th stroke; finally
the pulse will begin to change its character, one or two strokes
in quick succession being soft, weak and fluttering.
In the second stage the pulse becomes slow, labored, intermitting and irregular, but is easily quickened by motion or
mental disturbance to double its previous amount of pulsations.
If the pulse beat only 60, 80 or 90 per minute, we may be certain that life will last for some days; but as soon as a new
acceleration ensues, death will occur in two or three, or at most
in five or six days. In the second quickening of the pulse it
generally rises to 112 or 120 on the first day, and will be from
140 to 160 on the very day of death, it increases in frequency
up to death.
The pulse always begins to become slow after the headache
and vomiting have lasted sometime, and before somnolency sets
in; it falls from 120 or 140, to 80 or even as low as 54.
These alterations in the breathing and pulsations are doubtless produced by irritation, followed by pressure upon the parvagum at the base of the brain.
Treatment.-Mercurius-corrosivus is indicated  when the
breathing is difficult and irregular.
Belladonna, when the respiration is natural at times, at
others almost extinct; also when it is labored, irregular, sometimes hurried, at others slow.
Opium, when the inspirations are slow, long or sighing; or
the breathing is irregular and suffocative; or deep and strong,
followed by difficult and feeble breaths.
1Stramonium, when the inspirations are slow, followed by
sudden expirations, with frequent sighing.




468             TUBERCULOUS MENINGITIS.
Camphor, when the breathing is slow and deep.
Laurocerasus and Hydrocyanic-acid, when it is slow, moaning and rattling.
Iodine and Spongia, when it is slow and deep, as after exhaustion.
Aconite, when it is slow during sleep.
Nitric-acid, when slow and feeble, with wheezing.
Scilla, when it is slow and heavy.
Lobelia-injiata, when there is an inclination to sigh.
As regards the Pulse:
Belladonna is indicated when it is quick and strong, or slow
and full.
Aconite, when it is slow irregular and intermitting.
Opium, when slow and full, afterwards becoming weak.
Stramonium, when irregular, frequent, quick; intermittent,
tremulous' and weak.
Laurocerasus, when irregular, slow, down to 30.
Digitalis, when irregular and small; irregular and unequal,
or slow; very slow, down to 35 or 40; intermitting and slow.
Agaricus, when it is unequal, slow, feeble and intermitting.
EHyosciamus, irregular and weak; intermittent, small and
quick; falling from 80 to 59.
Cuprumn, irregular, small and contracted.
Conium, unequal in strength and quickness.
iSecale, irregular, at times slow and full, then small and contracted; intermittent, slow and small.
Tartar-emetic, irregular and weak; slow, down to 50.
Tobacco, slow, small and intermitting; down to 45, and very
weak.
Mercurius, irregular and small; feeble, slow and tremulous.
Plumbum, irregular, first quick, then slow; sluggish and intermittent.
Phos. and Nitric-acid, irregular and intermittent.
Muriatic-acid, intermitting every 3cld beat.
Hellebore, slow and very small.
Cough.-A slight false cough which partly resembles a suppressed effort to vomit, and not unlike the morning liver cough




TUBERCULOUS MENINGITIS.                469
of drunkards, is not unfrequent in all three stages. When it
occurs in conjunction with the peculiar breathing before described, it is supposed to be a sign of effusion in the ventricles.
It may depend upon irritation of the pneuno-gastric nerve at
the base of the brain; or upon the deposit of miliary tubercles.
Treatment.-It is stated that nothing will relieve it; but
Conium is often a useful remedy.
Retraction of the abdomen is a valuable diagnostic sign; it
usually occurs about the sixth day; the belly becomes depressed
at its centre and takes on the form of a boat; it is almost a
constant symptom, and does not arise from the constipation, as
it is equally present when diarrhoea sets in; it is almost peculiar to this disease of the brain.
Treatment.-Plumbum and Zincum are the most homceopathic remedies, although Nux, Ignatia, Angustura, Alumina and
Colocynth may seem to be indicated.
I have been in the habit of placing great stress upon. the
presence of stiff neck, occurring every afternoon or evening, and
disappearing in the morning. It probably arises from irritation
at the base of the brain, near the origin of the twelfth pair of
nerves, as this supplies the muscles of the nape of the neck and
shoulders. If this symptom occur in a person born of tuberculous or consumptive parents, and is attended with headache,
fever, vomiting, constipation and signs of irritation of the brain,
it always excites our liveliest apprehensions as to the result.
Treatment.-Zincum and Plumbum are the best remedies.
The precursory stage above alluded to is of variable duration,
but on the average does not exceed four or five days. When
the second stage sets in, the nature of the affection becomes very
apparent. The child no longer has intervals of cheerfulness,
nor attempts to sit up, but wishes to be left quiet in bed, and
the face assumes a permanent expression of anxiety and suffering. The eyes are often kept closed, and the eyelids are knit,
the child endeavoring to shut out the light from its morbidly
sensitive retina. The skin continues dry, the face is sometimes
flushed, and the head often hot; and though these two symptoms vary much in their duration, coming and going without




470             TUBERCULOUS MENINGITIS.
any evident cause, yet there is a permanently increased pulsation of the carotids, and if the skull be not ossified, the brain
may be seen and felt forcibly beating through the anterior fontanelle. The child is now very averse to being disturbed, and
often lies in a drowsy condition, unless spoken to; when old
enough to answer, it usually complains of its head, or of weariness or sleepiness. Its replies are generally rational but short;
and if it needs anything, it asks in as few words as possible, in
a quick, pettish manner, and shows much irritability, if not at
once attended to. At other times it lies with its face turned
from the light, either quite quiet, or moaning in a low tone of
voice, and now and then uttering a short, sharp, lamentable cry,
which is regarded as characteristic of the disease, and hence
termed the cry hydrencephalique.  To this, however, there are
exceptions, and children sometimes scream out with the intensity of the pain. As night comes on, there is almost always a
distinct exacerbation of the symptoms, and the quiet of the day
is frequently succeeded by a noisy and excited state, in which
vociferous cries about the head alternate with delirium.  At
times, however, an increase of restlessness is the only difference
from the state of stupor in which the child lay during the day.
At the commencement of this stage the pulse is quickened,
sometimes very much so. The child sometimes keeps its eyes
so firmly closed that we can scarcely see the state of its pupils.
Usually they are not much affected, but sometimes one is more
dilated and acts more sluggishly than the other; or, in other
cases squinting exists, though perhaps in a very slight degree,
or confined to one eye. It is seldom that vomiting continues
beyond the commencement of this stage, but its cessation is not
followed by any desire either for food or drink. The bowels
usually become even more constipated than they were before,
and the evacuations continue quite as unnatural, while all flatus
disappears from the intestines, and the abdomen thus acquires
that shrunken form on which much stress has been laid by some
writers, as characteristic of dropsy of the brain.-WEST.
Treatment.-In this stage Mercury and purgatives are generally given freely and barbarously by allopathic physicians.
But the most efficient allopathic remedies are a few small doses
of Mercury or Proto-iodide of Mercury, followed by Hydriodate




TUBERCULOUS MENINGITIS,.               471
of Potash internally, aided by the free and frequent application
of Hydriodate of Potash ointment over the whole of the head,
and back of the neck. In desperate cases Dr. HIAHN has several times succeeded in arousing the child with the cold effusion,
after the supervention of complete coma. Friction of the scalp
with Tartar-emetic ointment, repeated every two hours until
pustulation was established, enabled Dr. tAIHN to save fourteen
cases, when in an apparently hopeless state of coma; even in
tuberculous meningitis cures were obtained in several cases by
the Tartar-emetic frictions under the most unpromising circumstances.
The third stage commences when tile brain itself becomes
involved and becomes softened. The transition is sometimes
effected very gradually by the deepening of the state of drowsiness, till it amounts to a stupor, from wihich it is impossible to
arouse the child. At other times, the stupor comes on very
suddenly, immediately after an attack of convulsions.  These
convulsions usually affect one side much more than the other,
and after the fit has passed off, one side is generally found
partially or completely paralyzed, while the child makes constant automatic movements with the other, carrying the hand
to the head, and alternately flexing and extending the leg.
The side which is the most affected during the fit, is generally,
though not invariably the most palsied afterwards. When the
third stage is fully established, the child lies upon its back in a
state of complete insensibility, with one leg stretched out, the
other drawn up towards the abdomen. The tremulous hands
are either employed in picking the lips or nose until the blood
comes, or one hand is kept on the genitals, while the other is
rubbing the face or head. The head is at one moment hot, and
the face flushed, and then the heat disappears and the flush
fades, though usually there is an increase of heat about the
back of the head. Sometimes the skin will be dry, at others
though the extremities are cold, a profuse sweat will break out
on some part of the body, or on the head. The pulse becomes
regular again, but grows smaller and more rapid until it can
only be counted at the heart. The eyelids close only partially;
there is some squinting; light is no longer unpleasant, for the
dilated pupils are motionless. The child now often makes auto



472             TUBERCULOUS MENINGITIS.
matic movements with the mouth as if chewing, or as though
endeavoring to swallow something, and it generally happens,
that although sensibility is quite extinguished, the little patient
will still swallow anything that is put into its mouth, and the
power of deglutition is in most cases one of the very last to be
abolished.-WEsT.
Many of these symptoms are sometimes very stupidly regarded as signs of worm disease, and Cina and Spigelia or other
worm remedies are administered. But these are signs of softening of the brain, and cannot be removed by any remedies,
although Zincum, Plumbum, Nux and Arsenicum are the most
appropriate medicines.
An attack of convulsions now sometimes puts an end to the
painful scene; but often the child lives on for days, though
wasted to a skeleton, alid its features so changed by suffering
that those persons who had seen it but a short time before
would now scarcely recognize it. The head often becomes retracted, and the child bores the back of its head into the pillow;
the eyelids are wide open, and the eyes are turned upwards, so
as to conceal three-fourths of the iris beneath the upper lid,
while the countenance is still further disfigured by a horrible
squint, or by a constant rolling of the eyes. The pupils are
now fixed and glassy, the white of the eye is extremely bloodshot, and their surface besmeared with a copious secretion from
the meibomian glands, which collects in their corners. One
arm and leg are stiff and motionless; the other in constant
spasmodic movement, while the hands are often clenched, and
the wrists bent upon the forearm. Subsultus and spasmodic
twitchings of the face are common. Cold clammy sweats break
out, the breathing is labored, swallowing becomes difficult, and
the child almost chokes with the effort to swallow, or lets the
fluid run out at the corners of the mouth. It is uncertain how
long this condition may endure; sometimes many days will
pass, during which death is hourly expected and earnestly
prayed for, to put an end to the patient's sufferings.
Treatment.-In this stage, palliatives only should be used,
such as Opium, Conium, Hyosciamus, Cannabis-indica, Chloroform, Ether, &c. In some instances I have applied anodyne
fomentations to the head, and used anodyne inhalations after
the little patient was unable to swallow.




TUBERCULOUS MENINGITIS.               478
TUBERCULOUS MENINGITIS.
IN YOUTHS AND ADULTS.
Dr. KENNEDY, of Dublin, has seen about 30 cases in the
course of nine years; and thinks that it is more common in
females than males, in the proportion of 2 to 1. Of 80 cases of
tubercular meningitis observed by GUERSENT, 33 were over 15
years of age; and of 12 cases by JACKSON, 7 were adults.  Of
10 cases, 6 were in females, aged 27, 20, 28, 28, 26 and 23 respectively; and 4 in males, aged 22, 20, 21 and 24.
According to KENNEDY, in the majority of cases the disease
commences with the symptoms of a mild, continued or remittent
fever, which goes on without change for 10, 12 or 14 days. It
occasionally begins by a distinct complaint of the head, the
patient still being able to go about.
When it commences with fever, the symptoms are usually
very mild; there is some quickness of the pulse, heat of skin,
furred tongue and headache. The case seems to go on favorably, remedies seem to avail, and the patient may even be pronounced convalescent; or the symptoms may become so slight
that the tongue is scarcely furred, some appetite may be present,
and the patient may sleep well at night.
When the disease commences by fever, the first sign of anything going wrong commonly takes place at night; a marked
increase of fever may then be observed, the tongue becomes
more furred, the skin feverish and the pulse rises to near 100.
KENNEDY has sometimes been led to suspect the serious nature
of the case, by the nurse casually stating that on the previous
night the patient had not slept so well, had talked in her sleep,
or awakened with a scream; these symptoms may return for
four or five nights in succession, and yet the patient seem comparatively well during the day.
Alterations in the movements or expression of the eye, are
often among the earliest signs, pointing to coming trouble.
Squinting may occur, and yet be so slight as to be doubted or
disputed, or it may be intermitting, i. e., present at one moment
and absent the next; or else it only occurs when the patient is
left to herself, but disappearing the moment she is spoken to;




474             TUBERACULOiUS MENINGITIS.
these slight changes may occur in one or both -eyes, and are
better observed at a little distance. One eyeball may be almost
immovable, and yet it is easy to overlook this; or one pupil
may be somewhat larger than the other; neither are dilated,
but they differ in size. Sometimes the eyelids have a tendency
to droop, and this ptosis may be most marked in one eye.
These eye symptoms are among the most constant and important signs.
At times the first symptom is vomiting, occurring most frequently in the morning; it may happen one or more times, but
never takes the prominent part it does in the hydrocephalus of
childhood.
The head is now more apt to be complained of; perhaps there
may be pain, only when the patient coughs; as a rule it is referred to the forehead over the eyes, but sometimes extends to
the whole head.
This state may continue for four or five days when the symptoms will become more serious; the patient is apt to wander a
little while awake, generally towards evening, but only momentarily, as she is quite herself again when spoken to.  The
countenance is also apt to become heavy, as if she were inclined
to doze.
The next sign which attracts attention is the pulse; in the
course of 24 hours it may fall remarkably, viz.: from 100 or
108 to 60, 55 or even 48. After the lapse of 48 hours more it
begins to rise again, often getting up to 130 or 140, and now the
case progresses rapidly; the patient becomes obtuse, difficult
to rouse. and the signs of confirmed dropsy of the brain are
soon added.
In the advanced stages it is very common to find the patient's
hand applied to the head, and the brows strongly knit, even in
sleep. In some cases the patient will sing the same tune all
night, or may grit her teeth with a degree of violence almost
insupportable.  The entire duration of these cases is about
three weeks; the disease seems to run in families, several members, young and adult being affected; three-fourths of the patients have naturally a heavy aspect; their faces are apt to be
large in proportion to their heads, the lips to be large, and the
skin rather coarse. In fact if a mild remittent fever occur in a




HYDROCEPHALOID DISEASE.                 475
young person, especially in a girl about fifteen years old, born
of scrofulous or consumptive parents, and slight brain symptoms
show themselves, be upon your guard.
Treatment.-See Tuberculous Meningitis of Children.
HYDROCEPHALOID  DISEASE, 
THIs is a most frequent and often fatal affection, though if
rightly treated it is a very manageable one. It is especially
common in this country, where infantile diarrhbea and summercomplaint occur frequently and severely, and blood-letting and
other reducing treatment are resorted to so commonly, quickly
producing that state of general exhaustion which leads to a train
of symptoms about the head, closely resembling those of dropsy
of the brain. According to WEST, hydrocephaloid disease is
that condition which is induced when the brain is somewhat
suddenly deprived of its usual supply of blood. Even in the
adult a profuse loss of blood is often followed by an extremely
severe headache, and by various other brain-symptoms; while
in the child, whose brain needs a proportionably larger quantity
of blood for the due performance of its functions, the symptoms
that follow its excessive loss are of a corresponding gravity;
often indeed they present a striking similarity to those which
betoken inflammation, or dropsy of the brain.  MARSHALL
HALL even says that in young children, bleeding, purging and
giving calomel enough, in any disease, will bring it on.
Again, there is no disorder in which the two conditions of
considerable sympathetic disturbance of the brain, coupled with
rapid exhaustion of the vital power, are so completely fulfilled
as in infantile diarrhoea, and summer-complaint, and in no other
affections do we meet with such frequent or such well-marked
instances of the supervention of the hydrocephaloid disease.
Synmptoms.-This affection may be divided into two stages:
the first, that of irritability; the second, that of torpor. These
two stages resemble in many of their symptoms the first and
second stages of dropsy of the brain.
In the first stage the infant becomes restless, irritable and
feverish; the face is flushed, the surface hot, and the pulse
frequent; there is an undue sensitiveness of the nerves of feel32




476             HYDROCOEPHALOID DISEASE.
ing, and the little patient starts on being touched, or from any
sudden noise; there are sighing and moaning during sleep, and
screaming; the bowels are apt to be flatulent and loose, and the
evacuations are mucous and disordered. —M. HALL.
if the affection arises from the exhaustion caused by diarrhoea,
and if from an erroneous notion as to the nature of this disease,
nourishment and cordials be not given, or if the diarrhoea be
allowed to continue, or be kept up by medicines, the exhaustion
which ensues is apt to lead to a different train of symptoms:
The second stage then sets in: the countenance becomes pale,
and the cheeks cool or cold; the eyelids are half closed; the
eyes are fixed, and unattracted by any object placed before
them; the pupils unmoved on the approach of light; the breathing from being quick becomes irregular and sighing; the voice becomes husky, and there is sometimes a husky, teazing cough; and
eventually, if the strength of the little patient continues to decline, there is a rattling in the breathing, and the feet become cold.
Again, according to WEST, under no circumstances are mistakes more easily committed, and never are their results more
mischievous, than when primary and real congestion of the brain
has been somewhat over-treated allopathically, and the consequent symptoms of exhaustion are supposed to be those of advancing disease of the brain. In such a case, however, it would
usually be observed that great faintness had been induced by
the profuse depletion, and that the quiet which succeeded it
was that of exhaustion, as much as of mitigated suffering; the
fontanelle sunk below the level of the bones of the skull, instead of being tense and pulsating; the cool surface, and the
pulse presenting no other characters than those of frequency
and feebleness, would all point to the real nature of the case.
To deplete further under such circumstances would be to destroy the patient; food is needed, not physic; the sunken powers
of life mnust be rallied, and as strength returns the functions of
the brain will again go on harmoniously.
The early stages of inflammation of the lungs, are also often
attended with so much sympathetic disturbance of the brain, as
to throw the other symptoms into the back-ground. The child
may vomit, refers all its sufferings to the head, and possibly
have an attack of convulsions almost at the onset. The routine




HYDROCEPIALOID DISEASE.                 477
allopathist will naturally assume the case to be one of congestion of the brain, and treat it accordingly with free local depletion; the next day the indications of disordered breathing are
more apparent, and more leeches are applied to the chest.  The
urgency of the symptoms may be relieved by these means, or at
least the child may seem to suffer less; but soon the restlessness of exhaustion comes on, and then follow the soporose condition and the apparent coma; if the antiphlogistic treatment is
resumed to arrest this imaginary dropsy of the brain, the little
patient will die.
Treatment. —A  large number of cases of hydrocephaloid
disease are not only caused, but absolutely killed by allopathic treatment, while a proportionately large number will die
under purely homoeopathic treatment: for as-WEST truly says,
food and stimulants are required, not medicine. Although the
diagnosis of this affection is sometimes attended with difficulty,
the rules for its prevention and cure are happily very simple.
Bearing in mind the possible supervention of hydrocephaloid
disease, an infant should never be kept from the breast. nor a
young child put upon spare diet for several days without the
most absolute necessity. Especial attention must be paid to
the food of young children, if the disease from which they suffer
be diarrhoea, or some other which interferes directly with their
nutrition; if the child be "given nothing more nutritious than
barley-water in shiall quantities, because the irritability of the
stomach which results from weakness, seems to be the indication
of disease in the brain, the restlessness will before long alternate with coma, and the child will die either comatose, or in
convulsions. The irritability of the stomach is best overcome
by giving nourishment in extremely small quantities, as a
desert-spoonful of ass's milk, or equal parts of milk and barleywater for an infant, or of strong veal tea, for an older child,
given little by little, every half hour. If the exhaustion be
very great, and a state analagous to stupor impending, a hot
mustard bath is sometimes very serviceable in rousing the child,
while, at the same time, a few drops of Spirits of Hartshorn, or
5 to 15 drops of Brandy may be given every few hours.  It is
desirable, however, to suspend the use of the more powerful
direct stimulants as soon as it can safely be done, though a
nutritious diet will be necessary for some time.-WEsT.




478              ATROPHY OF THE BRAIN.
WASTING OF T HE BRAIN.-(ATROPHY. )
IN CHILDREN.
SMALLNESS of the brain sometimes occurs in consequence of
a premature closure of the sutures and fontanelles.  Such cases
are apt to be attended with frequently recurring convulsions;
loss of taste, so that the child cannot distinguish between what
is nice and what is nasty, swallowing all things with the same
readiness; the body and limbs may seem well nourished and
well formed, yet the patient cannot stand or use his limbs properly; the urine and faces are apt to be passed involuntarily
and unconsciously; and gradually every glimmering of understanding will disappear.
Treatment. —-These cases are generally quite hopeless;
Phosphoric-acid in full doses may do some good.
According to WEST those cases are of much higher practical
importance in which the brain of the child wastes or grows
smaller during long-continued ill-health. The scalp will usually be found pale, thin and bloodless, the fontanelles sunken, and
the process of ossification of the skull unusually tardy; fluid
will be found effused into the sac of the arachnoid and the subjacent pia-mater; the substance of the brain is pale and its
texture firmer than usual.
The important point about such cases is, that brain symptoms and frequently recurring convulsions may be observed in
a child whose brain is not absolutely diseased, but merely too
feeble and too wasted to perform its functions.
Treatment.-In infants who have been exhausted and wasted
by previous illness, the physician must not interpose too hastily
with remedies directed against a supposed brain-disease, but
pursue a tonic and nourishing plan of treatment.  Iodide of
Potash may be used internally and externally to remove the
fluid effused, and may possibly have some effect upon the hardening of the brain, although Plumbum is the most homceopathic remedy.
Partial atrophy will be marked by symptoms most decided
in particular parts, or on one or the other side of the body.




ENLARGEMENT OF THE BRAIN.               479
IN ADULTS.
According to ROKITANSKY this disease is also common in old
age, and is within certain limits a natural process of shrinking
or decay; it becomes, however, a pathological condition even in
old age, if it proceed to a very great extent, and still more if it
come on prematurely at an early period of life.
The grey substance of the brain is apt to become of a dirty,
or rusty brown color, running into yeast yellow; its consistence
may be natural or distinctly softer than usual.  The white
substance loses its clear color and becomes of a dirty white; it
is denser too than natural, and is sometimes as tough as leather.
The vacuum within the skull, produced by the shrinking of the
brain, is filled up chiefly by a clear colorless serum; the vessels
of the pia-mater become enlarged and varicose.
It leads to congestions of the brain, or Hypereamia ex-vacuto,
causing transient or protracted attacks which simulate apoplexy, and are so frequent in old age; or to actual apoplexy, with
hemorrhage within the brain; or to cedema of the brain.
Treatnment.-Iodide of Baryta, Plumbum, and Iodide of Iron
are the principal remedies.
ENLARGEMENT OF THE BRAIN. 
HYPERTROPHY.
ACCORDING to ROKITANSIY enlargement of the brain is
sometimes congenital and is then often combined with dropsy of
the brain; still it more usually comes on after birth, and is
almost exclusively confined to the period of childhood. It is
occasionally met with about the time of puberty, and sometimes,
although exceedingly rarely, even in manhood.
It is the white substance of the brain which is increased
in volume; it is always dazzling white, and remarkably pale
and bloodless, showing that it is not caused by congestion.
When it comes on in childhood, and at puberty, it is combined
with general enlargement of the lymphatic glands and partial
obliteration of the thymus; it is also apt to be attended with
rickets and feeble muscular development.
Its course is generally chronic, but not unfrequently it is




480           ENLARGEMENT OF THE BRAIN.
somewhat acute; the cause of the acute symptoms when they
occur, is a rapid and tumultuous addition to the bulk of the
brain; this only takes place in some instances.
The majority of cases of enlargement of the brain which have
fallen under WEST'S notice in London, occurred in infants about
six or eight months old. Their history has usually been, that
without any definite illness, they had lost their appetite, and
grown by degrees dull and apathetic, though restless and uneasy.  Notwithstanding the general apathy, this restlessness
is often very considerable, though it does not show itself in
cries, as much as in a state of general uneasiness, and in frequent startings from sleep. Short gleams of cheerfulness occur
when the children are awake, but these are usually very transient.  The head seems too heavy to be borne, and even when
its size is not much greater than natural, it hangs backwards,
or to one side, as if the muscles were too weak to support it.
If placed in its cot, a child who is thus affected, bores with its
occiput in the pillow, while its head is almost constantly in a
profuse perspiration.  Convulsions sometimes occur without any
evident cause, but threatenings of their attack are much more
frequent than their actual occurrence, the child awaking suddenly with a start, and a peculiar cry, like that of spasmodic
croup, the surface turning livid, and the respiration becoming
difficult for a few moments, and the symptoms then subsiding of
their own accord.  Such attacks may issue in general convulsions, which may terminate fatally; but infants thus affected
do not by any means invariably die of the cerebral disorder,
but, being weakly, they are often cut off by the first malady
that attacks them.
If life be prolonged the child loses flesh, and looks out of
health, while enlargement of the wrists and ankles, shows the
connection between this disease and rickets; a connection which
becomes more evident in the second and third years-of life.
When the child survives infancy, or when as occasionally happens the.symptoms of enlargement of the brain do not come on
until dentition has been in a great measure accomplished, convulsions are of very rare occurrence.  Complaints of headache,
however, are frequent and severe; and, though drowsy in the
daytime the child generally rests ill at night, and often awakes




ENLARGEMENT OF THE BRAIN.                481
crying and alarmed. Besides these symptoms, too, the child
has occasional attacks of feverishness, with great increase of
headache and giddiness, which last for a few hours or a day,
and then subside of their own accord, while it grows by degrees
more and more dull and listless, and its mental powers become
obviously impaired.
It happens in some cases, that, as the child grows older,
these symptoms become less and less severe, the health improves, the ricketty deformity of the limbs gradually disappears and the infant who had excited so much solicitude becomes at length a healthy child.
Chronic dropsy of the brain is the only affection with which
enlargement of the brain is liable to be confounded.  The
diagnosis between the two affections is often by no means
easy, though it is of much importance with reference to the
treatment.
The symptoms of chronic dropsy of the brain generally come
on earlier, and soon grow much more serious than those of enlargement of the brain, and the disturbance of the brain is
throughout much more marked in chronic hydrocephalus than
in hypertrophy.  Convulsions, sopor and restlessness attend
the early stages of chronic hydrocephalus, while spasmodic
affections of the respiration are among the earliest indications
of enlargement of the brain.
The form and size of the head, too, present peculiarities by
which we may often distinguish between the two conditions;
both diseases are attended with enlargement of the head, and
in both the ossification of the skull is very tardy, but the head
does not attain so large a size in hypertrophy of the brain,
neither are the fontanelles and sutures so widely open.
The skull also presents some remarkable peculiarities; the
head not only shows no tendency to assume the rounded form
characteristic of chronic hydrocephalus, but its enlargement is
first apparent at the occiput, and the bulging of the hind-head
continues especially striking.
The forehead may, in the course of time become prominent
and overhanging, but the eye remains deep sunk in its socket,
for no change takes place in the direction of the orbitar plates,
such as is produced by the pressure of fluid within the brain,




482           ENLARGEMENT OF THE BRAIN.
and which gives to the eye that unnatural prominence, and that
peculiar downward direction which are so striking in cases of
chronic hydrocephalus.
In chronic dropsy of the brain the anterior fontanelle is tense
and prominent, owing to the pressure of the fluid within, but
when the brain is enlarged, there is no prominence but an
actual depression in this situation. WVEST has more than once
observed this condition in a remarkable degree, the depression
not being limited to the anterior fontanelle, but being also observable at all the sutures.
When enlargement of the brain occurs in the adult, the symptoms that arise are in a great measure due to the compression
which the organ undergoes from its bony case being too small
to contain it. The symptoms are of course exceedingly obscure.
-MAUTHNER and WEST.
Trealment.-Vinum-ferri, Ferro-citrate of Quinine, Iodides
of Iron and Potash and Cod-liver Oil, have been used most frequently and successfully.  Agaricus, Calc.-phos., Kali-carb.,
Mezereum and Rhododendron are the principal homoeopathic
remedies.
Daphne-indica is suitable when there is a sensation as if the
outer part of the brain were inflamed and striking against the
skull.
Sulphzur, Staphysagria and &tannum when there is pain
as if the brain were beating against the skull, or a painful
pressing of the brain against the skull and occipital bones, in
the evening, even after going to bed.
Clhelidoniun when there is a pressing in the brain, as if the
skull were too narrow, and the brain would be pressed out of
the eyes, nose or ears.
Baryta and Conitimn when the head seems too full as if it
would burst; especially in both frontal eminences and in the
orbits.




HYDROCEPHALUS.                     483
HY DR  OCEPHALUS.
DROPSY OF THE BRAIN.
IN by far the greater number of cases the fluid collects in
the interior of the brain, constituting what is called internal
hydrocephalus in contra-distinction to other cases in which the
fluid is contained in the sac of the arachnoidl, and to which the
name of external hydrocephalus has been given.
INTERNAL HYDROCEPHALUS.
The internal membrane of the ventricles of the brain is
composed of a very delicate continuation of the arachnoid and
pia-mater, and a layer of epithelium.  The most frequent and
important diseases to which it is liable, have, from one most
striking characteristic which they present, viz.: an excessive
accumulation of fluid, been included together under the title of
hydrocephalus.
The disease may be acute or chronic, inflammatory, or noninflammatory.
In the acute infcammnnatory form, a turbid fluid is found in
the ventricles, composed of serum and lymph or pus; the lining
membrane of the ventricles becomes dull, opaque, softened and
even diffluent, so that shreds of it often appear in the inflammatory effusion in the ventricles.
The substance of the brain is in a state of acute cedema, and
infiltrated to such a degree that it seems as if it were in a state
of watery softening; hence the brain itself is swollen and actually increased in volume, so that its convolutions are forced
against the skull and flattened.
It is very apt to be associated with tubercular meningitis.ROKITANSKY.
In the acute non-inJlan2tatory formn,a clear, colorless, serous fluid, varying in quantity from one or two to six ounces, is
found in the ventricles. Although the disease is often acute, it
cannot be admitted to be inflammatory; it arises from congestions of various kinds, viz.: such as are connected with the
development of the brain in childhood, or those produced by
chronic eruptions on the scalp, by the irritation of morbid




484                  HYDROCEPHALUS.
growths within the skull, &c.; or it may be occasioned, too, by
the congestions which follow concussion of the brain, or mechanical obstructions of the heart, chronic catarrh of the lungs, or
bronchi, &c., &c. The result of these congestions is an excessive effusion of serum, first from the lining membrane of the
ventricles, and then into the brain itself.  It is friequently
associated with enlargement of the whole system of lymphatic
glands, and of the follicular apparatus of the intestinal mucous
membrane; with enlargement of the thymus gland, with chronic
catarrh of the bronchi, and with rickets. —IROioITANSKY.
CHRONIC HYDROCEPHALUS.
According to ROK1TANSKY this disease may be divided into
three varieties, viz.: 1st, into congenital hydrocephalus; 2d,
that which commences at various periods after birth, but generally during the first six months; and 3d, hydrocephalus occasioned by a vacuum  within the skull, from atrophy of the
brain.
According to WEST, in the majority of cases the disease is
not a mere passive dropsy, but is the consequence of a slow
kind of inflammation of the aracbnoid, especially of that lining
the ventricles, which may have existed during fcetal life, or not
have attacked the child until after its birth.
In 50 cases collected by WEST, some symptoms of it were
observed- in 46 instances before the child was six months old;
in 12 of these the disease was congenital; and in 19 Ymore, the
malady was established before the child was three months old.
Symnptovns. —The early symptoms vary; when it is congenital, indications of disturbance of the brain are generally apparent from the infant's birth; these are sometimes serious, such
as convulsions, recurring almost daily; or slight, consisting of
nothing more than squinting, or strange rolling of the eyes.
The size of the heafi generally attracts attention before long,
and causes importance to be attached to symptoms which otherwise might have given rise to but little anxiety. In some instances, however, the increased size of the head is not very
obvious until the child is a few weeks old, although well-marked
symptoms of mischief in the brain existed from its birth; en



HYDROCEPHALUS.                    485
largement of the head, in fact, is by no means invariably the
first indication of chronic hydrocephalus. According to WEST
in 12 cases out of 45, fits returning frequently, had existed
for some weeks before the head was observed to increase in
size; in 6 instances the enlargement of the head succeeded to
an attack resembling acute dropsy of the brain; and in 4
other examples, it had been preceded by some well-marked indications of mischief in the brain; in the remaining 23 cases,
out of 50, no distinct brain-symptoms preceded the enlargement
of the head.
In whatever way the disease begins, the child's health will
have been noticed to be failing for some time, although the
cause of its illness may not be apparent; impairment of the
processes of nutrition is sure to be among its earliest symptoms.
The child may nurse or feed well, and indeed may seem eager
for food, but still it loses both flesh and strength; and often,
although the head has not yet attained any disproportionate
size, the child is unable to support it, either losing the power
it had once possessed, or never attaining that which, with its
increasing age it ought to acquire; the bowels are generally
constipated, but diarrhcea often comes on for a day or two, and
the evacuations are almost always unhealthy. In short, in the
primary symptoms there is but little to distinguish the case
from any other in which a young infant is imperfectly nourished;
even, although occasional attacks of heat of head may be observed, attended with pulsation or tension of the anterior fontanelle, attended with crying and restlessness, alternating with a
drowsy condition by day and restless nights, still these symptoms occur frequently enough from transient causes: they
acquire a more marked significance, if coupled with an unusually
open state of the fontanelles and sutures, even if no marked
enlargement of the head be yet perceptible.
By and by, however, the increased size of the head grows
very manifest, and the child's physiognomy soon assumes the
distinguishing features of chronic hydrocephalus; the sutures
become wider, the fontanelles increase in size, and the head
assumes a globular shape. But the greatest increase in the
size of the head is effected by the enlargement of the anterior
fontanelle, and by the widening of the sagittal suture. The




486                  HYDROCEPHALUS.
forehead is projected forwards; the orbitar plates of the frontal
bone are driven by the accumulating fluid from a horizontal into
an oblique direction, and sometimes indeed they become nearly
perpendicular, when by contracting the orbits they give to the
eyeballs that unnatural prominence and that peculiar downward
direction which constitutes one of the most remarkable features
in cases of chronic hydrocephalus.  In hypertrophy of the brain
the back of the head is much larger than the front.-WEsT.
The symptoms of disturbance of the brain that attend the
advance of the disease differ much in severity; sometimes there
is little but uneasiness and restlessness, afggravated at intervals
when the head grows hot and the fontanelle grows tense; in
other cases, convulsions occur frequently, from very slight, or
no evident causes; in another set of cases, spasmodic attacks of
difficult breathing, attended with a crowing sound in inspiration
are apt to occur, even before there is much enlargement of the
head.-WVEST.
Treatment.-WAHLE says that Hellebor.-nig., Arsenicum
and Sulphur are the principal remedies; he has often effected
radical cures even in congenital hydrocephalus.  He always
commenced the treatment with HTellebore, and persisted in its
use for eight or ten days.  Against the spasms, Sulphur 30,
was the most efficient remedy, all other seemingly appropriate
remedies were useless. Aconite 30, was most useful against
mental disturbances.
The treatment of GdLIS of Vienna, was to have the head
shaved, or hair cut close, and one or two drachms of the mild
mercurial ointment rubbed daily into the scalp; the head to be
constantly covered with a flannel cap, and 1, or 1 grain of calomel to be given twice daily, unless diarrhoea comes on. This
plan requires perseverance for thirty to forty days. Hydriodate of Potash is safer and perhaps more efficient.
Methodical compression of the head with strips of adhesive
plaster has been used successfully; and 18 cases out of 63, or
2 cases out of 7 are said to have been radically cured by puncture of the cranium and evacuation of the fluid.
CASE  1. —A rhachitic child, aged 3 years, had swollen
joints, was unable to walk, even when supported, and finally
became affected with full developed chronic hydcrocephalus; the




HYDROCEPH ALUS.                    487
sutures were widely separated; the child lay upon its back,
covered with a sticky perspiration, it had constant fever, grasped
at its head, became unconscious and passed its evacuations involuntarily.
Treatlent. —Calc.-c. 30, one dose every week; in five weeks
the dropsy of the head seemed removed and the enlargement
of the joints lessened.  By the continued use of Cale. the child
gradually recovered perfectly. —IvANovICHu.
CASE  2. —A boy, aged 14 months, was attacked with inflammation of the brain which terminated in dlropsy; spasmodic
and paralytic affections ensued, and finally the clhild lay unconscious with all the usual signs of' hydrocephalus.
Treatment. —The patient was entirely restored in the course
of ten weeks by Bell., Bryon., MIere., Hell., Ilyose. and Sulph.
-MALY.
CASE 3. —A boy, aged 1 year, had a very large and heavy
head, with widely open fontanelles; the eyes projected over the
edge of the orbits; there was strabismus; almost entire absence of all human expression; the child only made grunting
and beastly sounds; the skin hung loose upon the emaciated
hands and feet; the abdomen was much bloated; there was offensive diarrhoea intermixed with hard masses of foeces; involuntary discharge of urine and fieces; spasms and opisthotonos;
canine appetite.
Treatment and Result.-From Jan. 6 to Nov. 18, the child
received Cale. 200 and Sulph. 200, in alternation every ten or
fourteen days, with constant improvement; the spasms lessened,
the teeth came through, the eyes retreated into their sockets,
the expression became human and pleasant, it improved in body
and began to walk and speak. —BREDENLL.
CASE 4.-A boy aged 3 vears. had already suffered for two
years with signs of hydrocephaius; his head was large, and
inclined to fall forwards; the fontanelles were very large, the
forehead projecting, the eyes sunken, the pupils dilated, face
earthy and bloated; there was constant dribbling of water from
the mouth; the teeth were small and imperfect; the limbs weak
and unable to support the body; greedy desire for food.




488                  HYDROCEPHALUS.
Treatmzent. —Five doses of Bellad. 30, 1 drop doses, were
given in the course of sixteen days, with evident signs of improvement. A feverish attack with aggravation of all the symptoms, was then relieved by Aeon., followed by 2 doses of Bellad.,
without further benefit to the principal disease; hence 9 doses
of Mer.-viv. 6, were given, 1 dose every three or four days,
with remarkable relief from all the symptoms. The paralytic
weakness of the limbs was removed by 2 doses of Phosph. 30
and China 6.  Finally the child was perfectly restored.SCHWARZ.
CASE 5.-A boy, aged 3 years, was attacked with dropsy
of the head. Bellad., Hepar. and Conium diminished the great
size of the head.
Sometime after he fell in the water, after -which he could no
longer stand upon his feet, nor move himself, nor speak, or eat;
while drinking he pressed his tongue against the hard palate,
so that one-half of the fluid ran out of the mouth again.
Treatment. —Hyosc. 18, 1 dose every night and morning removed this state in three days.-HARTUNG.
REVIEFw. —Calcarea was used in 2 cases, in the 30th and
300th potencies; the latter in alternation with Sulphur.
Belladonna effected most in case 4, but was also useful in
cases 2 and 5.
WAHLE calls particular attention to Hellebore, Sulphur and
Arsenicum.
Mlercurius was very useful in case 4.
The general paralytic state in case 5, was evidently in close
connection with the previous state of the brain and was soon
cured by Hyosciaimus.
EXTERNAL HYDROCEPHALUS.
In this disease according to HowstIP the patient seems
always disposed to doze, yet it) senses are awake to the lightest
and least impression; the peculiar symptom is that of being at
one and the same time light-headed, yet perfectly sensible; the
patient speaking incoherently to himself, yet if spoken to answering clearly and rationally. This peculiar state is supposed
to occur only when there is an abundant serous effusion between
the membranes, and none in the ventricles of the brain.




HYDROCEPHALUS.                     489
Treatment of Ilydrocephalus. —Aconite is supposed to be
homceopathic to congestion of the brain only.
Aethusa-cynapitumn to congestion of the brain and its sinuses.
Ammonizm-mnur. is homoeopathic to atrophy and collapse of
the brain.
Arsenicum, to inflammation of the membranes and substance
of the brain, serous effusion into the ventricles.
Belladonna, to excessive congestion of the brain.
Bismuth, to serous effusion, here and there between the convolutions of the- brain, and in the ventricles.
Bronine, to venous congestion and considerable redness of
the pia-mater.
Brucea-antidysenterica, to great congestion of the left hemisphere of the brain and cerebellum, with effusion of a considerable quantity of serum into the ventricles.
Camphor, to violent congestion and inflammation of the
membranes and substance of the brain, with softening.
Cannabis-sativa, to congestion and extravasation upon the
arachnoid, clear serous effusion in the convolutions of the brain,
throughout and into the lateral ventricles, with some softening
of the brain.
Cantharides, to congestion of the brain, particeularly of the
cerebellum, which is covered with a thick layer of exuded
lymph, attended with an effusion of a quantity of serum at the
base of the skull.
Chininum-sclplhuricutm, to congestion of the brain and spinal marrow, red and white softening of the medullary substance,
with effusion of serum.
Cicutta-virosa, aga:inst meningeal apoplexy, induration of the
brain, serous effusion in one of the ventricles, and dark red fluid
at the base of the skull.
Colocynth, against congestion of the surface of the brain, and
inflammation of the pia-mrnater.
Conium, when there is a considerable quantity of water in
the ventricles of the brain.
Digitalis, when the membranes of the brain are strongly injected.
Gratiola, when there is a fiery-red injection of the pia-mnater.
Helleborus, when there is no fluid in the ventricles of the




490                   HYDROCEPHALUS.
brain, but the superficial veins are fltlled with black blood, and
the pia-mater is considerably injected, the brain being softened
and withering, or atrophied.
Hydrocyanic-acid, when the brain and its -membranes are
congested, with extravasation of blood, (true apoplexy,) with effusion of serum at the base of the skull; congestion of the walls
of the ventricles.
tI-yosciaizus, when the brain is congested and the ventricles
enmpty.
Latrocoerasuss, when the upper surface of the brain is congested, and also the inner vessels of the ventricles.
Nt7ux-voInozica softening of the brain and spinal marrow, congestion of the cortical substance and pons varolii.
Oleanzder, when the ventricles of the brain contain a small
quantity of reddish fluid, and the superficial vessels of the brain
are tinged with blood.
Opium, when there is congestion and extravasation of blood, in
and upon the brain; softening of the brain so that it was almost
impossible to distinguish the medullary from  the cortical substance; extravasation of serumn at the base of thle brain and in
the ventricles.
Oxalic-acicl, wIhen there is effusion under the atlachnoid.
Phosphoruls, wheen there is a wid(e-spread and thick accumulation of yellowish-white, opalescent exudation (plastic lymph,)
between the pia-mater and arachnoid, by means of which these
two membranes are glued together, (nmeningitis).
Plnbubzttmn, when there is a considerable flatness (atrophy) of
the convolutions of the brain, with paleness and softness of the
parenchymSa, brown clear serum in the mliddle ventricle, unusual
softness or hardness of the substance of tlhe brain, with clear
serum at the base of the skull.
Secale, when the vessels of the brain are empty.




ACUTE AND GENERAL INFLAMMATION OF THE BRAIN. 491
ACUTE AND GENERAL INFLAMMATION OF THE BRAIN.
IN ADULTS.
According to WATSON, acute inflammation does sometimes
appear to invade at once the whole of the parts that are lodged
within the skull, or, beginning in one part, it extends rapidly to
all the rest. This disease as it occurs in adults presents two
periods, which are marked by different symptoms, and are in
most instances distinctly observable. In the first period, what
are called symptoms of excitement predominate; in the second
period those symptoms appear which are comprised under the
term collapse. Sometimes these two periods instead of following each other are more or less mixed and confounded. But
the distinction is real and requires to be attended to.-WATSON.
Period of excitement.-The symptoms are pain in the head,
often intense and deeply seated, or extending over a large part
of it; a sense of constriction across the forehead; throbbing of
the temporal arteries; flushing of the face; injection of the
eyes, which have a wild and brilliant look; contraction of the
pupils; unusual sensitiveness to external impressions, amounting frequently to impatience of light and sound; violent delirium;
want of sleep; paroxysms of general convulsions; a parched
and dry skin; a frequent and hard pulse; white tongue;
thirst; nausea and vomiting; constipation.
Modes in which the disease commences.-The attack may
come on in three or four different ways:
1st. Sometimes there is a sudden alteration of manner, and
the patient, complaining probably of his head, becomes all at
once and furiously delirious; fever is also lighted up.
2d. In other cases the first thing noticed is nausea and vomiting, which may soon cease, or continue for several days, or even
throughout the whole course of the disease. Great quantities
of yellow, bitter, bilious fluid are brought up, and whatever is
introduced into the stomach, even a small quantity of the most
simple drink is immediately rejected. With this state of matters there is generally much constipation, and the bowels refuse
to act except under the influence of strong purgatives. It is
33




492 ACUTE AND GENERAL INFLAMMATION OF THE BRAIN.
very easy to mistake these cases for attacks of sick-headache,
bilious derangement, &c., &c.-WATsON.
3d. Another set of cases of acute inflammation of the brain,
commences with paroxysms of general convulsions, such as often
usher in an attack of meningitis. This symptom according to
ANDRAL is a much more certain sign of inflammation of the
brain, than the occurrence of active delirium, and WATSON
quite agrees with him in so thinking.
WATSON supposes that the cases which are characterized by
early and fierce delirium are cases in which the inflammatory
action has invaded the whole of the brain and its membranes
simultaneously. It is more probable that a large portion of the
grey substance of the brain is principally inflamed. He also
assumes that when nausea and vomiting are the earliest symptoms, the inflammation has taken its point of departure in the
cerebral pulp; in the substance of the brain. The seat of the
disease is, however, doubtless in the corpora-quadrigemina and
striata, (see Treatise on Headaches, p. xiv.)  Finally, he
guesses that when the attack comes on with a sudden fit of
convulsion, the inflammation has commenced in the pia-mater or
arachnoid. It is more apt to be located in the white substance
of the brain.
Simple inflammation of the brain proper, without any simultaneous affection of the membranes, has been fully considered
in the chapter on red or inflammatory softening of the brain,
(see Treatise on Apoplexy, p. 143.)
Period of collapse. —The first or acute stage lasts for a variable period, i. e. from one-half to two days or more, and then it
is succeeded by the second stage, or that of collapse.  The
patient then ceases to complain of headache; instead of being
excited or wildly delirious, he mutters indistinctly, and falls
into a state of stupor, from which it is difficult, and at length
impossible to arouse him. His vision and hearing are no longer
painfully acute; squinting and double vision are not uncommon;
and the pupil, from having been contracted to the size of a pin's
point, becomes first oscillating, then widely dilated, and ultimately motionless. Twitchings of the muscles and startings
of the tendons take the place of convulsions, although some of
the limbs may be agitated with tremors, or become powerless




ABSCESS OF THE BRAIN.                493
and palsied. The face becomes ghastly and cadaverous; cold
sweats break out; the sphincters relax; finally the coma becomes profound and life ceases. —WATSON.
Treatment.-In this disease, which is too often fatal under
any mode of treatment, a mere symptomatic homoeopathic procedure is ruinous. If too much attention be paid to the management of the delirium, convulsions or vomitings, the inflammation will progress rapidly and unchecked. Aconite should
be used freely, internally and externally; if this fails Veratrum-viride may be used. In some cases Opium  and Aconite
should be given in alternation. As soon as exudation takes
place, Mercurius, Hydriodate of Potash and Phosphor. are the
principal remedies.
ABSCESS  OF  TH E  BRAIN.
According to VALLEIX it is much more rare to find a perfectly circumscribed abscess than a diffuse softening with suppuration.
The causes of this affection are very similar to those of inflammatory softening, such as external violence in young and
vigorous subjects, absorption of pus in consequence of operations
on distant parts, and especially from the suppression of chronic
discharges from the ear.
Syymptoms.-The most important one is headache, the pain
of which is acute, persistent, and causes constant complaints
from the patient, who almost always presses his head with his
hand, contracts his brows, and assumes the strangest positions
in the hope of escaping his agony.  After the disease has
lasted a certain length of time the pain subsides and even disappears.
The intelligence may be disordered in various ways; sometimes there is an active, more frequently a quiet delirium; at
other times there is a marked dulness of the intellect, and the
patient has an obtuse manner, does not answer questions, but
continues to complain of his head. This hebitude generally follows after previous delirium and agitation.
On the motor side, we may observe convulsions, epileptiform
attacks,, or rigidity; or there may be paralysis more or less




494              HYDATIDS IN THE BRAIN.
complete, or merely a weakness and sluggishness of every movement, similar to the hebetude of the brain. The paralysis does
not ordinarily set in suddenly, but sometimes it succeeds soon
after the convulsions. The sensibility is not always diminished
unless there is simultaneous paralysis.
Sometimes there is fever, with heat of skin, acceleration of
pulse, redness of the face, &c.; in other cases there is none.
Vomiting and constipation are far from being constantly
present; the respiration is not apt to be affected.
It is supposed that the symptoms of abscess of the brain
from external violence are the most decided and acute, and that
paralysis promptly follows the agitation and delirium. Abscess
from disease of the bones of the skull, has less severe and urgent symptoms; while that which arises from suppression of a
discharge from the ear, follows a slow and insidious course, with
but few prominent symptoms.
When the abscess is seated in the grey substance of the convolutions, the delirium and agitation are the most marked symptoms; when it is located in the grey portions of the interior
of the brain, rigidity of the limbs and convulsions are the
most prominent symptoms; paralysis is most common when the
disease is in the white substance; general paralysis occurs
when the collection of pus is in the annular protuberance;
when the abscess is in one hemisphere of the brain or cerebellum, the paralysis will be on the opposite side.-VALLEIX.
Treatment.-The truly homoeopathic remedies against suppurative inflammation are Tartar-emetic, Cantharides, Rhus,
Sabina and Phosphor. The solvents of the pus globules are:
Kali-carb. and Baryta-muriatica.
HYDATIDS IN THE BRAIN.
There are several varieties:
1st. The hydatids spuria is merely, a hydropic primordial
cell; it is more frequently met with than the other varieties
and may be found in almost every part of the brain.
Symptoms.-The pain in the head they cause is constant;
in true hydatids it is intermittent.  They are apt to be attended with loss of sensation, dulness of intellect and loss of
memory.




HYDATIDS IN THE BRAIN.                495
2d. Acephalocysts, are very rare; of 21 specimens presented
to KLENCKE for examination, only 3 were genuine; they are
generally of the size of a lentil or pea, of an opaline color, and
contain a mass of microscopic cells.
Symptoms.-These vary much; generally there is headache,
but not more severe than in some other diseases.
If they are developed in the pons, fornix, crura-cerebri, hemispheres of the cerebellum, or base of the medulla-oblongata, or
if they compress these structures, they induce peculiar affections
of the muscular system, ending ultimately in epilepsy.
When confined to the cerebral hemispheres they cause stupor
only, or headache, or in extreme cases, apoplexy.
If the acephalocysts be numerous, the respiration is apt to
be slow; if they are seated in the corpus callosum the pulse
is generally slow; if in the pes-hippocampi the pulse may be
quickened.
If seated in the thalami-optici and crura-cerebri, they are apt
to be attended with hallucinations, flashes of light before the
eyes, or blindness.
If in the corpora-striata, or quadrigenema, we are apt to find
spasms of the stomach, spasmodic colic, or paralysis of the colon.
If the cerebellum be implicated, there generally is paralysis
of the bowels or bladder, with abolition of the sexual functions.
3d. The presence of polycephalus causes the rotary disease
in sheep. In man it causes headache, rotation, loss of memory,
and insensibility to light.
4th. The cysticerus, and also the polycephalus are apt to
cause periodic headaches, owing to the greater or less active
movements of the parasites; every motion of the neck, or the
crown of hooks around it causes irritation of the brain.
Treatment.-Many of the symptoms produced by these parasites are relieved in a remarkable manner by brandy, for alcohol acts as a poison, especially upon the cysterceri and converts
them into a torpid mass.
Nitrate of silver has relieved many of the gastric affections,
also the trembling of the hands and convulsive action of the
eyelids, &c.
Nux-vomica and Secale are supposed to exert a beneficial
action upon them.




496             TUBERCLES OF THE BRAIN.
TUBERCLES OF THE BRAIN.
Under this head we do not refer to cases in which tubercle is
present merely in the membranes of the brain, producing that
granular appearance which has been alluded to when treating of
tubercular meningitis, but to separate and independent deposits
of tubercular matter into the substance of the brain itself.
Tubercles of the brain though exceedingly rare in the adult,
are not very uncommon in the child: thus, while Louis met
with only 1 case of tubercle in the brains of 117 adults who
died of tubercular disease, RILLIET and BARTHEZ found it 37
times in 312 cases of fatal tubercular disease in children.
WEST knows of no instance in which tubercle was limited to
the brain in childhood, for if present there it always existed in
other viscera, especially in the bronchial glands and lungs,
shewing that it is but one of the results of that general
cachexia which may show itself in any of the various forms
of scrofulous or consumptive disease. This fact is very important in forming an opinion as to the nature of various local
diseases of the brain; for softening of the brain, or abscess, or
tubercles, hydatids or cancer, do not disclose their precise nature by any peculiar symptoms, or succession of symptoms.
They all, sooner or later disturb the functions of the brain, and
they may all disturb them very nearly after the same fashion.
But we may judge sometimes, from other circumstances, that
the disease is of this or that character; thus, if we find scrofuious or cancerous disease in other parts of the body, we may
safely infer that the symptoms which denote disease of the
brain, are caused by scrofulous or cancerous tumors there
situated; but from  the symptoms themselves, we can only
learn that there is some morbid condition of the brain.-WATSON.
According to ROKITANSKY the number of tubercles in the
brain is usually small; one or two being met with in most
cases, and more rarely, three, four, five or a few more; some
extremely rare exceptions do occur in which twenty or more are
found. When they are but few, each separate tubercle acquires
a considerable size, the most usual size is that of a hazel or




TUBERCLES OF THE BRAIN.               497
walnut; when they are more numerous, no single one often is
found much larger than a hemp-seed or pea, although I have
seen at least twenty in one child's brain, and none less than a
hazel-nut in size. Tubercles of the brain are also peculiar in
not being generally aggregated together, but separated widely
apart.
Every part of the brain is occasionally the seat of tubercle.
They are very common in the brain itself, and less so in the
cerebellum; they are rarely found in the pons, and still less so
in the medulla-oblongata. As a general rule they are deposited
in or near the grey substance, hence near the surface of the
brain, or in the grey portions of the corpora striata or optic
thalami. The corpus callosum, fornix, septum lucidum, and
crura scarcely ever contain any.-ROKITANSKY.
Its most frequent combination is with tuberculosis of the absorbent glands; and next in frequency with tubercle in the
lungs.
When seated near the surface of the brain, they may cause
tuberculous inflammation of the membranes, and acute dropsy
of the brain.
Symptoms.-These vary according to the number and location of the tubercles, and to the existence or non-existence of
softening of the brain around them.
In one case, in a boy aged 3- years, and in the left hemisphere of whose cerebellum WEST found a tubercle, there had
been an almost constant and involuntary rotary motion of the
head when lying down; but this is a rare symptom.
As they are generally seated near the surface of the brain,
*we would expect often to find delirium, stupor, or headache. In
fact HENNIS GREEN mentions pain in the head as the most
constant symptom of the early stages of the disease, having met
with it as a prominent symptom in 17 cases out of 20. This
pain is often very severe, so that during its continuance the
child shrieks with the agony of the suffering; but singularly
enough it does not continue with this intensity for more than a
few hours, and on the next day the child may be found to be no
worse than usual. Vomiting in many instances attends these
exacerbations of pain.
In other instances a general dulness steals over all the facul



498             TUBERCLES OF THE BRAIN.
ties, and the child grows quite indifferent to what is going on
around it; he may never complain of headache, but be fretful
and cry if moved, yet be perfectly quiet if allowed to remain
undisturbed, dozing for hours together.
According to GENDRIN when the tubercles are located in one
cerebral peduncle, convulsions commence in one leg and from
thence extend to the whole of the same side on which the peduncle is affected.
When they occupy the mesocephalon, the muscles of the face
and especially of the mouth are most convulsed, and generally
spasms only occur at a later period.
In a very few cases no symptoms are present; much more
frequently, however, the signs of disturbance of the brain,
though not entirely absent, are too vague to excite much attention and too slight to occasion much suffering, so that if they do
not wholly escape notice, they are confounded with other indications of ill-health attendant upon the general tubercularization
with which this disease of the brain is frequently associated.
In these latent, or semi-latent cases death finally takes place
rather suddenly, under the indications of the most serious braindisease. This acute stage sometimes lasts for a few hours ogly,
and a child who had shown no sign of head-affection, though
probably the symptoms of tubercular disease of the lungs or other
organs had long been present, suddenly sinks into a state of stupor, which soon deepens into a profound and fatal coma. In another set of cases convulsions take place suddenly, followed by paralysis of one limb, or of the whole of one side, and either is
immediately succeeded by coma, or this does not come on till
after the fits have recurred several times. In a third variety
of cases death is preceded by symptoms of acute dropsy of the
brain.  This sudden outbreak of symptoms may take place
without evident cause, or follow a not very severe blow or fall
upon the head.-WEsT.
When headache, nausea and vomiting are present, the case
may still be obscure; for some delicate children have irregular
attacks of violent headache, off and on for years, accompanied
with vomiting, from slight causes or no apparent cause at all,
and finally recover as their health becomes more robust. Some
children may even have headache aggravated at intervals and




TUBERCLES OF THE BRAIN.                499
associated with occasional convulsive movements of one limb,
and even with attacks of an epileptic character, and yet show
by the confirmed health they subsequently attain to, that some
cause of a less abiding nature than a tubercular deposit must
have given rise to the disturbance of the brain.-WEST.
Affections of the motor system are, however, often among the
earliest indications of this disease; convulsive movements are
the most frequent of these; paralysis of a limb, or impaired
power over it, usually succeeds the convulsions, and but seldom
take place independently of them.  Sometimes we observe
nothing more than an occasional convulsive twitching of one
limb, more frequently of the arm than of the leg, unattended
with any loss of consciousness, or impairment of the intellect;
but the seizure is more frequently attended with stupor, though
the convulsive action may be confined to one side, or even to
one limb. When convulsions, whether general or partial, have
once occurred they are seldom absent for many days together.
The transition from the premonitory to the acute stage sometimes takes place gradually, the convulsions becoming more and
more frequent, and the other brain symptoms more serious, and
the intervals of freedom from suffering shorter; or the change
takes place suddenly, and without such previous increase in the
severity of the child's suffering as to make one anticipate its
approaching death; and yet we cannot always discover such
differences between the morbid appearances in the two cases as
should explain the dissimilar course of the disease.-WEsT.
When tubercles are seated solely in the corpus-striatum,
there will probably be convulsive movements when a portion
only is involved, and paralysis if the disease includes the whole
of the organ.
If located in the optic thalami, there will be more or less loss
of sensation.
Tubercular disease of the medulla-oblongata and pons-varolii,
is attended with difficulty and irregularity of breathing.
Disease of the crus-cerebri is followed by convulsions or
paralysis of the opposite side; also when the white substance
of the brain is involved. The symptoms of tuberculosis of other
parts of the brain will be similar to those which have been observed when hydatids are present.




500             TUBERCLES OF THE BRAIN.
Treatment.-The infants of tuberculous mothers should be
weaned early, or given to a healthy wet-nurse, or what perhaps
would be better still, they should be fed upon diluted cream; as
milk, both human and animal, contains a large proportion of
albumen and caseine, it should be entirely avoided. Milk. as is
well-known, is a watery liquid, having in solution a certain
amount of caseine, sugar of milk or lactine, extractive matter,
together with several inorganic salts, (such as the Phosphates
of Lime, Magnesia, and of the Per-oxide of Iron, the Chlorides
of Potassium and Sodium, and Pure-soda,) and holding in suspension myriads of extremely minute globules of fatty matter,
plainly visible through the microscope. Fresh milk is almost
invariably slightly alkaline, but on exposure to air, especially
in warm weather, it rapidly becomes acid, owing to the conversion of the sugar of milk or lactine, into lactic acid, under the
influence of the caseine which acts as a ferment. If the milk
has been long retained in the breast, this change occasionally
takes place before being drawn; and in some morbid conditions
also, the milk is found to have an acid reaction even when freshly drawn. Such milk would be especially injurious to children
with a tendency to tuberculous ailments; if milk be used at all,
the mother should be supplied with litimus paper to test each
specimen before it is given to the babe.
Acidity of the stomach and bowels should be carefully obviated and prevented; still ordinary acidity of the digestive organs
will not necessarily produce tuberculous disease. As the Chlorides and Phosphates of Soda and Potassa are deficient in tuberculous blood, it might be advisable to use these salts to correct
or prevent acidity of the stomach and bowels.
As Iron is decidedly deficient in the blood of tuberculous
subjects I have long been in the habit of using a combination
of equal parts of Phosphate of Iron and Phosphate of Lime or
Soda, thoroughly triturated together, and mixed with double its
weight of Sugar, in order to prevent acidity of the stomach, and
supply the requisite quantity of Iron to the system.  Phosphate of Lime ought also be an excellent dietetic and preventive,
if not curative remedy against tuberculous acidity. According
to ANCELL crude tubercle contains but a very small proportion
of Phosphate and Carbonate of Lime-say one per cent.



TUBERCLES OF THE BRAIN.                501
whereas, chalky tubercles frequently weigh 10, 20 or 30 grains.
Hence in order to form chalky concretions, the deposition and
resorption of animal matter, such as Albumen and Caseine must
have taken place to a very great extent, or for a considerable
period.  It appears to ANCELL that where the tendency to
cretaceous aggregation has existed in the highest degree, the
blood must have wholly or partially lost its tuberculous quality;
and that after having secreted intractable tubercle, owing to
this favorable change it pours out a blastema, which depositing
its earthy salts, is in the main susceptible of resorption, and is
actually absorbed, the earthy particles gradually accumulating
in the tuberculous cavity. That some such process as this occurs, he thinks, follows from a consideration of the whole series
of chemical facts. Supplying an excess of Phosphate of Lime
to the system may perhaps favor and hasten these beneficial
changes.
The acids in the normal gastric juice are: the Muriatic, Lactic and Acetic; the Muriatic generally predominates, although
either may be in excess and require peculiar treatment. The
chyme which is made from the fibrine of meat and coagulated
albumen, contains much  IMuriatic acid; that which is made
from quite fresh meat and milk contains an excess of Lactic
acid; while that which is made from amylaceous and farinaceous substances and vegetables contains much Acetic acid. In
some states of the system quite new and unusual acids are
found, or get into the stomach, such as: Phosphoric, Uric,
Oleic or Butyric, and even Fluoric acid. It is not yet known
positively which one of these acids predominates in the tuberculous dyscrasia, but they all require their peculiar and specific
antidotes. The best antidotes of Muriatic acid are: Zincum,
Ferrum, Argentum and Ammonia; Soda, Plumbum and Baryta
are the best antidotes for Phosphoric acid; the tendency to the
formation of Uric acid in the stomach is best antidoted by Cuprum and Colchicum; while an excess of Lactic acid is best
met with Zincum.-(See Treatise on Diseases of Married Females, p. 52.)
Hepar-sulphur. may correct acidity of the stomach, and neutralize the predominance of albumen in the blood, besides having
a symptomatic relation to tubercular disease.




502             TUBERCLES OF THE BRAIN.
When deposits of tubercle have actually taken place, they
cannot be removed by any known solvent. Still trials may be
made with at least a shadow of a hope of success. Thus, if we
admit with HECHT and SCHARLAU that tubercle contains 30
per cent. of Fibrine, the solvents of Fibrine may be used. According to DENIS if moist Fibrine be digested in a solution of
Nitrate of Potash containing a little Soda, it gradually becomes
converted into a substance in almost every respect identical
with Albumen; being soluble in water, and coagulable by heat.
Again, the alkalies and their carbonates and acetates entirely
prevent the coagulation of Fibrine; and tolerably strong solutions of Nitrate of Potash, Nitrate of Lime, and Muriate of
Ammonia, retard it for a long time; the Muriate of Ammonia,
indeed, gradually dissolves Fibrine, after it has been allowed to
coagulate.
If we assume that tubercle consists in an excessive formation
and deposition of Albumen, the solvents of Albumen may be
tried. Hepar-sulphur. has already been alluded to. Coagulated Albumen is also readily soluble in Potash and other alkaline solutions; the Phosphoric, Acetic and Tartaric acids, also
appear to exercise a decided solvent action upon it, and when
present even prevent its coagulating on the application of heat.
On the other hand, the Nitric and Muriatic acids, the Bichloride
of Mercury, and Ferrocyanide of Potassium coagulate and precipitate Albumen and hence may be more homceopathic to Albuminous tubercles.
Finally, if we assume that tubercle consists merely of Caseine,
we may be obliged to resort to Acetic, or some other acid, for
although Caseine coagulates and is precipitated by Acetic
acid, it redissolves if the acid be added in decided excess. In
fact, although Caseine is precipitated and coagulated by Acetic
and nearly all the acids, it redissolves in a considerable excess
of most of them.
The experienced physician can easily decide when to give the
preference to one or the other of these remedies; or to use two
or several of them in alternation or combination; also when it
will be advisable to use the inhalation of the vapors of these
medicines in combination with their internal use; and finally
when to rely upon infinitessimal quantities in order to overcome




CANCER OF THE BRAIN.                  503
a qualitative or dynamic predisposition or tendency to tubercular disease, and when to give more massive quantities in order
to remove absolutely material and quantitative deposits.
CANCER OF THE BRAIN.
THE symptoms of cancer of the brain and its membranes are
similar if not identical with those of tubercles or other tumors
of these parts.  An accurate diagnosis is seldom more than conjectured, except when the cerebral symptoms happen to coincide
with the phenomena observed in other parts of the body, which
may serve as a clue to the disease going on in the brain. Thus,
tubercles in the brain are more common in children and young
adults; hard cancer, is more common in persons over 40, while
medullary cancer may occur in young subjects. In tubercular
disease the skin is apt to present a pasty or doughy appearance;
in cancer it often presents a peculiar straw-yellow color. As
WATSON truly observes various local diseases and tumors of the
brain, do not disclose their precise nature by any peculiar
symptoms or succession of symptoms; but if we detect signs of
tuberculous or cancerous disease in other parts of the body, we
may safely infer that the symptoms which denote disease of the
brain are caused by tuberculous or cancerous disease there
situated; but from the symptoms alone, we can only learn that
there is some morbid condition of the brain. If there be signs
of disease of the lungs, bronchial glands, peritonmum or bowels,
the probability is that the disease is tuberculous. If there be
disease of the breasts, axillary glands, womb, &c., &c., the
probability is that the disease is cancerous.
Hence the treatment, although it may be homoeopathic, must
not be merely symptomatic; it must be directed against the
nature of the disease, and not merely against its symptoms or
manifestations.
However similar the symptoms of tubercular and cancerous
disease of the brain may be, viz.: headache, blindness, paralysis,
convulsions, &c., &c. yet there is a decided antagonism not
only in the nature of the two diseases, but also in the localities which they prefer: thus, cancer of the breast, stomach,




504               CANCER OF THE BRAIN.
liver, large bowels and womb, is very common; tubercular disease of these organs is very rare; tubercular disease of the
lungs, spleen, small bowels, bronchial glands, peritonaeum, &c.,
is sufficiently common, while cancerous affections of these organs
is decidedly rare. Hence the remedies for cancerous disease
may or must be injurious in tubercular disease, and vice versa.
In tuberculosis, the cellular, vascular, albuminous and glandular tissues are most apt to be affected; in cancerous disease,
the gelatiniform, fibrous, albuminous or medullary and glandular
parts. Caseine and Albumen are the predominant elements in
the tuberculous dyscrasia; Gelatine, Fibrine, Phosphorised fat,
Cholesterine, and perhaps Albumen are the most abundant constituents in cancer. Caseine is never found in cancer.
In scirrhus we may find from 0.2144 to 0.2778 of Gelatine;
0.1428 of Fibrine; 0.1388 of Phosphorized fat; and 0.0278 of
Albumen; the rest water and salts.
Treatment.-The best remedies against the cancerous dyscrasia, are: Arsenicum, Alumina, Carbo-animalis, Soot, Calendula, Muriates of Gold and Soda, D.onovan's Solution, &c.




ON THE
HOM(EOPATHIC TREATMENT
OF
INFLAMMATION AND DROPSY OF THE BRAIN,
&c., &c.
THE following remedies have been used most frequently,
viz.: Aconite, Arnica, Belladonna, Bryonia, Chamomilla, Cuprum, Digitalis, Hellebore, Hyosciamus, Iodine, Opium, Rhus,
Spts.-Nit.-dulc., Stramonium, Sulphur, Veratrum and Zinc.
ACONITE.
GENERAL REMARKS.-According to WARING the comparative activity of the different parts of the plant has been closely
examined by Drs. FLEMING and TURNBULL. They agree that
the root is the part which is most energetic, certain and eligible for medicinal use; the seeds rank second; the leaves third;
the flowers fourth, and the fruit and stem last. The homoeopathic tincture which is made from the whole plant is much weaker
and more inefficient than the tincture of the root, because the
root contains a much larger proportion of the active principle
of the plant, (Aconitine,) than any other part, or all other parts
combined. When the homceopathic tincture is diluted one-half,
or even twenty times as it frequently is, it becomes a very uncertain and weak preparation to combat acute congestive or inflammatory affections, because Aconite is antipathic rather than
homoeopathic to these affections, and hence tangible or even massive doses are required. Although Aconite resembles Digitalis
and Tobacco in its action upon the heart and arteries and is not




506                       ACONITE.
strictly homceopathic to inflammatory or actively congestive diseases, still it is used as a matter of course, or of routine, by the
majority of homceopathists against the majority of these affections; consequently it frequently fails to produce any good effect,
especially when the dilutions, either high or low are used. Lately, Dr. HENRY, homoeopathic physician in Montgomery, Alabama, has found out that the Veratrum-viride, exerts a still
more powerful action upon the heart and arteries; predicts
that it will soon stand as a great rival to the long tried Aconite:
and asserts that lie prefers it to Aconite, and has never failed
in reducing the action of the heart with it.  Singularly enough,
Yera.trum-viride is quite as antipathic to fever and inflammation
as Aconite.
According to FLEMINGC and WARING, when a small piece
of the root of Aconite is chewed, it causes an increased flow of'
saliva, a peculiar numbness of the lips and tongue, with a tingling sensation, and partial loss of use of the lips. Its topical
application is unaccompanied by either pain, redness or swelling,
even when its pathogenetic effects are developed to the fullest
extent; proving that it is not homemopathic to inflammation, but
that;it exerts a depressing and benumbing, or paralyzing effect
upon the vascular system and nerves of sensation.
Given internally, Dr. FLEMING, divides its operation into
four degrees:
First Degree. —Half an hour after a dose of 5 drops of the
Tincture of the Root, warmth is felt in the stomach, with slight
nausea, oppression of breathing, general warmth of the body,
numbness, tingling and a sense of distension of the throat, lips
and tongue. There is also a tingling at the tips of the fingers,
with a peculiar sensation at the roots of the teeth; slight muscular weakness is generally experienced, with indisposition for
exertion, either mental or bodily. In about half an hour more,
the pulse will be found diminished in strength, and in another
hour both the pulse and breathing will have become less frequent, viz.: the pulse will have fallen from 72 to 64, and the
breathing from 18 to 15 or 16.
Second Degree.-If 10 drops be taken at first, or the original dose of 5 drops, be followed in two hours by another of
equal amount, the above symptoms will supervene more rapidly




ACONITE.                      507
and with greater severity. The tingling will extend up along
the arms, and the sensitiveness of the skin is more or less impaired. In one and a half hours, the pulse will probably have
fallen to about 56 beats per minute and become smaller and
weaker, still maintaining, however, perfect regularity.  The
respirations will be about 13 per minute and laboring, attended
with great muscular debility, giddiness and confusion of sight,
with lethargy, coldness of the skin and extremities.
Larger doses will be followed by the same symptoms to a
more severe extent. The pulse occasionally falls to 40, or even
36, but more generally rises to 70 or 80, becoming small, weak
and irregular; respiration is oppressed, and the skin becomes
moist and cold. -FLEMING.
Of the allied remedies of Aconite, Tobacco acts specifically
upon the stomach, solar plexus of nerves, heart, arteries and
nerves of motion and -muscular system. Digitalis acts principally upon the heart, arteries, kidneys, and serous membranes.   Veratrum-viride upon the stomach, liver, bowels,
heart and arteries. Colchicum upon the liver, kidneys, heart,
arteries and fibrous tissues.  Tartar-emetic and Ipecac. upon
the stomach, solar plexus, skin and muscular system. Aconite
upon the skin, sero-fibrous tissues, heart and arteries.  All
these remedies depress the action of the heart and arteries in a
similar and specific manner.
Although I believe that the majority of TESTE's remarks on
the Materia Medica are flippant and insincere, still I agree
with him when he says, that of all the medicines used by homoeopathic physicians, Aconite is the one which they use erroneously most frequently.  As it only possesses the power of
perturbating or depressing the action of the heart and arteries,
and is not homnceopathic to inflammatory local lesions, whenever
inflammatory fever and local inflammation have already acquired
a certain degree of intensity, infinitessimal doses cannot be
administered without involving a loss of very precious time.
Either, some decidedly homoeopathic remedy must be used in
small quantities; or more massive doses of Aconite must be
given. TESSIER found that when inflammation of the lungs
was at its height, the high dilutions only produced some
slight effect upon the pulse, none upon the disease. —PETERS.
34




508                     ACONITE.
a. In opposition to the above, KREUSSLER Says: whenever
traces merely of inflammation of the brain present themselves,
or whenever this disease seems fully developed, Aconite is the
first remedy which ought to be given. It is not the question
whether inflammatory fever is present or not, for pure inflammation of the brain or its membranes requires the use of this
remedy from the very commencement of the disease, until effusions and exudations have taken place. Two or three doses of
the 6th or 12th dilution may be given, ana its action awaited
for twelve or twenty-four hours. If not the least improvement
occurs during this time, viz.: neither perspiration, se1iment in
the urine, nor bleeding of the nose, and the restlessness continues, followed by stupor and delirium, then another remedy
must be used. —KREUSSLER. I venture to assert that either
other remedies, or larger doses will be required in the majority
of caseS.-PETERS.
b. HEICHELHEIM says he has treated eight children in the
first stage of dropsy of the brain and relieved them all with
Aconite followed by Bellad.
c. SCHROEN asserts that when congestion of the brain with
impending inflammation sets in during dentition of young children, he has always found Aconite useful; but large and repeated doses had to be given. KREUSSLER, with characteristic
flippancy and dogmatism assumes that Aconite will not remove
simple congestion, but only that stasis and congestion which is
the first stage of acute inflammation.
CASE 1.-A girl, aged 10, had heat and redness of the
whole body, especially of the head and eyes, contracted pupils,
entire unconsciousness, delirium, dryness of the tongue, vomiting of greenish substances, subsultus, quickened respiration,
pulse 120 to 130, with grasping at the head.
Treatment and Result. —Acon. 18, one drop in 6 spoonsful
of water, 1 spoonful every half-hour; in six hours consciousness
was restored, the fever and vomiting had ceased; Bryonia was
given on the next day, and she was quite well in two days more.
-GASTFREUND.
CASE 2.-A lady, aged 32, who had often suffered with
severe headache, was suddenly attacked with symptoms which




ACONITE.                     509
denoted approaching inflammation of the brain. She ran in
perfect despair about the room, complained of pain in the forehead, as if everything would be forced out of it; her head was
glowing hot; she had nausea, white coated tongue, pain in the
back, constipation for two days; pulse tranquil, and skin natural.-[I have frequently seen similar attacks in nervous and
hysterical females, but never supposed that I had either threatened or actual inflammation to deal with.]-PETERS.
Treatment.-Aconite 6, 1 drop; in five minutes the pain
abated; the patient soon became composed and slept till morning, when she was quite restored.-KREUSSLER.
CASE 3.-A boy, aged 5 years, sickened with the usual
signs of inflammation of the brain, of which the following were
the most prominent::Symptomrs.-Spasms of the limbs, alternating with trembling
motion of them; vomiting of food or mucus as soon as he raised
his head; starting up from sleep with delirium, or pain in both
sides of the head; dryness and heat of skin; much thirst; full,
hard and quick pulse.
Treatment.-Aconite 30, in 2 ounces of water, 1 teaspoonful
every hour at first, then every two hours, with perfect recovery
in three days.-WVEBER.
CASE 4.-A maiden, aged 14, had suffered for twentyfour hours with the following symptoms of brain-affection:
vertigo and vomiting whenever she rose up; constant pain in
the forehead; delirium, sopor, screaming and starting up from
sleep, with fixedness of look; her face was pale at times, at
others red; skin hot and dry; thirst, and constipation.
Treatment. —14 doses of Aconite 30, removed the whole
disorder in three days. The constipation was removed by Nux.
30.-WEBER. X
CASE 5.-A girl, aged nine years, was attacked with inflammation of the brain, for which she received Bell. 4, 1 drop
every three hours, for thirty-one hours without benefit.
Symptoms.-Wandering of the mind; constant chewing motion of the lower jaw; incoherent muttering; the pupils were
contracted; expression of the eyes unsteady and indifferent;




510                     ACONITE.
face moderately flushed; skin moist; pulse full, hard, quick
and frequent.
Treatment. —Aconite 3, 1 drop every hour; in five hours
she fell asleep and slept for four hours; she awoke conscious,
and was gradually restored on the third day. —NOACK.
CASE 6. —HAUBOLD cured a case of acute hydrocephalus,
attended with vomiting; boring of the very large head into the
pillow; by means of three doses of Aconite in thirty-six hours,
followed by 1 dose of Bellad.
CASE 7.-After a somewhat hard fall upon the head, a boy,
aged 2 years, was attacked suddenly with the following:
Symptoms. —He dozed a great deal, but often awoke suddenly, raised himself up and vomited up a clear, watery fluid;
his tongue was clean and he drank again immediately afterwards, then fell asleep and awoke vomiting at least three times
in every hour. He frequently started in his sleep; had rolling
of his half-opened eyes; bored the back of his head into the
pillow; grasped at his head automatically; frequent alternations of the color of his face from pale to red; picking of his
nose; and gritting of the teeth.
Treatment.-Two doses of Aconite 3, 1 drop per dose, every
hour; followed by Bellad. 3, 1 drop every two hours. On the
following day he was quite well.-FRIANK.
CASE 8.-A child, aged 3 years, was attacked with inflammation of the membranes of the brain, which terminated in
effusion into the ventricles. It was given up as hopeless by
two physicians.
Treatment.-Aconite was then given every half-hour, until
the quickness of the pulse was lessened; then Bellad. was
given in the same way. The child improved in some days,
and had completely recovered at the end of a fortnight. —DUNsFORD.
CASE 9.-YELDHAM  thinks that many of the slighter affections of the brain, giving rise to headache, and other symptoms clearly referable to disorder of that organ, are doubtless
of an inflammatory character. Hence he would doubtless meet
with, and cure more cases of inflammation of the brain than
most other physicians. —PETERS.




ACONITE.                      511
A hearty young man, aged 20, caught cold on his journey
home, about a week ago; yesterday was seized with shivering
and violent pain in the head; took pills which acted freely, but
without relief; he lies with his neck stretched out and head
thrown back on the pillow, from which position he cannot bear
to move; complains of intense pain in the forehead over the
eyes; cannot tolerate the least light or noise; his brow is knit;
eyes red and angry; his skin, especially that of the forehead is
hot and dry; pulse 95, full and hard; mouth and tongue dry,
with incessant thirst; no other pain, but is liable to rush of
blood to the head.
Treatment. —Aconite 3, directly followed by Bellad. 3, every
two hours; was rather better the next day; head not so hot
and painful; thirst not so urgent; pulse as frequent, but not
so hard and throbbing; skin cooler.-Aconite 3, and Bellad. 3,
in alternation every three hours; recovered entirely in two days
more.
REVIEW. —Of nine cases, 7 were in children, and two in
adults.
In case 7, a fall upon the head was the exciting cause.
Vomiting was present in 4 cases.
In most of the cases there was a state of excitement, with
delirium, spasms, subsultus, &c., &c.; the pulse varied from
72 to 95, or even 120 or 130, and was full, hard, quick or suppressed.  Yet in cases of poisoning with Aconite, the brain
is remarkably undisturbed and clear, and the pulse is apt to be
weak, small and slow.-PETERS.
The stage in which it proved most useful was that of irritation, only occasionally approaching that of exudation.
DosEs:-Aconite 3, was given twice, in repeated doses;
Aconite 6, once; Aconite 18, once in solution, and repeated
every half-hour; Aconite 30, twice in solution.
In 3 cases Aconite effected a cure alone.
" 5  "      "    was followed by Bellad.
" 1  "      "        "    " " Bryon.
The duration of the attacks was twenty-four hours in 1 case;
thirty-six hours in 1 case; three days in 5 cases; and fourteen days in 1 case.




512                      ARNICA.
Aconite probably acts as a powerful antiphlogistic sudorific,
as it induces perspiration in the majority of acute cases in
which it proves beneficial.
ARNICA.
According to SOBERNHElM it facilitates the circulation of the
lymph, and increases the absorbent powers of the collective
lymphatic and venous systems. It was used and highly recommended in arachnitis with effusion by the celebrated G6LIS of
Vienna; he had the head of the patient freely and frequently
bathed with an infusion of Arnica, when signs of effusion or
exudation, or of a sub-paralytic state of the brain came on;-he
also regarded it as the principal remedy against concussions of
the brain, or spinal marrow; in sanguineous, or sero-lymphatic
exudations from falls, blows, contusions, concussions, &c. It is
very useful in low states of the system when there is dulness
of the senses, dejection of spirits, drowsiness, sopor, or even stupor, or muttering delirium with dryness and blackness of the
tongue, &c., &c.  If it fails, Hydriodate of Potash may be
used internally and externally, aided or not by a few doses of
Iodide of Mercury, or of Apocynum-cannabinum.- PETERS.
CASE  10.-A  delicate boy, aged 2 — years, was attacked
with the following symptoms about five weeks after he had had
an attack of measles.
He complained of pain in his head; squinted; was afraid of
falling, and at times even fell backwards; he had attacks of
vomiting, cramps of the hands, and fits of screaming; was only
comfortable while lying upon his back; had attacks of unconsciousness, from which he could only be aroused by loud
talking; his head was hot; pupils dilated; breathing anxious;
urine scanty and red; pulse quick and small.
Treatment and Result.-Aconite 9, followed in three hours
by Bellad. 12; but the disease increased steadily for nine
hours, when he became exceedingly restless, with severe convulsions of the limbs, violent fits of screaming; he was only
easy when lying on his right side, with his head bent far back;
the pupils were very much dilated; eyes entirely insensible to
light; he was perfectly unconscious, and grasped at his head.




ARSENICUM.                     513
Arnica 3, in 1 drop doses; by the next night he could open his
eyes; his consciousness returned the next morning; he wished
for food, and to be carried about, but was unable to hold his
head up; the pupils were somewhat contracted; his urine turbid, with a yellow sediment; and he was very irritable. On
the second day he attempted to stand, but fell over; Arnica 6
was given. On the third day, a return of fever was removed
by Aconite.  On the fifth day he seemed restored and had
some appetite. Merc. 2 finally restored him perfectly in fourteen days.-MALY.
CASE 11.-In a case of acute hydrocephalus, in which
Aeon. and Bell. afforded no relief, Arnica 6, repeated every
four hours, effected a rapid improvement.-HAUBOLD.
CASE 12.-Inflammation of the brain with violent symp.
toms in a maiden, aged 21, arising from a fall upon the head,
was soon removed by several doses of Arnica 4; remaining
blindness was cured by Bellad. and Opium.-THORER.
REvJIEw.-It has been decidedly useful in the second stage
of hydrocephalus, especially when induced by falls or blows
upon the head.
ARSENICUM.
This remedy ought to prove one of the most efficient homeeoopathic remedies against serous inflammations in general and
inflammatory dropsies.  One of its most marked and frequent
effects is to produce dropsical effusions about the head and face,
attended with fever and great scantiness of the urine. It is
most homoeopathic to the acute variety of hydrocephalus, yet
WAHLE only recommends it in the chronic form, after the previous use of Hellebore and Sulphur, and when the patient is
peculiarly irritable and passionate.
CASE 13.-A boy, aged 6 years, had been drooping for
some time, finally he had all the symptoms of brain-disease, accompanied by gastric derangement; he lay doubled up in bed,
with his knees drawn up to his stomach; bowels very sensitive
to touch; was drowsy and heavy, and lay in a stupor with halfclosed eyes and open mouth, whenever he was not disturbed;




514                   BELLADONNA.
when aroused, and also at other times he often started and
screamed out with a loud and piercing cry; his features were
sunken; mouth and nostrils sore, dry and black; his tongue
dry and parched, with a thick, brownish-yellow coating; red
edges and papillae. The skin of his whole body, but more particularly of the head and bowels was hot and dry; he was
thirsty and had no appetite; his bowels loose and evacuations
unhealthy; pulse 125, hard and incompressible; he was annoyed by a short hacking cough.
Treatment.-Arsenicum  6, every four hours; at the end of
two days he seemed much the same, only his tongue appeared
to be cleaning at the edges, and his thirst was not so great.
The Arsenicum was continued for three days more, with only
slight shades of amendment; he was then ordered Hellebore 6,
every four hours, with decided improvement at the end of the
second day; his tongue became moist and cleaned off rapidly;
skin cool, thirst moderate, pulse less frequent and more soft,
eyes clear, bright and intelligent, little or no screaming or
drowsiness.  Ile was perfectly restored in a few days more,
under the continued use of Hellebore.- YELDHAM.
BELLADONNAA.
GENERAL REMARKS.-a. This remedy acts specifically upon
the blood, brain, nervous, muscular and lymphatic systems, —also
upon the throat, skin and kidneys.
Its action upon the blood is similar to that produced by Alcohol, or extreme heat of the sun; there is a commotion and
actual expansion of the blood, as is shown by the quickness and
fulness of the blood-vessels, heat and redness of the face and skin.
It would seem to cause an intense arterial and inflammatory
condition, but in fact it causes a tumultuous conversion of the
arterial blood into venous, for after a while the apparent increased arterial action ceases, and excessive and predominant
venosity supplies its place. The apparent arterial storm lasts
for about twelve hours, when great venosity becomes apparent;
the redness of the face gives place to lividity; the veins everywhere seem to be crowded and overfilled; the muscles become
relaxed; confusion and stupefaction of the brain ensue; but




BELLADONNA.                      515
finally profuse sweats and urination restore the balance of the
system.
It may be that this powerful commotion and intoxication of
the arterial system  is removed by the exertions or natural
functions of the venous and lymphatic systems, which absorb or
remove the noxious element from the arterial system, and thus
become contaminated themselves.
Its action upon the brain is that of a powerful irritant or
stimulant, unless the dose be in great excess, when the powers
of the brain are completely overcome or stupefied; Belladonna
stupefaction may also arise from exhaustion from previous overexcitement.-(See Treatise on Mental Derangement.)
Its action upon the muscular system is rather depressing
than exciting; Belladonna convulsions are rare, and when present slight; while paralysis of the sphincters, such as-dilatation
of the pupils, of the neck of -the bladder, womb, and the rectum
are common; besides it is one of the best palliatives against
those wandering pains in rheumatism, which arise from  spasmodic contraction of the muscles, caused by the fleeting irritation of the poison of rheumatism; also against rheumatic colicky
pains from spasmodic contraction of the muscular coat of the
stomach and bowels.
Its action upon the throat and skin is similar to that produced by the poison of scarlet fever.
Its action upon the kidneys is very decided; the secretion of
urine is increased excessively.-PETERS.
b. LOBETHAL says he gives 2 or 3 drops of the tincture of
Bellad. in several spoonsful of water, against violent congestion
towards the head in young children, with threatening of inflammation or dropsy of the brain, with far more confidence
than he does the 24th or 30th dilution. In slighter and more
chronic cases, in some of the latter of which he has several
times succeeded in effecting cures even when there was entire
dulness of the senses, he prefers the 24th or 30th dilutions to
the lower potencies.
c. KREUSSLER advises the 18th or 24th dilution, repeated
twice a day, when there are aching and outward pressing pains
with dull stitches in the head, preceded by dizziness and feeling




516                    BELLADONNA.
of intoxication; when the patients stare fixedly before them,
and their faces and eyes are much flushed; when infants bore
with their heads into the pillow; also when there is retention
of feces and urine, which afterwards pass off involuntarily; the
thirst being excessive, the pulse frequent and quick. When
improvement sets in the doses are to be repeated less frequently
than twice a day.
d. KNORRE thinks that Bellad. is most indicated in the first,
or inflammatory stage of hydrocephalus, when this is strongly
marked and bears an arterial, or venous-inflammatory character rather than a torpid or sub-inflammatory.  In the second, or
incurable stage it is of no further avail, except that it sometimes
relieves the vomiting, and that perhaps only imperfectly.
IN CHILDREN.
CASE 14.-A girl, aged 6 years, after several days' sickness,
had the following:
Synnptoms.-Acute fever, general heat of body, redness of
the face, quick, hard pulse, quick breathing, sleepy-drowsiness,
frequent vomiting, gritting of the teeth, and great anxiety and
restlessness while awake.
T'reatmenzt.-Bellad. 3, 15 drops in 3 ounces of water, 1 teaspoonful every hour; with relief in twenty-four hours and
speedy recovery.-ELWERT.
CASE 15.-A  boy, aged 6, had been sick for six or eight
hours, with violent fever, quick pulse, hurried breathing, trembling, great redness of face, general dry heat of skin, drowsiness, frequent starting, fixed and glassy look, cramp of the
jaws.
Treatment. —Bellad. 3 relieved him in twenty-four hours.E LWERT.
CASE 16.-A  boy, aged 5, had suffered for several hours
with active fever and nervous excitement. He received Aconite
3, followed by general perspiration and by increase of the disease; he was aroused with difficulty, stared fixedly, and did not
understand when spoken to, had startings and tremblings of




BELLADONNA.                      517
the limbs, jerks, twitchings of the muscles of the face; pulse
not to be counted and respiration hurried.
Treatmzent.-Bellad. 3, 10 drops in 3 ounces of water, 1 teaspoonful every half-hour, with evident improvement in twentyfour hours.-ELWERT.
CASES 17 and 18.-Two similar cases were treated with
Bellad., one with 15 drops of the tincture in two ounces of
water, the other with the second dilution; the doses were repeated every quarter or half-hour.-ELWERT.
CASE 19.-A girl, aged 5 years, had been sick for twentyfour hours; she had passed a sleepless night, screamed, raged,
spoke in a confused manner, her face was bright red, forehead
hot, eyes glassy, protruding and injected, the carotids beat
violently, pulse could not be felt on account of her restlessness;
urination involuntary.
Treatment. —3 doses of Bellad. 30, cured her so quickly that
she could leave her bed on the fifth day. —SCHWARZE.
CASE 20.-A male infant, aged 13 weeks, had three attacks
at short intervals of time, as follows:
Symptoms. —Red, scarlet-colored spots appeared upon the
abdomen, and after they disappeared he had constant drowsiness, squinting and rolling of the eyes, frothy mucus before the
mouth, green stools and whitish urine; he was only aroused
from his stupor by attacks of suffocative cough.
Treatmnent. —6 doses of Bellad. 30, 1 dose every twenty-four,
thirty-six or forty-eight hours removed the brain-affection in six
days; the suffocative cough, with vomiting, greenish and fluid
stools were removed by Ipecac. 30, followed in twenty-four
hours by Veratrum, in the course of five days more.-Dr. B.
in D -.
CASE 21.-A delicate boy, aged 8, played for a long time
in the sun on a hot July day; soon after he was attacked with
violent headache, fever, drowsiness and stupor; every quarter
or half-hour he would start up suddenly, with shrill screams,
then mutter several words, and grasp at his head; his pupils
were unequally dilated, especially the right; his face much
reddened; skin burning hot; and fever ran very high.




518                    BELLADONNA.
Treatment. —Bellad. and Aeon. 6, in solution, every two
hours; after a few doses, profuse perspiration set in and lasted
all night; he awoke in the morning as after a long sleep, and
was quite restored in the course of the day.-RAMPAL.
CASE  22. —A  4 year old, spongy and ricketty child, was
attacked with fever attended with evening and night-aggravations, violent headache, and inability to sit up.
Treatment.-1 dose of Bellad. 24, benefitted him so much in
twenty-four hours that all danger seemed over.  A  similar
attack in a healthy 3 year old child, was cured by the same
treatment.-MORITZ MiLLER.
CASE 23.-A healthy girl, aged 8, was exposed to the hot
sun in July, and became sick on the following night; she was
treated allopatbically for several days, and was left with the
following:
Syymptons.- Violent headache, face pale and suffering, unconsciousness, with delirium about food; she was constantly
boring her fingers in her nose, had great heat of the body with
thirst, and some perspiration upon the head.
Treatrent. —Bell. 30, followed by sound sleep for several
hours, from which she awoke better, but with a violent cough,
which caused severe pains in the head. Bryon. 12, 2 doses in
twenty-four hours completed the cure.-SEGIN.
CASE 24. —A delicate child, aged 3 years, who had had two
attacks of inflammatory brain-affection, and recovered under
allopathic treatment, was taken with a third and very violent
paroxysm. Bellad. 3, 1 drop in divided doses soon relieved her.
-SEGIN.
It is doubtful whether any child would survive three attacks
of inflammation of the brain under any mode of treatment.- -
PETERS.
CASE 25.-A strong and well-nourished child, aged nine
months, became restless, coughed much, started in its sleep,
and was attacked with repeated convulsive movements of the
face and limbs.
Treatment.-Bellad. 30, produced rapid relief; a similar
attack, eight days after, was relieved in the same way; but in




BELLADONNA.                      519
two days more there was a second relapse, attended with a red,
psydracious eruption. Bellad. 30, followed by Sulph. 30, effected a radical cure.-SEGIN.
CASE 26.-A male child, aged 3 years, whose brother had
died a year before of inflammation of the brain, was attacked
with similar signs of commencing disease.
Treatment. — Bellad. 30, only relieved the vomiting; but
after 4 doses of Aconite 24, followed on the next day by Bellad.
30, a rapid improvement ensued, and perfect recovery on the
fourth day. —SEG1N.
CASE 27. —A robust boy, aged 10 months, had been sick
for two days.
ASymptoms.-Lachrymose, irritable and restless at night;
sleeplessness, or half-slumber with frequent startings; pungent, dry heat; hanging backwards of the head; jaws dropped;
and seemed to have thirst, but rejected the proffered drink;
loose stools, with some straining.
~Trealtnent.-Bellad. 30, at night; his sleep was more quiet,
was more lively in the morning, but still irritable and inclined
to cry.  A violent increase of fever was relieved by 2 doses of
Aconite 24, and on the fifth day of the disease the fever nas
very slight, but the irritability and depression were great.
Bellad. 30, was followed by quiet sleep, pleasant awaking,
moderate heat, profuse sweat and urination during the day, and
greater clearness of mind.  Recovery on the fourth day of
treatment, and sixth day of the disease.-SEGIN.
CASE 28.-A child, aged 21 years, whose sister had died
one year before of inflammation of the brain under allopathic
treatment, was treated allopathically for several days, constantly growing worse.
Syynptomns.-Sensitive, irritable, lachrymose, half-slumber
from which it often started up in a fright; frequent flushes of
fever; a red, moist eruption behind the ears.
Treatnment.-Bellad. 12, repeated in three hours; in five
hours after the second dose, she was more quiet; 3 more doses
of Bellad. were followed by quiet night sleep, and earache in the
morning.  Sulph. 12, was followed by boring with the fingers
in the mouth, nose and ears, and profuse urination. Bellad.




520                    BELLADONNA.
12, followed in twenty-four hours by Merc. 1 and Sulphur,
effected a recovery on the fifteenth day of treatment.-SEGIN.
CASE 29.-A  boy, aged 7 months, was suddenly attacked
with frequently repeated vomitings, high fever and involuntary
movements of the facial muscles and arms; also with great
restlessness, constant boring of the head in the pillow, and remarkably dilated pupils.
Treatment. —Bellad. 5, four doses, one every two hours, from
evening until midnight; after two o'clock at night, all these
threatening symptoms subsided, and he was quite well on the
next day. —SEGIN.
CASE 30.-A boy, aged 7 years, very sensitive and delicate,
with tendency to scrofula, was attacked suddenly, five weeks
after having the measles, with violent fever, pulse full and 100,
skin dry and hot, especially on the head and stomach, eyes
brilliant and injected, also sensitive to light, pupils contracted,
thirst and constipation.
T'reatient. —Aconite 1st dilution, 6 drops in solution, 1 teaspoonful every half-hour; at the end of four hours the symptoms had much increased, pulse was very hard, full and 150,
with violent throbbing of the carotid and temporal arteries; the
skin of the whole body was glowing hot and dry; face red and
bloated; eyes still more reddened, and sensitive to light, and
only one-half closed during sleep; there was deliriun, with
grasping of the hands at the bed clothes; and great dryness of
the tongue.
Treatmnentt.-Bellad., 1st dilution, 10 drops in water, 1 teaspoonful every half-hour in alternation with Aconite, also cold
applications to the head; perspiration sat in some time after
midnight, followed by greater quiet, and return of consciousness
in the morning; the pulse was soft and had fallen to 120; after
a restless night he had a movement of the bowels on the third
morning and pulse fell to 100. Bellad. 3, three drops in solution,
one teaspoonful every hour, was followed by recovery on the
fourth day. —SCrIWELCKERT.
CASE 31.-A girl aged 5, had been sick for three days.
Symnptoms.-Face hot, red and bloated; boring with the
head into the pillow; eyes half open during sleep, or else much




BELLADONNA.                     521
distorted; much thirst, no appetite, stools seldom and in small
hard lumps; jaw dropped; nose quite dry; grasping at the
head, during the heavy sleep; sudden starting up in a fright,
with anxious staring about, and quick relapse into stupor.
Treatnment.-B-ellad. 30, followed by sound sleep for two
hours, and speedy recovery.-BETHMANN.
CASE 32. —A little girl, aged 21 years, had been failing in
health for some time; three nights ago became hot and feverish,
and soon became very ill indeed; lying about the room, complaining of headache, and referring all her suffering to her head,
she was drowsy and heavy; eyelids drooping; eyes sunk deep
in their sockets; mouth parched; cheeks flushed; head and
body dry and hot; pulse quick and throbbing; tongue white,
with red points upon it; great thirst; quick breathing, some
cough; bowels quite regular; she avoided light and was distressed at the least noise; starts suddenly from her sleep, and
screams as if frightened.
Treatmnent.-Aconite 12, every four hours, without benefit,
as she still remained drowsy, with constant starting and screaming, heat and thirst. Belladonna 6, every two hours, followed
by great relief, fever and thirst diminished, slept well, did not
scream or start, tongue cleaning, her look was placid and intelligent, and she was able to sit up a little. Continued Bellad. 6,
three times a day, and was quite restored on the sixth day.YELDHAM.
CASE  33.-Threatened hydrocephalus.  A  delicate boy,
aged 5, has been complaining for some time of headache, loss
of appetite and listlessness; is now quite chilly, creeping into
the fire, although a very warm day; has a staring, unmeaning
look; does not answer when spoken to; pupils sluggish; pulse
slow and feeble.  The parents state that they have already
lost two children with dropsy of the brain, and fear that this
little boy is going off in the same manner.
Treatment. —Bellad. 3, and Ipecac. 3, in alternation; on the
next day there was some improvement. Bellad. 3, and Tinct.sulph. in alternation; in five days more he was almost well, and
the cure was completed by Pulsatilla 3.




522                    BELLADONNA.
Subsequently his little sister was affected in much the same
way, and was restored by similar treatment.-Brit. Jour. Horn.
Vol. 9, p. 585.-Dr. SHARP.
Case8s which approach thte second stage of Acute
Fly: r ocephalus.
CASE 34.-A boy, aged 3-~ years, after headache for several
days, was attacked with violent vomiting, heavy stupor with
snoring, from  which he could hardly be roused; convulsive
starts shook his whole body occasionally; his head was glowing
hot, and thrown backwards; his cheeks alternated from glowing
red, to pale; eyes rigid, insensible, glassy, somewhat reddened,
half-open, and turned upwards; pupils dilated, at times insensible to light; breathing quick, deep, heavy and hot; pulse full
and hard at times, at others small and contracted; skin hot,
and dry; entire unconsciousness, confused speech, startings and
vomiting.
Treatiment. —Bellad. 400, in a wine-glass half-full of water,
one teaspoonful every hour; in six hours he was much better and
the Bellad. was omitted. In fifteen hours consciousness was
restored, and fever lessened; well on third day.-STAPF.
CASE 35. —A girl, aged 3 years, was attacked from taking
cold during the desquamation of scarlet fever, with:
Symnptoms.-Great restlessness, drowsiness, unconsciousness,
boring with the head in the pillow, parchment-like dryness of
the skin, with large drops of perspiration upon the face, constant rolling of the eyes, great thirst, and frequent vomiting.
Treatment. —Tinct. Bellad., one drop per dose, every hour, for
five hours; pimples broke out upon the scalp, the glands of the
neck swelled, loose stools set in, and quiet sleep, followed by
return of consciousness and great relief. Several doses of Bellad. 3, completed the cure.-F. MfiLLER.
CASE 36. —A boy, aged 3 years, was attacked with an inflammatory affection of the brain, during the period of desquamation of scarlet fever.




BELLADONNA.                    523
ASymptoms.-Swelling of the parotid and cervical glands; he
lay constantly in a soporose slumber with bloated and red face;
short, rattling and groaning respiration; involuntary stools; loss
of speech and consciousness; inflammation of the mouth; thin
offensive stools; red and hot urine.
Treatment. —Bellad. 30, 20 doses, one every four or six
hours; consciousness commenced to return in twelve hours,
followed by more quiet sleep and voluntary evacuations. Profound sleep was removed by two doses of Tartar-emetic 12.GROSS.
CASE 37. —A previously healthy girl, aged 2, years, was
attacked with vomiting, convulsions and fever; on the second
day she had the following:
Synmptoms.-She lay in a soporose slumber, from which she
started up at times, grasped at her head, which was very hot;
bored with her head into the pillow; rolled her head about;
when roused she only opened her eyes one-half, stared stupidly
before her; pupils dilated, with squinting; paleness of the
face; nose pinched, dry and stopped up; lips covered with a
brown crust; skin parched and hot, with traces of a purplish
scarlet-rash; abdomen sunken; constipation for six days; involuntary urination. Her head fell back whenever it was raised
up; she uttered a peculiar cry and was very uneasy whenever
she was raised up from the horizontal position, or even moved.
Did not answer questions or pay any attention to what was
going on around her.
Treatment.-Bellad. 3, one drop four times a day; after the
first three doses violent convulsions sat in, and then the disease
gradually subsided, until the fifth day when she was quite restored.-KNORRE.
CASE 38.-A girl, aged 15 months, was attacked with fever
and stupor, and was treated allopathically for six days, when
she presented the following:
Symptoms.-She lay with closed and agglutinated eyes,
when they were opened they looked dim; constantly groaning;
heard nothing; wished for nothing, and could not speak a loud
word; tossed the left arm and leg about, and held them up in
the air; her face was pale and sunken; skin and nostrils dry;
35




524                    BELLADONNA.
breath short and quick; tongue moist; she could drink when
raised up, but let her head fall back immediately; pulse very
frequent and irritable, with a false hardness, beating more violently in the right, than in the left arm; abdomen drawn in,
and painful to touch; stools and urine were passed involuntarily.
Treatnient.-Bellad. 24, one drop; in five hours frequent
greenish stools sat in, followed in twelve hours by relief, and
ability to open the eyes, although the left eye was only half
opened., On the eighth day, Chamomilla 12. was given with
transient relief, followed on the tenth day by increased restlessness, whimpering during the attacks of diarrhcea, tossing
off of the bed-clothes; the skin was dry and torpid; cough
spasmodic; breathing quick and short; nose reddened. Bellad. 30, 1 drop, was followed by recovery on the fourteenth day.
— MORITZ MhiLLER.
CASE 39.-A boy, aged 31 years, was attacked during the
period of desquamation of scarlet fever, with discharge from the
ears, and inflammation of the brain sat in when this ceased.
He was treated allopathically and left in the following condition:
S'ymptonms.-Restlessness; tossing about of the body; grasping at the head with the hands; paleness and shrunken state
of the face, with pinched nose; dilatation of the pupils; boring
of the head into the pillow; heat of the head; stupefaction;
brown and blackish tongue; the child desired nothing, but
drank water when it was offered; skin dry and burning hot;
pulse small and frequent; some cedema of the scalp.
Treatment.-Tinct.-Bellad., half-drop, every two hours; the
following night was very restless, but perspiration followed by
some repose ensued; boils broke out upon the scalp and back;
re-appearance of the discharge from the ear. Bellad. 3, one drop
every four hours, followed by quiet sleep, perfect restoration of
consciousness; desire for food; offensive stools; Bellad. 3,
every night and morning only, was succeeded by perfect recovery in ten days. —F. MOLLER.
CASE 40.-A little girl, aged 21 years, previously healthy
and intelligent, had been sick for five days, notwithstanding
the use of Aconite, Pulsat., several doses of Calomnel, again




BELLADONNA.                     525
followed by Aconite.  The exciting cause of the -attack was
measles with scanty and livid eruption.
Symptomns.-Stupefaction; slumber with half-opened eyes;
gritting of the teeth; starting up from sleep; whimpering, alternating with violent motions of the limbs; tossing to and fro
of the body; attempts to get out of bed; wild delirium; congestion to the head; violent pulsation of the carotids; boring of
the head into the pillow; grasping at the head; alternating
paleness and circumscribed redness of the face; squinting;
very frequent and irregular pulse.
Treatment. —Bellad. 2, every three hours; the second dose
was followed by more quiet sleep and improvement of most of
the symptoms; on the eighth day of the disease, after a fresh
exacerbation, sweat sat in at night, and quiet sleep was followed
by gradual improvement.  She recovered entirely under the
continued use of two doses of Bellad., daily. —D1EZ.
CASE 41.-Bellad. 30, in 1 drop doses acted very favorably
and promptly in a case of acute dropsy of the ventricles, at.
tended with opisthotonos, and unconscious stupefaction in which
the patient lay part of the time as if in an apoplexy, but from
which it started up occasionally in great alarm and agony as
if from severe pain.-KAMMERER.
CASE 42.-A boy, aged 2 — years, had been treated allopathically without avail, but was restored in fourteen days with
Aconite and Bellad.; Hyosciamus and Veratrum  were also
somewhat useful; but repeated doses of Bellad. effected the
most goo00d.-SCHINDLE R.
CASE 43.-A girl, aged 18 months, took cold during an
attack of measles, and the eruption receded.
Synmptoms.-Much thirst; squinting; boring of the head in
the pillow; dripping perspiration on the head; spasms, during
which the head was drawn back to the spine; she lay constantly
in a stupor with half closed eyes, and widely dilated pupils.
Treatment.-Bellad. 30; on the next day there were no
convulsions and all the other symptoms were improved; it was
soon out of danger, and recovered entirely on the fourth day.BETIHMAN.




526                   BELLADONNA.
CASE 44.-A child had lain for two days in a deep stupor,
with convulsions and slow pulse; the eyes were half closed,
covered with mucus, and squinting.
Treatment. —Several doses of Bellad. 30, effected a cure in
three days.-BICKING.
CASE 45.-A boy, aged 4 years, was attacked six weeks
after having the measles with Encephal. insolationis, attended
with violent tonic and clonic cramps; pulse hard, small and
from 160 to 170.
Treatment.-Aconite 1, ten drops in water, and Bellad. 1, in
the same doses, in alternation, every half, one, or ope and a
quarter hours, a teaspoonful at a time. Recovery on the fifth
day.-SCHWEICKERT, Jr.
CASE 46.-A one year old boy, had all the signs of effusion
into the ventricles.
Treatment. —Bellad. 1, in solution, one teaspoonful every two
hours, followed by Sulphur 3, and again by Bellad. A cure
was effected in four weeks, and no relapse had occurred at the
end of seven months.- IEICHELHEIM.
CASE 47.-A girl, aged 5, had been sick for three days;
she neither spoke nor ate; her head was hot and drawn backwards; pupils much dilated and insensible; pulse quick and
moderately full.
Treatment. —Bellad. 12, 3 drops in a glass of water, one
teaspoonful every two hours; the patient recovered quickly.SCHROEN.
IN ADULTS.
CASE 48.-A powerful man, aged 30, sickened suddenly
after taking cold; on the second day he had:
Symptoms. —Sleeplessness; dizziness on attempting to sit
up; violent delirium; raging, screaming, attempting to get out
of bed, tossing off the bed clothes, and tossing to and fro; eyes
painful, reddened, intolerant of light, wild and rolling; pupils
contracted; sparks and flames before the eyes; hearing acute
and sensitive, with roaring and tinkling sounds before the ears;
face hot and red, although at times moist and sticky. In his




BELLADONNA.                    527
clear moments he complained of confusion in the head; of
frightful, fixed, burning, aching and piercing pains therein; he
had fits of sneezing and of bleeding from the nose; his lips
were red, hot and dry; tongue red and covered with a little
tough mucus; throat contracted, with urging to swallow; disgust for food; yellow and slimy vomits; hiccough; constipation; red and hot urine; breathing anxious, sobbing and interrupted; voice hoarse and speaking difficult; pulse quick, hard
and spasmodic; skin dry, hot, red and tense.
Treatment. —Bellad. 30, 1 drop; followed by great improvement in twelve hours; on the seventh day of the disease the
patient was able to leave his bed for a short time. One dose of
Bryon. completed the cure.-SCHUBERT.
CASE 49.-A servant girl, aged 28, after suffering with
headache for eight days, was attacked with the following:
AS ymptoms.-Head hot; violent pain in the forehead as if
the blood were violently forced into it; protrusion of the eyes;
frequent vomiting of greenish fluid, excited by every movement
of the head, and only abating when she was lying quietly on her
back; pulse full and slow; constipation.
Treatment.-Nux-vom. 3, was given without benefit; -on the
next day the symptoms increased and unconsciousness with
quiet delirium sat in. Bellad. 1, every two hours, was followed
by gradual and steady recovery at the end of seven days.ROTHANSL.
CASE 50.-A man aged 30, was attacked after taking cold
with fever, signs of inflammation of the brain, &c.; after bleeding blistering and leeching, he was left with the following:
Symnptoms. —Violent fury, he sprang up, broke the windows,
and had to be bound.
Treatment.-Bellad. 18, every quarter of an hour; followed
by improvement in a few hours; he was entirely restored at the
end of eight days.-IVANOVICH.
CASE 51.-A man, aged 40, was taken with signs of arachnitis after an attack of erysipelas of the face.
Symptoms. —His eyes stood wide open, and were dull; the
pupils dilated; nose dry; tongue with a whitish yellow coating;




528                   BELLADONNA.
thirst moderate; constipation for thirty-six hours; urine light
yellow and clear; breathing irregular, at times quick, at others
slow, now deep and anxious, and then scarcely perceptible;
pulse contracted and small, but quick and hard; at times he
could speak rationally, but always hastily; at others he would
stare horribly at one place where he seemed to see some frightful object, then would spring up from the bed, strike around him
and attempt to escape; followed by attacks of trembling and
ability to speak quietly and rationally again.
Treatment.-Bellad. 3, was followed by an aggravation for
one hour, and then immediately by improvement; on the second
day after the use of Bellad., Cocculus 6, was given on account
of the presence of pressing headache, noises in the ears, irritable, sensitive and vexatious disposition. In two days more he
was entirely restored. —RAU.
CASE 52.-Mrs. S., aged 67; particularly liable to head
attacks, for which she has been repeatedly cupped, leeched and
blistered.
Symptoms.-Her head has not been right for the last week,
and for three days past it has grown much worse; is now confined to bed, complaining of a throbbing and hard aching pain
right through the head, from back to front; light and noise
distract her; she can get no sleep, and feels as if she would lose
her senses; sees everything double; her forehead and top of
head are burning hot to the hand; pulse hard, full and 100;
she is very thirsty; tongue foul, but moist; she had a shivering fit the day before and then vomited.
Treatment. —She had taken aperient and other medicines
and used cold applications to the head without benefit. Aconite 3, one dose, to be repeated in four hours and then followed
by Bellad. 3, every four hours; on the next day she was much
better, had no headache, her forehead was cool, she could bear
light without inconvenience, pulse soft and only 65, no nausea.
She continued the use of Bellad. and on the third day took
Pulsat. 6, and Sulphur 12, for some pain in the stomach and
slight confusion of the head. —YELDHAM.
REVIEW.-Of RiiCKEIT'S 37 cases, 33 were children, viz.:
15 boys and 11 girls from the age of 13 weeks to 7 years; and




BELLADONNA.                      529
4 were adults, viz.: 3 males and 1 female from the age of 28
to 40 years.
As causes of the disease we find: taking cold in 2 cases;
suppressed measles in 1 instance; sun-stroke in 3 cases;
during mneasles in 1 case; after measles in 2 cases; during the
desquamation of scarlet fever in 3 cases.
The above cases prove incontestibly that Bellad. has proved
useful not only in the first but also in the second stage of hydrocephalus; it has frequently removed redness and heat of the
face, throbbing of the carotids, squinting, and also involuntary
urination.
The inflammation in -two of the adult cases had reached a
great height.
DOSE.' In 29 cases:
The Tincture was given in 3; viz.: 15 drops in solution in 1
case; l and 1 drop doses each in 1 case.
The 1st dilution in 4 cases, 3 times in solution.
"c 2d    "    " 2  "   once    "    "c
cc 3d   C"    " 5  "   twice   "    "   and twice
in drop doses.
The 6th, 12th and 18th each in 1 case.
"  24th dilution in 2 cases.
c"  30th   "    " 9  "   5 times in single doses and
4  "   " solution.
"  400th  "        1  "I
Hence the doses varied from the strong tincture through all
the dilutions to the highest potencies, and generally with satisfactory results; as aggravations only occurred in two instances
from the use of the 3d dilution. LOBETHAL even prefers the
pure tincture in solution to the higher dilutions.
In these 37 cases, Bellad. effected the cure alone in 21; in 6
instances, Aconite was given with advantage in alternation
every half, or two hours; Tart.-emet. was given in 1 case after
Bellad. to remove drowsiness; in 1 case Sulphur was given
between two doses of Bellad; and Cocculus in 1 case to remove
a remaining peculiarly irritable state of mind.
In the first stage of dropsy of the brain Belladonna generally
removed all danger in twenty-four hours; in 5 cases, however,




530                   BRYONIA-ALBA.
from two to six days were required. In the second stage, three,
four, five or even fourteen days were required, and in one case
even four weeks.  In adults from  five to eight days were
necessary.
BRYONIA-ALBA.
The root which is the only part used in medicine bears a
sufficient resemblance to a thick turnip to have given rise to
very alarming mistakes; hence it has received the common
name Devil's turnip. Some French peasants use it fresh as a
purgative. Allopathic physicians look upon it as a drastic purgative and as a substitute for Colocynth, Elaterium, &c. Towards the end of the last century, Dr. DE MONTGAMY fancied
that Bryonia contained all the therapeutic properties of Ipecac.
and proposed its substitution.  In all probability it is very
similar in its action to Colchicum, Helleborus-niger, and Veratrum-album. At least it acts decidedly upon the stomach, liver
and bowels, also upon the serous and fibrous tissues, and probably upon the kidneys.
It has principally been used against rheumnatism; mild typhus fever, which commences with pains in the limbs and bones;
against inflammatory swelling of the joints, cedema of the legs
and pleurisy; the ancients often employed it internally against
dropsy, and more particularly in hydrothorax, of which it must
have effected many cures. DE MONTGAMY says he has frequently cured bilious fevers, vomiting, colic, diarrhcea and dysentery
with it; hence TESTE terms it an emetic which cures vomiting
and a drastic which stops diarrhcea and colic. HAHNEMANN
probably got the hint for its use against pleurisy, from the
ancient use of it against hydrothorax. KASPAR Says it is homceopathic to infiltrations into the cellular tissue and serous effusions into the serous cavities; but not to plastic and fibrinous
exudations. In dropsy of the head, chest, &c., if small doses
do not suffice, it may be allowable to use it in large doses after
the manner of the ancients in these diseases, in fact, so as to
produce a decided action upon the liver, bowels and kidneys.PETERS.
According to the Oestreichische Zeitschrift, the pathological




D3RtYONIA-ALBA.
appearances produced by Bryonia, together with the symptomatic phenomena, point to congestion and inflammation of the
brain.
According to KREUSSLER, Bryonia is indicated when there
is great restlessness, tossing about in bed, especially at night,
troublesome and frightful dreams, extremely irritable state of
mind, heat of the head, greater redness of the cheeks than of
the rest of the face, violent and piercing pains in the head,
nausea and constipation. He prefers the 12th or 18th dilutions,
repeated twice a day.
According to WAHLE it often happens that Aconite and Belladonna, even when given in the first stage, will not prevent
effusion and exudation. Then Bryonia will often effect wonders
when the face is very red or almost mahogany colored, the eyes
rolling about, at times closed and at others wide open, the lips
dry, tongue dry and brownish yellow, abdomen distended, bowels
constipated, urine suppressed or sharp and burning, skin of the
whole body dry and hot, breathing quick, anxious and groaning,
thirst excessive and urgent.
He prefers a few globules of the 30th dilution. If Bryonia
be given too late, which may easily happen, as the first occurrence of effusion is often overlooked, so that a cure is not effected in twelve or twenty-four hours, then some other remedy
must be resorted to.
CASE  53.-A powerful man after lying drunken in the
snow for six hours, had the following:
Symptoms. —Heat and redness of the head and face; great
thirst, chilliness, constant inclination to sleep, starting up in
affright, screaming out, delirium, complains of frightful images
before his sight, frightful dreams, cold sweat on the forehead,
pains in the head and limbs.
Treatment.-Tincet.-Bryonia in one drop doses; followed by
an aggravation in two hours; after this he drank water freely,
broke out into a profuse and offensive perspiration, so that he
had to change his shirt five times in fifteen hours, and was
completely restored in several days. —SCHULER.




532                 sB YONIA-ALBA.
CASE 54.-A youth, aged 18, had suffered with a discharge
from the ear, which became suppressed by cold.
Symnptons.-Yiolent piercing and insupportable pains darting from one ear to the other through the head; high fever,
intolerance of light with very moveable pupils, sleeplessness or
starting up from slumber, violent cough with pain in the forehead; constipation.
Treatment.-Bryonia 2, one-sixth of a drop every two hours;
at the end of twenty-four hours the discharge from the ear had
returned, he had profuse perspiration especially upon the head,
the pain and fever were but slight, the skin only moderately
warm, thirst not urgent, but he atas restless, tossed about,
thought he was going to die, slumbered a good deal, and had an
involuntary discharge of mucus from the bowels. Hyosciamus
2d dilution, followed by the 1st, removed all danger in three
days, and the patient was well in six.-SEGIN.
CASE 55.-A man, aged 37, of nervous-venous constitution
and afflicted with piles, had had inflammation of the brain three
years before, and was attacked with acute arachnitis fourteen
days after the suppression of the h,'emorrhoidal flow.
Symptoms.-Restless sleep, typhoid delirium with spasmodic
twitchings of the fingers, constant thirst, redness of the face,
heat of the head, jerking of the hands, contraction of the abdomen, with sensitiveness to pressure, profuse perspiration, pulse
large soft and quick, 100 per minute; if spoken to sharply he
started up, answered yes or no in broken tones, then fell into a
slumber again, but complained of violent pains in the head, his
eyes closed spasmodically, pupils were contracted, tongue moist
and broad.
Treatment.-Bellad. 4, one drop every two hours; in two
days there was some improvement, he could speak more connectedly, his urine commenced to deposit a sediment, but his
pulse remained frequent and quick and he soon relapsed; violent drawing and beating pains shot from one temple to the
other, and his pulse became quicker, smaller and harder. Bryonia 2, was then given, one drop every two hours the first day,
every three hours on the second, and night-and morning on the
third day, with progressive improvement; the patient only complained of a sense of fluctuation in the head, with slight dizzi



CUPRUM.                      533
ness when he sat up, and some pain in the right temple. A fit
of vexation caused a fresh relapse which was quickly cured by
Bellad. 4, one drop every two hours.-NOACK.
REVIEw. —The above 3 cases all occurred in adult males;
2 cases were in the first stage, and in the other the presence of
effusion was feared. In every case Bryonia was the decisive
remedy; in one instance it effected a cure alone; in one case
I-yosciamus had to be used; and in the other, Bellad. had been
used with only transient benefit.
Taking cold was the exciting cause in two cases; while suppression of an ear and hemorrhoidal discharge complicated the
others.
WAHLE'S exact indications for the use of Bryonia are very
important; he lays stress upon the presence of a red, almost
mahogany-color of the face, while KREUSSLIER prefers redness
of the cheeks, rather than of the whole face as an indication;
the violent pains from the ears and temples through the head
were well marked in one case.
DosE. —The curative doses were the 1st and 2d dilutions;
although KREUSSLER prefers the 12th or 18th dilution, and
WATLE the 30th, from notional and theoretical grounds.
CUPRUM.
Cuprum is homceopathic when there is a febrile-inflammatory
affection, attended with quite severe pain in the forehead, with
paleness and sunkenness of the face, warmth and dryness of the
skin and some quickness of the pulse.
Also when there is a remitting or mild typhoid-like form of
fever, with great weakness and lassitude of the limbs, vertigo,
heaviness in the head and headache, pains in the stomach and
bowels and constipation. Also, when the patient is so dizzy
that he cannot sit up, with occasional headache, restless sleep
disturbed by dreams, slight delirium, or constant slumber, which
may increase to perfect coma; or there may be entire sleeplessness, with paleness of the face, with expression of extreme
prostration or entire stupidity, the eyes being sunken and dull,
and the pupils dilated. Or there may be a sensation of utter




534                      CUPRUM.
exhaustion and lassitude, which may be increased to the point
of fainting, from slight exertion. The tongue may be red at
the edges, or red, dry and rough with enlargement of the papillue; the thirst great, appetite extinct, with disgust for food,
skin warm and moist; pulse quick; urine turbid and jumentous. If these symptoms pass off, vertigo and confusion of the
head will remain, with long-continued and obstinate weakness
and lassitude.
When there is frequent and violent vomiting, or persistent
nausea. The pulse may be full, hard and frequent, or weak and
slow.
In almost all copper-cases there will be headache, at times
violent and generally seated in the forehead and vertex; this
headache may abate in a few days to return again. In the
milder cases there will only be aching and heaviness in the
head, with decided and obstinate dizziness, and a certain amount
of stupefaction. In the majority of cases the patient will lie
still and apathetic, with dull and unexpressive eyes, stupid and
relaxed expression of countenance and great inclination to slumber, but the sleep will be disturbed by dreams, restless and not
refreshing. In some there will be a well-marked soporose condition; in others, entire sleeplessness for three or four days,
attended with a feeling of internal restlessness and anxiety.
Actual delirium occurred only 7 times out of 38, and generally
was of the quiet kind, interrupted by mutterings and occasional
groans.  In one case furious delirium  was present.  In all
cases loud speaking to them would break up their delirium, but
they were obliged to collect themselves for a long time before
they could answer questions.
There may be darkness or flimmering and sparks before the
eyes; the pupils are generally and widely dilated, but not insensible to light; but when the congestion to the head is very
great the pupils may be contracted.
In the ears there may be roaring and tinkling in many cases,
and long-continued deafness.-LANGENBECK.
Cuprum is supposed to be peculiarly homeuopathic when
there is vomiting of greenish substances, followed by copious,
green, offensive and liquid stools. Hence in the brain-affections
which follow cholera infantum.




CUPR UM.                       535
It proved homceopathic in one case in which there was colic
and anxiety, great rigidity of the body, coldness of the hands,
swelling and redness of the face with great drops of perspiration upon it, eyes fixed and dull, tongue swollen and stiff, pulse
full and hard, breathing short and heavy, followed by oppression
of- the chest, throbbing and roaring in the head, surprising dulness of the intellect, so that everything which the patient said
was erroneous.
It proved homeopathic to severe pain in the stomach, followed by violent convulsions, especially affecting the abdomen,
arms and legs, attended with frightful and violent cries, or
howling or croaking, also with disturbance of the intellect, appearance of fright and attempts to escape; the eyes were brilliant and seemed as if they would start out of the head. Also
to severe vomiting, violent cramps in both of the great toes
which were drawn tetanically towards the soles of the feet, with
excessive pain.
According to CHRISTISON and ORFILA it is homoeopathic to
insensibility, almost always to convulsions, to rigidity of the
body and even tetanus; also to violent convulsions and insensibility. According to BLAKE, however, the salts of copper
when injected into the blood-vessels act with peculiar force in
exhausting muscular irritability and paralyzing the heart; the
force of the heart's contractions are speedily reduced, allowing
of distension of the heart from loss of contractility. It is also
homceopathic to vomiting, difficulty of breathing and stiffness of
the limbs. It is peculiarly homoeopathic to violent headache,
vomiting, cutting pains in the bowels, followed by cramps in the
legs, and pains in the thighs, especially if associated with
bilious derangement and jaundice; also to severe headache, with
great prostration of strength.
It is indicated when there is insensibility, with the jaws
locked, muscles rigid and frequently convulsed, breathing interrupted and pulse small and slow; or by convulsions and loss
of consciousness, followed by extraordinary paralytic weakness
of the arms and legs, especially if there be pains the stomach,
an eruption over the breast, general shooting pains, thirst, frequent small pulse, vomiting, hiccough and purging.
Copper, or more especially BRASS, is homoeopathic to irrita



536                       cuPRUM.
tion about the genitals, a vesicular eruption about the hairs on
the pubes, with loss of appetite, tendency to vomiting, obstinate
constipation, soreness and dryness of the throat and irritation
of the nose, and great want of sleep.
Among the pathological lesions it is homceopathic to Jaundice, congestion of the surface of the brain, perforation of the
bowels by ulceration; especially of the rectum.-PETERs.
Concerning the adaptation of this remedy in inflammatory
diseases of the brain, we find only a general remark, and one
case where it had been given and then in frequent alternation
with Stramon. and Bellad., so that in regard to Cuprum and its
influence little is to be learned; it requires further examination
by practitioners. —RUiCK RT.
GENERAL REMARKS.-SCIIMID has alluded to a particular
kind of affection of the brain, developing itself in children
during febrile catarrh, difficult dentition, and eruptive diseases,
which finds its remedy in Cupruin-acet.  The following are
characteristic:
Symptoms.-The little patients have a surly, very irritable
temper, or are indifferent and feeble, with restless sleep, tossing about in the same; are sleepy, without being able to sleep;
unable to hold their heads up while awake; dryness of the
mouth, disgust for food, nausea, vomiting, constipation, scanty
urine; chilliness accompanied by heat; heat, generally slight,
but at times burning; pulse very changeable, moderately full
and irritated, with evening exacerbations; convulsions, gritting
of the teeth.
Bell. does not afford relief; the exacerbations may be moderated by Aconite; but Cuprum acet. is the most reliable remedy.
— Hyg. 12, 2, 116.
CASE 55. —R., a large-headed, robust boy, 4 years of age,
formerly atrophical, was attacked on the evening of the 30th of
June, with general convulsions.
Treatment. —Acon. 1, and Bell. 1, aided by sponging the
head with cold water. At nine o'clock in the evening he had
the following:
Symptoms. —The burning heat existing before sponging
with cold water was changed to a moderate temperature of




CUPRUM.                       537
the skin; pulse quick, hard, almost uncountable. General convulsions of the limbs from time to time; on the left side the
spasms were more clonic, on the right more tonic; spasmodic
convulsive movements of the muscles of the face; eyes mostly
open and staring, but at times closed by the convulsion of the
muscles of the face, attended with squinting. The pupils were
fully dilatedand insensible to light. Lower jaw tightly pressed
aginst the upper one, with gnashing of the teeth. Respiration
very heavy, accompanied by rattling in the chest, and intermitting at times for eight to ten seconds, as in the dying. Palsy
of the lungs awias momentarily expected.
Prescription and PResult.-Cuprum-acet. 1; I gr. per dose,
dry upon the tongue, followed in ten minutes after by Tinct.
Strain. 1, and cold applications to the head.
After the second dose of each medicine an intermission of the
convulsions was followed by coldness and relaxation of the limbs
and apparent cessation of the respiration, so that paralysis of
the nerv. vag. seemed imminent.  Phosph. Tinct. was then
given; some contraction of the pupils was soon observed, and
the Phosphor. was continued after the lapse of a quarter of an
hour, in alternation with Cuprum and Stram. At twelve o'clock
at night there was an important intermission of convulsions, but
frightful reaction of the blood-vessels, the face and body became
glowing hot and dark red, the carotids throbbed violently, the
eyes were decidedly injected and the pupils contracted. The
child was conscious and screamed when sprinkled with cold
water.
Cupr. S., 2 gr. per dose, in alternation with 10 drops Bell.
(in solution.) - On the following morning the little patient was
sitting up and playing in the bed, his pulse was still 120, but the
hardness was diminished, and his eyes yet somewhat staring.Both remedies were continued till the 3d of July, when the boy
was dismissed cured. —SSCIIEICKERT.
DIGITALIS-PURP.
This remedy has long enjoyed a high reputation against many
dropsical affections, and also in dropsy of the brain. According
to WARING it has been found serviceable by WITHERING,




538                   DIGITALIS-PURP.
BROWN, WHYTE, CHEYNE and G6LIs. The latter however,
without appearing to place much faith in its efficacy, advises
gr. i of the pounded leaves, with gr. ~ of Calomel, every second
hour.  He gave it, both in the inflammatory stage, and in that
of effusion; in the latter, chiefly as a palliative, to moderate the
violence of the convulsions.  KLEBER advises its external application, in combination with Squills to the scalp. MERRIMAN
treated cases successfully with Digitalis and Calomel as advised
by G6LIS. Of 92 cases of dropsy of all kinds collected by
]BAYLE, 65 are said to have been cured by Digitalis, 15 improved and 11 not cured. WITHERING, of 126 cases, in the last
stages of dropsy, cured 48 with Digitalis alone; FERRIA of 20
cases, cured 8 perfectly, improved 8 materially, and only failed
entirely in 4 cases; JONES of 24 cases cured 15 perfectly, improved 4, and saw no good effects in 5 cases only; in 7 other
cases out of 12 of ascites, it acted as a diuretic; also in 6 cases
out of 15 of hydrothorax.  Hence we may agree with PEREIRA,
who says, of all the remedies for dropsy, none have gained more
and few so much celebrity as Digitalis.
We propose next to inquire whether it has been found most
useful in inflammatory or dyscratic dropsies. It is a decidedly
antipathic remedy to fever and inflammation, as in full doses its
most ordinary effects are: nausea or actual vomiting, slow and
often irregular pulse, coldness of the limbs, fainting, or a tendency to it, giddiness and confusion of vision. Yet WARING
says, experience has shown that although it exercises a powerfully depressing action upon the heart, it possesses little or no
power in controlling inflammatory action. PEREIRA says that
in violent and acute inflammation accompanied with great excitement of the general circulation, especially in plethoric subjects,
Digitalis is in some cases hurtful; in others it is a trivial and
unimportant remedy, and fox-glove if serviceable at all, can
only be used successfully after other and more powerful antiphlogistic measures. Again, he says: inflammation of a chronic
kind may be going on in one part of the body, to an extent
sufficient to produce complete disorganization, and ultimately to
cause the death of the patient without the action of the larger
arteries or vascular system generally being remarkably increased; in such cases Digitalis is for the most part of little




DIGITALIS-PURP.                  539
use. Finally, PEREIRA decrees that as a remedy for inflammation, fox-glove is principally useful in less violent cases,
particularly when accompanied with increased frequency of the
pulse, and occurring in subjects not able to support copious
blood-letting. Still he admits that it has some influence over
inflammation of the arachnoid, and is certainly a most valuable
agent in arachnitis of children; while its specific influence over
the brain would make it a doubtful remedy in phrenitis.
There is one stage of dropsy of the brain in which it is peculiarly homoeopathic.  In the second stage, the pulse becomes
slow, labored, intermitting and irregular, but is easily quickened
by motion or mental disturbance to double its previous amount
of pulsations; in this stage the pulse falls from 120 or 140, to
80, or even as low as 54, and this is the time in which Digitalis
is peculiarly homoeopathic; if rightly given it may prevent the
second quickening of the pulse, or at least prevent it from
rising again to 140 or 160, which it is very apt to do. Dr.
BAILDON first noticed the effect of posture in ascertaining the
real effects of Digitalis on the pulse; when by gradually increased doses, he took it to the extent of gr. vj. in the day, the
pulse fell from 110 to 40; when it was actually 40, the erect
posture would raise it to 100; when sitting it was 72; and on
again lying down it fell to 40. Digitalis acts specifically upon
the par-vagum, and the slowness of the breathing and pulse in
the second stage of dropsy of the brain, is produced by pressure
upon this nerve at the base of the brain.
PEREIRA and HOLLAND have both observed several times in
patients affected with a slow, intermittent and otherwise irregular pulse, that Digitalis would produce regularity of pulsation.
If it will remove the symptom it may also remove the cause
upon which the symptom depends; besides, Digitalis produces
absorption and acts profusely upon the kidneys, and hence may
remove the slow pulse of hydrocephalus, by producing absorption of the dropsical effusion. It is not advisable to use Digitalis in the first stage, if for no other reason than that given by
HOPE, who says in no disease do the symptoms more require
to be kept, as farA-s practicable in a simple, uncomplicated, and
intelligible state, and no remedy is so calculated to confuse
them as Digitalis. The reduction of the pulse which it occa36




540                  DIGITALIS-PURP.
sions cannot be discriminated Faith any degree of certainty, from
that occasioned by the supervention of pressure in the second
stage; again, Digitalis is apt to produce vertigo, faintness and
nausea, and how, asks Dr. HOPE, are these symptoms artificially excited, to be distinguished from the same results of
inflammation and dropsy of the brain?  Easily, by not using
Digitalis at all, during the first or inflammatory stage; but by
giving it boldly and perseveringly in the second or dropsical stage.
PEREIRA says the quantity of Digitalis that may be given to a
patient without destroying life, is much greater than is ordinarily imagined. In one instance he saw 20 drops of the tincture
given to an infant laboring under hydrocephalus, three times
daily for a fortnight, at the end of which time the little patient
was completely recovered without one untoward symptom. I
do not propose that Digitalis should always be given in such
large doses; but if slMaller ones will not suffice, larger ones
should be made to do the work, and effect the cures they have
accomplished before. It is exceedingly doubtful whether Digitalis can be given usefully during the first or inflammatory
stage; WITHERING has correctly observed that it seldom succeeds in dropsical persons of great natural strength, of tense
fibre, of warm skin, of florid complexion, or in those with a tight
and cordy pulse; on the contrary, he says, experience teaches
that if the pulse be feeble or intermitting, the countenance pale,
the lips livid, and the skin cold, we may expect the diuretic
effects to follow in a kindly manner. In short, when nature or
disease brings the pulse and general system into that condition
which is most peculiarly apt to be produced by Digitalis, then
the other and curative effects of the drug may be expected to
follow promptly and from moderate doses.
It is surprising how frequently a symptomatic similarity
between the action of a drug and of a disease, affords a hint for
the selection of a curative remedy. Thus the principal diseases
of the valves of the heart are contraction and patency of the
Aortic valves and of the Mitral. The slighter degrees of contraction of the Aortic valves have little- or no effect upon the
pulse, which will remain firm and full as long as the contraction
of the valves is not so great as to prevent the left ventricle from
emptying itself; again, Aortic-regurgitation produces a pre



DIGITALIS-PURP.                  541
eminently jerking pulse, for the beat of the artery is short and
quick, as if the blood were smartly jerked or shot under the
finger. Hence the homoeopathist would conclude from the pulse
alone, that Digitalis will rarely prove useful in diseases of the
Aortic valves, and old school experience has already shown that
it is rarely useful when the pulse is hard, tight or corded.-But
when the Mitral valve is contracted, and also when it admits of
free regurgitation, the pulse is in various degrees small, weak,
irregular, intermitting and unequal, i. e. the pulse resembles
that produced by Digitalis. From the pulse alone the homceopathist would conclude that Digitalis ought to prove useful if
not curative, in diseases of the Mitral valve. What does experience teach on this point? CORRIGAN was the first to allude
to the injurious effects of Digitalis in diseases of the Aortic
valves, while he found the most favorable results to follow its
use in affections of the Mitral valves. In patency, admitting of
regurgitation through the Aortic valves, the less frequently the
heart beats, the greater will be the opportunity for regurgitation, and hence the prolonged employment of Digitalis, so as to
lessen the frequency and force of the heart's action, cannot fail
to be injurious.  On the other hand in contraction of the Mitral
valve, the lengthened interval between the contractions of the
heart, produced by Digitalis, permits the left ventricle to become
more fully distended, while it also lessens the frequency of the
interruptions to the passage of the blood, and hence the pulse
becomes fuller, stronger, and more regular. Again, in patency
of the Mitral valve, Digitalis prevents the regurgitation from
being so frequently repeated.
Slowness and intermittence of the pulse in the second stage
of hydrocephalus, are probably as safe guides for the use of
Digitalis as they are in disease of the Mitral valve; at least as
Digitalis does not generally exert its absorbent and diuretic
action until it has lowered the pulse and reduced the system, it
will of course be more apt to produce absorption of the hydrocephalic fluid, when the pulse has already become slow, weak
and irregular or intermitting from the effects of disease.PETERS.
In conclusion, Digitalis has long retained a reputation against
scrofulous affections, ani hence it may be suitable in scrofulous




542                  DIGITALIS-PURPo
meningitis. VOG.T says: next to its diuretic action it exerts a
decidedly powerful action upon the lymphatic glands and the
whole lymphatic system.  From  its great curative powers
against scrofula we can conclude that it fluidizes the lymph,
facilitates its circulation, and removes obstructions of it. Next
to the vascular, urinary and lymphatic systems it acts especially upon the serous membranes. In the second degree of the
action of Digitalis, pains are often felt in the lymphatic glands,
and also a very abundant flow of saliva; hence it also acts upon
the salivary glands, and perhaps upon the pancreas. —oGT.
Digitalis may prove to be one of the most homceopathic
remedies against sick-headache, especially in that variety which
is attended with disturbance of the urinary secretion. Even in
small doses it causes headache especially in the temples and
back of the head; decided disturbance of vision, such as clouds,
sparks, flimmering or colors before the eyes, with sensitiveness
to light; also paleness and coolness of the skin, weakness of
the pulse, general prostration, nausea and vomiting; with a
peculiar disturbance of the urinary organs.  Many persons,
subject to sick-headaches, will have their urine clear and abundant when they are well; when the headaches occur frequently
and severely their urine is apt to be thick and dark, like coffee
or brandy, with more or less brick-dust, or other sediment.
When the headache comes on, the urine will again become clear,
and be like spring-water and abundant; when the headache is
going off, the urine becomes thick and dark. In another class
of headaches the urine acts entirely differently, being scanty and
irritating during the headache, and becoming clear and abundant
when the headache passes off. In one or both of these forms of
headache, Digitalis will prove useful. It would seem that many
headaches arise from derangement of the kidneys and retention
of urea, or some other effete substance in the blood.-PETERs.
CASE 56.-A little girl, 2 years of age, blond, of delicate
constitution, and merry disposition, fell into the second stage of
hydrocephalus, with the following:
ASymptoms. —Head hot, falling backwards on lifting up the
child; sleep-like condition, with half-opened eyes and widely
dilated pupils; look staring, with squinting; dulness and rolling




HELLEBORUS-NIGER.                  543
of the eyes; convulsions of the muscles of the face; great
thirst, constipation; urine scanty, leaving on the chamber a
glossy, glimmer-like deposit; skin, sometimes hot and dry,
sometimes cold and covered with sweat; pulse irregular, weak
and soft; convulsions of the limbs during sleep; piercing cries.
Treatment.-Bell. 9. in water: four hourly; the first and
second day without result, afterwards Digit. 3., also four hourly.
The following day improved consciousness, increased flow of
urine; soft, slimy stools, followed by green, looser, more slimy
passages, preceded each time by crying, drawing up of the legs,
screaming and convulsions of the limbs. After three days' use
of the Digitalis, Cham. 3. was given, followed by sleep for five
or six hours, from which she awoke conscious, with appetite,
natural expression, pulse more regular and stronger.  Still
some Sb. Cham. 3. On the twentieth day of the treatment the
recovered child went into the fresh air.- Y. 95.
HELLEBORUS-NIGER.
GENERAL REMARKS.-According to VOGT and PEREIRA in-.
small doses it acts as a mild stimulant to the stomach, bowels and
abdominal nerves, also quite especially upon the pelvic nerves
and those of the rectum and genital organs; in short, it is a
powerful alterative remedy for the abdominal nervous system.
In somewhat larger doses it increases the secretions from the
stomach, and causes the excretion of a larger quantity of fluid
bile; it arouses the circulation in the portal system, and in the
liver and spleen.  It acts less powerfully upon the abdominal
lymphatic system, and very little if at all upon the kidneys.
Next to its action upon the abdominal nervous system, its effects
upon the skin are most decided.
It is much.more apt to excite vomiting in large doses than
purging, and EMMERT found it more apt to excite vomiting
when injected into the veins, than any other drug. In excessive doses it causes most violent vomiting and purging.
It is one of the oldest medicines used in the practice of medicine. Thus, about the year 1500 before the Christian era., a
certain Melampus, son of Armithaon, a most celebrated augur




544                HELLEBORUS-NIGER.
and physician, is said to have cured the daughters of Proctus,
king of the Argivans, who in consequence of remaining unmarried were seized with an amorous furor and a wandering
mania. They were cured by means of Hellebore given in the
milk of goats. From this circumstance the great fame of this
plant is derived. In the course of time the use of Hellebore
became so frequent, that every year a large concourse of patients flocked to Anticyra, where this plant grew in great abundance and perfection, in order to be cured with it of mania,
melancholy and other mental affections. At first it was thought
to be especially useful in cases with derangement of the pelvic
organs, and even in later times it was greatly esteemed by
MEAD aS an emmenagogue, and is still much valued by some
practitioners. He gave two teaspoonsful of the tincture in a
glass of warm water, twice a day.
But soon it was conjectured that Black Hellebore possessed
the power of carrying off black bile easily and promptly, and
hence its use was extended to liver and spleen diseases, and
such cases of epilepsy, mania and melancholy as were supposed
to proceed from the presence of black bile.
Finally it was regarded as simply an evacuant remedy, and
given against dropsy, jaundice, suppressed menses and haemorrhoids, worms, obstinate eruptions, chronic gout and rheuma.
tism, and fever and ague. And against diseases arising from
the suppression of eruptions, or accustomed hoemorrhagies.
HAHNEMANN says: if it is used for a long time it will cause
severe headaches and a fever; hence he infers its usefulness
against chronic headaches, mental affections, quartan fevers and
dropsy, as proven by old school experience, i. e., because a remedy which acts upon the head and causes headache, it may cure
mental affections homceopathically; a remedy which simply
causes fever, may cure quartan fever homceopathically; and last
of all dropsy, because the worst kinds of dropsy are always accompanied by remitting fever-certainly never have such wholesale assumptions been made from such slight premises; yet
such overstrained attempts to fasten a homceopathic explanation
upon allopathic cures are not at all uncommon with IIAHNEMANN.-See Lesser Writings, p. 292.
a. BREDENOLL says; since I have been a homoeopathic




HELLEBORUS-NIGER.                  545
physician, (fifteen years,) I have frequently treated patients,
suffering with hydroceph. acut., and have cured at least twelve.
The principal remedy is and remains IHelleb. I never have
seen any result from Bryon. and Sulph. if I abandoned Helleb.
-N. Arch. 3, 3, 46.
b. WAHLE says; if the first stage of effusion has already
begun, and Bryon. was not given at the proper time, so as to
effect a cure in the course of twelve to twenty-four hours, and
there appeared during an intermission of the fever, the wellknown symptoms of effusion, such as heavy breathing, unconsciousness, trembling, and putting of the hands to the head,
squinting, indifference to light, chewing motions of the mouth,
sopor, then one dose of Helleb.-nig. 30. will often remove all
danger in the course of a few hours.-Arch. 15, 2, 23.
CASE 57.-A boy, 21 years of age, was treated for inflammation of the brain, for fourteen days with Mercur., Moschus,
leeches, &c. On the 31st of July he was in the following condition:
Symptoms. —He had lain for six days in a soporific state;
the eyes could only be half-opened; eye-lids were stuck together
and dry; the eye-balls reddish, glassy and turned upwards;
the pupils dilated; no sign of consciousness; face pale and
disfigured; head hanging down behind; pulse, weak, quick and
irregular.
Prescription. —Hell. 3. a few drops in a wine-glass of water,
a teaspoonful to be taken every half-hour.
On the 2d of August there were signs of consciousness; the
eyes were less fixed; he commenced to take food; on the 3d of
August, state improving in general, but there were frequent
convulsions of the right arm, convulsive pain in the limbs, and
sudden starting up from sleep. Hyosc. 3. and Helleb. in alternation till the 8th, with continual improvement. Then he was
conscious and without fever, still the convulsive movements had
abated but little, saliva accumulated in the mouth, his speech
was indistinct, voice groaning, he coughed at night, with severe
vomiting. Bell. was given morning and evening, one drop per
dose for four days, when the recovery was complete.-ELWERT.




546                HELLEBORUS-NIGER.
CASE 58.-A little girl, 29 years of age, sickened with all
the signs of disease of the brain, and the following symptoms
were present on the sixteenth day of her illness:
Symptoms. —She has been lying for a week upon her back,
apparently in slumber, her eyes only half-shut, pupils contracted, cornea and albuginea dim as if covered with dust; in
the corners of the lids dry mucus, squinting, eyes turned inwards, sunken and surrounded by blue circles; face pale and
thin, nose pinched; nostrils covered with sordes; lips chapped
and dry; body emaciated, covered with loose, harsh skin. The
pit of the stomach drawn in, legs extended, the legs were drawn
up to the thighs at every attempt to change the posture.Groaning; painful, lamentable crying; face distorted by pain;
the head fell back involuntarily; eyes wide opened, with enlarged
pupils; oscillationof the iris; access to light, speaking and calling did not arouse the patient. He drank largely, biting violently at the spoon, without arousing from his unconscious state;
distortion of the face, chewing with the mouth; grasped with
the hands at his head, had cramps in the dorsal muscles, gritting of the teeth, constipation, involuntary urination, partial
sweat on the scalp; pulse quick, weak and intermitting.
Prescription.-Tinct. HIelleb.-nig. Gtt. ij., to be taken every
two hours, day and night, for six days, finally every three to six
hours.
On the third day the brilliancy of the eyes had returned, he
cried out seldom, gave attention to objects, and from the sixth
day of the treatment, the improvement advanced so rapidly
that no other remedy was required.-Allg. Hornm. Ztg. 19, 39.KNORRE.
CASE 59.-A  boy, aged 6 years, had been drooping for
some time, and finally got all the symptoms of brain-disease,
attended with gastric derangement; he lay doubled up in bed,
with his knees drawn up to his stomach, and could not bear his
abdomen to be touched; he was very drowsy and heavy, and
when not disturbed, remained constantly in a stupor with halfclosed eyes and open mouth; when roused, and also at other
times, he started up and screamed out with loud piercing cries;
his features were sharp and sunken; his mouth and nostrils
sore, dry and black; his tongue dry and parched, also thickly




HELLEBORUS-NIGER.                  541
coated brown and yellow, the edges and papillae being of a deep
red color; the skin of the whole body, but more particularly of the
head and bowels, was dry and hot; he was thirsty and had no
appetite; bowels loose and evacuations unhealthy; pulse 125,
and hard; he was also harassed by a short, hacking cough.
Treatment.-Arsenicum 6., every four hours; at the end of
two days he was much the same, except that the tongue appeared somewhat clearer, and he was not so thirsty; continue
Arsen. 6., every four hours; in three days more there were
only some shades of amendment. Then Hellebore 6. was given
every four hours, and in two days there was a decided improvement, and in a few days more he was perfectly restored.YELDHAM.
CASE 60.-A boy, aged 3 years, was taken sick three or
four days ago, with disordered bowels, and soon fell into a
drowsy and heavy state, in which he hangs back on his mother's
arm, shewing the greatest repugnance to being moved or disturbed; his brow was knit and frowning; his eye-lids drooping,
pupils contracted; eyes dull and unexpressive; his head as well
as body generally hot and dry; breathing short and quick,
pulse 160 and throbbing; was very thirsty, could not bear the
least noise and avoided the light; his tongue was white and
thickly coated; bowels loose; he was exceedingly weak, and had
commenced to emaciate.
Treatment. —Aconite 12. and Bellad. 12. in alternation every
four hours; the next night he was quite delirious, but much improved in the morning, his skin was cool, pulse only 100, thirst
less, eyes still heavy and frowning; omit Acon. and continue
Bellad.; on the next day there was an increase of stupor, but
his skin was still cool and pulse laboring; gave Hellebore 6.
every four hours with marked improvement in twenty-four hours
and rapid recovery.-YELDHAM.
CASE 61.-A girl, aged 7, had been failing for some time;
bowels relaxed and passages unhealthy.
Treatment.-Mercurius 6., three times a day; in two days
was considerably worse, stupid, heavy and lethargic; started
and screamed; her head was hot, and she was feverish and
thirsty; her tongue coated brown and dry. Bellad. 6., every




548                    HYOSCIAMUS.
four hours; at the end of three days more she was still worse,
was perfectly lethargic and unconscious of everything; she
screamed and started terribly; and rolled her head; her lips,
tongue and teeth were black and dry, and covered with a thick,
hard and offensive matter; pulse very rapid, and skin and head
very hot. Then took iHellebore 12. and Rhus. 12., every four
hours in alternation, with decided improvement at the end of
two days, when her lips and tongue were moist and cleaning,
mind more quiet and intelligent, no more screaming.  The
medicines were continued for five days more, when she was
quite restored.
HY OSCIAMUS.
The most marked effects observed by GREDING were:
1. Perspiration.  Seven patients out of forty had a profuse
dripping perspiration on the first night; and two-thirds of all
the others had more or less sweat; they perspired not only in
summer, but also in the fall and winter; the perspirations were
sour at times.
2. Sleep.  A quiet, refreshing and deep sleep, generally attended with breaking out of the perspiration; many patients
slept the first night, but more, viz.: twenty out of forty, slept
better afterwards.
3. Happiness of mind, activity of body, and greater clearness
of intellect; fourteen out of forty patients experienced the former, and nine the latter.
4. Dulness and heaviness of the head occurred in four cases.
5. Headache in fifteen cases.
6. Dizziness in eight cases.
7. Torpor of mind in three cases.
8. Eruptions occurred in five cases, viz.: brown spots, or
liver-spots, small pustules, boils, and also swelling of the left
parotid gland.
9. Profuse urination occurred in three cases, on the first day;
and finally in at least one-third of all the cases.
10. Diarrhcea more or less profuse and continuous occurred
in twenty-three cases; with expulsion of worms in three cases;




IYOSCIAMUS.                     549
with vomiting of bile and mucus in ten cases; with colic and
rumbling in six cases; with nausea in five cases. Constipation
only took place in two cases, and then only in a slight degree.
11. Menstruation was brought on, or increased in twelve
cases; in one case it was brought on after a suppression of five
months.
12. Salivation occurred in one case.
13. Profuse catarrh in one case.
14. Rheumatic pains in seven cases.
15. Dry, convulsive cough in two cases.
16. Hiccough in three cases, in one with involuntary uriilation.
In one case, in an adult woman, an overdose of the Root produced, slight and then increased stupefaction; flimmering before the eyes, brilliancy of the eyes, double vision; considerable
dilatation of the pupils; dimness of sight; dizziness; gre:,t
dryness of the mouth; trembling of the limbs and staggering;
small, scarcely perceptible, frequently intermitting and moderately slow pulse.
In a girl, aged 4 years, a large quantity of unripe seeds, produced unsteadiness of gait, small, white blisters on the lips, and
flushed face; at the end of three hours the face was very red,
the eyes injected, the pupils extremely dilated and insensible to
light, the tongue coated, pulse small and moderately frequent;
heart beating violently and irregularly; there was entire loss
of consciousness; frequent groaning; grasping about, with outstretched fingers, as if something had to be seized suddenly;
frightful gritting of the teeth; frequent jerking of the hands
and feet; constant incomprehensible babbling; skin almost natural; abdomen soft.
In a boy, aged 3 years, the seeds caused him to fall down
senseless upon the floor; he thrashed around him; frothed at
the mouth; his face was much reddened; and he had alternate
convulsive movements of the face and limbs.
In a girl, aged 6, the seeds caused paleness of the face without heat of the head; great dilatation of the pupils; smallness
and quickness of the pulse; throbbing of the heart; coldness of




550                    HYOSCIAMUS.
the hands and feet; slight convulsions of the limbs; squinting;
gritting of the teeth; and unconsciousness.
In a girl, aged 6, the seeds caused: heat of the head and
whole body; redness and bloating of the face; fulness, without
quickness of the pulse; violent and irregular action of the heart;
protrusion with great redness of the eyes and much dilatation
of the pupils; the most happy delirium, so that she sang and
spoke and babbled constantly, but very hastily and indistinctly;
but she became very violent, and struck around her whenever
she was spoken to loudly or taken hold of.
In an adult, three ounces of the seeds, made the face bluish;
the eyes red, wild and sparkling; the veins of the neck and
limbs, but especially of the face, much distended; the whole
body was convulsed; frequently returning subsultus; and such
a furious delirium that no one could hold him. During the intermissions the patient was occupied in trying to catch flies
which seemed to be flying about, or in picking shreds-out of his
quilt. Afterwards he seemed much exhausted and breathed
like one in an apoplexy, from which he was aroused by still
more violent convulsions; the pulse was small, quick, contracted
and distinctly intermitting; tongue dry and clean; hypogastric
region much distended and very painful; urine very scanty;
there was such excessive itching that he expended his little
strength in scratching himself until the blood came; invincible
horror for all liquids; afterwards perspiration sat in very profusely and lasted for two whole days, over the whole body, but
especially on the legs, and a pimply eruption broke out upon
the thighs, both before and behind, from the hips down to the
knees; the pimples were large, red and confluent, like those
of small-pox, but did not contain any fluid. His sight remained
very dim for some time. —FRANK.
A coachman, from the herb, experienced confusion of the
head, and such stiffness of the arms and legs that he could
scarcely stand, and finally fell down; his eyes seemed inflamed
for a long time afterwards.-FRANK.
SCHNELLER from four grain doses of Extract, experienced:
mist before the eyes and weakness of sight; dryness of mouth;




HYOSCIAMUS.                      551
yellow coated tongue; great distension of abdomen, with inclination to breathe deep; sour eructations; scanty stools; rather
slow pulse; also left frontal headache, with ambliopia, frequent
inclination to yawn and sleepiness, with evening nausea. Some
of the doses were not followed by head-symptoms, but merely by
frequent inclination to sneeze, with the feeling as if a catarrh of
the head would set in; also frequent sour eructations, some
little constipation, and good sleep.
In other experiments he had: tickling and burning in the
throat, with increased secretion of mucus, dryness of the mouth,
white tongue, hoarseness, loss of appetite, and some colic; also
peculiar drawing and rending pains in the joints, especially in
the wrists and knees.
Five grain doses caused: thick coating of the tongue, insipid
taste, offensive breath, eruption of small boils upon the face,
dimness of vision and redness of the eyes. Eleven grain doses
caused: vertigo, gauze before the eyes, headache on the right
side of the forehead, prickling feeling in the arms, followed by
sticky perspiration, with heat, redness and turgor of the face.
At other times he experienced: dryness of the nostrils, pain at
the root of the nose, and excretion of a very little mucus mixed
with blood, &c. —FRANK.
In an adult soldier, the young shoots caused some burning in
the throat, stupefaction, and a dropsical swelling of the arms
and hands.
Two other soldiers experienced: very violent dizziness, and
they finally fell down as if deeply intoxicated; their eyes were
wild, pupils much dilated, expression fixed and stupid, respiration difficult, pulse small and intermitting; loss of voice, lock-jaw,
risus sardonicus, loss of sensation, typhomania, coldness of the
limbs, paralysis of the legs, carphologia and convulsions of the
arms. The patient who vomited least, had mania with delirium,
but without fury, although it was difficult to hold him, when he
sought to escape.
A girl, aged 4- years, ate one root, and seemed as if intoxicated; she was awake, but without consciousness, did not answer
questions, but looked around the room as if seeking something,




552                   IIYOSCIAMUS.
made frequent, but not convulsive motions with the hands and
feet; if she attempted to take hold of anything she grasped to
one side of it; her eyes were wide open, pupils dilated, pulse
natural, and face reddened.-FRANK.
Four children, from 4 to 8 years of age, ate of the leaves:
They began to stagger, then fell down in convulsions; their
faces were bloated, skin dry, pupils excessively dilated, eyes
turned upwards and inwards. In one child the abdomen was so
much distended that it seemed as if it would burst, but without
pain; the tongue was stretched far out of its mouth, turned up,
and occasionally thrown spasmodically against the nose. In the
two youngest, such violent convulsive movements sat in at times
that a strong man could scarcely prevent them from injuring
themselves; when free from convulsions they spoke much, very
hastily, and unconnectedly. The two oldest were affected quite
differently; they lay quite quietly in a perfectly stupid and
unconscious state. None of them seemed to be in pain; all
seemed comfortable, and one was occasionally merry and silly.FRANK.
Two girls, aged 5 years, ate several capsules, and were attacked with trembling of the limbs, anxiety, restlessness and
confusion of words and actions; in six or eight hours they were
talking incessantly and confusedly, they laughed and sang at
times, did not know their relatives, had frequent spasms of the
facial muscles, especially if one attempted to hold them or take
anything out of their hands, when they became violent and attempted to bite, pinch and scratch; they seemed very strong in
their hands and feet, and at times attempted to dance; they
gritted their teeth, and had a spasmodic stretching out of their
tongues, with a peculiar trembling motion of it; their eyes were
brilliant and rolled about unsteadily, and were reddened; the
pupils exceedingly dilated and insensible to light; pulse almost
extinct, small, and very quick.-FRANK.
CASE 62.-A man, aged 24 years, healthy and strong, got
sick after a severe chill. On the second day the malady was
the following:
Symptoms. —He lay senseless with closed eyes, did not open
them when spoken to; his mouth could be opened with diffi



IOD NE AND HYDRIODATE OF POTASH.            553
culty; tongue, covered with a white, foamy slime; he dreamed
about business affairs, animating his servant to work; he sang
unintelligible songs; murmured, laughed and then became quiet
again, started often, worked with his hands, as if he intended to
prick on the ceiling; pupils enlarged, eyes dull, face red, skin
dry and parched, breathing quick and anxious; pulse regular,
but full, abdomen somewhat contracted, but he did not complain
of pain if touched and pressed.
Prescription.-Hyosc. 6., one drop per dose, in half an hour
after, slept for four hours, passed urine involuntarily; seven
hours after, awaked with consciousness. On the following day,
some signs of inflammation of the lungs were soon removed by
Arnica. -MosSBAUER.
CASE 63.-It was useful in an affection of the brain, attended with convulsions of the whole left side of the face and
body; the right arm and the right leg constantly affected, although not spasmodically, while- the limbs of the left side, without being paralysed, lay quite still. Ipecac. was of no use,
but Hyosc. effected a speedy cure, and caused a quiet sleep.GROSS, Jr.
REvIEw. —The presence of redness of the face, delirium,
picking at the bed-clothes, fright, convulsions, are indications
for the use of this remedy.
IODINE AND  HYDRIODATE OF POTASH.
Iodine acts principally upon the absorbent system, and the
particles absorbed are quickly ejected through the kidneys, as
the urine is generally much increased in quantity; some persons experience this latter effect so instantaneously that Iodine
has been detected in the urine almost immediately after each
dose has been taken. This excessive absorption and drain from
the system may lead to great emaciation, or it may excite an increased demand for food so that one of the first and most important effects of this remedy may be a great increase of appetite,
which will enable us with ease to invigorate the constitution by
wholesome and sufficient nourishment. Again, although it is
well-known to all practical men that Iodine acts as a diuretic, it




554       IODINE AND HYDRIODATE OF POTASH.
is not equally known that the Iodine-urine contains large quantities of urea. Now, urea is the product of the decomposition of
the albuminous tissues, and as it has been clearlljshown by
chemical analysis that tubercle is composed chiefly of albumen
and caseine, we can understand how Iodine acts by carrying a
large quantity of albumen out of the system, thus retarding the
growth and promoting the absorption of tuberculous matter.GLOVER. We have already seen that Hepar.-sulphur diminishes the quantity of albumen in the blood; it might be advisable to put a tuberculous subject upon alternate courses of
Hepar.-sulph. and Iodine; the one to diminish the quantity,
and the other to expel the excess of albumen from the system.
WARING( says: In tubercular meningitis or acute hydrocephalus Iodine has been used with benefit. Drs. CHRISTIE
and WONINGER relate two cases which had reached the paralytic stage, but which recovered under the external and internal
use of Iodine. Dr. BENNETT has derived decided benefit from
Iodine and its preparations in this disease; and Dr. W1LLSHIRE
bears similar testimony; he advises the use of Iodine externally and internally in the early stages of the disease, before there
is much evidence of congestion and inflammation; he applies
the Iodine-ointment to the shaven scalp, and gives internally,
gr. 9- of Iodine and gr. iij. of Potass.-iod. in solution, every
three hours; this, aided by turpentine enemas will be found in
most cases a palliative, and in some a curative mode of treatment. Dr. RILLIET advises the use of Iodine frictions to the
shaven scalp in the second and third stages of hydrocephalus.
ROWLAND HOSKINS relates a very aggravated and apparently hopeless case which yielded to the Iodide of Potassium in
half-grain doses, every four hours; but Scammony was given at
the same time as a purgative. Another case illustrative of the
efficacy of this salt, is related by Dr. GUEROUD. Dr. COPELAND also states that he has prescribed it in small doses with
evident advantage.
CASE 64. —A child, aged 21 years, was attacked with fever
and vomiting, followed on the third day by convulsions, and all
the signs of dropsy of the brain; on the fourth day the eyes
were open, squinting and dim; the pupils much dilated; there




IODINE AND HYDRIODATE OF POTASH.             555
was unconsciousness with incessant screeching, without weeping; entire blindness; the eyes were moist, the edge of the
lower lid relaxed and inverted, (entropium); the little patient
lay on its back, with its head pressed back into the pillow;
when it was raised up its head fell back hopelessly; there was
entire paralysis of the right limbs, with partial palsy of the
left; frequent, involuntary and automatic motions were made
with the left arm and leg; drinks passed over the clean and dry
tongue into the windpipe and excited spasmodic couching; the
urine was scanty; the cheeks which had been pale yesterday
were red to-day; the pulse which had been slow and irregular
yesterday was very quick to-day; the whole body was in a dripping perspiration, notwithstanding that ice was applied to the
head. The last febrile reaction had taken place previous to
dissolution.
Treatnzent. —K ali-hydr. 1 drachm in 2 oz. of water, 30 drops
per dose, every hour; notwithstanding the difficulty of swallowing,
the whole of the above medicine was given in less than twentyfour hours and the prescription repeated, without alteration of
the symptoms except an increase of the dryness of the mouth
and thirst; but on the tenth day of the disease, and the
second day of this treatment, the first traces of improvement
were observed in commencingr contraction of the pupils; on the
seventh day consciousness was restored, there was regular movement of the pupils, natural position of the eyes, the countenance
was expressive, the little patient began to move the left hand
and arm, and two days afterwards motion was also restored to
the right side; great appetite set in, and many small boils broke
out on the face and neck. Finally this critical eruption of boils
became a perfect torture to the child, for at least one hundred
large and small ones appeared first and last upon the head, back,
neck, face and chest; shortly after the pimples appeared, they
quickly changed without much redness or inflammation into
larger or smaller abscesses, some of which attained the size of a
hickory-nut and then burst.
At the end of four weeks the child was perfectly-well of disease and eruption, after using about ten drachms of Iodide of Potash in the course of eleven days. —Frank's Magazine, Dr. ROESER.
CASE 65.-A case of hydrocephalus progressed notwith37




556       IODINE AND HYDRIODATE OF POTASH.
standing the most active antiphlogistic and derivative treatment
into the second stage, but after the use of half an oz. Iodide of
Potash in the course of three days, consciousness had returned,
the pulse was no longer irregular and intermitting, but still frequent; a perfect cure was effected in six days by smaller quantities-about two.drachms more. Tartar-emetic ointment had
also been applied to the nape of the neck. —Dr. YEIT.
CASE 66.-A girl, aged 6 years, after eight days of sickness, lay in a deep stupor, from which she occasionally started
up with screaming; the pupils were dilated, one considerably
more than the other; the eyes were insensible to light, with
squinting; she could be rendered conscious for a short time by
shaking and loud talking; she gritted her teeth in her sleep;
the pulse was quick and irregular; she could still move her
limbs, hold up her head, and swallow.
Treatment.-Kali-hydriod. was used without aid from any
other medicine; at the end of two days and after taking
drachms ij., all dangerous symptoms had disappeared, the position of the eyes was natural, the pupils normal, and stools
regular. But great redness of the cheeks and strong pulsation
of the carotids set in, calling for the omission of Kali-hydriod.
and the use of Calomel, leeches and cold applications to the
head; on the next day this congestive and febrile paroxysm had
subsided, and the face was again pale, but the stupor sat in
again, and the pupils became dilated and sluggish. Kali-hydriod. was resumed, and in five days more perfect recovery had
taken place.-IDr. VEIT.
CASE 6T.-A boy, aged 3} years, of strong constitution and
active temperament, but who had frequently suffered with crustaserpiginosa and catarrho-scrofulous opthalmia, was attacked with
incipient inflammation of the brain, and treated with Calomel,
&c., from the 17th to the 26th of June, when all the signs of
effusion sat in; he was entirely unconscious; tossed about the
right leg in a restless manner, while the left lay paralysed
and motionless; occasionally sudden starts of the whole body,
and screaming fits; the eyeballs were drawn spasmodically upwards, and only partially covered by the lids; the pupils were
entirely immovable and very widely dilated; the conjunctiva
was reddened and the cornea and edges of the lids covered with




IODINE AND HYDRIODATE OF POTASHI.           557
purulent mucus; the nostrils were dry; face pale and sunken;
mouth distorted and partly opened, with frequent sucking motion of the lips; tongue moist; gums touched, and together
with the teeth and lips were covered with brown sordes; there
was frequent gritting of the teeth; slow and unfrequent pulse;
dry skin; great thirst; constipation and almost entire suppression of urine.
Treatment.-Kali-hydriod., half a drachm in three ounces of
water, and one ounce of simple syrup, a moderate tablespoonful
every two hours. On the next day, with the exception of some
congestion of the head, for which seven leeches were applied to
the mastoid processes, there was evident improvement, which
progressed steadily under a renewal of the prescription on the
28th and 30th of June, and 2d of July. The critical appearances were a profuse secretion of urine, which was at first turbid, but soon became clear; several semi-fluid stools; moderate
warm perspiration, some white miliary eruption upon the chest
and neck, especially in the outbreak of boils upon the forehead,
scalp and nape of neck; these were of various sizes, some as
large as a hazel-nut; they suppurated and ulcerated, and their
irruption was aided by the application of Tartar-emetic ointment
for several days. Dryness of the mouth, and a frequent, dry
cough, were also noticed as effects of the remedy. The child
was entirely restored in eighteen days, under the use of half an
ounce of Hydriodate of Potash.-AMELUNG.
CASE  68. —A  little boy, aged 2- years, suffering with
dropsy of the brain and consumption, was so far restored by the
use of six drachms of Kali-hydriod. in four days, that there
seemed but little doubt that he would recover from the brain
disease.  The pupils became regular, consciousness was restored, although the little patient could not speak, he could hold
up his head somewhat, and move his emaciated limbs, he passed
much urine, had several stools per day, and pimples and boils
commenced to break out upon his head, aided by the application of Tartar-emetic ointment.  Finally the hydrocephalic
symptoms disappeared entirely, but the child ultimately died of
consumption.-Dr. ROESER.
CASE 69.-A boy, aged 2~ years, previously quite healthy,




558        IODINE AND HIYDRIODATE OF POTASH.
was attacked with decided inflammation of the brain attended
with fever, headache, contracted pupils, intolerance of light,
vomiting and constipation.
Trea tment and Resuzlt. —Eight leeches were applied to the
ternmples, and two grains of Calomel given every two hours; the
Mercury had not operated upon the bowels at the end of several
days, the vomiting had ceased, the headache persisted, also the
stupor, -from  which, however, the little patient occasionally
started up with frightful screams. Ice was applied to the head,
six more leeches to the temples and a blister to the back of the
neck. After the use of several drachms of Calomel, the constipation persisted and the most decided signs of dropsy of the
brain sat in. There was constant stupor, squinting, very much
dilated and insensible pupils, frequent automatic screaming,
dirty and dry tongue and slowness of the pulse.
Treatmenlt. — Kali-hydriod., two drachms in one and a half
ounces of water, twenty to thirty drops per dose, every hour;
the whole quantity to be used every twenty-four hours.  At the
end of two days several loose stools had occurred, the pulse was
fuller, harder and quicker, the pupils someen hat contracted and
sensitive to light, gums touched by Mercury.  At the end of
nine days consciousness was entirely restored, pupils natural,
sopor gone, and there was only a little squinting with one eye.
Violent mercurial gangrene of the mouth was followed by
great restlessness and delirium; and the Hydriodate of Potash
was stopped, but had to be resumed again in seven days on account of a return of the brain symptoms; two drachms were
used per day with rapid improvement for seventeen days, when
the patient had perfect possession of his mental faculties, was
stout and blooming, but some of his teeth, had fallen out, and
part of his jaw-bone was loose. —Dr. RLOESER.
N. B.-Since RPOESER has resorted to such heroic doses of
Hydriodate of Potash, sometimes using three ounces and six
drachms in one case, he has only met with three fatal cases out
of many; in one of these cases a post mortem examination revealed tubercles and ulceration of the lungs;'in the two other
cases the remedy was given too late and quite irregularly.
CASE 70. —A boy, aged 5 years, was attacked with violent inflammation of the brain, eight days after a fall upon the
head.




IODINE AND HIYDRIODATE OF POTASH.             559
Sy!mptomns.-Perfect stupefaction and blindness, heat of the
head, immoveableness of the pupils, entire suppression of all the
secretions, quickened pulse, and violent, finally incessant convulsions, passing over into opisthotonos.
Treatrnent.-After the fruitless use of leeches. ice to the
head, Calomel and Sublimate in unction, Kali-hydriod. was
given, one to two drachms in two ounces of water, a teaspoonful per dose.  At first the symptoms were rather aggravated, but improvement soon sat in after the occurrence of profuse urination and copious discharge fromn the nose.-ZimI;,eRMANN.
CASE 71.-A boy, aged 2 yea.rs, previously afflicted with
eruptions upon the head and face. was attacked with violent infiammation of the brain, apparently in consequence of repeated
falls upon the head.  Very active antiphlogistic and counterirritant treatment had produced no good effect at the end of five
days, on the contrary all the signs of effusion hadt taken place.
Symptons. — The eyes were fixed and wattery; pupils immoveable and widely dilated; absolute blindness; tetanic rigidity of the muscles of the nape; retraction of the head; paralysis
of the left side; deep stupor; slow pulse, clown to 50; frequent
screaming and vomiting.
Treatrient. —Kali-hydriod., one dratchmn in half an oz. of
water, forty and finally fifty drops per dose, every two hours;
without improvement for the first three days; but on the fourth
day of the Potash treatment and ninth of the disease, profuse
secretion of urine sat in, with evident impr: vement in all the
alarming symptoms; after the use of two drachms of the Ilydriodate he was almost out of danger on the twelfth day of the
attack.-Frank's Magazine. —Dr. WOENIGEiR.
CASE 72. —The head of the patient at birth was unusually
large and the fontanelles widely separated, the membranous
portions being quite protuberant, with fluctuation; the child
had had frequent convulsions and occasional paralysis.  When
IDr. BARBOUR saw the case, the heald was of monstrous size;
the fontanelles very large, the anterior being at least three
inches in diameter, and occupied by a large fluctuating tumor,
elevated about an inch above the level of the skull; the sagittal




560       IODINE AND HYDRIODATE OF POTASH.
suture was widely open, and all the bones of the head quite
moveable and compressible; his neck was remarkably emaciated
and slender, so much so, that the weighty head could only be
sustained by the shoulder on which it constantly leaned. Chronic diarrhcea also existed, attended with general emaciation, tumid
abdomen and irritative fever; in fact he presented the most
prominent symptoms of marasmus in connection with chronic
dropsy of the brain.
Treatrment.-In order to improve the secretions and check
the diarrhoea Hydrarg.-cicuta and Pulv.-dover, grs. xv., made
into twelve powders, one every six hours; this had such decided
effect that an occasional laxative had to be given. To promote
the absorption of the fluid and improve the general constitution,
Hydriod.-potass., half a drachm in 2 ounces water, one teaspoonful three times a day was given. A blister was applied to the
head, and frequent effusions of cold water were used. This
course was continued for six weeks, and the result was highly
gratifying; the irritative fever gradually yielded; the head
diminished in size, day by day; the fontanelles became gradually reduced to their natural size; the convulsions did not
recur; and the little boy gained flesh, strength and color, and
finally appeared perfectly well. Dr. BARBOUR's great reliance,
at least theoretically, was upon the Hydriodate of Potash.
CASE 73.-A girl, 12 years of age, was attacked with arthrit. acut. vaga. About midnight on the 16th of January, she
became delirious and restless, sometimes sitting up in bed, at
others lying down again.  The inflammation of the wrists had
ceased, and appeared to settle in the meninges; the patient was
nearly given up.
Treatment-Iod.-solut., (ten gran. in half ounce of Alcohol,)
two drops, p. d., to be taken half-hourly, for one day; on the
second day, hourly; on the two following days every two hours.
On the 17th the consciousness was already regained, the right
hand had re-inflamed, the meninges were free. She then took
Ant.-cr. and Bryon., and on the 26th was also recovered from
the arthritis.-ScHMID, 130.




IODINE ANJ) HYDRIODATE OF POTASH.           561
NATURAL CURES,
CASE 74.-A boy, aged 21 years, robust, with a large head,
and prominent forehead, was taken sick on the eighth of December. Six days afterwards acute hydrocephalus, was fully developed; the fontanelles were still widely open; leeches, Calomel, &c. were given without benefit, and on the eighteenth day
the boy lay helpless and stupefied; his head and face were
alternately hot and red; he gritted his teeth; the pupils were
dilated and insensible to light; he swallowed fluids hastily:
this state lasted two days more, when a larger quantity of clear
watery fluid flowed from the ear, and the patient improved on
the same evening; profuse flow of urine also sat in and lasted
for several days; in a few days more the little patient was
decidedly convalescent, and recovered perfectly in six weeks.
Two profusely suppurating spots also formed on the back of the
head. The author had previously witnessed a similar case.RIECKE.
CASE 75.-A little girl, aged 4 years, bad been sick for five
days with inflammation of the brain, for which she had received
no medical treatment, and now seemed at the point of death.
Her face was red; eyes rigid and immoveable; breathing frequent and irregular; pulse hard and intermitting; for two
days everything that she had swallowed had been ejected again
through the nostrils. Ice to the head, leeches and injections
were used without benefit; at the end of eight (lays more, her
face was pale and sunken; nose and ears cold; pupils dilated;
eyes turned up; mouth open; breathing scarcely perceptible;
pulse small, frequent and intermitting; constipation for eight
days: and no urine had been passed for three days; the right
arm and leg were moved automatically; the whole left side
seemed paralyzed. On the next day the whole scalp was slightly reddened and covered with an immense number of small
miliary vesicles, which increased in size for two days more, then
ran together, burst and discharged a large quantity of yellowish
watery fluid, followed by improvement of the brain symptoms.
At the end of a few days more the whole head and face were
covered with a thick scab, through the fissures of which a bloody




562        IODINE AND HYDRIOI)ATE OF POTASH.
serous fluid exuded; evacuations from the bowels and bladder
had commenced. In eight days more the little patient was out
of danger; but she did not recover her speech or the use of the
left side until after the lapse of many,weeks. —MALIN.
CASE 76.-A little boy, aged 1~ years, became sick two
weeks after an attack of scarlet fever; gradually all the signs of
dropsy of the brain developed themselves; his face became
pale; pupils dilated and fixed; the conjunctiva reddened; cornea dull and coated with mucus; entire stupor for three days;
convulsions of the right side; boring of the head into the
pillow; vomiting and constipation had been followed by involuntary diarrhcea; pulse was small and frequent, with occasional intermissions.  Elder tea caused such a profuse Ferspiration that a large bed was saturated both above and' below, and
the child speedily recovered.-RI1TscI-ER.
CASE 77.-A boy, aged 11 years, had so large and heavy a
hydrccephalic head that he could not hold it up without support;
the head ~was soft and doughy to the feel; the fontanelles were
wide open; the rest of the body delicate and relaxed. At the
end of five years the reporter was surprised to find him alive
and well; the head was only a little larger than natural; the
bones were firm and closed; the body well nourished; the mental faculties moderately developed; the parents assured him
that no medicine had been given and that everything had been
left to nature.-Frank's Magazine. —DoRFMtiLLER.
CASE 78.-An infant, aged 6 months, had suffered severely
during the month from cold, which resulted in an enlargement
of the head, which was one-third larger than natural; the sutures were all widely open, the fissure commencing at the root
of the nose and extending up the forehead, being one inch
across; the anterior fontanelle was capacious enough to admit
three fingers; the coronal and sagittal sutures were also widely
extended; the scalp covering these broad fissures was puffed
and elastic to the touch, indicating the presence of fluid beneath.
Dilatation of the pupils, squinting, jerking of the limbs, screaming, tossing of the arms upwards, plainly denoted the dropsical
nature of the little patient's brain affection; the bowels were
also costive, and vomiting frequently occurred.




IODINE AND HYDRIODATE OF POTASH.             563
Treatment.-IKali-hydriod., twenty-five grains, gradually increased to forty grains to the ounce of lard, to be rubbed over
the whole head, twice in twenty-four hours; also a solution of 20
grains to the ounce of water, ten drops to be given morning and
evening. This treatment was continued for nearly one month
without benefit; then blisters were ordered to the head; first
on one entire half, and then on the other, so that one side was
always. under the influence of the irritant; two grains of blue
pill were given twice daily; but in spite of this, general anisarca sat in, and IHydriodate of Potash ointment was applied
over the whole chest and abdomen. And now appeared the
crisis of the case, for a vesicular eruption broke out over the
whole body, the vesicles bursting and discharging pure lymph.
From this critical discharge, the convalescence of the patient
commenced, but the remedies were still continued for four
months, when the child was perfectly healthy and sprightly,
although there was still some obliquity of vision.
Dr. KENNEDY asks: Is the treatment of the more ordinary
or sub-acute form of hydrocephalus too heroic? He believes it
to be so, in the allopathic school, and that a better prospect of
cure will be held out by a treatment a good deal modified from
that in common use. Of bleeding he is fully satisfied that very
little of it will answer every purpose; he has even noticed that
cases left to themselves, without treatment for days, did not
appear to run a more rapid course than those where active
measures had been adopted from  the outset.  To MIercery
similar remarks, Dr. KENNEDY thinks, apply. It would seem,
as far as he has seen, to be used as a sine qua non; and yet
the results do not appear to justify such faith in it; he has
notes of more than twenty cases of hydrocephalus, in which the
specific effects of Mercury were produced, and yet in not one of
these cases was the result favorable, to say nothing of others,
Wvhere salivation could not be induced.  Is it right to give
Mercury to weak and strumous children, he would ask, and do
our utmost to induce its specific effects? The answer to this
must be in the negative.  KENNEDY gives four cases, which
include all those of recovery which he has seen in a period of
several years, after the disease had passed into the second
stage, that is when the pulse had fallen.. Now it is specially




564        IODINE AND HYDRIODATE OF POTASH.
worthy of notice that three out of four had never been salivated,
and in the fourth salivation was produced more by accident than
design.
Treatment.-All four cases were leeched; the grey powder
in very minute doses, as an alterative was administered in antimonial powder; blistering was very freely used, at first in the
ordinary mode, and subsequently in two cases, under the form
of the Tartar-emetic plaster applied to the head; and in this
way a constant discharge was kept up. But, in addition to
these measures, particular attention was paid to keep up the
strength; some got beef-tea and others wine, and this while the
disease was still present. A child of six years of age, got two
ounces of wine, which was increased to three in the day, and
this while the pupils were still dilated, while the screaming
was constant and the convulsions persisted; and it was apparently under its use that this child rallied.
Several of the natural cures took place after the outbreak of
pustules upon the head, or eruptions over the body. Dr. HAHN
has saved fourteen cases by means of frictions of the scalp with
Tartar-emetic ointment, repeated every two hours, until pustulation is established; he claims to have saved fourteen cases in
apparently a hopeless state of coma.
CASE 79.-A fine boy, aged 9 months, was suddenly atItackediwith convulsions; he recovered from these and cut his
first teeth shortly afterwards; but soon began to fall away, to
become listless and lose his appetite; his bowels became constipated; pulse irregular; he also began to vomit and to become
torpid; fever was soon added to his symptoms, and it was evident that he was the subject of meningitis.
Treatment.-Leeches were applied, and Calomel given, but
in spite of this treatment he lapsed into complete coma. As
soon as the coma became distinct, Tartar-emetic ointment was
rubbed into the scalp every four hours, over a space the size of
a crown piece; free suppuration ensued and signs of improvement were speedily witnessed; the child gradually became
more conscious, his appetite returned, and in two weeks all
traces of his disease had vanished.




OPIUM.                       565
L0 P I U M.
GENERAL REMARKs.-According to WARING Opium is generally contra-indicated in acute inflammation of the brain, which
tends to produce death by coma; there are, however, occasional
exceptions to this rule; as, for instance, in inflammation of the
brain, in which Dr. GRIFFIN states that Opium, given in combination with Tartar-emetic, exerts an extraordinary power in
allaying nervous irritation, quieting increased action in the
capillaries, and inducing sound and refreshing sleep. It should,
however, be employed with extreme caution, and only, by one
whose experience in this class of diseases gives him a title to
depart fioon what is generally regarded as safe practice.
In delirium occasioned by inflammatory action of the brain,
or its membranes, particularly when it assumes a maniacal or
violent character, and after depletions have been carried as far
as may be thought prudent, and the bowels have been freely
evacuated, Dr. COPELAND states that he has frequently seen a
full dose of Opium or Hyosciamus, given either alone, or with
Antimony and Camphor, produce the happiest effect. Any unpleasant symptoms which may result, either from too large
doses of these narcotics, or from their inappropriate use, will
readily be removed by the cold or tepid affusion upon the head.
-WASHNG.
In hydrocephalus, Opium has sometimes been employed in
the second and third stages, to lessen the acute pain in the head,
convulsions and irritability of the stomach and bowels; and
may be given with this view, at an early period when dropsy of
the brain depends upon exhaustion and debility uncomplicated
with inflammation. It has often succeeded, observes Dr. BENNETT, in effecting this without in any way interfering with the
action of other remedies, or inducing constipation when moderately employed. At the early period of the second stage, it
may be given with Calomel, James' powder, or Tartar-emetic,
in doses varying from gr. 8 to gr. ~, every four hours. According to CRAMPTON and CHEYNE, contraction of the pupils following the exhibition of this remedy indicates that it has been
pushed sufficiently far. Dr. RISDON BENNETT has since stated,
that, avoiding its use when the pupil is contracted, he has em



566                        OPIUM.
ployed Opium with the best effeet, and has sometimes saved an
apparently hopeless case.  Drop doses may be repeated every
four hours, if no unpleasant symptoms present themselves.WARING.
WNIST says: In the treatment of many diseases you see
physicians destroy pain by narcotics, and the question naturally
suggests itself to you whether you may not sometimes venture
in the management of hydrocephalus to mitigate by their means
your patients sufferings?   The inquiry is one not very easy to
reply to satisfactorily.  I think, however, that there are two
conditions under which you will be justified in trying the experiment of giving them.  Sometimes the disease sets in with
great excitement, and a condition closely resembling mania in
the adult, symptoms which may have been ushered in by convulsions.  In such a case although the heat of the head and
flush of the face may have disappeared after free depletion and
purgation, and though the pulse is feeble as well as frequent,
yet the excitement may be scarcely if at all diminished.  IHere
an opiate will sometimes give relief which nothing else would
procure; your patient will fall asleep and wake tranquilized in
the course of two or three hours.  In other cases which do not
set in thus violently, restlessness, talkativeness, or a kind of
half-delirious consciousness of pain in the head, become very
distressing as the disease advances, being always aggravated at
night, so that your patient's condition seems one of constant
suffering.  Under these circumstances, I [WEST] have sometimes given a full dose of Morphia, and have continued it every
night for several nights together with manifest relief. —PETERS.
CASE 80. —Gatoss observed during the winter months in a
number of children, under 7 years of age, a rheumatic-inflammatory affection of the meninges, which he treated accordLing to
circumstances with [Bellad(., &c. In some, the following condition prevailed: They were continually in slumber, with snoring (land half-opened eyes, were awakened with difficulty, on
awakin g, insensible, complaining of nothing, wanted nothing, but
vomitedl frequently.
TireatifneJt. —Opium  6., cured generally within a few hours.
-Arch. 9, 2, 140.




OPIUM.                       567
CASE 81.-A boy, aged 4 years, after a fall upon the head,
got an attack of hydroceph. ac.-Acon. was taken first, then
Bell. 30., and after fourteen hours he appeared to be out of
danger.  The recovery progressed until the fifth day of the
disease; but there still existed a state of apathy, accompanied
by a short, dry cough, constipation, all of which were relieved
after Bryon 30. had been taken.  On the seventh day of the
malady he had the following:
iSyrntonzs.-An increased condition of stupefaction, the Iris
more insensible than in the last few days, the eyes not quite
closed in sleeping.  Three large worms passed without excrement through the fundament.
Treatbnent.-Opiunm 6. followed by sixteen hours sleep and
after awaking by a profuse sweat, when the brain was entirely
relieved. — BET  MANN.
CASE 82.-A  girl, aged 17 years, of delicate phlegmatic
constitution, whose sister had died with hydroceph. acut., complained of dizziness, headache, and vomiting, which increased
daily; for four weeks she had been surly, and had lost her good
looks; her cheeks were hollow, face pale yellow; eyes weak
and without expression; the brain appeared as if oppressed by
a heavy burden.
Treatmnent.-Bell. 18. in solution; she soon became unable
to speak; was continually drowsy; she stared vaguely when
spoken to, without giving any answer; all the former symptoms
remained. Opiumn 4. in solution, two spoonsful morning and
evening, was followed by a tolerable state of quietness, and the
excessive desire for sleep disappeared; the patient improved
rapidly.-MooR.
REVIIEW.-In the foregoing cases we find an amazed and
stupid state, continual slumbering with half-opened eyes, snoring, and insensibility of the iris.  Gi-oss observed principally
a rheurnatic-inflammatory irritation of the meninges; in one case
a fall upon the head preceded the attack, and Acon., Bell. and
Bryon. were given, with little effect; in another Bell. was prescribed without benefit.  The doses, Opium 6. in two cases; the
4th dilution, in solution, in one case. This remedy is so decidedly homrneopathic to congestions of the brain, that it deserves
more frequent trials.




568               RHUS-TOXICODENDRON.
R IIUS- TO XI CO D E N D  0 N.
GENERAL REMARKS.-RhUS is peculiarly homoeopathic to
inflammatory cedema, and to all inflammations attended with a
copious effusion of serum; hence to all inflammatory dropsies,
and to dropsy and cedema of the brain. In this respect it is
the analogue of Arsenicum and Cantharides. If it were possible to obtain and retain the recent juice in all its original
activity, it would probably form a more efficient external application than Cantharides, Croton-oil or Tartar-emetic.
It will perhaps prove most useful in the paralytic stage of
hydrocephalus, and in those cases which arise from the suppression or retention of eruptive diseases.  At least DUFRESNOY, army physician and professor of botany in Valenciennes,
employed it with success against tetters and paralysis.  Of the
twelve cases he published in 1788, seven refer to cutaneous affections, and five to paralysis consequent upon convulsions.
PONTAGNON of Montpelier cured a paralytic patient in a fortnight; and GoNAN cured a young lady in a few weeks of
hemiphlegia. VERDEGEN, KOK and VAN BAERLEM  obtained
similar results. Finally ALDERSON of England has published
seventeen cases which go to prove the efficacy of Rhus against
paralysis, and in general against all affections characterized by
debility of the muscles.  HULL and DUNCAN also advise it. It
proved successful in four cases in which it was employed by
DUNCAN; in each, a peculiar feeling of pricking or twitching,
preceded permanent benefit. This sensation was so unpleasant
that Dr. DUNCSN was obliged to discontinue it in one case. In
general it operated as a gentle aperient, notwithstanding the
torpid state of the bowels of such patients. In bad cases it
may be commenced in doses of gr. j. of the dried leaves, and
continued until grs. iv. or v. are taken daily, or until a pricking
sensation is experienced in the affected part. Frictions with
oil in which the fresh leaves have been digested may be employed at the same time. —PETERS.
In the inflammatory dropsy of the brain, Rhus is, particularly
in the second stage, or that of the effusion, one of the most
important remedies. It is indicated when there is a soporific




RHUS-TOXICODENDRON.                  569
condition, inclination to paralysis, with a continuance of the
sensorial activity; when there is a sense of fluctuating of the
head, turning dizziness, and a painful, anxious disturbance,
principally on the hind-head, where the patient feels the fluctuating; when there are convulsive motions of the limbs, with
great complaint of severe headache; when the patient lies for
a time in a state of dizziness, until the more severe attacks are
renewed in shorter intervals; this hopeless state may often be
cured within a few hours with this remedy.-HARTMANN.
CASE 83.-A  little girl, 8 years of age, suffering for ten
days with inflammation of the brain, showed the following:
Symptotms.-Loss of consciousness for two days; the right
upper and lower limbs paralyzed; pulse quick, trembling, scarcely perceptible; urine passed involuntarily; slow breathing with
frequent sighing; general appearance cadaverous; eyelids cedematous and swollen; body cold.
Treatment.-Arsen., Digit. and Mere.-s. produced but transient improvement. —Rhus. 6. one drop in one ounce of water,
every four hours a teaspoonful, led within twelve days to a
complete recovery.  The second day after commencing the
Rhus., a moist cough appeared, which is to be considered as a
favorable sign.-STURM.
STURM remarks, that in eight cases of Hydroceph. aec. which
he had treated, (the above one is the third,) were under the unfavorable circumstances of the already existing second stage, a
recovery was obtained. In the first case Digit. and Hyosc.in the second Mere., Arnica anrd Sulph. were the efficient remedies; the other five cases came under treatment at the beginning of the disease.
REVIEW. —But little, yet enough is to be remarked, in regard
to the use of Rhus., in the second stage of inflammation of the
brain. HARTMANN says it removes an inclination to paralysis,
and STURM that it cured paralysis of the upper and lower
limbs.  The cadaverous appearance, cedematous and swollen
eyelids, are symptoms we often meet wvith in cases cured with
Rhus.




570                    STRAMONIUM.
ST R A MON I U M.
GENERAL REMARKS.-The action of this remedy is very
similar to that of Belladonna, (see page 514); it seems to act
principally upon the blood and many of the ramifications of the
great sympathetic nerve, especially in the brain, eyes, throat
and genital organs.  Its action upon the throat and skin is
similar to that produced by the poison of scarlet fever; it is
apt, like Belladonna, to produce paralysis of all the involuntary
muscles, or those supplied by the sympathetic nerve, while its
action upon the motor or spinal system of nerves, is nearly the
opposite of this, or that of an irritant: thus it produces dilatation of the pupils, spasmodic contraction of the muscles of the
face, relaxation of the cardiac and pyloric orifices of the stomach
and of the muscular coat of the stomach and bowels, while
it causes violent spasmodic contraction of the muscles of the
throat; it will allay spasms of the bronchi, and excite cramps
of the muscles of the limbs, &c., &c. It does not act upon the
glands like Belladonna.
A tablespoonful of the seeds produced in a man aged 60, and
his wife: vertigo, stupefaction, coma and spasms; their respiration was stertorous, they were completely unconscious, with
hanging down of the lower jaw; they had cramps in the hands
and feet, and rolling of the eyes with dilated pupils and intolerance of light; they made automatic motions and graspings with
the hands, sometimes towards the nose, ears or head; the skin
was cool, pulse somewhat quickened, with occasional intermissions; the swallowing of fluids was very difficult. After vomiting and purging there was some return of consciousness, with
abatement of tihe cramps, but the face and hands remained cold;
they had some burning pain in the distended abdomen, and
their voices were hoarse and lisping; swallowing was painful
and difficult. —-FRANK.
A girl, aged 4, ate of the seeds; she complained of pain in
the ears and was put to bed; but instead of sleeping she became more and more excited and began to sing and speak confused stuff; her eyes were bright, pupils dilated and almost
entirely insensible to light; pulse tranquil and skin cool; she




STRAMONIUM.                     571
began to talk almost incessantly in a most confused and incomprehensible manner, and often wept; she grasped frequently
with her hands into the empty air, as if she would seize something, and occasionally seemed to be seeking something in the
bed with her fingers; she could not stand for her knees bent
under her immediately when she attempted it, and when she
tried to rise she fell staggering about as if intoxicated; the
abdomen was soft and painless and she was not thirsty. She
recovered after free vomiting. -FRANIr.
- A boy, aged 4 years, from eating the seeds, was found sitting
up in bed, entirely unconscious, with flushed face, restless and
brilliant eyes, widely dilated and rigid pupils, a peculiar and
drunken look; he chattered incessantly without rhyme or reason
and entirely without connection; he frequently sprang upwards
hastily and anxiously, grasped about with his hands, and snatched
at the air; he had no fever and his pulse was sluggish and
slow; still he had a hot perspiration and drank -eagerly, but
these arose from his violent muscular exertions and from dryness of his throat. HIe recovered after free vomiting and purging. —FRANK.
A robust boy, aged 3 years, ate of the seeds; soon after he
complained of scratching in his throat and wished to be put to
bed; he laid down upon his stomach, bored with his head into
the pillow, and his hands and feet commenced to tremble; in
half an hour afterwar'ds he became unconscious and fell into the
most violent spasms; his head was very hot, face dark red, his
limbs redder than natural, his pupils greatly dilated, and he
had profuse salivation; gritting of the teeth, violent trembling,
convulsive attacks and paroxysms  of great anxiety sat in, during
which the child constantly exposed his genitals; the abdomen
was distende(d, but not painful.  Free vomiting and purging,
with cold applications to the head, produced much relief; the
intense redness of the face and the convulsions abated first, but
the other symptoms persisted, especially the excitement, for the
child continued to sing, scream and moved its eyes and hands
for several hours, until it finally fell into a refreshing sleep, but
the singing and screaming were still present on the next day,
after which he slept for eight hours, and awoke quite restored.
-FRANK.
38




572                   STRAMONIUM.
The leaves produced in four persons: sudden mental derangement, they made laughable movements, had vertigo, dilated pupils and distended abdomens. —FANK.
Three cupsful of an infusion of the plant and seeds produced:
nausea and great anxiety; the patient a robust and plethoric
woman was found lying unconscious with closed eyes and mouth,
violent throbbing of the pulse and spasms of the limbs; she
was bled two pounds, when she opened her eyes, and stared
wildly about her; her pupils were widely dilated and insensible
tolight and touch; the mouth could be opened, but the tongue
was immoveable and she could utter no sound; the upper part
of the body was drawn backwards spasmodically. Injections
and counter irritation were followed by sleep and perspiration,
with relief from the spasms.-FRANK.
A child, aged 11 years, ate of the seeds, and was attacked
with spasms and distension of the abdomen, followed by unconsciousness. It was restored by vomiting and purging.FRANK.
A girl, aged 3 years, ate a considerable number of the seeds 
she was attacked with violent convulsions of the arms, paralysis
of the legs, the tongue hung out of her mouth, her eyes were
quite fixed, pupils widely dilated, with muttering and loss of
consciousness. Vomiting and purging were followed by relief;
but on the next day the child complained that it was very dark
and wished candles to be lighted; the pupils still remained
much dilated; she had several bloody stools and finally recovered on the third day.-FRANK.
A man, suffering with rheumatism of the head, took six drops
of the Tincture every two hours, and was apparently cured in a
few days; but he increased the doses three or four-fold, and
was suddenly attacked with heaviness of the head, stupefaction,
inclination to vomit, great debility and dejection, staggering
walk and inability to walk even a few steps, dilatation of the
pupils, dryness of the lips and tongue, violent delirium, hard
and full pulse, and discharge of thin almost spring-water-like
urine. IIe recovered in a few days and his head-rheumatism
never returned.-FRANK.




STRAMONIUM.                     573
From their tendency to produce eruptions upon the skin, the
internal use of Belladonna and Stramonium may prove as useful as Croton oil or Tartar-emetic ointment applied externally.
Thus, in one case in which the patient was quite stupid, with
quick pulse, hot skin, constant motion of the head, and of
the hands to the head, intolerance of light, &c., and all these
symptoms became gradually aggravated for nine days when a
well-marked eruption of measles appeared with improvement in
all the head symptoms; the child appeared less stupid, somewhat conscious and could more readily distinguish those about
her. In another case of strongly marked cerebral symptoms,
simulating meningitis in a child five years old, where they appeared to depend upon a slight erythematous affection of the
face imperfectly developing itself; there was great restlessness,
high fever, extreme dilatation of the pupils, unconsciousness,
insensibility to light, and incessant rolling of the head from one
side to the other; these symptoms lasted five or six days and
subsided on the appearance of a full eruption from Croton oil on
the back of the neck.
Belladonna and Stramonium may have a homoeopathic relation to a peculiar diagnostic sign in tubercular meningitis, first
announced by TROUSSEAU, and which consists in the appearance
of a remarkable red line remaining upon the skin of the forehead, or of the abdomen, after drawing the finger across it. A
female patient of Dr. PARKMAN'S who had scrofulous disease of
the clavicle, was, when about to undergo an operation seized
with a fatal illness, which Dr. P. diagnosed as tuberculous
meningitis, from the peculiar red line spoken of above.
The above remedies are also homoeopathic to Igreat dryness
of the mouth and nose, and Dr. ROMBERG states that the condition of the nasal mucous membrane constitutes a good diagnostic sign in head-affections; if the secretion be arrested and
the nose be dry, then meningitis is impending. Other signs of
meningitis in infants, are: the continual attempt to bury the
occiput in the pillow, and a frequent change of color in the
cheeks, and especially in one cheek only. Vomiting is often
observed, but with these peculiarities, that it occurred when the
stomach was empty, without nausea, without straining, and was
brought on by moving or shaking the head. The expression of




574'                  STRAMONIUM.
the eyes is noticeable; children usually follow with their eyes
the eyes of their attendants; in meningitis they cease to do this.
-ROMBERG.
CASE 84.-A girl, suffering with small-pox and meningitis,
was attacked with convulsive and paralytic symptoms.
Treatment.-Tinct.-stram., five drops, in spir.-vini. half an
ounce, removed the dangerous condition instantly.-Arch. 20, 2,
145, GOULLON.
In cases, where during and after an attack of small-pox, the
most violent and most dangerous affections of the brain set in,
accompanied by delirium, STAPF found Stram. in the 12th potency a quick and lasting remedy. Ibid.
CASE 85.-GRoss observed during the winter season, among
children under seven years, a rheumatic-inflammatory affection
of the meninges, with the following:
Symptomzs.-Sleep was not very heavy and soporose, but frequent convulsions of the limbs sat in, attended with groaning;
disturbance of the mind; on awaking there was'a peculiar kind
of fatuity; the look was staring, and the child had a desperate
air, gazing fixedly at one point, this state sometimes disappeared slowly, sometimes it passed off with a severe fit of crying, during which the child clung to near objects; the whole
attended with high fever, redness of the face and perspiration.
Stramonium 9. removed this state quickly and completely.Other persons between fifteen and twenty-five years suffered
with extreme absence of mind, they slept little, were taciturn,
did not feel inclined to answer questions, were almost insensible
and immovable, without being unconscious.  Spirit.-nitr.-ether;
was more useful than Stramon.-Arch. 9, 2, 140.
REVIEW.-Both experience and the remarks of STAPF, tend
to prove that Stram. in suitable cases, is peculiarly adapted to
inflammation of the meninges. STAPF says Stram. is particularly useful when spasms of the bladder are present.




SULPHUR.                      575
SU LPHU HR.
GENERAL REMARKS.-a. In the period, says WAHLE, where
the signs of exudation, under the well-known phenomena have
appeared, if Hell.-nig. does not remove the danger in the course
of six or eight hours, we have still a good remedy in Sulph. 30.
and 60. It ought not to be given internally, but a few globules
only should be smelled at. (Bah!)-Arch. 15, 2, 23.
b. RUMMEL says, that a physician is frequently not sent for
in diseases of children until convulsions have set in, and these
then mask the real malady which existed previously.  The
principal remedy is, according to his experience, Sulph. 30.
Ile has used it with good effects even when inflammatory and
exudative affections of the brain were present. If this remedy
produces no good effect, the patient is generally in a hopeless
state; but occasionally he found the previous and alternate use
of Aeon. and Bell. somewhat useful. He did not use Sulphur
in any other potency than the 30th, and found it more useful in
the erethistic than in the torpid stage.-Allg. Horn. Ztg., 32,
345.
CASE 86.-Resume of the symptoms of inflammation of the
brain in thirteen children, from four to ten years of age, boys
and girls, of whom only one died, on account of too'late assistance.
Premonitory Symptoms.-A short time before the beginning of the attack there was observed an insignificant scurf
upon the face, or a little roughness of the chin, ears or face, or
scurfy pustules on the lips. The scurf fell off suddenly, the
pustules dried up quickly and healed. One or two days before
the beginning of the malady the patient had no appetite, with
heaviness of the head, chilliness and debility.
Symptoms of the Attack. —Soporific sleep disturbed every ten
to twenty minutes by a sudden awaking, with a heavy, audible
crying, ah! ah! or: oh! dear me! or restlessness for several
minutes, followed again by sopor; gnashing of the teeth, vomiting of the food, intolerance of light, constipation, weak and frequent pulse, thirst, dry and white coated tongue, sour smell of
the mouth, redness of the cheeks, or one cheek red, the other




576                     SULPHUR.
pale, perspiration of the head, with a dry, more or less cool skin of
the body; the perspiration of the head emitted a musk-like smell.
Treatment. —Acon. and Bell. without effect. Sulphur 1 530 0,
every six to twelve hours, effected the cure; to one child, Phosphor. XN was given with the best effect.
Course of the Disease.-After giving Aeon. and Bellad.;
crying out in the sleep rarely took place, sleep became more
natural, still the child complained about pain of the fore- and
hind-head, as well as about the vertex. From the use bf Sulphur and Phosphor., the vomiting ceased, constipation abated,
the symptoms of fever ceased, as well as the heavy sweating of
the head, the skin got moist and a cure followed. Some children were cured after sixteen, others after twelve, and still
others after eight doses.-Arch. 16, 1, 61, WVEBER.
CASE 87.-A boy, 21 years of age, was taken sick with the
following:
Symptoms. —Head so heavy that it could scarcely be kept
straight and fell to the side; holding it erect produced vomiting
of liquids, or of slime; the child slept most of the time; was
frightened, as if from anxiety; the cheeks changed frequently
from pale to red, or if one was red, the other was pale. The
limbs were cold; there was perspiration only on the head, which
was very hot; thirst; pulse 100.
Treatment. —Acon. -T-, ten drops, every two hours, followed by
Bell. 30. after eight hours, without effect.  Afterwards Sulphur   v every twelve hours. After four doses the child was
perfectly cured, with the exception of great debility. Bell. 3-0
removed the weakness within four days.-Arch. 16, 2, 3, WEBER.
CASE 88.-Three cases of inflammation of the brain, in the
persons of a boy, aged three years, and two girls of five years.
Symptoms. — Could only lay the head in certain situations;
it had to be kept low, otherwise the child would cry and vomit;
deep sleep, interrupted by raving; awaking with a heavy start,
although ordinary calling and speaking would not awaken the
patient; penetrating sour smell of the mouth.
Treatment.-Acon. and Bellad. were of no use, but after
several doses of Sulph. 1500. a cure began instantly.-Arch.
16, 2, 5-10, WEBER.




VERATRUM.                      577
REVIEW. —Of no remedy have we so many observations as
of Sulph.; it proved useful even when the disease was approaching to the second stage, and when Acon., Bell. and lHellebore
had been given without effect. It was given in high potencies,
the 30th, 60th or 1500th. Among the characteristic symptoms
we do not find the boring with the head, but rather a sinking
down from heaviness; sweat on the head with a musk-like
smell; changing of the color of the face; sour smell of the
mouth.
The cure was in all cases rapid and progressive.
The doses as above mentioned were all high potencies.
VERA T RUM.
CASE 89.-A child, 11 months of age, had on the fifth day
of illness the following:
Symptoms.-It lies slumbering upon its back; eyes half
closed; face pale and thin; it rolled its head violently from
side to side, with sharp screams; or bored into the pillow;
transient redness of the cheeks; throwing off the bed-clothes;
the head when raised fell down backwards, with convulsive motions of the limbs; the eyes were languid and lifeless, with
greatly contracted pupils; the child noticed nothing; its eyes
resembled a dull, gliding glass, covered with a thin transparent
mucus, which dried into hard masses in the corners; it remained
in a torpid state even when spoken to loudly; when it was
raised up it had several convulsive shocks and inclination to
vomit.  At the beginning of the attack there were frequent
paroxysms of vomiting and diarrhoea; the head was hot, the
body almost cool; pulse without strength and of diminished
frequency; it refused to nurse.
T'reatment and Result. —Verat.-alb. 2., twenty drops in two
ounces aq. d., a teaspoonful every three hours. At the end of
twenty-four hours after the patient had received three doses,
there seemed little chance of life; but on the fourth day of the
treatment, the patient having taken the Veratrum regularly, the
following state of things was present: when called, the child
cast its eyes to the place where the call came from; the pupils
were of natural size, eyes bright and expressive; the child was




578                 GENERAL REVIEW.
awake almost every hour; has taken the mother's breast; tried
to hold its head up; there were thin discharges from the bowels.
The recovery was soon perfected.-Allg. Hone. Ztg. 19, 38,
KNOR RE.
z I N C U M.
GENERAL REMARKS. —In the irritative stage, says HARTMANN, if Bell. is without effect, Zinc. is incomparable in the
second to third triturations; it should be given every two hours.
He has never given this medicine in vain, and generally after
the lapse of twelve to twenty-four hours, the crisis was perfectly formed. —Dess. Therap. 1, 540.
GENERAL REVIEW,
BY RUECKERT.
The principal remedy was Bell. thirty-seven times. Sulph.
sixteen times. Aconite fifteen times. Bryon. and Opium three
times.  Arn., Hell., Hyose. and Strain. twice. Cupr., Digit.,
Iod., Rhus. and Verat. once. Zinc. is recommended. Opium,
Stram. and Spir.-nitr.-dilc. were frequently used in some epidemics.
Form of inflammation:
1. In encephalitis: Bell., Bry., Hyosc.
2. In inflammation of the meninges: Bell., Bry., Iod., Op.:,
Spir.-nitr.-dulc., Stram.
3. In hydrocephalus-acut.
a. In the first stage: Acon.
b.   "   second stage: Arn., Bell., Digit., Hell., Rhus.,
Sulph., Verat.
c. In the third stage: Helleb.
In order to secure a quick survey of the principal indications,
we append the annexed synopsis.
During and after acute exanthems, such as scarlet fever or
measles, when inflammation of the brain appeared, Arn., Bell.,
Cupr. —From dentition, Acon., Cupr.-During febrile catarrh,
Cupr.-After sun-stroke, Bell. —During and after small pox,




GENERAL REVIEW.                    579
Stram. Reports of cases have been contributed by thirty-eight
physicians.
DosEs.-The strong tincture was only used in a few cases;
from the first to the third potencies 35 times, viz.: 5 times in
drop doses, 14 times in single doses, and 15 times in solution
and repeated doses. From the fourth to the high potencies
were used in 58 cases. 24 times but one remedy was given, 10
times single doses, 7 times in solution, 17 times in high potency
in repeated doses. Of the cases in which one remedy alone
proved successful: Acon. was given in 3 cases.
Bell.'' "c 21  cc
Bryon."    "  "cc     1 case.-25 cases.  To
these we may add the 16 cases treated with Sulph., in which
Acon. and Bell. were given without effect; 16, without regarding many other cases in which other remedies were given without effect, thus we have in whole 41 cases cured by one remedy.
These cases deserve sufficient attention to encourage us to attempt to cure without a sudden change of remedies.. In general
we may say that 12 children were cured by taking Sulph. Some
required 16, others 12, others eight doses to effect a cure.
Among 18 cases:
In 10 the cure was effected in from 4 to 12 hours.'  6   "          "         "  15 to 24   "
cc  2   "c        "        c"    3 to. 5 days.
A complete cure was effected in 30 cases;
23 times in from 1 to 5 days.
6  "      "    6 to 2'
once in 4 weeks.
Most of the cases, after the dangerous signs had ceased, were
cured gradually without particular crisis. In 7 cases there was
a quiet, many hours' lasting sleep; in 5 cases sweat; in 2 cases
diarrhoea; in 2 cases boils; in 2 cases discharge from the ears;
in one case a loose cough.
39




580                          SPECIAL INDICATIONS.
SPECIAL INDICATIONS.
10
- ~  — i ~        B c            O....
Headache, violent and.....
piercing......',''.. Bry.......*..
In the head, like swinging,    Bell ry...           hus.
I-ead warm and body cold,..                                                          Vera.
Heat of the head        l......   Bell. Pry.  "Dig
Sweat of the head, sel......
ing like musk............  *..
o~ /
Boring with the back o
the     d............         Bell                                       Sr.      Vera. i 
Flnctnating, fallingr bark
of the head,....          Bell     Cup Dig. Hell.              Rhus.           Vera.
I-ead, violent turning in,.Vera.
ace, red................       Bell  ry.              Ilyos.               Str.
bright h nearly brown,     P...ry...          Str.
slightly red...........
Cheeks red.........                  ry...... i 
Sweat of thehead, sme~B..
Face hot...Bel...... e..
*' pale...                    Bell.Hell......
changin. color....Ac... Snip.
Eyes rolling, turning,..Ac.        ell..      Di Hell
squiting....                Bell.. /..  Di,. Hell............
"staring...B.......          Bell         D.....            Sir.
cc hri~~ht,  nearlybrolBell. ry.     Di'        yos
half open.........     B.              g. Hell. Hyos.... Vera,, sparkling,,.......            Bl....
dim, weak,.ll. H....s..V era.
Face ~~~~~~~~~~~~hus.....~     ~~~~~nl
cc din                         B ell.            He ol
Eyelids, edematous.......... hus.
Pupils enlarged......B... ell          Dig.. Hell Hyos...
C   contracted....... Belll.op.                                      Snip Vera.
Tongue, dry........ell ry...                    Sp.
white coated,....Bell..                                Sp.
Bell.......~..
c' spnrklin~~~~~~~~~~~~~~a,~~.....~~~
Sour smell of the mouth,.                                                       Sulp...
Great thirst............. Ai.    Bell Bry.    Dig.                     Sulp.
Gnashing oftheteeth,....el.  l...Snip.
Vromiting......       Ac.  Bell         Cup.. C... Hyos...Snip.
"    on rising up,...Ac...   Bell..
Abdomen,  painful  and.y.....
swollen..................   Bell Dry...   yos...
Stool, hard, wanting.......     Bell. Bry.     Dig..                          Sulp.
64  involuntary,.              Bell.
Urination involuntary,.....      Bell..        ell...
Breathing, anxious, groan-..
ing.Am. Bell Dry.H11yos..
Breathing quickened......  eBell.        Hyos...
Pulse, quick, weak...... A. Arn.ellHell.                                       Suip.
full, hard......... Ac.    Bell.
trembling,  intermitting~o"........?elle.             Rhus.
"   scarcely  pereeptible........                                                  Rhus.
Beating of the carotids,..         l......  ell.
Convulsive fits............. Arn, Bell.      Di-. Hell..
Trembling of the limbs,..        Bell....  ell.
Grasping with the hands..
at the head............. Ac... Bell..   1     Hell...
Cramps.......         Bell...... Hyos. R..       hus.Str.
Inclination to paralysis,......                                       Rhus.i Str.
Heat, general............Ac.      Bell....
Skin, dry, hot...........         Bell         Dig..     yos.
Sleep, with snoring,.....         Bell.... Op.
"      starting,....Ac...  Bell. Bry.                           Rhus...  Sulp.
"         gnashing  of..
the teeth.......   Ac....... Bell.. Sup.
Inclined to sleep, but not..
abl...................  Bry. Cup...
Sopor.....................      ell..... DigHell.. Op. hus. Str Sulp.
Delirium.................Ac... Bell. Bry.Hyos. Iod.Str.
Passionate...............    Bry...
Stupid................   Bell.    Cup... Hell.            6.Op...    Str.
Inclination to run away,. Ac.  Bell... ell.




INDEX.
A.                                                      PAGE.
PAGE.  Apoplexy, True or Typical,..150-155
Abscess of the Brain........... 493       Simple or Congestive..... 155-161
Acidity of the Stomach in Head-           Hiemorrhagic,...........161-175
aches,...................   xv.      of Optic Thalami,............ 168
Nervous-bilious Headache,.... xvi.      of Medulla Oblongata,........  168
Aconite, remarks on, 1, 4, 102, 193 to     of Pons Varioli,............. 168
209, 327, 505     of Crus Cerebri.............169
Case of Headache, treated with, vii.    of White Substance of Brain,.. 169
2, 3     of Cerebellum...............169
Cases of Apoplexy, treated with,        of Ventricles of Brain,........   170
205, 209     from Aneurism.                  170
Cases of Mental Derangement,            from Diseases of the Arteries,.. 171
treated with,.............. 328      of the Meninges,...........   171
Cases of Disease of Brain, treated      Sub-arachnoid,............. 172
with,................  508, 511      Intra-arachnoid,..............172
Dose of, in Headaches,........  4      Febrile and Inflammatory,.... 175
Dose of, in Apoplexy,......... 209     Serous,....... 176
Dose of, in Mental Derangement, 329     Nervous,.................      178
Dose of, in Diseases of Brain,.. 510    from Disease of the Heart,..... 181
Acquisitiveness in Mental Derange-         Bilious................... 182
ments,...                    419      from Derangement of Stomach, 184
Acute and General Inflammation            Infantile,.187
of the Brain....        491      Result of Old-school treatment, 140,
Additional cases of Headaches, by                                         243
Dr. Peters,.......      vii., 101    Result of Homccopathic treatAdhesiveness in Mental Derange-              ment,................ 140
ments,...........          419      Secondary effects of.......... 189
Agaricus, remarks on, in Head-          Appendix on Haschisch,........ 421
aches,.............      4, 102   Arnica, remarks on,..6, 103, 212, 512
In Apoplexy,........ 210      Cases,..................215-216
Case 3, in Headaches,.....    5   Arsenieum, remarks on,. 7, 8, 103, 104,
Dose.....5, 212                                                   331, 513
Amativeness in Mental Derange-            Cases treated with, 9, 104, 331, 332
ments................... 419   Dose,...................               10
Anatomy of Great Sympathetic            Arum, remarks on,.......10, 105
Nerve,.........             xvi.   Asarum-europeum, remarks on,... 105
Anaemic Headache,....... xxv., xxii.      Case,...................        10
Arsenic,............. 9, 103           Dose,.............              10
Belladonna,......             12   Atheroma, nature' of,............ 173
Calc.-c.,..................  25, 109   Treatment of,................   175
China,......        35, 112, 113   Atrophy of the Brain,...... 165, 478
Natrum-m.,...... 55, 120  from Lead................252
Sepia,.............7.....       9      treatment of,................ 315
Anacardium, general remarks,.... 329   Aurum, remarks on...... 11, 105, 333
Cases treated with............ 329     Cases treated with,.............  334
Antagonistic states of the Mind,.. 321    Dose,...............           11
Antipathies, treatment of,....... 321
Anxiety,...............         417                      B.
Apathy, treatment of,.......... 321
Apoplexy, Introduction to,.. 137-140   Baryta, remarks on,........ 217, 334
Premonitions of,.........141-143       Cases treated with,.......220, 221
Prevention of,............143-149       Doses...                       221
581




582                               INDEX.
PAGE.                                   PAGV.
Belladonna, remarks on,.....11, 12, 16,   Causes and Nature of Mental De17, 74, 106-108, 221-239, 335-345,      rangement,.........295-325
514-530   Chamomilla, remarks on, in HeadCases,......12-16, 107, 230-239,         aches,...............33, 34, 112
336i-338, 516     Cases, in Headaches...........  34
Dose,....... 17, 18, 239, 529    Dose,.......................  34
Review of,.........343-345    China, remarks on, in Headaches,
Benevolence,........            419                              34-36, 112
Bernard, Experiments on Sympa-            Remarks on, in Mental Derangethetic Nerve,.............. x. xiii. ents,....................       347
Bilious Sick Headache.....xv., xvi.      Cases, in Headaches........35, 113
Ag'ar...........               102      Cases, in Mental Derangements,
Carb.-an.,.110                                                   347, 348
Chain.,.............           112     Dose,..................6, 113
Coloc.,                        114   Claude Bernard, on Sympathetic
Gratiola,.118                            Nerve,....................  xiii.
er.,............              119    Cocculus, remarks on, in Head-.Blood-letting, and results of,..239-244    aches..................6, 113
in Insanity-,..................  310   Remarks on, in Apoplexy,..244-247
B]ryonia, remarks on, 19, 23, 108, 345,   Remarks on, in Mental Derange530    ments....................        349
Cases of Headaches treated with,        Cases, in Headaches,.......37, 114
20-22, 109      Dose, in Headaches,........ 44
Dose,.................    23, 24  Cases, in Apoplexy,....    246
Budge, Experiments on Corpus              Dose, in Apoplexy,.........247
Striatum, &c.,.............  xiv.   Coffea, remarks on, in Headaches,
C.                                                    38, 39
Colocynth, remarks on, in tIeadCalcarea-carh., remarks on,.....24, 28,     aches,...............40, 42, 114
109, 346     Cases, in Headaches,..........  41
Cases,.....................25-28      Dose, in Headaches,........  42
Dose,...........29, 30   Combativeness,...419
Camphor, remarks on,........30, 310   Congestion of the Brain,........ 430
Cases,..                   30   Congestive Theory of Headache, xxiii.
Dose.                          31  Congestive Headaches,.. xxiii to xxvii
Cancer of the Brain,............    503   Aeon.,..........,,.    2, 3, 102
Cannabus-indica,..              353      Agaricus,......., 4, 5
See Appendix on Haschisch,... 421       Aurum,.................. 11, 105
Capsicum, remarks on, in Head-            Bell.,......11, 12, 13, 23, 106
aches,.......32, 111   Bryonia..............., 19, 108
Dose...................... 32          Calcarea,............24, 29, 109
Carbo-animalis, remarks  on, in           Camphor.,.............., 30, 110
Headaches,......3......31, 110       Carb.-an.,.................   3
Dose...                        31      Carbo.-veg.,..............31, 111
Carbo-vegetabilis, remarks on, in         Capsicum,.                     32
Headaches,................  110      China,..........34, 35, 67, 112
Cases,........            31, 111      Crocus.................  43, 115
Dose,........                 31       Magnet.,                        48
Cases of Mental Derangements in           Natrum-m.,.............52, 56
which several remedies were          Nux-vom.,.        57, 63
used................. 410-415        Opium,                          67
one remedy only was used, 328, 410     Phosphor.,................ 67, 121
Catarrhal Headaches,........... 96       Sanguinaria,..............77, 124
Causticurn, remarks on,.. 32, 112, 347    Sepia,....................78, 83
Cases, in Headaches,.......33, 112 S2ilex,.................  84
Dose,....                      33      Sulphur,..............    91, 93
Caution.................. 419   Conscientiousness,..............419




INDEX.                               583
PAGE.                                   PAGE
Conium-maculatum, in Apoplexy,
247-250
Doses of,...................250   Erotomania.................... 309
in Mental Derangements,......  350      treatment of................ 309
General remarks..........350-352   Exaltation, treatment of....... 416
Cases treated with,.........352, 353
Constant Headache, Arsen., case
7; Bell., cases 9, 11, 14, 17;     False Impressions, treatnment of,.. 416
Bryon., case 25;  Calcarea,        Ferrum, in Apoplexy,.154
p. 25, 26, 29; Camphor, case       Fixed Ideas,.............. 417
37; Carb.-veg., case 41; Caus-     Foolish Imaginings,.........  416
ticum, case 42; Hepar-s., case     Form,........................ 419
55;- Ignat., case 57; Lachesis,    Fully developed Tuberculous Mecase 59; Merc., cases 61, 62,          ningitis,...........        460
63, 64; Natrum-m., p. 52,                           G
cases 68, 71; Nlux, cases 77,
78, 80, 81, 86; Phosphor.,         Gay Monomania,...............308
case 88; Platina, case 89;           treatment of,.........308, 310
Puls., cases 92, 93, 95, 97,       General review, in Apoplexy,..292 to
98; Sepia, p. 78, cases 105,                                        297
106, 110, 111, 112; Silex, p.        in Mental Derangements,.....   416
84; Spigelia, p. 87....    120      in Diseases of the Brain,.....    578
Corpora-quadrigemina,.......... xiv.   Glonoine, in Apoplexy,...  253 to 257
Corpus Striatum,................ xiv.  Cases treated with,......255 to 257
Course of Headache  along the             Doses of,                      257
Sympathetic Nerve........ xvii.       Remarks on, in Headaches..... 115
Crotalis, in Apoplexy,.......... 250      Cases 141 to 147........ 115 to 117
Cases treated with,........... 250     Dose...................... Ibid.
Creosote, remarks on, in Head-         Gratiola, remarks on,........ 44, 118
aches,................ 43, 114       Dose,.. 44
Case 53..                      43                    H
Dose,...                       43
Crocus, remarks on, in Headaches. 43,   Hallucinations, in Mental Derange115       ments,.............. 309
Dose,..................         43      of Sight,..................  309
in Mental Derangements......   348     of Hearing,.......            310
Cases treated with,............ 349   of Touch,.                    310
Cuprum and Plumbum, in Apo-              of Taste and Smell......... 310
plexy,................250-253   Headache from irritation of eyes
Doses of,............       253         and Iris,............. xvii, 18, 74
Cuprum, in Mental Derangements, 357   Helleborus-niger, in Mental DerangeCases treated with,........ 357-359      ments,...................  359
General remarks,............. 359     General remarks,........... 360
in Diseases of the Brain,.... 533      in Diseases of the Brain,...... 543
Hepar-sulph., remarks on, in Headaches,.......45, 118
Dejection of Spirits,............. 417  Cases 55, 56................. 45
Delirium Tremens,.310                   in Mental Derangements,......  359
Dementia,...................  310   Hope...................           419
Depression, treatment of,....   417   Hydatids in the Brain.......... 494
Despair,.417'Hydriodate of Potash, in Diseases
Destructiveness,.419                       of the Brain,............... 553
Digitalis..              537   Hydrocephaloid Disease........ 475
DosEs, remarks on, in Headaches,  vii  H-lydrocephalus, on............ 483
Dulcamara, Case 54, in Head-              Internal...................483
aches..................... 44       Chronic,                       484
Dose..                          44      External,.................... 488




584                                INDEX.
PAGE.                                   PAGE.
Hydrocianic-acid, in Apoplexy,.... 260   Melancholy, treatment of,....... 317
Hyosciamus, in Apoplexy,..257 to 260   Menstrual Headaches, Aurum,.11, 105
Cases treated with.......... 259      Arnica,........ 103
in Diseases of the Brain,....... 548   Asarum,................. 10, 105
-Niger, in Mental Derangements, 361     Bell.,.......................   106
"   General remarks....... 361      Bryon.,.22
"   Cases treated with, 363 to 365   Calc.-c.,.............25 to 28, 110
" Review of,............ 365         Caust.,.............32, 112
Hypertrophy of the Brain,...... 479       Cham.,....              112
Hypochondria, treatment of,.... 318       China.,..................  35, 113
Cocc....................37, 114
Crocus..                  43, 115
Idiocy,..315                        Creosote...................115
Plumbum in,......... 392   Laehesis..              119
Ignatia, remarks on, in Head-              Magnes-c..          119
aches,................45, 118     Natrum,.................   54, 55
Case 59,....             46   J Nux,....................... 57
Dose,................... 47   Phos..122
in Apoplexy,..261                 Plat.,...................  69, 122
case treated with, No. 52,...... 261    Puls.,................ 71, 72, 75
in Mental Derangements,...... 366      Sepia,..........79, 81, 124 to 128
cases treated with,........... 367      Spigel.,...................87, 99
Imitativeness,............. 419        Sulph.,...................... 130
Inflammation of the Dura-Mater,. 436       Verat......   132
of the Arachnoid,.            441   Mercurius, remarks on,..49 to 52, 119
of the Pia-Mater,....     443      Cases 61 to 64..            50
INTRODUCTION to Headaches,.....xi to      Dose................. 52
xxviii   Misanthropy, treatment of,...... 318
Iodine,...                       553   Monomania................... 308
Ipecac.,                         253   Morbid Anatomy of Insanity, 306-308
Iris-versicolor, remarks on, in Head-   Mortality in Insanity,........... 303
aches.                        47
Dose,                           47
Irritation of the grain,........... 427   Narcotics in Mania............. 314
K.                     Natrum-m., remarks on, in Headaches,.............. 52, 120
Kleptomrnia,..309                  Cases 65 to 71,........... 52 to 55
L.                        Dose..                         56
Lachesis, remarks on, in Head-          Natural Cures......561
aches,................ 47, 118   Nervous Headaches,..........  i, xii
Cases 58, 59,..............   47   Nostalgia,...            319
Dose.................. 48   Nux-moschata......     372
in Mental Derangements,........ 368   Nux-vomica, remarks on, in HeadList of Remedies for Headache,..           aches       56 to 58, 63, 64, 120
Lycopodium, Case 148, in Head-                72 to 86                  to 62
aches,................. 119          Cases 150 to 152............. 120
in Mental Derangements...368  Dose..64....        in Apoplexy,............ 261-271
M.                        Cases treated with,........ 264-271
Milagnet., Case 60.............. 48       Doses of,.............. 271
Magnesia, carb., Case 149,........ 119   in Mental Derangements...... 369
Mania................... 303   General remarks,..            369
treatment of,................  319     Cases treated with......370 to 372
with fury; treatment,........   323
Marvellousness,.............. 419
Megrim or Megraine............xviii   Opium, remarks on, in Headaches,
Melancholy,................ 417                                      65, 66




INDEX.                              585
PAGE.                                 PAGE.
Opium, Cases 86, 87............ 65   Pulsatilla, remarks on, in HeadDose,........              66   aches................ 70, 74, 75
in Apoplexy,....... 159, 271 to 274   Cases 90 to 98,..         70 to 73
Cases treated with, Nos. 67, 68,      Cases 154, 155,... 123
and 71 to 76,........ 273 to 276    Dose.......   76
in Mental Derangements, 373 to 381    in Mental Derangements.....383
Cases treated with,........... 379    Cases treated with,......383 to 386
in Diseases of the Brain,...... 565   Purgatives, in Mania,........... 313
Pyromania,.................. 309
Pain, remarks on, in Hleadache,... viii               R.
Paralysis, Plumbum in,......... 392   Recoveries, per-centage of, in MenPeriodical Headaches......... xviii      taT Derangements...... 303, 304
Agar.,..                        5   Relapse, liability to, in Mental
Arsen.,...................9, 104       Derangements..............302
Asar.,.........          10, 105   Religious Mania,............309, 416
Aurum,......1............. 11        treatment of,..................323
Bell.,...       12, 13, 14, 106    Melancholy,.......          318
Bryon.,...................21, 22   Results of Allopathic treatment,.. 302
Calc., Carb.-v.,............31, 111   Rheumatic Headaches,.......... xxvii
China................. 35   Rhus-toxicod., remarks on, in HeadCocc.,....................... 37       aches................... 76, 123
Coloc.,....................... 41    Case 99...................  76
Crocus,........              43      Cases 156, 157............... 124
Mere.,...............49, 52       Dose..................        76
Natrumn-mur.,........    52, 120    in Mental Derangements,.... 393
Nux,........   57, 58, 59, 60, 63    in Diseases of the Brain,...... 568
Puls.,........ 71, 75
Sanguinaria,.......      79                    S.
Sepia,.............81, 125, 126   Sad Monomania................ 308
Spigelia,........ 86, 89   Sanguinaria, remarks on, in HeadSulphur,....        93, 130       aches,............77, 124
Glonoine,.............116            Cases 100, 101............... 77
Magnes. c.,.... 119      Dose,.....             77
Phos.,..................... 122  Seat of Insanity.............306
Sies,........................ 128   Secale-cornutum, in Mental DePetroleum, in Mental Derange-             rangements................ 393
ments,................  381   Sepia, remarks on, in Headaches, 78,
Phosphor., remarks 6n, in Head-                             79, 82, 83, 124
aches,............. 67, 121, 122    Cases 102 to 111.......... 79 to 82
Case 88,........           67      Cases 158 to 164........ 125 to 128
Case 153,........ 122             Dose..................... 83, 84
Dose,................. 69      in Mental Derangements.......394
in Apoplexy............274 to 276   Sick Headaches,.....xi, xii, xx. 96, 74
Cases treated with, Nos. 69, 70.274   Acon.,...................  102
in Mental Derangements,...... 381     Ars.,.......................  104
Platina, remarks on, in Head-           Arum,.................... 105
aches,...................69, 122  Aurum,..................... 105
Case 89,................... 69    Carb.-an,...................  111
Dose......                   70   Carb.-v.,......                 112
in Mental Derangements.......382     Caust..................... 112
Plethora,..................  151-155  Cocc......................... 113
Plumbum,.................386 to 393     Creos.,......                114
in Delirious forms of Insanity,.. 387  Lach.,................... 119
in Furious................... 389    Lycopod.................... 119
in Epilepsy,.................. 392   Magnes.,.................... 119
in Idiotcy,...... 392                 Natrum.................. 120




586                                INDEX.
PAGE.                                    PAGE.
Sick Headaches, Phos......... 122   Suicidal Monomania........ 309, 319
Rlius,.................. 123      Treatment of,........... 309, 323
Sanguin.,.            124   Suicide, Inclination to.......... 419
Sepia....................... 78   Sulphur, remarks on, in HeadSilex, remarks.on, in Headaches,.            aches................... 90, 130
84, 128     Cases 121 to 126.........91, 92
Cases 113, 165,............84, 128      Cases 167, 168, 169.......... 130
Dose,..............             85  Dose..93
Softening of the Brain, 277 to 291, 315    in Mental Derangements,......404
Inflammatory,.............. 279         in Diseases of the Brain,...... 575
Chronic, &c.,................282                       T.
Yellow........                 283
Red........................ 281   Thickening of Dura-Mater, treatWhite,.................... 284            ment of,.................. 316
Treatment of................ 285   7Thuja, remarks on, in Headaches,
Arsenicum in........... 285                                    93, 94
Nux in,................  263, 287        Dose,..........94
Ferrian in,.................. 287   Tabaccum, in  Mental DerangePlumbum in,............. 288     ments,................        405
Iodide of Bar yta in,........... 288   Tonics and Stimulants in Mania,. 316
Agaricus inl................. 288   Tubercular Meningitis......... 450
Opium in................... 288   Tubercle,                             453
Sympathetic treatment of,..... 288   Tuberculous Blood,..........  455
Special Indication of Disease of the       Dyscrasia.............        455
Brain..................... 580            "    Dietetic treatment of, 455
Spigelia, remarks on, in Head-             Indigestion,.....458
aches........85, 86, 89, 90, 129   Tubercles of the Brain.......... 496
Cases, in Headaches, 114 to 120,                        V.
86 to 88
Dose,....................  90   Veratrum, remarks on, in HeadStaphysagria, in Headaches, Case             aches.................. 95, 131
120...................... 89          Dose.....................95
Case 166,....... 129   Veratrum-album, in Mental DeSTATISTICS of Cures of Headache,  ix         rangements...............405
of Insanity, (Allopathic,)..298-308      Cases treated with,.....  405 to 409
"'    (Homceopathic,) 324, 325      Diseases of the Brain......... 577
Stramonium, in Mental Derange-                            Z.
ments,............ 394 to 404
General remarks............394   Zincum, Case 127, in Headaches,. 95
Cases treated in..........98-403        Dose.95
Review of,................... 403        in Mental Derangements....... 409
in Diseases of the Brain,......570       in Diseases of the Brain....... 578
Styptics,............... 162, 297