IC d








A
HOM(EOPATHIC  TREATISE
ON THE
DISEASES OF CHILDREN.
BY
ALPII. TESTE,
DOCTOR IN MEDICMNE; MEMBER OF SEVERAL LEARNED
SOCIETIESX ETC.
TRANSLATED FROM THE FRENCH
BY
EMMA  H. COTE.
FOURTH EDITION.
REVISED  BY J. H. PULTE, M.D.
AUTHOR OF "' HO1M(EfPATHIC DOMESTIC PHYSICIAN,"
"WOMAN'S MNEDICAL GUIDE," ETC.
BOERICKE & TAFEL:
NEW YORK,                PHILADELPHIA,
145 GRaND STREET.           635 ARCH STREET.




Entered. according to Act of Congress, in the year 1854, by
EMMA H. COTE,
In the Clerk's Office of the District Court for the District of Ohio.
Entered, according to Act of Congress, in the year 1857, by
MOORE, WILSTACH, KEYS & CO.,
In the Clerk's Office of the District Court of the United States for the
Southern District of Ohio.




PREFACE BY THE TRANSLATOR.
THE motives which originally prompted the composition of the present work, as stated by its Author, are
also those which incited its translation. It was then
the only work in Homeopathy, upon the DISEASES OF
CHILDREN, and it is now first rendered available to a
large portion of the world, by being presented in the
language of this country.
The incentives, indeed, to its translation, had
become even higher than those which were, at first,
professionally deemed warrantable for its publication.
its value had been proved. It had survived the assaults of opposition, and become crowned with the
clustering laurels of triumphant merit. The intrusive
novelty of the greater part of its numerous therapeutic
indications, and the unlicensed independence of its
attitude, aroused the usual armed resistance to its
admission within the guarded portals of science, notwithstanding the many humiliations incurred by proscriptive orthodoxy, in the history of Homceopathic
discovery.
The inveterate objection was, that the author's
startling innovations upon established opinions, were
predicated solely upon his individual experience, unsanctioned by that of older and higher authorities; as
if this were not almost necessarily the case with every
original contribution to knowledge; and as though
(1)




2          PREFACE BY THE TRANSLATOR.
such primary precognitions could be determined, in
general practice, before they were made known!
It was in vain that he had diligently explored the
voluminous records of juvenile disease, accumulated
both in the capital and in the provinces of France;
in vain that he had pursued his investigations, for a
period of five years, in a professional position so enviably favorable to multitudinous and reliable results.
None of these considerations could be admitted in
extenuation of his heretical transgressions.
But it is one of the highest functions of time to
vindicate the patience of truth. This author is now
esteemed by many of the most eminent Homceopathic
therapeutists and practitioners of this continent and
Europe, as a brilliant exemplar of enlightened and
untrammeled advancement in their science.
It was at the urgent solicitation of several of these
candid and competent physicians, who had fully verified many of the author's new remedies, over an ample
field of observation, that the translator commenced
the task she has here performed.  Such personal
incitements, however, would scarcely have sufficed to
induce an undertaking so unusual and adventurous,
in one of her unprofessional sex, but for those urgent
impulses of humanity toward the infantine misery
and mortality of our race, in which, that sex may
claim at least, an equal participation with the
other.
The grand cycle of alternate production and destruction which perpetually controls the whole sphere
of terrestrial being, as the only obvious economy of
nature, seems to concentrate its intensest action upon
the infancy of the human family. And it is among
the loftiest mysteries of Divine government, and more




PREFACE BY THE TRANSLATOR.            3
suggestive, perhaps, than any other, of some compensatory progress of mind in a future state, that so
vast a numerical majority of the human race should
so continually perish in the mental and organic immaturity of their existence, and in the acutest agonies
of disease. But it is, apparently, at the same time,
one of the most providential mitigati(,s  of that
destiny, that an improved system of medicine has at
length been discovered, which, to say the least, no
longer artificially multiplies the number of these gentle victims, nor aggravates their sufferings.
It has ever been one of the most flagrant reproaches
of the Allopathic system, that its violent and repulsive
remedies should be so barbarously inapposite to the
peculiar sensibilities of childhood. Drugs, so revolting in smell, taste, and quantity, and so inevitably
productive of derangement and prostration, in the
strongest constitutions, as to severely test the resolution even of adults, have to be forced, by manual
cruelty, upon the convulsive repugnance of helpless
infants, with the certainty of introducing new distresses, purely medicinal.
It is, therefore, with a maternal sister's liveliest
sympathies, that this approved IIomceopathic Treatise
on the ACUTE AND CHRONIC DISEASES OF CHILDREN, is
presented to the anguished mothers of America and
England. To those heart-wrung watchers of infant suffering, whose yearning hopes and wailing fears have
hitherto  obtained but slight relief from  medicinal
resources, the new information furnished in this volume, may restore many a cherished bud, rescued from
blight and death to expand in bloom and beauty amid
the sunshine of domestic joy




4         PREFACE BY TIHE TRANSLATOR.
To professional and literary readers, this Translation
is submitted with the deference and diffidence becom
ing its feminine source.
For the too obvious literality and versional inele
gance of the more technical portions, she can only
plead her paramount concern for perspicuity and
accuracy, at whatever sacrifice of the graces of style;
and, from all readers of critical discernment, she
courts that liberal consideration which she cannot
believe will be ungenerously withheld.




CONTENTS.
PAGE
rNTRODUCTION...............................   11
What Homoeopathy is....................................... 11
SIMILIA  SIMILIBUS   CURANTUR.............................   15
Dynamisation of Medicines................................ 28
Of the Nature  of Disease.................................. 45
PART I.
HYGIENE  OF CHILDREN,..................................... 53
Importance  of Education,.................................... 53
First Care of the New-born.................................. 56
Nurses —their Duties and  Regimen......................... 61
Nursing  Bottles............................................. 69
Of the Cries of Children................................... 73
Weaning,....................................              79
Second  Period  of Childhood................................. 85
Onanism.......................................... 100
Regimen during Homceopathic Treatment,........                                    110
PART II.
DISEASES OF CHILDREN...................................                          115
DISEASES OF THE SKIN...................1.................116
ACUTE EXANTHIEMATA...............116.........
Erythema........,...........................1............   16
(5)




6                                    CONTENTS.
PAGE.
Ci acks..................................................... 118
Burns,...............................................                                   118
Frost Bites..............................................   120
Stings.....................................................121
Erysipelas..................................................122
Zona-Shingles............................................. 125
Pemphigus.............................................. 126
Urticaria, or Nettle-Rash....................................126
Furuncles, or Boils........................................126
Measles..........................................127
Roseola,...................................................134
Scarlatina,..........................................135
Purpura...................................................143
Miliaria.............................................                                   144
Sudamina.................................................. 145
Vari ola-Small-Pox.........................................146
Varioloid..............................................164
Varicella —    Chicken-Pox.....................................165
Vaccina and Vaccinella-Cow-Pox, and Spurious Cow-Pox.....lG166
CHtoNIo EXANTHEMATA....................................168
Itch..................................................... 171
Eczema-Humid  Tetter,...................................185
Herpes-Tette,.............................................. 187
Crusta  Lactea-Milk  Crusts...............................   191
Crusta  Serpiginosa.......................................  194
Impetigo................................................... 195
Impetigo  Rodens...........................................197
Tinea  Favosa-Scald  Head...........................                                 197
Tinea  Granulata....................................... 201
Tinea  Annularis............................................202
Pityriasis..................................................205
Strophulus.............205
Prurigo,....................................... 206
Psoriasis............................................... 207
Scrofula.................................................. 207




CONTENTS.                                               7
PAGE.
Syphilis  of  the  New-Born,..................................221
DISEASES  OF  THE  DIGESTIVE  ORGANS...........................228
Stomatitis —Inflammation  of the Mouth-Muguet,.............229
Aphthee-Thrush........................................... 232
Gangrene  of  the  Mouth..................................... 236
Dentition,.........................................240
Gastritis................................................... 243
Enteritis,..2................................................49
Gripings  in  Infants  at the  Breast............................258
Colic......................................................259
Constipation.........................................260
Lientery..................................................261
Dysentery,...............2...........................  265
Typhoid  Fever........................................ 268
Icterus-Jaundice,...................................27 6
Peritonitis......................................277
Intestinal Worms,....27...............278
Ascaris  Lumbricoides..................................... 279
Ascaris  Vermlicularis....................... 285
Tabes Mesenterica-Atrophy of Children,...............290
DISEASES  OF  THE  RESPIRATORY  ORGANS,................. 295
Coryza..................................................... 295
Epistaxis —Bleeding  from   the  Nose.......................... 298
Angina......................................... 298
Crop..................................................... 301
Asthma  of Millar,.......................................312
Bronchitis................................ 316
Pneumonia,...................................317
Pleurisy.....................................319
Hooping-Cough,.........................................320
Phthisis Pultnonalis-Pulmonary Consumption...............324
DISEASES OF THE CIRCULATORY APPARATUS,..................... 26
DISEASES  OF  THE  CEREBRO-SPINAL  APPARATUS...................328
Cerebral Fever.............................................329
Spinal Meningitis..........................................333




8                                   CONTENTS.
PAGE.
Myelitis-Inflammation  of the  Spinal Marrow................334
Hydrocephalus, (Chronic).................................. 334
Convulsions,............................................... 336
Chorea-St. Vitus's Dance...............................                               338
Balbuties-Stammering.................33................ 338
DISEASES OF THE  ORGANS OF  SENSE,.......................... 340
Ophthalmia.............................................    340
Otitis...................................................... 340
DISEASES OF THE  LOCOMOTIVE  APPARAT US.....................341
Rachitis,................................................. 341
NOTE.
As the term ounce and ounces of water has been used in different formulae
in this book, it may be necessary, for the benefit of persons unused to this
mole of measuring fluids, to state that, a fluid ounce is equal, in quantity, to
two tablespoonfuls.




PREFACE TO THE SECOND EDITION.
THE first appearance of Dr. Testd's work on the
Diseases of Children, created quite a lively attention
among the practitioners of Homoeopathy. Many of
his therapeutical propositions were entirely new, and
seemingly unwarranted by a close reference to the
pathogenesis of the proposed remedies; the distrust
and suspicion, therefore, with which at first the profession regarded them, were just and excusable. But
these were soon dispelled by frequent and successful
trials on the sick, and some of them have proved to
be exceedingly efficacious.
Though we may not agree with Dr. Teste in all his
propositions, as we certainly do not in many of' his
pathological views, yet we cheerfully admit that by
his singular method in arriving at therapeutical
conclusions, he has opened a new and easier way of
selecting the prioper and specific remedy.  In the
Pneumonia of children, for instance, which is mostly
complicated with hepatic congestion, he precedes the
application of pulsatilla and spongia, which he considers
specific, by that of chelidonium, which has a specific
relation to hepatic disorders. This method seems to
shorten the attack very considerably, as I had frequent
occasion to observe. The application of chelidonium
would generally be followed by the peculiar greenish
discharges characteristic of liver-affection.
(ix.)




X          PREFACE TO SECOND EDITION.
In croup, on the contrary, his ipecac and bryonia
is only efficacious in its catarrhal form, not in the
inflammatory, where I still was obliged to exhibit the
formerly known remedies. In a like manner does his
ipecac and petroleum relieve only the catarrhal dysentery, not the bilious inflammatory or typhous. In many
other cases he is deficient in pathological distinctions;
his generalizations are too sweeping, and may induce
the heedless to condemn them on the first unsuccessful
trial. Yet these faults are outweighed by much that
is good.
At this day, I should think, no Homceopathist would
like to dispense with the aid he may derive in his
practice from consulting Dr. Teste's suggestions.
It is hoped, however, that the present work will
receive, as it certainly deserves, a thorough revision
and greater completeness, particularly in its pathology, which should be accomplished by the distinguished author himself.
As this is not yet done, the American publisher contented himself to issue the second edition with such
revisions and notes by the undersigned, as slight
alterations of the plates would permit, without
increasing the cost of the book.
J. H. PULTE, M. D.
CINCINNATI, May, 1857.




INTRODUCTION
SEC'riON I.
WHI AT  HO M E OPATHY I S
SAMUEL HAHNEMANN, to whom we are indebted fbr
the fundamental laws of Homceopathy, is, notwithstanding the insults, that folly and ignorance still
offer to his memory, one of the finest geniuses the
world has produced
Among all the benefactors of humanity, no one,
perhaps, has a larger claim upon its gratitude. We
may safely predict that his reputation will increase
with time, and that generations yet unborn will bless
his name.
Sixty years have passed since Hornceopathy made
its appearance in the world. In consequence of the
-bstacles which, in the beginning, it encountered
from the folly of some, and the envy of others, its
progress was at first slow; it shared, in this respect,
the fate of all great discoveries. At present, however, it has ceased to be a novelty; no medical school
counts more adherents. It is practiced in all civilized
(11)




12           WHAT HOMEOPATHY IS.
countries; it has its representatives in Turkey, in
India, in the two Americas, its dispensaries and its
hospitals in most of the capitals of Europe. The
books which treat of it would already fill libraries.
These works, many of which testify to the great mental superiority of their authors, possess this remarkable feature in contrast with the medical books of the
Old School, that they are all devoted to the development of the same principle. It is in fact the unity
and invariability of this principle which constitutes
the strength of Iomceopathy, and which so forcibly
distinguishes it from those deceptive utopias which,
under the usurped name of medical science, have
reigned in the schools from Empedocles to Broussais;
that is to say, for more than twenty centuries.
The history of medicine, during this long period, is
a compendium of all the dreams, all the extravagances, and all the absurdities which it is possible for
the human mind to elaborate, when it strays without
an axiom in the domains of abstraction.
To judge it by its history, we must believe that, the
medical art, which ceased to be anything when it
endeavored to become a science, claimed always to
ally itself to metaphysics. If by this ambitious alliance, it escaped the inconvenience of remaining
within reach of the vulgar, it incurred the still greater
one of losing itself in the clouds.
This strange substitution of sophistry for the pure
and simple observation of nature, has its root in an




WHAT HOMCEOPATHY IS.             13
almost invincible tendency  of the human  mind.
"Man," says Broussais, " is tormented by a desire to
know the first cause of what he sees, and when the
impossibility of discovering it is demonstrated to him
he takes refuge in a supposition."*
We need not then be too much astonished if, from
the most remote ages, physicians supposed the first
causes of diseases; and if, this first step made, proceeding from hypothesis to hypothesis, they have supposed
even to the virtues of the remedies they prescribed.
The exposition of the system of Galen, whose
sterile branches reach even to the present generation,
is a summary of all the systems which have succeeded
each other, from the infancy of rationalism down to
the too famous so-called Physiological School.
Abstractions of the closet, chimerical hypothesis, fantastical intervention of three spirits and four humors,
whose harmony produces health, and disagreement
disease; mysterious connection of these spirits and
these humors with the four elements of Aristotle; in
short, empiric expedients taken at hazard, to equalize,
correct and purify at need, these imaginary principles:
such was humorism in its cradle, and such the humoralism which was the favorite practice of our ancestors,
and of which the grossest errors are perpetuated in the
medical practice of the present day.
Thank Heaven, Homceopathy has nothing in com+ Examen des Doctrines Medicales, tome 1, page 9.




14          WHAT HOM(EOPATHY Is.
mon with these fatal extravagances which have so
long made medicine a subject of laughter to the philosopher and of deception and dread to mankind in
general.
Homceopathy is not a creation, but a discovery.
It is not a system, but a method.
It has no other theory than the logic of facts; no
other principle than a certain law of nature, as evident as an axiom in geometry-as certain as gravitation and the rotation of the earth.
If the honor of being the first to signalize this law,
whose incidental manifestation had struck from time
to time some of his predecessors, may be contested
with Hahnemann, his glory, his great glory consists
in having proved that it was not an exceptional phenomenon, as was believed before him, but a general
and constant physiological fact.
We shall consecrate the second paragraph of this
introduction to the examination of this axiom of
modern medicine.




SIMILIA SIMILIBUS CURANTUR.          15
SECTION II.
SIMILIA  SIMILIBUS CURANTUR.
As we have before observed, the system of Galen
served as a model to all succeeding writers. In
studying them, in fact, we may remark, that the
object aimed at by all of them was to reduce to a certain number of entities, or, if you will, to connect
with a limited number of morbid agents, material or
dynamic, the diseases, so numerous and so dissimilar,
to which man is exposed; then, to oppose to each of
these entities, or to each of these morbid agents, a
group more or less heterogeneous of therapeutic means.
Thence two orders of artificial, arbitrary, forced, unnatural classifications: classification of diseases - classification of remedies.
Let us first observe, that between these conventional
diseases and the remedies to be opposed to them, no
one thought of seeking to establish any relation. The
idea of speckfic remedies was incompatible with the
spirit of the system; so that no suggestion of this
idea appears until toward the close of the middle
ages; that is to say, until the epoch when empiricism
succeeded in stifling in its brutal grasp an art false
from the beginning, and'which, notwithstanding its
old scientific pretensions, was still more worthless
2




16        SIMILIA SIMILIBUS CURANTUR.
and more dangerous than empiricism itself. But let
us consider things in their origin.
The first elements of therapeutics were a deduction
from the precepts of hygiene. As this considered health
an equilibrium resulting from the reciprocal neutralization of certain opposite forces in the economy, the
first pathologists believed themselves wisely imitating
nature in provoking artificially, against the abnormal
and excessive tendency of a function at a certain
time, a tendency equally excessive, of the same function, in an opposite direction. Thence, naturally, the
dogmatic inclination for all the contrasts, whether
physiological, or purely physical, which it was possible to obtain. The corrective of cold was heat; of
humidity, dryness; of satiety, abstinence, etc. More
abstract considerations did not fail to give rise to new
oppositions.  The error of the hygienic precepts,
generalized by the successors of Hippocrates, was
especially in assimilating the living economy to inert
matter, and in eliminating theoretically the power of
reaction against the external world, which characterizes animal existence, and whose character is such
that the same physical causes have almost always
upon organic and inorganic being, very dissimilar
results. But if, as we begin obscurely to foresee, the
harmlessness of these precepts was already very questionable, conceive what medical practice must become,
when, to imaginary morbid'principles, they ventured
to oppose as conftraries remedies absolutely unknown!




SIMILIA SIMILIBUS CURANTUR.         17
HIowever, this fatal doctrine of contraries, invented
by Galen, seduced away even the finest minds, which
then exhausted themselves in vain endeavors to enlighten the chaos of medical art.
Points of departure the most opposite did not
hinder its advocates from meeting, almost by fatality,
upon this field of fiction, there to labor in the idle
search of those abstractions which, under different
names, form the basis of the vitalism of Stahl, as well
as of the materialistic systems of Brown, of Rasori,
and of Broussais.
The theory of contraries is then the common tie of
all the medical doctrines anterior to Homeopathy.
Let the falseness of this theory be demonstrated and
all the systems of which it is the key-stone will
crumble at once.
This is what we shall endeavor to do, and this
labor of analysis will cost us no great effort.
To cure a disease by means capable of producing
in the patient attacked with it, a pathological condition contrary to that which it presents: such is the fundamental law of the theories of the Galenists, in other
words, the ideal end of all the schools of medicine
from Grecian antiquity down to the present day. But
the theory of contraries necessarily supposes between
two things certain relations of form or substance, implying, so to speak, a sort of negative similitude, without which, all comparison becoming impossible, there
is nothing for the mind to seize upon. In metaphy



18         SIMILIA SIMILIBUS CURANTUR.
sics, for example, affirmation and negation are contrary
things, when relating either to two abstractions of the
same category, or to two perceptions exercised by the
same sense.
Thus, to the eyes, light is the contrary of darkness,
as sound, to the ears, is the contrary of silence. We
understand in the same manner, by analogy, but without prejudging, lest we err with regard to the nature of
the phenomena, that cold is the contrary of heat;
dryness, the contrary of humidity; hunger, the contrary
of satiety. In being but purely relative to our senses,
these dychotomies are not on that account the less
legitimate, since, after all, the abstractions which they
place in contrast have always for each couple identity
of substance. But is health then the contrary of disease?  No! for if, in an abstract and general sense,
which represents nothing obvious to the senses, it be
so considered, it is by no means the contrary of any
definable disease. The contrary of a disease is another
disease, at the same time analogous and identically
dissimilar to the first. What a problem, just Heaven!
Who had ever wittingly the temerity to state it, and
above all, the pretension to solve it!
I admit in all strictness and concede, for the moment,
to the system-makers, the truth of their hypothesis; that
bleeding is the contrary of hypersemia; leeching the
contrary of a local inflammation; a purgative the contrary of the inertia of the intestines; but the contrary
of variola, of psoriasis, of cancer, of tubercles, of




SIMILIA SIMILIBUS CUTRANTUR.       IS
herpes, of syphilis, of hysteria, of chorea, of epilepsy,
etc., etc. Who has seen it?  Who knows it? Who
can conceive it? Who has a mind acute, and inventive enough to represent it?
The doctrine of contraries is then without foundation. It is but a monstrous vagary, of which routine
has propagated the dogmas-of which humanity has
borne the terrible effects-and of which physicians
themselves have not seldom deplored the emptiness.
" Medicine does not advance," says Van HelIuont, " it
turns upon its axis."  And the celebrated Boerhaave,
still more pointedly asked himself, in a moment of
doubt and discouragement, if it would not have been
better for humanity if there had never been a physician in the world.*
Nevertheless, empiricism, that is to say, chance, had
fiom the most remote antiquity sown the germs of a
doctrine opposed to that of contraries, which only
waited the appearance of a man of genius to be fecundated.
It is twenty-two centuries since Democritus wrote
to Hippocrates: " Iellebore, which restores reason to
the insane, produces derangement in the healthy."
Hippocrates himself had said: " Vomiting is cured by
vomiting."
These two propositions, put forth by the two
greatest physicians of antiquity, contained the most
* Boerh. Instit. Medic., page 401.




20         SIMILIA SIMILIBUS CURANTUR.
complete contradiction to all received ideas which it
is possible to imagine.
Later, the popular observation of facts analogous
to the singular curative virtues of hellebore and of
emetics, propagated certain practices of which the
experience of centuries only confirms the efficacy.
Everybody knows, for example, that the best means
of alleviating the pain caused by a superficial burn,
is to hold near the fire the burned part; while this
pain, momentarily suspended by immersion in cold
water, is reproduced with increased intensity as soon
as the immersion is discontinued.
Everybody knows also, that frictions with snow are,
so to speak, specific for freezing, in cases where the
contrary influence of heat would have no other result
than to produce gangrene.
But by the side of these striking facts, empiricism,
which, without suspecting it, undermines all systers,
hatched other facts still more conclusive. They saw
purgatives arrest diarrhea, that rationalism, at the end
of its resources, had abandoned. They saw opium, on
the contrary, that they had cried up against diarrhea,
triumph over constipation, which the use of purgatives had greatly augmented.
These apparent singularities were so often repeated,
that it was at length admitted that the greater part of
purgative substances, at least, contained contradictory
properties, and produced, successively, two orders of
phenomena; first, the primary efect, augmentation of




SIMILIA SIMILIBUS CURANTUR.          21
the peristaltic action, and of the intestinal secretions;
the other, secondary effect, dryness and inertia of
the intestines; so that we need not be surprised to find,
in ancient treatises upon medical substances, the same
substance, rhubarb for example, figuring at the same
time in the class of purgatives and in the class of tonics.
This succession of contrary effects, generally established in regard to purgatives, is by no means a mode
of action peculiar to this species of remedies. With
closer attention, and above all, with fewer prejudices,
physicians would have had no difficulty in understanding that all medicines, without exception, are subject to
the same law; and this first observation would infallibly have led them to verify that other capital point,
that the primary efyect of medicines, upon which
turns the whole system of therapeutics, hardly ever
constitutes more than a crisis of short duration, and
generally insignificant results; while the secondary
effect, of which little notice was taken, persists for a
long time, and in reality represents the virtues and
final action of the remedies.
Thus it is easy to comprehend, that the generalization
of such observations upon the double action of therapeutic agents, would have had the immediate result
of completely overturning the reigning theories. But
matters were not yet ripe for such a revolution.
However, this was very nearly accomplished in the
sixteenth century, under the auspices of a wonderworker.




2'2       SIMILIA SIMILIBUS CURANTUR.
Paracelsus, a sort of visionary and pseudo-savantinventor of the famous doctrine of sympathies, and of
the sympathetic ointment, and especially a great seeker
after the real-Paracelsus discovered, one day, in one
of the ingredients of a combination which, accor'ing
to him, ought to produce the philosopher's stone, a
marvelous remedy for one of the most dreadful diseases known. The remedy had this peculiarity, that
it cured without provoking either purgation, sweat,
diuresis, or any other species of trouble, apparent in
the functions of the organism. This remedy was mercury, and the disease it cured, was syphilis.
The discovery of this fortunate employment of mercury, the insensible, silent, and as it were, secret
manner, in which this precious medicine acted; in
short, and above all, the speciality of the cases in
which it proved itself salutary, opened evidently new
views of therapeutics.
The great problem of specifics, so long laid down
by empiricism, had finally, for one disease at least,
received a solution. The doctrine of specifics, in a
word, ceased to be a dream, to become an unquestionable reality. The whole future of medicine was contained in this; but unfortunately no one thought of
seeking the laws of specifics. It was still necessary,
as in the past, to trust to chance, and grope along in
the search for specifics; and, as chance is a bad guide,
a blind, a dumb guide-the more dumb the inoreyou
interrogate it-it happened that several centuries passed




SIMILIA  SIMILIBUS CURANTUR.                  23
before another medicinal substance was discovered to
take rank by the side of mercury.
At last, however, quinine appeared, to double the
number of specifics.
It was asserted that quinine * cured intermittent fever, in the same manner that mercury cured syphilis;
that is to say, without causing any of those violent
perturbations that all other medicines produced, and
from  the nature of which were inferred  the dominant
quality and generic denomination of each.
Quinine provoking neither vomiting, purgation,
urine, sweat, nor sleep, was not then an emetic, or purgative, a diuretic, sudorific, or narcotic; for the grand
reason that it was bitter, and under the not less specious pretext that it tanned the gastric fluid, as the bark
* The Allopathic physicians include iron, also, in the number of
their specifics. Let it be so-they have then three. What wealth!
And what a proof of the fecundity of clinical experience! Three
specifics in two thousand years! And yet, it is well to observe
that specificity, in the absolute sense, as understood by Allopathy, is
really but a gross and lying fiction. There really exist specific remedies against such or such a group of definite symptoms, (we
employ no others); but from the moment that these symptoms are
absent, or no longer exist, the specificity ceases, and the remedy no
longer cures, although the disease still exists and has not changed
its name. This is equivalent to saying, that it is almost always necessary to have recourse to the emnployment, successively, of several
specifics to cure one disease. This is the reason that Allopathists,
who for the most part do not suspect these facts, see so often, what
never fails to astonish them, mercury fail in syphilis; quinine, in
intermittent fever, anid iron, in chlorosis.




24         SIMILIA SIMILIBUS CURANTUR.
of the oak did leather, they made it a tonic. But this
silly denomination, while deceiving practitioners upon
the real effects of quinine, was very far firom explaining to them how it cured fever. In spite of the persistence and the sophisms of the classifiers, Peruvian
bark remained simply and purely afebrifuge, as mercury was an anti-syphilitic.  That is to say, that they
admitted only as primordial facts, that quinine cured
fever, and mercury, syphilis. But why did quinine.cure
fever? why did mercury cure syphilis a The science
of the most skillful was silent upon this point.
But this terrible wchy? —a stumbling-block to the
doctrine of contraries-was destined to become the
Xvery corner-stone of an opposite doctrine; that is to
say, the supreme law of true medicine.
We borrow from the excellent works of M. Auguste
Rapou, the interesting history of this great discovery:
" Tired of the errors of the practice, the vagueness
and insufficiency of the precepts of the schools, this
celebrated reformer, (Ilahnemann,) had abandoned
the exercise of the art, in order to devote himself entirely to the labors of the closet. One day, occupied
in translating the materia medica of Cullen, at the
chapter on quinine, he was struck with the numerous
arnd contradictory therapeutic properties attributed,
without criticism, to this remedy, and the various hypotheses, more or less singular, to explain its antifebrile action. Then, in one of those sudden inspirations of which tile history of' reat discoveries offers some




SIMILTA 8IMILIBUS UURANTUR.         25
examples, "Let us cut the knot," he exclaimed, "I
will try quinine upon myself, and observe its effects."
He took a strong decoction of this bark, and was attacked with an intermittent fever, accompanied by its
premonitory symptoms, and by its three stages of cold,
heat, and sweat. To argue from cause to effect, of the
febrific properties of quinine from its anti-febrile faculty, to generalize this mode of action, and apply it
to all specifics, such were, for so ardent a genius, the
results of this remarkable experiment.  He reflected
upon these facts after the manner of Newton, and the
conception of the law of similars was accomplished.
" The generalization of the facts was, however, an
exaggerated application of the analogy. This law of
similitude was as yet but a preconceived idea, which
could have little other value than as a possibly true
hypothesis; it was now to be proved by showing that it
is manifested not only in the effects of quinine, but
that it belongs to the mode of action of the various
other medical substances. The certainty of this could
only be established by a long series of experiments.
Hahnemann devoted himself entirely to this object.
Endowed with perfect health, he was willing for several
years to put himself into a state of permanent disease.
He tried, successively, the action of the specifics already
known, and established for each this remarkable property of producing upon him a totality of symptoms
analogous to the groups of symptoms against which,
according to the writers, they showed themselves




26         SIMILIA SIMILIBUS CURANTUR.
efficacious. In all that had been written upon the action
of simple drugs, and upon the eflects of acute and
chronic poisons, he saw the full confirmation of the results of his own experiments. At last, in order to make
the counter-proof of his experiments, he administered
to the sick substances which had produced upon the
healthy a state similar to that under which they were
suffering. Clinical success stamped upon this therapeutic law a last and irrefragable sanction." *
Behold then, at last, Galenism and its works irrevocably judged by the double means of experience and
experiment, and behold the whole therapeutic arsenal
of the Old School reduced to its real value; that is to
say, to nothing.
No! of the absurd conjectures of ancient medicine,
of the false doctrines of the middle ages, of Brunonianism, of Rasorism, of Broussaisism, there will
remain, hereafter, but the sad remembrance of their
extravagances, and of the evils they have produced.
The expectant medicine, the negation of all medicine,
had already asserted that the curative force of nature
was the only reason of all the pretended success on
which the active methods vaunted themselves.
The vast erudition of Hahnemann is, beside, employed to demonstrate to us that all the remarkable
cures reported in the books, that nature alone would
not have been able to effect, had always been the for* Aug. Rapou: Histoire de la Doctrine M6dicale Homceopathique,
t(mine 1, page 390.




SIMILIA SIMILIBUS CURANTUR.         27
tuitous effect of homceopathic remedies administered
empirically.
Thus the law of similars, sustained by the history
of innumerable facts and verified since its discovery
by millions of cases, is definitely substituted, in the
minds of men of good sense and good faith, for the
too famous adage: contraria  contrariis curantur.
The whole code of modern therapeutics is reduced to
this precept: To administerfor the cure of the sick,
the medicine which produces upon the healthy a
totality of symptoms the most similar to the totality
of the symptors presented by the sick.
But the practical application of this precept implied
a profound knowledge of all the effects produced in
the healthy by each medicinal substance; and it was
to the gigantic task, a labor most urgently necessary,
of re-constructing the Materia Medica upon an
entirely new basis, that the immortal Hahnemann,
assisted by his disciples, devoted thirty years of his
life.




es        DYNAMISATION OF MEDICINES.
SECTION III.
DYNAMISATION OF MEDICINES.
THAT, in which especially consists the immense
superiority of the Homceopathic, over the Old School,
is the advantage which belongs to the former, of proceeding always from experiment to experience, while
the latter is guided only by experience; that fallacious
thing of which Hippocrates speaks, and which he distrusted with so much reason.
If we have had the good fortune to make ourselves
understood, in the preceding paragraph, this proposition hardly requires farther explanation.
In fact, it is well known that while the Allopathist
borrows only from doubtful tradition the drugs so
often whimsical or disgusting, that he administers to
the patient, we make use only of simple substances,
whose properties have been discovered, by experiments, many times repeated, upon the healthy. It results from this, that even in cases where we employ a
medicine for the first time, we know in advance, with
great certainty, all the efbects we may expect from it.
In Allopathy, on the contrary, unless we give a
forced and paradoxical extension to this maxim of Iamblique: " Medicine is the daughter of dreams," I




DYNAMISATION OF MEDICINES.         29
maintain that it is impossible to explain otherwise
than by accident or imagination; the introduction into
therapeutics of any new medicine. But let us suspend
these critical reflections, which every day's experience
verifies, and which the good sense of the public, it is
to be hoped, will soon render superfluous.
When Ilahnemann undertook the heroic part of
trying upon himself the toxical substances, of which
it was so important to him to establish the pathogenesis, a double consideration induced him, from the
first, to reduce very much, in his trials, the doses in
which these substances were ordinarily administered.
He felt on the one part, in fact, that without this precaution, his health, however good it might be, would
not long resist these daily toxications; and on the
other hand, a sort of intuition, the test of genius, told
him that the proper specific action of these remedies,
if such they had, should be different from those violent derangements produced by large doses.
Observation demonstrated his foresight. He was
soon convinced that not only had physicians been deceived in what, till then, they had considered the
proper action of medicines, but that the organic commotions, excited by the enormous doses in which they
had been prescribed, so modified the manifestation
of their peculiar action, that it had never been observed.
In the preface to his Materia Medica, Hahnemann
expresses himself on this subject in the following
terms:




30        DYNAMISATION OF MEDICINES.
"As to the duration of action assigned to each
mnedicinal substance - which I have sought to determine by multiplied experiment-I ought to remark,
that it can never take place when the medicine is administered in large doses, and in a case of disease, to
which it is not appropriate. In either case, the duration of action is much abridged, because the medicine is, to a certain extent, thrown off with the evacuations, which are their result, (bleeding at the nose and
other hemorrhages, coryza, flow of urine, diarrhea,
vomitings, or sweat,) so that its virtues are promptly
dissipated. The living body rapidly expels this matter, as it does the miasm of contagious diseases, when
it weakens, and, in part, expels it by means of vomiting, diarrhea, hemorrhage, coryza, convulsions, salivation, sweat, and other movements and evacuations.
Thence it happens that, in ordinary practice, neither
the peculiar symptoms nor the duration of action can
be known of antimony, of jalap, etc., because the excessive doses, in which only these substances are administered, pushes the organism to disembarrass
itself promptly of them. It is only when they do not
produce this effect, that is to say, when they do not
provoke evacuations, that we may observe their characteristic effects, so often important, and of long duration, but which are rarely noticed, and still more
rarely recorded.
The vomiting produced by two or three grains of
antimony, or twenty grains of ipecacuanha; the purg



DYNAMISATION OF MEDICINES.           31
ing by thirty grains of jalap; the sweats provoked by
a handful of elder-blows in infusion, are less the pro.
per effect of these substances than an effort of the
organism to extinguish as soon as possible their particular action.
"We hlave here the reason that homceopathic doses
produce so great an effect; they are not sufficiently
large to excite the organism to rid itself of them by the,
as it were, revolutionary movements of which we have
just spoken."
It was, then, in progressively attenuating the doses
of the substances that he tried upon himself, for the
purpose, according to his views, of rendering the result of his experiments more and more perfeict, that
Hahnemann was conducted, without perhaps thinking
of it, to discover what he afterward called the Dyniamisation of Medicines. As this discovery, the most
extraordinary, if not the most important, that he
made, or that was ever made, is still, at this day,
erroneously regarded as the principal fact of homneopathy,-so also, are its wonderful phenomena continually made the target for the dull shafts of the Old
School.  Happily, raillery and sarcasm are as powerless as sophisms, against the immovable evidence
of fact. And if, for a certain time, Hahnemann, like
Galileo, had only to repay him for all his painful labors,
the sad satisfaction of being alone in the right against
all the world, the admiration of numerous disciples




32          DYNAMISATION OF MEDICINES.
was soon to him a presage of the universal assent,
destined him by the judgment of posterity.
Dynamisation  consists in a series of operations,
whose double object is to reduce, almost infinitely, the
doses of medicinal substances, and to augment the therapeutic action, inherent in their molecules, in direct
proportion to the division of these molecules themselves.
All the world knows the rules for these operations.
Theprinciple is the same for all medicines.
To extend by means of trituration, or solution, one
part of a medicinal substance, into one hundred parts
of sugar of milk, or of alcohol;* to incorporate in the
same manner a hundredth part of this first mixture,
into one hundred times its weight of one of the two
inert substances, we have just designated; to proceed
exactly in the same manner with a third, a fourth, a
tenth mixture -such is the mechanism of the startlingly decreasing progression to which the remedies
used by homceopathy are submitted: Each of the
mixtures prepared according to these rules, has, as
well as the number of its order, the name of dilution.
* The sugar of Imilk having absolutely no property, is perfectly
adapted to this use. It is the same with alcohol, which, in the
very small quantities given, either in solution or in globules, is without appreciable effect. The sugar of milk serves for the dynamisation of insoluble substances, especially the metals. After the fourth
dilution, it is in all cases replaced by alcohol.




DYNAMISATION OF MEDICINES.           33
The thirtieth dilution contains a decillionth, in
weight, of the substance incorporated in the first.
But, the most imperceptible atom of which the microscope reveals the existence, the impalpable, invisible,
and almost imponderable mote which floats in a ray of
the sun, is a world in volume, in comparison with a decillionth of a grain of any matter whatever.  Yet,
nevertheless, it is such doses of mercury, of lime, of
sulphur, or of arsenic, that often suffice to arrest the
progress of a mortal malady, and effect the miracle of
cure, in the most desperate cases.
Reason, however, even the coolest, in its deductions,
and the freest from  prejudices, revolts at first sight
from such an assertion; but let facts appear, and reason bends.  Forced to receive, in spite of itself, the
evidence of the senses, it draws upon the storehouse
of memory, and finishes by recognizing, for the purpose, as it were, of absolving its faith, that the universe abounds in facts analogous to this action, prodigious as it is, of homreopathic doses.
Analogies, however, Inust be regarded as exceptionable proof of the reality of phenomena, which, in fact,
need no other proof of their existence, than that they
do exist; but it serves at least the purpose of removing prejudice, and engaging in practical trial, those
sincere men, who, while doubting, yet seek to be
enlightened.  Permit us, then, to notice a few of
these analogies.
The deleterious effect of certain odors, whose prin.




34          DYNAMISATION OF MEDICINES.
ciple escapes the most delicate tests of chemistry, is a
notorious fact, denied by nobody, and at which no one
is astonished; because its frequency has rendered it
familiar.  Who, nevertheless, will tell us the weight
of the effluvia which exhales -from  a few flowers of
heliotrope or from a bouquet of hyacinth?
Does not the mniasm of swamps, that terrible and
subtle cause of intermittent fever, so completely escape our senses that no one would even suspect its
existence without the incontestable proof of its origin,
and of its effects? ~
Who has seen, who has touched, who has seized in
its flight, that terrible principle of cholera, brought us
by the winds of the east, from the shores of the Ganges, its cradle-and of whose material reality there
are, however, so few incredulous?
To what homceopathic fraction shall we compare the
quantity of variolous or pestilential emanations, with
which a letter may be impregnated, and which, nevertheless has more than once sufficed to carry to enormous
distances, the disease of which it contained the germ?
Recall the experiments of Spallanzani, and those of
Fontana. The one impregnated animals artificially,
by means of a few drops of sperm, mixed in great
quantities of various vehicles; the other caused the
* The celebrated Professor Folki, at Rome, has recently proved? by
experiments, that the atmosphere of the Pontine marshes contains
nothing injurious to the health-nothing that is not found in the atmosphere of the most salubrious localities.




DYNAMISATION OF MEDICINES.          35
instantaneous death of a lamb by inoculating it with
a millionth of a grain of the venom of the viper.
How many atoms of syphilitic virus does it require
to transmit the syphilis?
How many of the hydrophobic virus to inoculate
with hydrophobia? The tooth of the dog, which communicates it to man, only reaches the skin after having
passed through several folds of his clothing; less
than a millionth part of a drop of the saliva of the
animal is perhaps deposited in the wound. Again
we must remember, that far from being the virus itself,
this saliva is only its vehicle, which positively reduces
to a homceopathic infinitesimal the quatity of infecting liquid actually absorbed. Nevertheless, infection
takes place; the evil incubates; it silently develops
itself, the crisis arrives and death ensues!
But why dwell longer on particular instances, which
it would be easy to multiply almost to infinity? They
are all comprised in a general fact upon which we
entreat our readers to concentrate their attention; a
fact of immense value in physiology as well as in
physics, and which may be thus presented:
ThAe dynamic properties~ inherent in material
substances, are in inverse proportion to the cohesion
qf these substances.
Whence it results:
1. That bodies, the most essentially endowed wifth
*Gravitation excepted.




36           DYNAMISATION OF MEDICINES.
the power of modifying the condition  of animated
beings, are those which have no cohesion whatever,
and which constantly tend to evaporation.
2. That in artificially destroying the cohesion of
solids, we are almost certain to develop in these, the
properties that, until then, remained latent.
Now, the homceopathic dynamisation is precisely the
verification of that principle, which I present in its
turn as appropriately forming a basis for the rules of
dynamisation.
If this last, in fact, only aids the spontaneous rarefaction, or what comes to the same thing, the medicinal power naturally residing in mercury, in antimony,
in arsenic, in camphor, in all the aromatic plants, in
a word, in all volatile substances, it literally creates
the medicinal force of gold, of silver, of platina, of
silicia, of coral, of lycopodium, etc., since this modifying power would not exist without it.* Is it not
then rational to conclude, that if dynamisation, simply
useful in certain substances, (for we admit its utility
in all cases), is absolutely indispensable in others, it
* Certain writers, and especially M. Auguste Rapou, have emitted
an opinion upon the nature of dynamisation, which I, for a long
time entertained. According to these physicians, the inert matter
mixed with the medicine or trlturated with it, contracts its properties to such a degree as to become itself medicinal. In this manner,
they explained the transmission from dilution to dilution, of the properties of the mother substance. The hypothesis is without foundation, and I do not hesitate to pronounce it false. The secret of
dynamisation is exclusively in the division of matter.




DYNAMISATION OF MEDICINES.             37
should generally be carried farther, in case of these
latter, than in the former? *
It is to be remarked, that the expansive power natural to certain medicines, and developed ill others by
dynamisation, seems to exert itself in the living economy as well as in all other mediums. Thence results,
without doubt, the general effect so promptly produced
by homceopathic preparations, in contrast with the
action, almost always purely local, of allopathic remedies; thence, beside the appropriateness of the higher
dilutions to the treatment of those affections in which
the constitution is involved, and in which nervous
symptoms predominate, while organic alterations seem
rather to call for the employment of the lower dilutions.
This naturally conducts us, if not to draw up absolute precepts, at least to express our personal opinion
relative to homeopathic doses.
And let us commence by avowing, that on this subject, the most complete anarchy, the most deplorable
confusion reigns among practitioners. The choice of
such or such a dilution; of drops, or of globules; of
potions, or of powders, appears to be, with each, but
an affair of habit, contracted without reason, and
* It is to be remarked, that practitioners are rather disposed to
follow an inverse rule, that is to say, they willingly employ high
dilutions of substances, which are naturally energetic, and the low
dilutions of substances naturally inert, which is unreasonable.




38          DYNAMISATION OF MEDICINES.
continued, because commenced.  Some (the majority
of German Homceopathists) adhere obstinately to
mother tinctures, and large doses, under the frivolous
pretext, that dynamisation having not yet been discovered, it was under the influence of these doses that
the greater part of the pathogenesis, reported in the
materia medica pura was produced.  Others, with
Dr. Gross at their head, pushing to a fanatical length
the ideas of the master, only employ the extreme dilutions called korsakovienne, that is to say, the five or
six thousandths! The first, in yielding to their allopathic reminiscences, or perhaps, by being influenced
unduly by their deference to the prejudices of the Old
Sehool, voluntarily forego the fruits of a magonificent
discovery; while the others unnecessarily alarm public
opinion, by the almost fantastic improbability of their
pretensions!*
It is between  these two extremes that I would
endeavor to establish what is suggested at once by
reason and experience.
But let us begin by declaring that we take, as a
starting point, this practical truth, to which, as we
have before stated, we give full adhesion, viz: That
*If I charge upon the korsakovienne dilutions, the reproach of
furnishing arms to the adversaries of Homceopathy, and sharpening
against it the shafts of satire, I refrain, nevertheless, from pronouncing them absurd. I know too well, that the infinitely small,
is like the infinitely great, inaccessible to human understanding,
and that in principle, the six millionth dilutioi is no more absurd
than the tenth.




DYNAMISATION OF MEDICINES.          39
if dynamisation is not absolutely indispensable to certain medicines, it is useful to all, and adds, in all
cases, to their efficacy.
We know in fact, that certain medicines, given in
certain diseases, being dynamized, have often produced results demanded of them in vain, before their
dynamisation. I have myself, seen a few globules of
secale corn. of the twelfth dilution, arrest almost
instantaneously, a passive hemorrhage of several
months' duration, and against which the same medicine had constantly failed when administered in its
crude state, in doses of twelve grains. I have also
seen stacnnum, prescribed at the thirtieth dilution,
procure the expulsion of enormous quantities of ascarides, in the case of an infant who had taken allo.
pathic vermiifuges for three months without effect.
Such cases are constantly occurring to homceopathic
practitioners.
We may remark, beside, that facts contradictory to
those here alleged are yet to be produced; that is to
say, that never, in any known medicine, has the
power of large doses come afterward to invalidate the
superiority of properly chosen dilutions.
With so much the more difficulty do we comprehend
those who cry up the exclusive use of the first, since
they thus deprive themselves of therapeutic resources,
which, we declare it boldly, are so important that
without them, we should experience in our daily practice an invincible embarrassment.
4




40        DYNAMISATION OF MEDICINES.
With what, indeed, should we replace carbo. vege
tabilis, silicea, lycopodium, etc., etc., which have no
medicinal properties without dynamisation a
Will we give, on the other hand, by grains or by
tens of grains, the pure venom of the rattlesnake and
of the trigonocephalus lachesis?
The predilection for massive doses certainly arises
from incomplete notions of medicine, or false ideas of
diseases.
" What would you prescribe," said an Allopathist
to me one day, " to an unfortunate man who had just
swallowed a couple of hundred grains of vitriol i"
" Three hundred grains of magnesia," replied I, without hesitation. " Why not some of the decillionths? "
said my interrogator, jeeringly. " Because, before
combating the disease, it is necessary to destroy the
cause, when this cause still exists; because, in prescribing three.hundred grains of magnesia, I do not practice medicine, but chemistry; because, in such a case,
it is neither to the age, sex, constitution, or temperament, or even to the sufferings of the patient, but
only to the quantity of poison swallowed that I proportion the remedy, or rather the antidote. In this I
only conform to the old precept, tolle causam, etc.; a
precept which, by the way, is only absolutely true for
your School; for, notwithstanding the removal of the
cause, the disease will have its course; then medicines
will succeed to the use of antidotes, and the infinitesi



DYNAMISATION OF MEDICINES.          41
mals, worthless as they may seem to you, will then
show their power."
Let our readers judge, by this example, of the
general value of the objections made to dynamisation
by the partisans of the precepts and of the doses of
the Allopathists. We shall not return to this subject,
and it only remains to us, at present, to speak of the
choice of dilutions.
This is a difficult, arduous, delicate, and complex
question; it is even impossible to solve it, except with
reference to other considerations. It is easy to comprehend, in fact, that its solution must depend, as we
have already intimated: 1. Upon the species of
medicine; 2. Upon the nature of the disease; 3. Upon
the age and constitution of the patient.
Hence, there are three points to discuss. First,
concerning the species of medicine as deciding the
choice of the dilution, I have already somewhat fully
explained myself. Thus, it is well understood, that,
as dynamisa-tion develops the medicinal action, we
should prescribe, all other things being equal, the
dilutions higher in proportion to the natural inertness
of the substance.
It may be objected, that if the greater division of
matter in the high dilutions of inert substances establishes between these and the lower dilutions of active
substances, a certain equilibrium of power; this
equilibrium is broken by the abundance, relatively
more considerable in the last, of the medicinal matter.




42       IDYNAMISATION OF iMEDICINES.
But, however specious this objection, it vanishes, or
very nearly so, under the test of experience. Experience, in fact, impartial and infallible judge, proves
superabundantly that the activity of the hoinceopathic
dose is proportioned incomparably less to the quantity
of medicinal matter that it contains, than to the degree of its division. Were it otherwise, dynamisation
would be a chimera.
The little importance that we seem to attach to the
greater or less quantity of crude matter in our medicines may, I feel, appear strange. Nevertheless, do
we not know, to call analogies once more to our aid,
that neither the symptoms, nor the intensity of a contagious disease, are proportioned to the abundance of
the principle which gave it birth? Do we not know
that the pustules of the vaccine are developed so
much the more surely, as the hand of the operator has
been light, and the virus sparingly applied? Of two
unfortunate beings attacked by hydrophobia, who
have each the same anguish, and the same death, one
has hardly felt the bite which caused the infection,
while the other has been torn by the furious animal
and inundated with his deadly saliva.
I do not hesitate, then, to pronounce that, if not
entirely unimportant, it is, at least, of very secondary
importance, how many drops or globules should enter
into a dose. ~
* I prefer potions to the dry preparations. The diffusion of the
first has always seemed to me more sure and rapid.




DYNAMISATION OF MEDICINES.          43
The globules are very small pills of sugar of milk,
saturated with the medicinal tincture of the various
dilutions. A single drop is sufficient to saturate
several hundreds. The manner of this saturation appears to me to constitute, in itself, a veritable means of
dynamisation. Thus, the three hundred globules,
which represent, in quantity, but the value of a drop,
contain altogether a medicinal power greatly superior
to that, of a drop.
Hahnemann preferred globules to tinctures and used
them exclusively. In his horror of large doses, the
decillionths, even, in the liquid form, seemed to him
enormous doses! ~ * ~ So true it is that great
men have their little prejudices!
The principal advantage in the globules is their
portableness. It is, indeed, a precious advantage for
the physician, and especially for the country physician, to be able to have always about him a complete
pharmacy.
The nature of the disease, the age and constitution
of the patient, as we have said, complete our group of
reasons for determining the choice of the dilution.
Although this proposition evidently implies two
distinct points, we shall, for the sake of abridging
it, treat it without observing  this distinction.  It
may, beside, be summed up in a single principle, a
principle based upon observation, and of which the
following i's the statement:
The power of homceopathic medicines is in direct




44        DYNAMISATION OF MEDICINES.
proportion to the vital activity of the subject, while
the duration of their action is in inverse proportion to
the same.
Whence we immediately draw the practical conclusions:
The younger and more vigorous the patient, the
more acute, rapid and inflammatory the disease, and
manifesting itself;, as it were, by an increase of vitality, the more important it is to reduce the, doses,
while, at the same time, we lessen the intervals of
their repetition.
For old people, on the contrary, as well as for
emaciated or lymphatic subjects, of a low and feeble
vitality, who are refractory or almost insensible to
medicinal excitation, the lower dilutions are most
appropriate.
In conclusion, to increase to a greater or less extent
the intervals between the doses, in the treatment of
chronic diseases, is a rigorous deduction from the
principle we have just announced, and of which some
general notions upon the nature of disease, developed
in the following chapter, will perhaps better enable us
to understand the bearing.




OF THE NATURE OF DISEASE.            45
SECTION IV.
OF THE NATURE OF. DISEASE.
EVERY disease is a partial or general disorder of the
functions whose ensemble constitutes life, and whose
regular exercise constitutes health.
There exist, according to the terms even of this definition, two kinds of diseases: local and general, or,
what comes to nearly the same thing, organic-those
with material lesion of one or more organs-and essential or diffused diseases.
Clinical observation proves that the former, of however little intensity they may be possessed, tend constantly to generalize themselves, or, to speak otherwise, to derange the vital acts of the whole body,
while the latter almost always end in some local
lesion.
The difference between the two is not the less
marked: The former are primarily organic; the latter primarily essential.
The one has its origin in the presence of a subtle
agent, either acquired or spontaneous, but not cogniza
ble to the senses; the other. on the contrary, results
from the mechanical or chemical action of an appreciable agent.




46         OF THE NATURE OF DISEASE.
A man is attacked with typhus; he at first suffers
only a vague depression, torpor, or sleeplessness-an
indefinite discomfort, an irregular fever: the disease
is yet general; but pains in the bowels soon make
their appearance, with ulceration of the small intestines, and the disease is thus localized.
Another man crushes his finger under a stone; he
suffers, at first, only from his finger-the disease is
local; but we have soon traumatic fever, tetanus,
perhaps death-and the disease is generalized.
One may easily conceive how often this generalization of local affections, and this at least apparent localization of essential affections, must have put physicians
upon the wrong scent. Here, where there were two
distinct facts, the spirit of the system only wished to
see one. For vitalists and humorists, apart from surgical cases, there were only essential diseases; for
materialists and solidists, there were only organic
lesions.  The first did not sufficiently prove their
hypothesis; their adversaries denied the evidence.
If, in fact, the organs being the agents of our functions, it is impossible that an organic lesion could exist
without bringing on a functional disorder, it is a fact of
daily experience that serious functional disorders do
manifest themselves without apparent organic lesion.
When, in consequence of a prick in his foot, a man
dies of tetanus, a post mortem examination of the body
reveals no other lesion than the prick. Nevertheless,
tetanus, the immediate cause of his death, although it




OF THE NATURE OF DISEASE.             4'7
be only a secondary phenomenon, constitutes in itself
a definite affection, and one which is perfectly separable from its cause. Tetanus is, then, we will not say
an essential affection, but at least an affection exclusively dynamic.
Now, let us suppose that this terrible nervous affection manifests itself spontaneously; that is to say,
under the influence of a secret cause-in other terms,
a cause too subtle to come under the cognizance of the
senses-does not tetanus then offer us a type of essential disease?  Here lies the whole question.
Let us hasten, moreover, to remark, that the absence
of physical lesions is far from being the pathognomonic
and dominant character of essential diseases. If, in
their first period, they only manifest themselves by
simple functional aberrations, frightful ravages in the
different organs of the body, often mark the passage
of the greater part of them; as, for example, syphilis,
typhus, etc.
But, what particularly distinguishes this sort of
affections, is, with the obscurity of their origin, the
almost invariable regularity of their form. They each
have their own course-their constant symptoms-their
crises, and their duration.  They are susceptible of
being classed into (.enera and species, like animals or
plants.  They ale, in  fact, veritable  existences;
abstract beings, if you will, but whose germs are
nevertheless realities.
This, I am aware, leads us into a sort of inedicl!




48          OF THE NATURE OF DISEASE.
ontology, but not absolutely that attacked by the sarcasllls of Broussais. What to us, beside, is the opinion of this head of a school   If we have been, and
if to a certain extent we are still, his admirer, we are
not his disciple.
All superstitions, said D'Alembert, have their
nucleus of truth. Now, if medical ontology may be
considered a superstiton, it has, beyond a doubt, its
true side.
Assuredly, it is absurd to consider a disease as a
real being, like a parasite implanted in the economy,
to live there its own life at our expense. But for the
effect, substitute the cause; for the disease, its principle,
and you will have, in place of a chimerical conception,
an hypothesis, specious, rational, plausible, and bearing, even, shall I dare to say it, the criterion of certainty.
Is it not incontestable, in fact, that each of these
diseases, that we call essential, is the special result of
a poisonous principle? Grant that this principle is not
a visible and palpable matter, observation and experience do not the less clearly demonstrate that its existence is positive. The virus of syphilis, of variola, of
the plague, etc., are all for us simply poisons, having,
like arsenic, corrosive sublimate, prussic acid, the venom of the viper, or of the rattlesnake, etc., etc., their
respective pathogenesis. WVe are then in the right, not
only in admitting these viri, but in classing  them
exactly as we do known poisons.




OF THE NATURE OF DISEASE.               49
If we are now asked what advantage can arise from
this particular manner of regarding disease, nothing
can be more easy than to make it understood.
It substitutes general views for partial observations,
and thus conducts the practitioner to the employment
of general means and of dynamic remedies.*
The number of essential diseases, or if you will, of
essential principles, whose effects are determined, is
already considerable. It is beside very probable, that
we do not know them all, as every day reveals a new
one. The incomparable merit of the homceopathic
materia medica is, that it furnishes a priori, the
means of combating them. It is thus, that from the
first appearance of the cholera, the pathogenesis long
since known, of arsenic, of copper, of white hellebore,
of camphor, and of charcoal, represented for the
Homceopathist the specifics corresponding to the different forms of this frightful epidemic, to which Allopathy, groping, opposed but powerless, and very often
contradictory means.
The deleterious action of virus, or of the miasms,
(the words, save a light shade, are for us synonymous)
is, like all the other toxical substances, diffused throughout the universe, more or less active, and more or less
* To treat with local means and as so many distinct affections, the
various symptoms of an essential fever, is as puerile, as absurd as it
would be to combat the dangerous effects of a bite of the viper, by
only closing the wound made by the teeth of the reptile with adhe
sive plaster.




50         OF THE NATURE OF DISEASE.
formidable. The first are congenital, or develop themselves spontaneously in the economy; the last come
from the surrounding atmosphere. There are those
which exhaust themselves in us, and are extinguished
after the explosion which gave notice of their presence. Others, on the contrary, resist time-may
remain latent for years-and often only manifest themselves on the occasion of some accidental affection,
and transmit themselves from generation to generation.
The founder of Homceopathy occupied himself with
only the last of these, and has only pointed out three;
syphilis, sycosis, and psora. Psora was the especial
subject of his researches and meditations during the
latter half of his life. He saw in it the true cause of
all chronic diseases.
This conception of psora, notwithstanding the error
and confusion probably mixed up with it, was nevertheless a stroke of genius. It traced a line of demarcation, that we believe natural, although not recognizable, between acute and chronic diseases. These
are not simply, as was generally thought before
Hahnemnann, the prolongation of the first.
Acute diseases have, for the most part, their duration fixed by nature; and when, notwithstanding, the
removal of the cause which excited them, they pass
the limits of this duration, and seem  to continue
indefinitely, it may be safely affirmed, that they have
changed their character, and have awakened some




OF THE NATURE OF DISEASE.            51
morbid principle until then dormant, and foreign, in
the beginning, to their manifestations. But is this
morbid principle always the same? Is it always
psora?  Nothing proves this; and it is in this, at
least, so we think, that Hahnemann deceived himself.
There exist, perhaps, as many primitively chronic
diseases as primitively acute diseases. It is, perhaps,
as hazardous to consider psora as the unique cause of
all chronic, non-venereal affections, as it would be to
attribute the small-pox, the measles, scarlatina, miliaria, etc., to one and the same miasm. We are then
very much inclined to believe that this thousandheaded monster, named by Halhnemann, psora, is
essentially multiple.
HIow in fact admit, that the gout, aneurism, cancer,
tubercles, etc., etc., are only one disease?  This
appears so much the less probable, that we never see
these different diatheses transform themselves from
one to the other, either during the life of the individuals who present them  or the generations to
which they are transmitted. The son or the grandson
of a gouty parent, has gout, and not cancer. The son
or grandson of a cancerous parent, has cancer, and not
gout, etc., etc.
But if this remarkable phenomenon of hereditary
transmission ruins the hypothesis of psora in its unity,
it assuredly confirms the general idea.
I will say then, in summing up, that with the exception: 1st, of natural deformities, which may be reme



52         OF THE NATURE OF DISEASE.
died by mechanical means; 2d, traumatic or chemical
lesions, which belongto the practice of surgery or chemistry; 3d, and last, simple affections, resulting from the
physical impression of an irritating agent upon an
isolated organ, I admit but essential diseases, which
can only be efficiently combated by specific remedies.
It would remain for me now to speak of the classification of diseases. But such a classification, to be
logical, would suppose notions much more complete
than those we at present possess upon the analogous
action of the morbid principles. Perhaps experience
may some day furnish us their true elements; but
such a systematization, which will be the triumph of
Homceopathy, will require still much time.




PART I.
HYGIENE OF CHIILDREN.
CHAPTER I.
IMPORTANCE  OF EDUCATION.
THE impressions of childhood remain during life.
They exist in us without our knowledge. Our particular tendencies, our sentiments, our opinions even, on
many subjects, are oftener than we think, their consequences. We owe to them, without suspecting it,
many of our virtues or of our vices, the greater part
of our prejudices, our health or our diseases.
It is with men as with vegetables: a cutting, which
planted in good earth aid properly cultivated, would
have become a great tree, luxuriant and productive,
will produce, left to itself, or unskillfully managed,
but a stunted plant, without vigor and without fruit.
It may then be affirmed, that the destiny of men
depends, in a great measure, upon the care given to
the first years of their existence. We know not how
better to express the importance we attach to education.
(53)




54          IMPORTANCE OF EDUCATION.
This should commence for us on the day of our
birth, and hardly finish before the epoch of maturity.
It comprises the direction of the mind, and of the
body: the mind and the body are so dependent upon
each other, that hygiene and morals are almost inseparable things.
We shall, nevertheless, separate them in this little
work, where it is not our intention to encroach upon
the sphere of the moralist, but to occupy ourselves
solely with the physical care to be given to children.
But let it not be forgotten, that the health of the body
often makes that of the mind; the character of the
individual, and, if we dare not add his intellectual
aptitudes, at least the degree of mental application of
which he is capable, depend, in great part, upon the
strength of his constitution, and upon the more or less
normal manner in which his organs perform their functions.
Long protracted disease, generally, finishes by falsifying the ideas as well as the sentiments. Jean
Jacques Rousseau, undoubtedly, owed his misanthropy, and the aberrations of his magnificent intellect,
to the tormenting disease from which he suffered.
The sum of all hygienic laws, applicable to children, consists in the satisfaction of all their natural
wants, while we avoid the creation of factitious ones.
But the practice of this double precept, so simple in
appearance, exacts on the part of the mother almost
as much sagacity as solicitude. She must know how




IMPORTANCE OF EDUCATION.           55
to divine the cause of all the discomforts, of all the
sufferings, of even all the wants of her children,
which they yet know how to express only by their
cries. She must, beside, be on her guard, that in
endeavoring to console them by useless or dangerous
diversions, her tenderness does not lead her beyond
proper bounds.
Time has fortunately dissipated many prejudices
touching the first treatment of children. Thus, in the
majority of cities, at least, the use of long clothes and
of cradles has been abandoned. Unfortunately, in
place of the abuses which have ceased, luxury has
substituted others. The worst of all, is the carelessness of mothers who blindly abandon their children
to mercenary care. There are cases, we are aware,
where the mother herself cannot, and ought not, to
nurse. We are so far from absolutely proscribing
hired nurses, that we shall soon give them our especial attention. But the intervention of a nurse, whatever confidence she may inspire, should never exclude
the immediate and continued superintendence of the
mother.




56       FIRST CARE OF THE NEW-BORN.
CHAPTER II.
FIRST CARE OF THE NEW-BORN.
WHEN the labor has been long and fatiguing, when,
above all, the umbilical cord is found wound round the
neck, and has been compressed for some moments between the head and the walls of the pelvis, the child
always comes into the world in a state of asphyxia.
But, although it neither cries nor breathes-although it
makes no movement, and the pulsations of the heart are
imperceptible, the asphyxia is not always complete. It
is necessary then, after having cut the umbilical cord,
to allow a few drops of blood to flow before applying
the ligature. We should then take the child upon the
knees, remove from the mouth, with the finger, the
mucus which may impede the penetration of the air,
sprinkle it repeatedly with cold water, and rub it
briskly after each sprinkling, either with the hand or
with warm linen. Finally, if it does not soon recover,
it should be carried to the air, and we should blow
strongly into its mouth, and re-commence and continue the same treatment until it breathes, or until its
death is rendered certain.
We have seen children remain in this state for
several minutes, without giving any sign of life, then
begin slowly to recover, and be quite well two hours




FIRST CARE OF THE NEW-BORN.          57
after. If the accident is not immediately mortal, they
generally recover.
It is the same with the paralysis of one-half the
face, from compression of the facial nerve by one of
the branches of the forceps. This paralysis gives to
the infant, when it cries or when it attempts to nurse,
a strange expression, at which the mother and nurse
are sure to take alarm.
A few days, or, at the most, a few weeks, will suffice for its recovery, without the use of any medicine.
It is well, however, in such a case, to administer in
the course of the day, a few teaspoonfuls of a solution of one or two globules of arnica, of a medium
dilution, in a tumbler of water; a few small doses of
nux vomica, prepared in the same manner, will infallibly dissipate, the next day, or the day after, any traces
of the accident which may still remain.
Some children come into the world with the skin,
particularly the scalp, covered with a sebaceous
coating, so viscous and tenacious that water alone
will not suffice to remove it. It is very easily got rid
of by smearing it slightly with fresh butter, followed
by a warm ablution. We prefer this method to the
use of soap and water, which is sometimes irritating,
and of which, beside, the medicinal action is incontestable.
It is hardly necessary to add that the ablutions
should be given in a warm apartment, protected from
currents of air, and quickly enough to prevent the




FIRST CARE OF THE NEW-BORN.
water from becoming cold on the body of the child.
A bandage of linen, three fingers wide, applied to
the abdomen, will protect the remaining portion of
the umbilical cord. The real object of this bandage,
which should not be too tight, is to prevent hernia at
the umbilicus.  It is unnecessary in four or five days
after birth.
About this time, the skin of tile child commonly
changes color. From a red, purple, or rosy hue, it
becomes yellow, at the same time the epidermis
craclis and scales off. It is a natural phenomenon
that mothers and inexperienced nurses have sometimes taken for a disease; but is nothing with which
it is necessary to meddle.
The senses of newly-born infants are naturally
very delicate. Care should be taken to avoid exposing their eyes to too strong a light, and their ears to
a too loud noise; at the same time, it is better not to
carry these precautions too far. It is well, for example, that the child should accustom itself-and it does
it easily to sleep, in spite of the noise of conversation.
In some places, especially in the wine countries,
the matrons make it a duty to administer to the lyingin woman the rotie au sucre,# and regard it equally
indispensable that the infant, before taking anything
*This is a great cup of sweetened wine, with toasted bread soaked
in it. In the C6te d'Or, in the Haute Saone, the Jura, etc., not a
woman is delivered without being comforted with this heroic cordial.




FIRST CARE OF THE NEW-BORN.          59
else, should swallow a teaspoonful of pure wine.
Without considering this practice as very dangerous,
(although it might be so in certain cases) we consider
it, at least, quite useless.
We proscribe more explicitly the syrups of manna
or of rhubarb, administered previously to all nourishment, with a view of expelling the meconium.
" The health of man," says Hartlaub, " is in incessant strife with ignorance, and this struggle commences
with the first moments of his life.       #    *
Should not the least reflection suffice to convince us of
the injurious effects of such active medicinal substances upon a delicate being, whose organs are not
yet accustomed to external influences a  "e
Although we do not look upon manna and rhubarb
as very active medicinal substances, we subscribe to
the opinion of Hlartlaub.
This vulgar custom of purging the new-born, is one
of those old humoral traditions, which resist so much
the more easily the effects of time, that they have
their specious side, and seem founded in something
like reason.
The milk of a woman who has just been delivered,
differs from the milk of a woman delivered six months
since, in this, that it is less rich in cream and caseine
We may suppose it then, like the pure serum (whey),
endowed with laxative properties. Now as nature, in
her combinations, always shows herself possessed of
infinite wisdom, and admirable foresight, is it not




60       FIRST CARE OF THE NEW-BORN.
rational to suppose that the chemical composition of
the milk of a woman in child-bed, is exactly appropriate to the wants of the being to which she has just
given birth a Hence, the intention of physicians was
to supply artificially this provision of nature in favor
of the poor children, who, deprived of the maternal
breast, were destined to receive from the first, the
breast of a woman confined several months before.
But upon this point, as upon others, physicians
deceived themselves. In fact, the majority of infants
pass spontaneously the meconium, which at birth
is contained in the intestines. Laxatives are then useless, and beside, if the milk to be given them is unfortunately too nutritive for their young stomachs, we
doubt very much if the syrup of manna and rhubarb
are the ingredients best adapted to facilitate its
digestion.




DUTIES AND REGIMEN OF NURSES.         61
CHAPTER III.
NURSES-THEIR DUTIES AND REGIMEN.
THERE are circumstances, we have said, under which
mothers should not nurse their children, and which
even impose upon them the obligation of abstaining
from it. Such are abscesses of the breast, cracks in the
nipples, or any defect in the conformation of these
organs; the absence or bad quality of the milk; an
herpetic or syphilitic affection; any nervous disease,
such as hysteria or epilepsy, of which the maternal
milk would favor the transmission to the child; and
lastly, pulmonary phthisis, a feeble constitution, or indeed, one of those excessively impressible natures, who
make of everything a subject of irritation or chagrin.
In these various cases it is better to resort to artificial suckling, or to another nurse.
Artificial suckling is troublesome.  It requires
extreme care, and fatigues the mother almost as much
as natural nursing. But it has the advantage of
avoiding the interposition of a stranger between the
mother and child.
We recommend it, in consequence, to those mothers
who, not being obliged to labor for a living, are happily
at liberty to consecrate all their time to their homes,




62      DUvTIES AND REGIMEN OF NURSES.
and whom a bad conformation of the breasts, an accidental disease of these organs, or the want of milk,
deprive of the precious privilege of nursing.
The choice of a nurse, when this becomes indispensable, is a delicate and serious affair. I shall quote
word for word the reflections of a Swedish physician,
Rosen de Rosenstein, upon this subject, in his Tcraite
des JMalaadies des En faZts, one of the best works produced by the Old School
"A nurse," said Rosen, " should be of a tranquil,
gentle, moderate, gay and virtuous character. She
should be from twenty to thirty years of age, should
have been confined a little sooner than the mother,
and be accustomed to handle children. She should
be in perfect health, so that there should be no fear of
her communicating disease to her charge. Especially,
she should be exempt from the slightest taint of scurvy,
and her gums should be carefully examined, to be
assured that they are sound and firm; care also,
should be taken that she is free from any hidden
virus, cutaneous eruption, induration of the glands,
and every other affection which betrays a depraved
state of the fluids."
To this we would add, that careful inquiry should
be made concerning the family of the nurse, to ascertain if any of its members have suffered from any of
those terrible hereditary diseases, such as scrofula and
epilepsy, against the infection of which it is impossible
to be too carefully guarded. It would not be impossi



DUTIES AND REGIMEN OF NURSES.         63
ble, in fact, that the nurse herself should be infected,
although she had never presented the slightest symptom of it, and transmit with her milk the germ to her
nursling.
Rosen continues: "It is an advantage that the
nurse be rather fat than lean, and that her constitution should resemble that of the mother. She
should be able to suckle from both breasts, and the
nipples should be well proportioned; they should be
sufficiently irritable to become firm when the end of
the finger is passed over them, otherwise the flow of
the milk would be obstructed.
" The milk, to be good, should possess the following
qualities:
" 1st. The color should be of a bluish white; 2d, it
should have no odor; 3d, its taste should be very
sweet, and not salt or bitter —nor like that of the
first milk of a mother, when it begins to change, and
become real milk.  It is best, when it has the taste
of ordinary milk, diluted with a little water, and
sweetened with a small quantity of sugar; 4th, the
milk should have but little body, and should fall
readily from the nail upon which a drop has been
expressed, if the nail is ever so little inclined; and, if
the hand is suddenly shaken, there should remain no
whitish trace upon the nail; 5th, the milk should
make no impression on the eye, when a drop is let fall
into it; 6th, if, in allowing it to curdle, it gives much
curd, it is good for nothing; 7th, if, in allowing it to
6




64      DUTIES AND REGIMEN OF NURSES.
stand for several hours, it gives much cream, it is not
a good sign, which is also ascertained by weighing it,
for the lighter it is, the more cream it yields; 8th, the
older the milk is, the thicker it is —and the more
objectionable. If, then, one has to choose between
two nurses, one aged thirty years, with milk but a
month older than the mother's, and the other be but
twenty, with milk six or seven months old, the first,
though the oldest, should be preferred, other things
being equal."
Rosen enlarges afterward upon the regimen proper
for nurses, upon the kind of life they should lead, and
upon all the precautions they should take with respect
to their nurslings.
"It is not sufficient," says he, " to have a nurse who
possesses the qualities above-mentioned: the health of
the child still demands that she should observe a
proper regimen. First, she should, if possible, have a
spacious chamber, free from the passage of draughts of
air; she should keep moderately warm and observe great
cleanliness. The nurse ought not to expose herself imprudently to the cold, at least, her breasts should always
be well covered. If they are cold, she should warm
them before presenting them to the child; otherwise, it
will be likely to get a cough, or a cold in the head. I
should, however, be very far from advising a nurse
always to remain in her chamber; on the contrary,
she should be at liberty to go as she pleases into other
apartments, and to occupy herself with household




DUTIES AND REGIMEN OF NURSES.             65
affairs.  I have remarked, that from  shutting up a
good nurse in her chamber, her milk became changed;
but would recover its good qualities in a fortnight
after, if she was allowed to go and come in the house,
and occupy herself with some light labor.
"She should eat sufficiently, and at regular hours.
Wine, brandy, beer and coffee are not proper for her.
She may be allowed, although rarely, tea with milk.
It is unnecessary to be equally scrupulous with regard
to the choice of food.  The best kinds are those to
which she is accustomed, and which are most agreeable to her. She should, however, refrain from acids
and every species of onion.
" She may be permitted, from time to time, to partake of salt food,* but the child would soon be tormented with colic if she should eat peas, turnips, and
cabbage.    #      *    *     a      *     *     *    *
" A nurse who suckles well, is rarely taken with
her courses, and, if this does happen, she often suffers
pain. I have often distinctly observed that infants
who nurse at this time are made sick by it.  The
safest way is for the nurse to have her breast drawn
by another woman, and give only to the child, during
this time, clarified whey.      *      *       *      *
* The nurse by this means is excited to drink, and her milk
becomes in consequence more fluid. This she should do from time
to time, especially, if the child is observed while sleeping to have a
rattling breathing several times in succession, without having taken
too much milk.




66      DUTIES AND REGIMEN OF NIURSES.
" Exercise is indispensable for a nurse, as much on
account of her health, as for the production of good
nil.k, that is, milk not too thick, and which does
not sour too easily. Thus she should come and go,
and even work sufficiently every day to cause slight
perspiration. But she should take this exercise an
hour before eating, and not immediately after.
"If the child is not quiet enough to allow the
nurse to sleep well, she becomes feverish, and the milk
stops, becomes yellow and unwholesome, and she
should then have an assistant, in order that she may
sleep seven or eight hours a day.
" A nurse should know how to control her temper:
for if the child takes the breast soon after she has had
a fit of anger, it immediately suffers in consequence,
and has convulsive movements, or other dangerous
affections, which may cost it its life. Albinus relates
the following example: A woman gave her breast to
her child after a violent fit of anger; it was immediately attacked with hemorrhage of the eyes, ears,
nose, mouth, anus, etc., and died.
" It is not less injurious to give the child the breast
immediately after the nurse has had a fright; she
should, in such a case, have her breast drawn by another
woman, and take some suitable medicine before again
nursing the child."
Aconite is, in such a case, the medicine to which
she should have immediate recourse. Five or six globules of the twelfth dilution, are to be dissolved in a




DUTIES AND REGIMEN OF NURSES.         67
glass of water, of which she should take a few teaspoonfuls every two hours, or at greater or less intervals, according as she has been more or less seriously
affected by her fright. But in all cases, it is important that the child should not take the breast under
twenty-four hours from the time the nurse took the
last teaspoonful of medicine.
"If the nurse," pursues Rosen, " suffers from any
anxiety of mind or grief, the child will not fail to retrogade and lose its health. The cause of this state of
mind, should be ascertained, and if there is no remedy
for it, the nurse must be changed.
"If the nurse gets sick, the child should be taken
away until she has recovered. During this tinme, it
should take the milk of another person, or the food
of which I have before spoken.
" There is no danger in changing the nurse, for any
of the causes mentioned, if the one taken in her place
has the requisite qualities, and her milk be a little
younger than that of the first, six weeks at the most;
otherwise the child may easily have a bad diarrhea.
" Tlle nurse should present the breast to the child
whenever it is hungry or thirsty, but not every time it
cries; otherwise, the stomach of the child will become
surcharged with aliment it cannot digest, and the
milk, always tending to its usual alterations, becomes
acid, acrimonious, and causes vomiting and colic.
Mothers and nurses regard these vomitings as very
advantageous to the child; without doubt, they are as




68       DUTIES AND REGIMEN OF NURSEs.
useful as those which happen to adults, who eat and
drink so often during the day, that they are sometimes forced to vomit: but a nurse will do well to
accustom the child to take the breast only at regular
hours, and when it really needs it. She will know by
the following signs, if it is in need of it: 1st, if a
certain time has elapsed since he took it last; 2d, if
it fixes its eyes upon the nurse, following her with the
eyes as she comes and goes; 3d, if joy is expressed in
the eyes of the child at sight of the breast; 4th, if in
presenting the end of a very clean finger to the mouth,
it takes hold of it and commences to draw.
" The nurse ought not to give the breast to the child
immediately after her meals, otherwise the milk sours
quickly and causes co-lic; nor in the morning before
taking something, because the milk has then necessarily a little acrimony.
"To prevent the child from becoming deformed, he
should nurse alternately from both breasts, and for the
same reason, it is improper always to carry the child
on the same arm.
" In conclusion. a nurse who is subject to fall asleep
in her chair, should not be permitted to seat herself
near the fire with the child; but too many accidents
have resulted from this cause."
These wise counsels, given by Rosen, are addressed
to mothers as well as to nurses.  We earnestly recom.
mend them to both.




DUTIES AND REGIMEN OF NURSES.        69
CHAPTER IV.
NURSING BOTTLES
THESE were formerly simple bottles with a neck, to
which the nurses attached a little roll of fine linen or a
bit of sponge, and of which they made use to feed their
nurslings. But since artificial suckling, brought into
notice by the hygienists, has become as it were a custom, industry has taken in hand the simple invention
of our mothers; nursing bottles have become the objects of a special branch of commerce, and several persons have attached their names to successive improvements they profess to have made; so that we have now
the bottles of Darbo, Breton, Obin, Charriere, etc.; all
by the way constructed upon the same principle, and
iwhich can be embraced in one common description.
The primitive nursing bottle, of which we have
spoken, notwithstanding the apologists it still finds,
has a very serious fault: the vacuum, more or less cornplete, necessarily produced upon the surface by the
progressive diminution of the liquid, hinders its flow:
suction then becomes difficult, and even impossible,
if not interrupted from time to time. Now, experience and reason both demonstrate that there is nothing more prejudicial to the health of a child, especially to a feeble one, than repeated ineffectual efforts




70              NURSING BOTTLES.
at suction. For the rest, we agree with the old
ladies, that they were not expensive, and easily kept
in repair; but these advantages do not, in our opinion, justify their use.
Nursing bottles are now made with two openings,
the one intended for the passage of the liquid, the
other, for the entrance of the external air; so that a
vacuum is no longer possible, and consequently there
is no difficulty in the suction: and we now rarely see
a child become impatient while drinking, or desist
from his efforts, to cry. The various ways of arranging
this extra opening, without causing the liquid to
escape when the vessel is filled, constitutes, in part,
the difference which distinguishes the bottles of the
different manufacturers. But their ingenuity has not
stopped here: for in place of the bit of sponge or linen,
they have substituted an emery stopper, perforated
through its center, and covered with an artificial
nipple; this is sometimes but a simple adjustment of
elastic cork, of caoutchouc or of flexible ivory —is
oftener made of a prepared cow's teat, whose flexibility is preserved by immersion in cold water. This
last would be undoubtedly the most suitable, were it
not for the difficulty of keeping it clean, its liability
to become obstructed and to deteriorate; for these
reasons, we prefer the flexible ivory nipples of MI.
Charriere, notwithstanding their great fragility, which
makes them sometimes expensive. All the efforts of
these manufacturers, however, have not been able to




NURSING BOTTLES.               71
remove the prejudices still existing, against the use of
nursing bottles. These are evidently attributable to
the great care required by artificial suckling, care
that mercenary nurses too often neglect; and especially to the general ignorance respecting the composition of the food, to be given to the nursling.
What liquid is the best adapted to replace to the
new-born child, the mother's milk, of which he is deprived? This is the great question, up to the present
time badly understood, badly stated, and consequently
badly settled.
Chemistry and physiology, both demonstrate: 1st,
that the new-born child, whose digestive powers are
gradually developed, needs from day to day, an aliment more and more substantial; 2d, that with women in good health, the milk passes through precisely
the series of transformations which progressively adapt
it to the increasing demands of the child, from the day
of the labor, up to the period of weaning.
This granted, it'follows that no animal milk, that is
to say, no substance of a fixed nature, is a suitable
substitute for the maternal milk. The efforts of art
should consequently be directed to the discovery of a
variable formula, by means of which to imitate, in all
its phases, the work of nature.
We give here the recipe which we have already
published in another work, and the excellence of
which, we have tested in numerous cases.




72              NuRSING BOTTLES.
Take of beef and veal, each, three ounces, boil them
six hours in a quart of water, add a little salt-skim
when cold, —mix this broth with equal parts of cow's
milk and water, and warm it a little for use.* Suppose
we increase every day the quantity of meat in the broth,
and of broth in the mixture, so that the milk shall finally
disappear, and I venture to affirm, that we shall have
solved one of the most important questions in the
hygiene of children.
Let mothers remember these precepts; let them
have the courage to put them in practice, should circumstances prevent their following the course of nature, and they will not be slow to acknowledge, with
us, that nursing bottles, in a majority of cases, are
preferable, for their children, to the breast of a
stranger.
* Viande de bceuf, viande de veau;
De chaque, 60 grammes;
Un litre d'eau.




OF THE'CRIES OF CHILDREN.         73
CHAPTER V.
OF THE CRIES OF CHILDREN.
WHIEN a child cries, we may be sure that it experiences some want, discomfort, or actual pain. The
first thing to be done then, is to discover the cause of
his cries.
This cause, in the child just born, is found in the
impression which the air, a medium colder than that
to which he is accustomed, suddenly produces on his
body, in the introduction of this air into his lungssounds, light, the contact of the hands, of linen, etc.
He gives evident signs of the excitement these cause
him, by the rapid movement of his limbs, sometimes
by sneezing, and always by cries.
From the tone and degree of intensity of theselast,
we draw inferences which are rarely incorrect. "A
child," says M. Billard, "may be considered vigorous,
and likely to live, if his cry is sustained, sonorous and
easy, such a cry always indicates free and full r.espiration; ordinarily, a sign of health and vigor in the newlyborn. We are rarely in error, in relying on this observation; we see children, having a certain degree of
plumpness, and robust limbs, hardly able to breathe,
and crying with  great difficulty, who perish from




E74        OF THE CRIES OF CHILDREN.
asphyxia. rl' apoplexy, while others, more feeble, if we
judge b)\ heir external appearance, but with a vigorous and free cry, undergo, without danger, the sudden
changes that the commencement of extra-uterine life
imposes upon them."
The cause of the cries of children, after this first
commotion has subsided into a refreshing sleep, is not
always so easy to indicate.
"There are children," says AM. Billard, "who cry
without its being possible to assign a cause for it; and
whom, notwithstanding their continual agitation and
wakefulness, we do not see pine away. These children are distinguished among all those brought to the
Foundling IIospital, by the pertinacity of their cries;
and the nurses, who dread to take charge of them,
vulgarly designate them by the epithet. well enough
merited, of enfants me'chants.  This continual excitation proceeds, no doubt, from a greater sensibility in
them, than in other children."
Fortunately for the nurses, and especially for mothers, les enfants meohants are the exceptions, and nearly
always, with a little care, they can succeed, except in
cases of real disease, in appeasing the cries of their
children.
The want of nourishment, the discomfort caused
either by a fold in their linen, or in their bed; an uncomfortable position, or one too long maintained; cold;
the irritation produced by the presence of urine, or
tecal matter upon the external parts; the want of sleep,




OF THE CRIES OF CHILDREN.           75
and lastly, the pain caused by the process of dentition,
and other maladies, are the usual causes of the cries
of children.
Whether the cries are caused by hunger, is easily
determined, by considering the length of time that
has elapsed, since the child has taken food. "We
must not always conclude," says M. Billard, "because
a child is quieted by offering it the breast, that hunger is the cause of its cries; for there are children of
such insatiable voracity, that they never refuse the
breast when it is offered them."
It should be observed, that this greediness, far from
being an advantage to the child, has often no other result than to fatigue the stomach, and cause sometimes
a disease of this organ. It is desirable, then, to accustom the child to take the breast, from the beginning,
only at regular intervals, taking care to nurse it frequently, in proportion as the child is young.
We should ascertain if the cries of a child arise
from some derangement of its dress, or bed; we
sometimes, too, succeed in soothing them, by
changing its position, if it has lain long in one
posture.
Care should be taken to preserve a proper temperature in the chamber, and above all, not to allow it to
remain long wet by urine, or soiled with excrement.
Neglect of this last precaution is liable to cause cracks
in the groin and breech which are probably very painful; it is customary to powder these parts with lyco



76         OF THE CRIES OF CHILDREN.
podium, but we absolutely protest against this custom,
for the reason that lycopodium  possesses medicinal
properties, slightly marked, it is true, but capable,
nevertheless, of exercising a bad influence upon the
general health of the child. If necessary, we may
replace the lycopodium, by the use of a powder of
worm-eaten wood, a substance absolutely inert.
The want of sleep, as we have said, becomes sometimes a cause of these cries.
When wakefulness is not produced *by a morbid
state, one succeeds often in putting them to sleep,
by singing a low and monotonous air; this method
is used the world over.
As to the administration of opiates, as a means of
procuring sleep, and especially the syrup of poppies,
of which such monstrous abuse has been, and is still
made in certain countries, we cannot denounce it in
terms too energetic.
During the first three months, children that are
properly cared for, cry but little. But at the fourth
month, the period at which dentition generally commences, it is different; it is then only that other
means may be necessary to calm them than the breast,
or the nursing bottle. One may facilitate the coming
of the teeth, by passing the finger frequently over the
gums, and by giving them a piece of dry root of marsh
mallow to bite upon; but if this hastens and facilitates
the protrusion of the teeth, the pain which accompanies it is not lessened. There is indeed no way of




OF THE CRIES OF CHILDREN.            77
avoiding this, and it is best, quietly to let nature take
her own course.
During the period of dentition, children are relaxed
and their stools become green.  They drool, are rest.
less, and cry constantly. Their cries have at this time
an acuteness which denotes real pain. They have some
times cough, or slight ophthalmia, and almost always
redness, heat, and a little swelling of the cheeks. If
they are constipated, it is well to give them  a littie
whey. As to medicines, properly speaking, it is
better not to have recourse to them, except upon the
occurrence of symptoms sufficiently marked to constitute a real disease, as for example, violent diarrhea,
tympanitis, convulsions, etc. Chamomilla, in these
cases, is the medicine to which we should give thL
preference. It may be administered of the twelfth dilution, or of the twenty-fourth, if there is a predominance of nervous symptoms. Two or three teaspoo:
fuls, in the course of the day, of a tumbler of water,
in which has been dissolved one or two globules of
this medicine, will almost always suffice to restore the
normal state.  Aconite and Belladonna would only
be appropriate in the cases, fortunately rare, where
dentition has brought on either an intense fever, or
signs of cerebral congestion, or violent convulsions.*
Dulcamara administered of a medium dilution, in
* Belladonna, in this last case, should be administered on the
first appearance of the symptoms.




78        OF THE CRIES OF CHILDREN.
the manner we have just indicated for chamomilla,
appears to me preferable to this last, especially in
lymphatic children, when we have to combat an
ophthalmia occasioned by dentition.
I never consider it necessary to give to the nurse
B-Je medicine demanded by the symptoms of the child;;or if she herself has no need of it, it is not unlikely
that she would experience from it, and very uselessly,
some unpleasant consequences. It is one of the great,dATvantages of hoinceopathic medicines that they may
be administered to even the youngest and most delicate children, without exciting repugnance.
When the cries of a child are caused by a disease
independent of dentition, it is for the physician to:ascertain its nature and apply the remedy.
Physicians have sought to deduce from the rhythm,
t:one and duration of the cries, the character of the
disease which excites them. But with the exception
of the affections of the air passages, croup, for example,
or cedema of the glottis, which causes a peculiar cry,
it seems to me impossible to attach to them a symptomatic signification.
Excessive crying, independently of the cause which
produces it, has a danger of its own. We sometimes
see the efforts which they cause, produce hernia, and
even (much more rarely, it is true) cerebral congestions. Beside, as we have said, they express suffering which should be avoided by every possible means




WEANING.                  79
CHAPTER VI.
WEANING.
THE period of weaning is a difficult one, both for
the child and the nurse, when one commits the imprudence of entering upon it at an improper time,
or without having properly prepared for the transition.
The termination of the first dentition seems to be
the time assigned by nature for this change; but we
are rarely to be governed exactly by this indication.
It appears to me safer and even more logical to be
guided by the health of the nurse and the constitution
of the child.
When the nurse has but little milk, or milk of a
mediocre quality, it is better to hasten the time, in
order that the child may have nourishment of a more
abundant and substantial quality. In this case recourse should be had to artificial suckling, according
to the precepts laid down in the chapter on Nursingbottles. In this manner we shall be able gradually
to substitute solid food in place of milk.
For a weakly and ailing child, it is more necessary
to retain the breast of the nurse to a late period than
for a robust and healthy one; provided always, that




80                  WEANING.
its feeble state is not caused by her bad health or
defective milk.
In any case, it is not when the child is sick that a
change should be made in its food, unless the change
is made as a means of cure.
If, for example, it is foreseen during the first two or
three months that some unavoidable circumstance
will soon render it necessary to wean the child, it is
i _fiictely better to proceed to it at once, than by postpcning it a month or two, have it occur at the period,
El.Tays more or less painful, of teething.
We have recently had occasion to verify the importance of this precaution.
A lady had nursed her child but two months when
her father was attacked with a disease which was
expected to be fatal. The catastrophe was believed
to be inevitable. It could not be delayed more than
five or six weeks. The lady was devotedly attached
to her father, and could not reconcile herself to the
idea of his death. It was to be feared, in consequence, that the sad event that she dreaded, without
being yet willing to believe, would produce a violent
perturbation from which her child could not fail to
suffer. We advised her to wean it. She complied
the more willingly as the child evidently began already to suffer from  her inquietude.  Everything
occurred as we had anticipated. The father died,
and the grief of the daughter was so violent as to
produce an illness of several weeks' duration. But




WEANING.                   81
the child experienced no inconvenience from it,
when it would perhaps have died had it continued
to take the breast.
In some countries mothers make it an almost
sacred rule to nurse their children nine months. This
comes, no doubt, from the idea that nature intends that
the child shall receive its mother's milk, for exactly
the same length of time that it lived in her womb.
It is, however, one of those superstitious fancies that
are totally without foundation.
When from the eighth to the tenth month a child
begins to digest without difficulty other food than the
milk of its nurse, it is well to habituate it to the
change, and' to give it the breast less frequently in
proportion as it eats more. It should not take the
breast until a certain time after having eaten, otherwise, it will be likely to suffer from indigestion. The
nurse should especially avoid giving the breast if,
after having eaten, it appears to be thirsty; water
slightly sweetened is then the only suitable drink.
We say slightly sweetened, because the use of
sugar is so often abused. This substance, which, when
used moderately, aids digestion, irritates the stomach,
diminishes the appetite, and produces acidity and
spoils the teeth when taken in excess.
In fact, sugar mixed with bread crumbs and placed
in contact with a mucous membrane, the tongue, for
example, is almost instantaneously transformed into
an acid called by chemists pectic acid. It follows




82                  WEANING.
then that it is in exciting the stomach in the manner
of condiments, and especially of acids, that sugar aids
digestion.  But we can easily imagine the effects
upon the economy of this artificial stimulus, when
from being repeated every day, its use becomes a
habit, and the stomach can no longer do without it.
The digestive power is lost, the breath becomes sour,
and the teeth, constantly bathed in an acidulated
saliva, undergo a slow decomposition, which destroys
the enamel, turns them dark, renders them brittle,
and finally produces caries.
I am aware that individual instances may be cited
of persons who have all their lives consumed large
quantities of sugar, and who have nevertheless attained to an advanced age with very fine teeth.  But,
these are constitutions so privileged and robust in all
respects, as to resist the most extravagant and disor
ganizing regimen.  A particular idiosyncrasy, or
perhaps a natural predominance of the alkaline principle in the saliva, and the gastric juice, may suffice
to explain these exceptions.
It is a matter of common observation, that the
secretion of milk, like that of all the other glandular
fluids, becomes abundant in proportion as it is frequently solicited; the contrary proposition being but a
rigorous corollary from this, it follows that, in proportion as the breasts are less frequently drawn, the milk
will diminish, and thus by lengthening gradually the
intervals of nursing, the nurse will avoid both for




WEANING.                  83
herself and for the child, many of the inconveniences
of weaning.
Rosen advises, that when it is finally determined
to withdraw the breast, the nipple should be rubbed
with some bitter substance, like the extract of wormwood, whose disagreeable taste would not fail to
deprive the child of all desire for it.
Much has been said, and much written upon the
nature of the food which should replace the mother's
milk. Physicians agree upon this point, that the
lightest and most digestible substances should have
the preference, and by one of those inconsistencies so
common, they agree again in prescribing the most
indigestible things in the world, to wit: cow's milk,
pap and panada. Happily, the error they commit,
consists less in prescribing these substances to children, whose gastric activity readily accommodates
itself to them, than in calling them, as a general rule,
easy of digestion. The Inajority of adult stomachs
find milk and pap of difficult digestion; children digest them much better, but they, especially at a certain
age, would do quite as well with a diet of meat broth.
A bit of roast beef is the habitual plaything of English children; they suck it and bite it with their gums,
and it has thus the double advantage of nourishing
the body, and facilitating the protrusion of the teeth.
An excellent food, much preferable to pap, and
which children may take from the hour of their birth
to that of their weaning, and afterward, is a sort of




84                  WEANING.
broth much used in Germany, and in the north of
Europe, prepared with milk, warm water and grated
biscuit.  But the biscuit of which we speak, does
not in the least resemble the fancy article sold in
France, under the same name. It is a kind of very
light and firm cake, nearly resembling, with the exception of the flavors, which are left out, what is sold in
Paris, under the narme of biscottes. This biscuit may
be replaced by wheat bread, cut in slices, and dried
in an oven; the dried bread is then grated and boiling
water poured upon it, a little sugar is then added, and
lastly, some milk. The younger the child the thinner
should be the mixture.
It would be well to vary the food of infants, by
alternating this preparation with a porridge made of
semolina, sago, etc.; but, as a general rule, they
should not be kept upon an exclusively milk diet after
their first year, and if there is any predisposition to
scrofula, it may be necessary, at this period, to deprive
them of it entirely.
Lastly, there is above all, an essentially restorative
and tonic agent, imperatively called for by children
of whatever constitution, to wit: the open air. " It
is especially in the earlier years of life," says Jean
Jacques Rousseau, "that the air acts upon the constitution of children; it penetrates their soft and delicate skins, by every pore, affecting powerfully their
growing bodies, and leaving upon them impressions,
which are never effaced."




SECOND PERIOD OF CHILDHOOD.          8.
CHAPTER VII.
SECOND  PERIOD  OF CHILDHOOD.
TEE physical and moral education of children,
must be regulated, in each case, by a multitude of
different circumstances, such as constitution, sex,
climate, character, intellectual aptitudes, etc., etc.
There are, however, certain hygienic rules applicable
to all; and a summary exposition of these rules will
form the subject of the present chapter.
Notwithstanding the sophisms of Rousseau, who
professed to commence the reformation of humanity
by imposing upon it a sort of Pythagorean diet, man
is essentially omniverous; that is to say, he is intended at once to eat grains, fruits, roots, herbs and
the flesh of animals. This is shown by the conformation of his dental system and digestive apparatus;
and we see him in all parts of the universe, instinctively conforming to this natural tendency of his organization.
It is true, his tastes, or rather, his wants, vary a
little in the different latitudes in which he is forced
to live. Men in cold countries, consume larger quantities, and live more especially upon animal food, than
the inhabitants of warmer latitudes. The physiological
reason of this difference is easily understood, but its




86        SECOND PERIOD OF CHILDHOOD.
explanation does not belong to our subject. The only
point upon which we are called upon to express ourselves, is this: Is it proper that children should live
in the same manner as adults?
It is understood that we speak here of children of a
certain age, and not of those who are still at the
breast. But if, in the opinion of all the world, it
would be absurd to confine the latter to the kind of
food proper for adults, it would be but little more reasonable to submit them to it from the day that they
are weaned.
In nature everything operates by gradual transitions.
The teeth of children, have not the solidity of those
of men; they require, then, food which is easily masticated. And again, their stomachs, accustomed only
to milk and liquids, would not long bear up under the
necessity of digesting only solid substances and strong
meats. Thus the instincts of children, lead them to
prefer tender and juicy food, cream, blanc-mangegelatinous meats have almost always their preference;
and it is only gradually, that we see them accustom
themselves to eat like their parents.
Children digest rapidly; growth in them facilitates
assimilation; the least abstinence depresses them, and
if prolonged, would very soon be prejudicial; they
should then eat often. But however frequent their
repasts, it is important that they should be taken at
regular hours; otherwise they will eat the greater
part of the time, without appetite, without need, and




SECOND PERIOD OF CHILDHOOD.          87
sometimes, for want of something else to do, or for the
sake of amusement. Now nothing is more pernicious
to their health, than this bad habit that they contract
so easily, of constantly disturbing, by a useless repast,
the still unfinished digestion of the last one taken.
Children who live in this manner, are almost always
pale, delicate, suffering, and without ardor for study,
or even for play.
A vegetable diet, and especially the habitual use
of pastry and farinaceous food, are thought, like milk,
to favor in children the lymphatic temperament, and
consequently scrofula. We believe this opinion wellfounded; but, I think at the same time, that the permanent action of a cold and humid atmosphere has
far more to do, than a vicious alimentation, with the
grievous results attributed to this cause. The brisk
air of mountains, on the contrary, produces an opposite effect. Thence comes that softness, flabbiness
and decoloration of the flesh among the inhabitants
of the gorges and low places, while a sanguine
temperament, activity, vigor and courage, are in
all parts of the earth distinguishing traits of mountaineers.
Unfortunately, man has not the privilege of
choosing where he will be born, and rarely the choice
of the country where he will pass his life.
But if the influence of climate, when it is of an
injurious nature, is an irremediable evil, it behooves
us, when forced to struggle against it, to diminish as
s




88        SECOND PERIOD OF CHILDHOOD.
far as possible its effects, by means of a tonic alimen
tation. The English, in this respect, have perfectly
comprehended their situation, and reason among
them has corroborated instinct. This is why they
turn their fields into pastures, and give their children
more roast-beef than bread.
A child in good health should have an appetite.
The absence of appetite, among children, is then
always an indication either of a disease, more or less
latent, of the lack of exercise, or of some vicious habit
which we should endeavor to discover. It would in
any case be rendering them no service to oblige them
to eat without being hungry; for whatever they eat
in this manner, so far from being beneficial to them,
would in all probability but augment the disorder of
their health.
Some children manifest an invincible repugnance
for particular articles of food. To constrain them in
this respect, appears to me unwise. It is better to
leave the matter to time; it will change their tastes,
if these ought to be changed.  But, we have
unq'uestionably instincts which  indicate what is
proper for us, and the natural repugnance which we
experience for certain articles of food, is proof that
these are not adapted to our stomachs. Then, of
what use is it to torment children for trifles? They
have always enough of inevitable trouble, without
our procuring it for them now, under the vain pretext
of sparing it to them in the future.




SECOND PERIOD OF CHILDHOOD.          89
Nevertheless, when  children manifest a morbid
appetite for acids and green fruits, we may mistrust the state of their health; for even although these
substances should not seem to incommode them, the
very facility with which their stomachs support them,
proves that there is something abnormal in their condition. We should not forget, beside, that children
are as fond, and even more so than men, of excited
sensation, and that their desires are consequently far
from being always an expression of real wants.
Independently of a regular and well chosen diet,
many circumstances are still necessary to the health
of children, and to the free development of their physical powers. Habits of cleanliness, for example, are
of rigorous necessity.
They are to be bathed, as we have said, at the
moment of their birth, and there is no reason why
this bath should not be daily repeated. This is one
of those good habits which, once formed, cost nothing,
and may be continued through life to our infinite
advantage.
Be it well understood, however, that these ablutions
should always be made with cold water.
Cold water is a tonic which renders the skin firm
and fortifies it against inclemencies of the weather.
Children should then be accustomed to it from the
first week of their birth. In no country, in no season,
can cold baths, or cold ablutions cause danger or any
serious inconvenience, and it is only important that




90        SECOND PERIOD OF CHILDHOOD.
the baths should be taken quickly, in proportion as
the temperature of the water is low. Reduced to
simple and rapid immersions, they can have no other
effect, even in the midst of winter, than to excite in
the surface a salutary reaction, provided that the skin
be properly dried, and that the bath be followed by a
little exercise.
After what precedes, it is useless to add that we
approve, in summer, of river and sea bathing. The
bath is beside, in this case, an opportunity for taking
exercise. The custom of teaching girls as well as
boys, to swim, has gained ground within a few years
past in our large cities, and it is to be wished that this
custom might spread rapidly in the provinces, and
especially in certain parts of the country, where the
most intolerable want of cleanliness is still common.
Children should be combed every day. This recommendation, which among well-bred people will appear
superfluous, and even puerile, will on the other hand
seem  extravagant to more than one peasant. We
could cite many villages of Bretagne or Franchecomte, where the children are literally devoured by
vermin, under the fine pretext that they are a sign
of health.
It would be difficult to indicate the origin of this
revolting maxim; but, it is pretty certainly a false
one.
In fact, the spontaneous production, in the hair of
children, of these repulsive parasites, is really a




SECOND PERIOD OF CHILDHOOD.         91
symptom of disease, or at least of a bad condition of
the body, which ought to be corrected.
In some countries, mercurial ointment is resorted
to for the purpose of destroying them. This, in truth,
is an expeditious nmode; but it is not less dangerous
than prompt. Its most common result is to repel
upon the organs of the senses, or upon the brain, the
morbid action which was existing in the scalp, and
hence, to produce deafness, amaurosis, ophthalmia,
and often even fatal meningitis.
The children among whom these parasites are
spontaneously engendered, are pale and emaciated, or
bloated. They are subject to chilliness, on the least
exposure to- cold; lymph is abundant, the blood is
poor and circulates badly. They have generally blue
eyes, and light hair, with an earthy or diaphanous
skin, and in a word, all the signs of the lymphatic
temperament.
These parasites most commonly make their appearance between the seventh and twelfth years, in those
who are subject to them at all.
A species of tinea capitis, most frequently the tinea
favosa, very often accompanies them, and as a consequence of this last, engorgements of the parotid, and
submaxillary glands, and of the cervical ganglions, are
not unfrequently superadded.
Children in this state, require the immediate care
of their mothers; a good regimen is the first condi



92         SECOND PERIOD OF CHILDIOOD
tion of a return to health; that of boarding schools
is generally fatal to them.
The spontaneous generation of vermin, constituting, as we have said, a really morbid state, it is evident that combing frequently, will not alone suffice to
remove them; but it is at least incontestable, that to
neglect it, augments to an almost intolerable degree,
the discomfort they occasion.*
I shall say but little of the dress suitable for children-the subject is worn out —exhausted; there are
nevertheless, abuses which still exist.
All the world knows, for example, how pernicious
to young girls, is the use of corsets. If they are
badly made, they deform the figure; if they are well
made, they exercise upon the lungs and the abdominal
viscera, a compression fatal to the development of
these organs.
I do not hesitate to pronounce them among the most
frequent causes of phthisis pulmonalis, aneurism, gastralgia and spasms of the stomach; and especially, in
consequence of the obstacle they offer to the circulation, and free return of the venous blood to the
heart, it appears to me evident, that they have the
effect of keeping up a sort of passive congestion of
* Sulphur and Dulcamara, which are the specifics for tinea favosa,
are at the same time, those of the verminous diathesis which accompanies it.




SECOND PERIOD OF CHILDHOOD.         93
the organs of the abdomen, and thus causing the
greater part of the affections of the womb with which
women are so often affected.
"The use of corsets," says Hartlaub, "' is very injurious to young girls, and ought to be entirely prohibited, unless indeed, they are made so large as not
to cause the slightest pressm-a,.  It is an error to suppose that corsets are necessary to sustain the mammnee, and maintain the upper part of the body in a
vertical position. Instead of this, they actually hinder the breasts from taking a regular conformation,
and render them soft and flabby. They impede the
action of the muscles, especially those of the back,
weaken them and render them incapable of sustaining
the body erect; from  whence results, as may be
remarked in the majority of women, the impossibility,
without external support, of holding the upper part
of the body in a proper position; and to nature is
attributed a fault, produced by the means employed to
correct her pretended imperfections. An incontestable proof of this truth is, that boys, who do not wear
corsets, generally stand and walk with more grace
and firmness than  girls.  The want of exercise,
however, is not without its influence in producing
that relaxation of the muscles, which causes the bodies
of many women to yield when their corsets have been
removed. Finally, the whalebone placed in the back
uf the corsets to sustain the eyelets, twisting and
rending little by little, alternately in different diree




94        SECOND PERIOD OF CHILDHOOD.
tions, produces an unequal pressure, which joined to
other causes, may contribute to produce a more or less
considerable curvature of the spine."
It is beside, easily understood, that corsets are
the more injurious to young girls, in proportion as
they are delicate and undeveloped. We think, decidedly, that if they must absolutely wear them, they
ought not at least to commence their use before the
age of twelve or thirteen years. And then, we hasten to add, they must be worn loose and without a busk.
In general, all kinds of pressure produced by dress,
is injurious to the health of children of either sex.
It is then essential that their clothes should be
large enough to allow the most entire freedom of movement. They should be light without being cold, but it
is especially important, that they should not be too
warm. To cover children unnecessarily, with the
idea of avoiding cold, is just the way to provoke the
evil it is intended to prevent; for they become more
sensitive to changes of the atmosphere, the less they
are habituated to bear them.
Beside, to surround children -tith excessive precautions, evinces misconception of their destiny,
and a lack of proper foresight with respect to them.'A mother fails in her mission," says Jean Jacques
Rousseau, "when she makes an idol of her child,when she nurses his feebleness to prevent him fiom
feeling it, and, hoping to screen him from the laws of
nature, protects him from all rude effects and impres



SECOND PERIOD OF CHILDHOOD.         95
sions, without thinking how, for the sake of saving
him a few temporary inconveniences, she accumulates
future evils upon his head, and how barbarous a precaution it is to prolong the feebleness of the child, to
that period, when he must endure the fatigues of the
man. Thetis, in order to render her son invulnerable, plunged him, says the fable, in the waters of the
Styx. This allegory is clear and beautiful.  The
cruel mothers of whom I speak, do otherwise: by
plunging their children into effeminacy, they prepare
suffering for them, and open the door to evils of every
kind, of which, afterward, they do not fail to become
the prey."
The author of Emile, one or two pages farther on,
adds:
"'Experience proves, that more of those children
die, who are delicately reared, than of those who are
more exposed, and, provided one does not go beyond
their strength, we risk less by accustoming them to
the hardships they are, in all probability, destined to
support at a later period. It is well to harden their
bodies to the changes of the seasons, the climates and
the elements-to hunger, thirst and fatigue-to dip
them in the waters of the Styx. Befbre the habits of
the body are formed, we can give those we wish,
without danger; but when once fixed, change becomes
perilous."
We perfectly agree with Rousseau in these opinions.




96        SECOND PERIOD OF CHILDHOOD.
After the quotations we have made, it is hardly
necessary for us to say how much importance we
attach to corporeal exercise, in the education of children. The open air and exercise are almost as indispensable to them as the food they eat.
Deprived of this double stimulant, all their functions
are deranged-they only half exist. Their faces become thin; they no longer eat, or have capricious appetites; their fibers become relaxed, and their muscles
atrophied. They become irritable, weak and cowardly, and the least effort overcomes them. If, at the
same time that they are condemned to this deplorable
inaction, a constant effort is made to excite their young
minds, it may be that, for a time, these will gain, at
the expense of their bodies; but not very long; these
little prodigies, as they are called, will not live, or if
they live, they will probably be but men of moderate
abil ities.
The sterile precocity of these unfortunate children,
resembles those insipid fruits, whose maturity is forced
by warming the roots of the tree which bears them.
Let us remark beside, that the intellectual education
generally given to children, has, independently of the
radical vice of being premature, the not less injurious
one of perverting the judgment, and spoiling the
character. Instead of addressing the reason, little
beside the memory is cultivated; instead of being
contented to inculcate in them a love of goodness,
for its own sake, they are only excited by the van




SECOND PERIOD OF CHILDHOOD.         97
ity of surpassing children of their own age. Hence
that fever of self-love with which we are inoculated in
our cradles, by the vanity of our parents; a fatal and
tenacious fever, that no remedy can cure, whose paroxysms every day renews, and which constitutes the
misery of mankind.  But this does not belong to our
subject.
It does not require a great effort of intelligence to
comprehend the happy effects of gymnastic exercises,
upon the development of the human body. It is a
truth of such common observation, and so incontestable, that it would be superfluous to demonstrate it
here. Those. occupations which exercise a part of the
body only, give to this part, as every one knows, an
extraordinary  preponderance of strength.  Everybody has remarked, for instance, the prominence of
the shoulders of bakers, who exercise daily the deltoid
muscles. A muscle of the fore-arm, called the pronator radii teres, acquires almost always in blacksmiths, such a volume, that their profession has been
frequently recognized by this sign alone. Now what
partial exercise can effect for one muscle, general
exercise can do for the whole body.
Among the ancients, Gymnastics were the foundation of education. The Spartans attributed to this
cause, and with reason, their vigor, both of soul and
body. Perhaps it would not be an exaggeration to
say, that it was to this also, that the Greeks owed, for
a long time, their independence.




98        SECOND PERIOD OF CHILDHOOD.
The tendency of modern civilization has been, to
assign to Gymnastics but a secondary place in the
plan of education.
Formerly, the physical prevailed over the moral
man; it is so much the contrary, in our days, that one
is tempted to believe, from the manner in which many
parents raise their children, that in the human duality
they consider the body as the accessory part. In
modern times, we do for our animals, precisely what
the Greeks did for their children. The cattle-breeders
of Perche, of Normandy, and of Yorkshire, seem alone
to have profited by the example of the Spartans;
but does it not seem a strange mockery, in view of
the prodigies effected by training upon cattle and
horses, that no effort is yet made, by anthropologists, in favor of the physical amelioration of the
human race!
Nevertheless, let us be just.  England has her
boxers, as the Peloponnesus had its wrestlers. This
savage passion of the English for pugilism, has it not
its good side, and may not the human training, methodically practiced in London, for a detestable purpose, be destined, in changing its object, to introduce
certain rules of hygiene into our habits, whose benefits it will be almost impossible properly to appreciate?
A professor of the Faculty of Medicine of Paris,
M. IIyppolite Royer-Collard, published a few years
since, a memoir on this subject, full of interest.




SECOND PERIOD OF CHILDHOOD.          99
The English boxers, before their appearance in the
ring to fight, as formerly the gladiators of Rome,
or the beasts of the circus, are subjected for several
months, to a regimen of which the effect is to remove every trace of adipose matter, and replace the
fat with muscular fiber. They are, in a word, trained
exactly like race-horses.
Experience proves, and this is the important part
of the matter, that this regimen produces no inconvenience, but triples the strength, and consolidates the
health. Here is then, for the hygienic physician, a
grave subject for meditation, and M. Royer-Collard,
has treated it with all the gravity it deserves.
It is not impossible that, when a few years' experience shall have extended our notions, yet too vague on
this interesting subject, we may be tempted to treat
of i' somewhat more at length than at present.




100                 ONANISM.
CHAPTER VIII.
ONA NISM.
ONANISM is the saddest abuse man can make of his
body.  It is, par excellence, the shameful vice, the
vice of feeble souls; a sort of negative passion, in
which all other passions are extinguished. Shame to
the man who abandons himself to it!  Woe to the
poor child who is, through neglect, permitted to contract it!
" It is toward the twelfth or thirteenth year," says
ilartlaub, "that the sensual instinct is awakened."
This assertion would undoubtedly be true, if man was
always born and developed in the normal conditions
of his original nature. But it rarely so happens.
Civilization depraves his mind and his senses, and but
too often gives him an unfortunate precocity, which
some are foolish enough to admire, because they see
its advantages, without discovering its dangers.
There is a multitude of children, of both sexes, who
are liable to contract this habit at the age of five, four,
or even three years.
This incomprehensible and fatal sensuality does not,
assuredly, proceed in children from a depraved moral
state; but is the symptom of an unhealthy surexcita



ONANISM.                   101
tion, whose sad effects often survive their cause, and
seldom fail to become habitual, if not promptly remedied.
Let us observe, nevertheless, that independently of
all accidental or pathological cause, there are children
prematurely impelled to sexual excesses, by a congenital vice in their nervous system.
Gall's system, verified upon this subject by innumerable facts, may serve here as a guide.* The
children of whom we speak, have the occiput prominent, and the cerebellum manifests, by two large
protuberances situated immediately above the nape of
the neck, its relative preponderance in the encephalic
mass. It is unnecessary to say that these children
require a special surveillance.
Volumes have been published upon the physical
and moral results of onanism. The truth is, that it
alone makes greater ravages in the economy than all
the other passions together.  It is the scourge of infancy. Like the foul worm, which devours and corrupts the fruit befobre its maturity, it exhausts the
sources of life, frustrates all its manifestations, and
secretly consumes, without giving them time to act,
all the springs of the human organism.
We shall rapidly indicate the signs of this deplorable monomania; after which, we shall point out the
means of combating it.
* According to Gall, the cerebellum is the seat of the sensual instincts.




102                  ONANISM.
The first sentiment that this species of sensuality
awakens in children, is a sort of bashfulness, incompatible with the innocence natural to their age.
Bashfulness, in fact, springs from a more or less definite notion of sexual indulgence. It is the fig-leaf
with which Eve, after her fall, covered her nakedness.
The bashfulness of a child of ten years is always suspicious.
But this sign alone should not be considered sufficient to determine the judgment of the observer,
unless corroborated by observations of a different
kind.
Children who are so unfortunate as to acquire this
habit, carry in their external appearance, as well as
in their character, certain characteristic features.
They are commonly pale and thin; their drooping
eyes are surrounded by a bluish circle; there is an
uncertainty in their look, which seems to fear the observation of those around them; they are feeble,
cacochymic, chilly, apathetic.  Everything fatigues
them; or rather, they are always fatigued. The least
movement makes them perspire, and puts them out
of breath; they dread play as much as study.
They, nevertheless, eat a great deal; and one is
astonished to see so much nourishment profit them so
little. Sometimes, on the contrary, they lose all appetite, or have only capricious tastes.
Their character is unequal, irritable, sullen. They
are abstracted, taciturn; disposed to weep; indiffer



ONANISM.                 103
ent and susceptible. The necessity of concealing a
vice, of which they have the consciousness much
sooner than one would believe, and of which they fear
to be suspected, renders them timid to excess, dissimulating, and false.
Their intellectual faculties suffer from the debility
of their bodies. They are abstracted, and incapable
of continued attention to anything whatever. They
are accused of being indolent, and they are so, in fact;
but their indolence is caused by exhaustion. The
memory soon suffers, and to learn anything by heart
is beyond their strength. If an attempt is made to
compel them, their useless efforts only end in complete
discouragement. If they are punished, they resent it,
and finish by hating their masters, their parents, and
all human kind.
Thus years pass away, years of misery and tears,
leaving after them but bitter regrets and remorse.
Then comes adolescence; the child becomes a man.
Reason in him strives to master instinct; but whether
it succeeds or not, it is too late: the evil is done; a
debilitated body, blunted senses, an uncultivated
mind, a blighted soul-such are the fatal consequences of a childhood polluted with onanism.
The unfortunate children infected with this pest,
seek solitude, particularly avoiding the society of
children of their own age, whose presence disturbs,
embarrasses, and humiliates them, if they believe them
pure. They only approach those in whom they have




104                 ONANISM.
discovered the same shameful sensuality which devours themselves; but to these they readily attach
themselves. Such is, in fact, the nature of the human
soul, that it feels itself incomplete in isolation, and
even in its turpitude seeks sympathy.
The choice of associates for children, is, then, one
of the principal points to which maternal solicitude
should be directed. Vice has its affinities and its
masters, and this is one of those which is communicated, and the gangrene with which it inoculates, soon
extends to the heart.
This vice is often the unknown cause of a throng
of chronic affections.
Like all other disturbances of the nervous apparatus, it enfeebles the senses, confuses the mental faculties, and even, in some cases, produces softening of
the brain.  St. Vitus's dance, epilepsy, idiocy, insanity, and spleen, are the immediate and much more
frequent effects than is generally believed.
As for the secondary phenomena to which it may
give rise, they comprehend all the diseases commonly
referred, by homceopathic physicians, exclusively to
psora, of which it must always be a powerful auxiliary. For example, it undoubtedly accelerates the
development of pulmonary phthisis, if it is not in
many cases the first and generating cause of tubercles.
But if onanism should occupy an important place
in the etiology of morbid affections, it is not very




ONANISM.                 105
seldom, that it, in its turn, is the result of a pre-existent disease. It is, in fact, well known, that the
presence of worms in the intestinal tube, and especially of ascarides in the rectum, often occasions in
little girls a vaginal discharge, accompanied by a
slight itching, which may reveal to them the secret of
sensations that they would not otherwise have suspected.
These discharges, which are sometimes produced by
onanism itself, are also often caused by pathological
states very different from the verminous affections.
We shall necessarily allude again to this subject in
treating, in the second part of this little work, of the
chronic.diseases of children, and we shall then point
out the cases in which onanism, as a secondary and
purely symptomatic phenomenon, commonly yields
with the disease which caused it, to the medicines indicated.
We shall, then, at present, only occupy ourselves
with idiopathic onanism, if we may so speak, and
with the hygienic and moral means to be employed
for its cure.
There is no particular diet for otherwise healthy
children, addicted to this vice. The regimen which
they should follow, is that which is suitable for all
children of their age. But it is important that this
regimen should be rigorously imposed.
Spices, venison, salted or smoked meat, all highlyflavored dishes, are especially injurious to them.




106                 ONANISM.
Pepper is a poison we should be glad to see forever
disappear from our culinary preparations. It is sufficient to read the pathogenesis of pepper to become
convinced of the dangers to which this condiment exposes one, and of the daily abuse which is made of it.
Children should be completely ignorant of its flavor.
We extend the same proscription to all spiritous
drinks, and especially to pure wine, which is sometimes
given to little boys, and even to little girls, under the
insane pretext of fortifying the stomach. Pure wine,
like all other alcoholic drinks, momentarily increases
the action of the vital forces, in accelerating the circulation; but this factitious excitation is always
ephemeral, and the depression which follows sufficiently proves, that what a superficial observation
takes for an increase of strength, is really but a useless vitiation of the principle of life.
There is another substance in general, almost
universal, use, of which fashion has made an aliment,
illn spite of reason, and whose effect is, unhappily, not.
less pernicious to children than that of pepper and
alcohol: we allude to coffee.
Hahnemann, in 1803, published an interesting
memoir upon tile effects of coffee. It is, as one may
say, a formal indictment of this pleasant beverage.
But while dissenting from what we consider the exaggerations of Hahnemann-exaggerations which he
himself admitted thirty years later-we venture to
affirm, upon the testimony of our own experience, that




ONANISM.                  107
the daily use of coffee is the cause of a throng of diseases. Leucorrhcea in women; impotence in menthat infirmity so frequent and so premature in our
day-nine times in ten has no other cause.
Coffee is one of the special excitants of the genital
organs, and the disturbance it produces is so much
the more dangerous, as the imagination partakes of it.
Coffee is, therebore, a real poison for those already
inclined to onanism.
There are, nevertheless, many families, especially
in the provinces, where coffee is habitually given to
children with their breakfast!
Among the products of the soil of which the artificial taste of modern society has made eatables, there
are many substances equally objectionable with those
we have just proscribed: such as horse-radish, black
radish, celery, garlic, juniper, parsley, water-cresses,
angelica, and, generally, all aromatic plants.
We do not pretend here to decide whether these
vegetables really are, or are not, alimentary substances
which an adult may use with impunity; but what we
do insist upon is, that they are positively unwholesome for children, and especially pernicious for those
to whom this chapter more particularly refers.
" These children," says Hartlaub, "should sleep
upon hair mattresses, and not upon feather-beds; they
should be lightly covered, and they should not be permitted to eat too late, as digestion, when taking place
during sleep, exerts an influence upon the sexual




108                ONANISM.
organs, which occasions voluptuous dreams." They
should also be lightly dressed, and should take enough
exercise during the day, to insure them a tranquil
sleep, undisturbed by the phantoms of the imagination.
Some physicians have promised themselves great
results from mechanical contrivances, for the remedy
of this evil, such as night-gowns, with long sleeves
tied over the hands, and fixed upon the breast by
means of a handkerchief across the shoulders. These
coercive expedients inspire us with but little confidence. They may, however, be useful for very young
children, for those who are so confirmed as to pollute
themselves during sleep, and, in short, for those in
whom this practice has already produced imbecility.
The others have the consciousness, if not of the ininjury they are doing themselves, at least of the
reprehensible nature of the act, since they are ashamed
of it.
Let parents, then, not hesitate to put an end to the
matter at once, by entering openly upon an explanation with them. It is, undoubtedly, a delicate subject, and difficult to treat judiciously; but explanations are indispensable.
It is necessary to proceed with tact, and, above all,
with calmness. Threats and severity would be unseasonable; they would only, in a majority of cases,
alienate confidence forever, and substitute hypocrisy.
Let one be content, then, to represent to the child, in




ONANISM.                 109
a forcible manner, but without anger or bitterness, the
real evils sure to result from this shameful practice,
and to trust to the salutary impression which this can
hardly fail to make upon his mind, if the admonition
is made in a suitable manner, and at a proper time.
It is understood, however, that vigilance should not
stop here, blindly trusting to a promise of future good
conduct, a promise which the strength of habit may
so soon cause to be forgotten.
Masters, servants even, if they are worthy and capable of playing such a part, should be taken into
confidence. A complete system of surveillance should
surround the child, night and day, enveloping him
like a net-work, even in his most secret acts.
Solitude and idleness being for him beset with danger, he should never be allowed to be either alone or
idle; lie should be removed from the influence of bad
example, of bad books, but especially of bad society.
The best possible means would be to create an occupation for him which would be sufficiently attractive
to excite a real passion; for a new passion is the
surest means of extinguishing an old one.
To counterbalance one faculty by another-to extinguish the bad by calling forth the good-such is the
general plan of all good systems of education.




110             REGIMEN DURING
CHAPTER IX.
REGIMEN DURING HOM(EOPATHIC TREATMENT.
ALLOPATHIC physicians, and those who echo their
sentiments, are accustomed to say that IHomceopathy
is but a sort of me'decine expectante; that is to say, a
do-nothing system, and only cures diseases by means
of the regimen imposed.
This common-place, which does not deserve a
serious refutation, proves but one thing —the absolute
ignorance of those, who repeat it, touching the principles of the Hahnemannian doctrine, and the marvelous efficacy of the infinitesimals.
We are a little curious to learn, in fact, by what
singular privilege it is, that the diet prescribed by
homceopathic physicians, instead of the same diet
prescribed by their adversaries, should have the inconceivable virtue of curing croup, meningitis, scarlatina,
and many other acute diseases which, under the expeditious lancet of the physiological school, prove so
frequently, and so promptly fatal. Are the detractors
of Homceopathy then sincere, in thus interpreting its
success?  If so, it must be admitted, that medical
rationalism, is still more'absurd in its polemics than
in its theories.




HOMWEOPATHIC TREATMENT.           111
It is true, (and so far from denying, we proclaim it)'
that Homceopathy has, better than any other school,
appreciated, and given reasons for the importance of
diet.  She could not then, without inconsistency,
refuse the aid of an auxiliary whose power she so
well understood.
But nothing could be more unjust, than to attribute
her cures to any regimen whatever. Patients affected
with chronic diseases, which nature alone never cures,
are seen every day to recover under the influence of
the infinitesimals, without having confined themselves
at all, to any particular diet.
I admit, however, that these cases ought to be considered as exceptional, and nothing is more easy to
understand.
In fact, in order that a remedy should act with certainty in the sphere of its specificity, it is clear that
its operation should not be disturbed by the intercurrent action of other medicinal agents; and this is so
much the more evident, from the fact, that it is not
impossible that among these, might be found precisely
the antidote to the medicine administered, and upon
which the physician founded his hopes of success;
and what can be expected from a medicine constantly
ne'utralized?
But supposing even that this neutralization does not
take place, is it probable that several medicinal agents
would act simultaneously in the economy with as
much certainty, as if each one operated alone?  Un10




112              RPEGIRMEN DIRING
doubtedly not, and, from the instant that it was
proved by observation and experiments, that tea,
coffee, acids, and dentifrices, such as l'eau-de-Botot,
and in a word, all odoriferous substances, are medicinal, we are logical in absolutely proscribing them.
Let us add, nevertheless, that if for a long time the
patient has been habituated, and without sensible
inconvenience, to the use of some one of these substances, the physician may, in particular cases, be less
rigid.  Hahnemann, for example, willingly tolerated
in his patients the use of the pipe, and I, for myself;
believe that the use of an infusion of black tea, when
the patient is accustomed to it, is not injurious in the
treatment of chronic disease. But this toleration can
never, in any case, be extended to coffee, perfumes, or
dentifrices.
The character of the disease, the temperament of
the patient, and especially the nature of the medicine
prescribed, should determine the physician with regard
to the severity of the regimen to be observed. An
excess of rigor, when one does not fear to discourage the
patient, is preferable, in general, to the opposite course.
Tranquillity of mind, is a condition not less important to the normal action of remedies, than absti
nence from prohibited food.
It is difficult to realize how great an influence
mental emotions exert upon the course of diseases;
they may derange the action of the medicines completely.




HOMCEOPATHIC TREATMENT.           113
A hundred times, in experimenting upon myself
with substances whose pathogenesis I was studying, I
have remarked the entire, instantaneous and final
disappearance of the most marked symptoms in consequence of some surprise, a disagreeable accident, or
any lively emotion.
The ardent and sensitive minds of children, expose
them still more than adults to shocks from sudden
and violent external impressions, and they should be
as much as possible protected from them, as well as
from all useless irritation.
As to the quantity of food that they may be permitted to take in the course of a disease, we may
easily conceive that it depends entirely upon circumstances. All that can be said in this respect is, that
with the exception of cases of very acute inflammation, Homceopathy is opposed to dieting; that is to
say, to that absolute abstinence which has so often,
with the aid of venesection, conducted the victims of
Broussaisism to the grave.
A few practical indications concerning the drinks
to be allowed when the patient suffers from thirst, as
is the case in all fevers, will finish this chapter.
Everybody has remarked that, upon this point,
Allopatlhy is not over scrupulous. Citric and even
sulphuric lemonades, infusions of linden, chamomile,
wild poppy, hops, etc., decoctions of dog-grass, burdock, and sarsaparilla, solutions of carbonate, or of
tartrate of soda, etc., etc., are, for the physician of the




114 REGIMEN DURING EIOMCEOPATHIC TREATMENT.
Old School, so many soothing drinks, that he prescribes at hazard, without expecting from them any
effect, and without attaching the least importance to
whether the patient takes one in preference to another.
With us Homceopathists, it is different; the greater
part of infusions and diet-drinks, far from seeming
insignificant, have, in our eyes, the serious objection
of being medicines. They are consequently indiscriminately stricken out from our therapeutics.
The only drinks we tolerate, are those which quench
the thirst, without being displeasing to the taste,
such as slightly sweetened water, toast water, and a
decoction of dates, of jujube, or of raisins.
Everybody knows how to prepare toast water;
throw a few tumblers of boiling water upon a slice of
toasted bread, add a little sugar, and cool for use;
such is the recipe for making it.
As for the decoctions of dried fruits, it is superfluous to say how they are prepared. It is important
that they be not too strong. Those of IMalaga raisins
generally please children.
Drinks should be taken of the temperature of the
apartment, in chronic diseases; and tepid, but not
warm, in the majority of acute affections. It is desir
able that they should satisfy thirst without producing
other sensations.




PART II.
DISEASES OF CIHILDREN.
CHILDREN are exposed to the greater part of the
diseases which attack adults. There are, however, a
certain number which are peculiar to them, or which
assume. in them a gravity that they have not at a
more advanced age. These last will naturally form
the special object of our attention. As to the order
which I propose to follow in their description, I confess it is almost arbitrary. I have said, in my Introduction, that a philosophical classification of diseases is
not yet possible. I shall, therefore, content myself
with grouping those of which I shall give the history,
according to the sensible analogies of their prominent
symptoms. This mode of proceeding, vicious without
doubt, in this, that it brings together, upon the faith
of physical notions, sometimes illusory, affections
probably very dissimilar in their essence, is without
inconvenience, from the moment we admit it as purely
c inventional.
(115)




116           ACUTE EXANTHEMATA.
DISEASES OF THE SKIN.
The generic name, exanthemnata, is given to all diseases of the skin. A very small number of these
exanthemata result from  an irritating action, exercised upon the cutaneous envelope: the greater part
are only the apparent symptoms of miasmatic affections diffused in the economy.
The means employed by the Old School to combat
these exanthemata are generally pitiable and sometimes monstrous. I shall not stop to describe them;
but, I do not hesitate to attribute to them a great part
of the incurable diseases and infirmities, which we so
often meet with in old people, and even in individuals
still in the flower of their age.
ACUTE EXANTHEMATA.
ERYTHEMA.
This name is given to the partial and circumscribed
redness of the skin, caused either by the constant
attrition of two contiguous surfaces, or the contact of
acrid or irritating matter, such as urine, perspiration,
and even frecal matter, when in nursing children
these are not promptly removed; it is also caused by
exposure to the sun.
In the former instances, the erythema has received
more especially the name of intertrigo. It is observed
most frequently in the arm-pits, between the thighs)
on the neck, at the anus and in the groins. It is often




ERYTHEMA.                  117
accompanied by an albuminous secretion oi a disagreeable odor; but sometimes also, the affected places
are dry, and are then attended by the production of
scales or scabs.
Frequent lotions of tepid water, almost always
suffice to prevent and to cure this species of erythema; if this, however, is ineffectual, we should
have recourse to medicine, and that which deserves
the preference, is chamomilla.
The efficacy of chamomilla, in this case, is proved
by the frequent result of the abuse which is made of
it. Nothing is more common than to see in little
children, an intertrigo come on after they or their nurses
have taken an infusion of the flowers of this plant.
The natural remedy then is, the antidote of chamomilla, that is to say, ignatia and pulsatilla, taken
alternately in small doses at short intervals.
Jlfercurius sol., thirtieth dilution, a few globules
in a glass of water, taken by teaspoonfuls, every six
hours, would suit in a case where the intertrigo is
very painful, and the parts affected are raw.
The erythema caused by insolation, is commonly
manifested on the face, neck and hands; that is to
say, on the parts most commonly exposed to the sun.
The redness in which it consists, turns readily to a
copper brown or purple, and is accompanied by an
intense burning. Abandoned to itself, this affection lasts two or three days, and terminates by desquamation of the epidermis. It is not dangerous;




118           ACUTE EXANTHEMATA.
it is, however, of sufficient importance to be- treated,
especially when seated upon the face or scalp. We
have seen it, in this last case, occasion delirium, and
all the symptoms of meningitis, and this disagreeable
complication sometimes develops itself before any
remarkable redness of the skin has been observed-a
circumstance to which we would call the attention of
physicians.
Rhus toxicodendron, of a medium dilution, in
repeated doses, is the specific for erythema produced
by insolation.
CRAC KS.
Cracks in young children have the same cause, and
call for the same treatment as intertrigo..Xercurius
sol., when they are very painful, andpulsatilla, when
we may attribute the febrile state, which accompanies
them, to the use of lycopodium, with which they may
have been powdered.
BURNS.
As this disease, or rather the affection produced by
it, is not more common to childhood than to any other
age, we shall not give the subject the extension it
would admit of in a treatise upon surgery. That
which especially characterizes the species of disorganization caused by burns, however slight, is the intense
pain, which accompanies it, and the slowness with
which this disorganization is repaired; but it must be
observed also, that the various modes of treatment




BURNs.                  119
adopted by Allopathy for these accidents, contribute
not a little to their gravity and to the persistence of
their effects.
I have already pointed out, in my Introduction, the
objection to immersion in cold water. I return to this
point, for it is of the first importance, and comprises
in itself the whole spirit of the Old School. Whether
the burn has caused only erythematous redness of the
skin, or has produced phlyctaena, or destroyed the
whole thickness of the cutaneous membrane, I pronounce, in all these divers cases, cold applications an
error.
As to astringent or acidulated lotions, compresses
or pledgets saturated with lead or opiate ointments,
etc., I have seen them employed a thousand times
without any decided advantage.
The only local application of which I recommend
the use, is a layer of cotton moistened with sweet oil
of almonds, renewed twice a day.
In a case, however, where the falling off of the blister
has exposed a large surface of the true skin, it is better
to apply the oiled cotton mediately, that is to say,
over a compress of titlne linen perforated and saturated
with cold cream prepared without the essence of roses.
The homceopathic treatment of burns is very simple
and comprehends, complications excepted, but two
medicines; rhus toxicodendron and  tinctura sulphuris.
Rhus should be administered from the beginning,
1-1




120            ACUTE EXANTHEMATA.
every three hours, from the sixth to the twelfth dilu
tion; from six to eight globules, or a drop to four
ounces of vehicle. This medicine will suffice in cases
of erythema and of phlyctwena.
Its employment should be followed by that of tiaetura sulphuris when, the first pains being relieved
and the disorganization being more profound, it is important to hasten the cicatrization.  Tinctura sulphuris is commonly administered, of the thirtieth dilution.  The doses, repeated at first two or thiee times
a (lday, should be given less frequently, as the affection
alpproaches its termination.
F R OS T-B IT ES.
The effects upon organized tissues, of rapid addition
to, or abstraction of caloric from, a part, is attended,
under these two opposite circumstances, by identical
results; thus there exists between burns and frost-bites,
in their different degrees, the most striking analogy.
If, in ordinary cases, the symptoms of both are not
absolutely the same, it is only because the cold, which
causes the latter, does not act as instantaneously as
the artificial heat, which produces the former; they
are in reality the same disease, under a form more or
less acute, and the same treatment applies to both.
It has been recommended to employ rhus externally
for frost-bites; in other words, to foment, with the tincture of this plant, the congealed parts. We are little
in favor, generally, of external applications, and we




STINGS.                  121
are the more disposed to believe ourselves in the right
in discarding them in this case, as, most frequently,
frost-bites depend much less upon the violence of the
cold to which the individual has been exposed, than
upon a general disposition of the economy to suffer
from its effects; a tendency which should be combated
by general means.
Beside, rltus taken internally, almost always proves
so promptly, and sometimes so marvelously efficacious,
that we do not see whj one should seek any other
mode of administration.
We prescribe it at from the twelfth to the fifteenth
dilution, once or twice a day, taking care. to discontinue its use, as soon as the itching of the chilblains
disappears, and their redness begins to abate.
Sulphur is recommended for frost-bites that have
ulcerated, and passed as it were, into a chronic state.
Chilblains are very often the sign of a debilitated
state of the health; of an impoverished blood; in a
word, of a languishing vitality. It is for the physician to ascertain the cause and the nature of this
cachexia, and apply the proper remedy.
STINGS.
The sting of a gnat, or even of a bee, is certainly
not a very serious evil; but it is nevertheless sometimes very inconvenient, and the homoeopathic means
oftreating them, recommended up to this time, are
very insufficient, not to say absolutely inefficacious.




122             ACUTE EXANTHEMATA.
We are glad then to be able to point out, for the stings
of all kinds of insects, a medicine whose curative
effect is produced in a few minutes, often in a few
seconds: it is ledum  palustre, taken  internally,-a
teaspoonful of a glass of water, in which are dissolved
seven or eight globules of the fifteenth dilution.  In
case of a sting of the wasp or bee, the dose should be
a little stronger, and repeated several times.*
ERYSIPELAS.
Erysipelas is one of the cutaneous affections, with
which children are the most frequently attacked.
In very young children, it often succeeds erythema,
and then only appears to be an aggravation of that
disease; most commonly, however, it assumes at the
commencement its own  character, without passing
through the erythematous form, and acquires in a
very few days, a high degree of intensity.   In this
case it is preceded by fever, with somnolence and
constipation, or bilious diarrhea.
It is to be remarked, that the disturbance in the digestive organs which accompanies erysipelas in children, manifests itself rather in the intestines than in
the stomach. It is the contrary with adults.
* This remarkable specificity of ledum, induces me to believe,
that it might succeed against the bite of venomous reptiles. One of
my friends, a planter of Martinique, has offered to try it upon ani
mals that he would cause to be bitten by the viper. I shall be happy
to be able to report the success of these experiments in another edi
tion of this work.




ERYSIPELAS.                 123
The fever of incubation, lasts from two to three
days, and habitually disappears on the appearance of
the eruption; it nevertheless, in very serious cases,
persists after the appearance of the cutaneous affection,
and sometimes assumes an ataxic character.
That portion of the skin affected by erysipelas is
red, tense, slightly swollen, shining, hot and very
painful; it becomes white, under the pressure of the
finger, but resumes its red color, the moment that the
pressure ceases.
Unlike what takes place in adults, erysipelas in
children manifests itself less frequently on the face
than on the trunk and limbs. In the newly born we
frequently see it commence at the umbilicus, and
spread little by little over the whole abdomen. One
of its peculiarities, is a remarkable tendency to move
from place to place; it sometimes, as it were, jumps
from one part to another, disappearing, from its former situation, at the instant it appears in a new one.
Its ordinary duration, when left to itself, is from six
to ten days.
Erysipelas is said to be simple when it occupies
only the superficial layer of thile skin; vesicular, when
it is accompanied by the elevation of the cuticle in
watery blisters; phlegmonous, when it affects the
whole thickness of the skin, and determines the formation of abscesses in the subcutaneous cellular tissue.
Erysipelas is always, in children, a serious disease;
that of the face especially, readily extends to the




124           ACUTE EXANTHEMATA.
brain, if not promptly and properly treated. It is
more serious in very young children than in those
more advanced. Its different modes of termination
are desquamation, induration, suppuration and gangrene.
TREATMENT.-A great number of medicines have
been employed, and extolled for the treatment of erysipelas, such as aconite, bryon., acid. phos., bellad.,
ca7car., sulphur, pvulsat., etc. In order to avoid confusion in the minds of our readers, we shall content
ourselves with pointing out the medicinal substances,
which, according to the circumstances, deserve most
confidence. These substances are in the order of their
importance, rhuss toxic., bellad., bryon., pulsat.,
su7ph]., and arsenic.
Ihus is the remedy par excellence for erysipelas.
It is proper in almost all cases.
Belladonna is called for by a complication of high
fever with delirium or extreme agitation.
Bryonia corresponds to erysipelas of the articulations, with considerable aggravation of the symptoms
upon the least movement
Pulsatilla should be given in' erratic erysipelas;
that is to say, when it manifests a great tendency to
move from place to place.
Sulphur should be rarely used at the commencement. It is appropriate only in infants of a feeble
constitution, or in cases where the disease terminates
by suppuration.




ZONA - SHINGLES.              125
Arsenic, indicated especially by hectic fever, or by
a fever of bad character, is particularly adapted to
erysipelatous inflammation of the scrotum, peculiar to
chimney-sweepers, and which has a great tendency to
degenerate into gangrene.
Erysipelas does not require absolute abstinence
from food, except during its febrile period; it is better,
however, that the patient should eat but little until
after the disappearance of the eruption. Toast water
is. as in all acute diseases, the drink which should be
preferred, if the patient is thirsty. It may be taken
at the ordinary temperature.
As to cataplasms so called, emollient fomentations,
or local applications of any kind, we attach no importance to them. A layer of cotton, saturated with oil
of sweet almonds, such as we have recommended
for burns, is the only one which appears to us admissible.
ZONA - SHINGLES.
Zonae or Zoster, very much resembles erysipelas.
It is an exanthem forming, ordinarily, a semicircular
band, of a hand's width, around the body or a limb.
The eruption is very burning, itching and lancinating.
It is composed of little pustules upon an inflamed
surface and is accompanied with fever.
Zona is a disease which is very rare in early infancy.
Its treatment does not differ essentially from that of
erysipelas. (Mercury is its specific. Ed. 2d edit.)




126            ACUTE EXANTHEMATA.
PEMPHIGUS.
Pemphigus, is characterized by the development,
upon various parts of the body, of erythematous spots,
upon the surface of which soon appear blisters, which
burst and discharge a viscous, yellow fluid, which
hardens and forms on the surface of the skin, a not
very prominent crust, often granulated, and yellowish
like honey, or inclining to a fawn color.
This eruption is sometimes accompanied by fever,
and is sometimes without it. It is most frequently of
short duration; but occasionally, also, it shows itself
extremely persistent. I have seen it manifest itself
almost instantaneously in consequence of fright. 1
have twice had occasion to observe it in a chronic
form. RJLus, is its specific.
URTICARIA, OR NETTLE-RASH.
This exanthem, the most ephemeral of all, manifests
itself under the form of lenticular vesicles, precisely
similar to those which result from the sting of the
nettle, and is accompanied by a similar sensation.
This eruption, sometimes persistent in adults, never
lasts more than a few hours in children. It disappears instantly after a single dose of croton tiglium.
FURUNCLES, OR BOILS.
A boil consists in a small, red and circumscribed
elevation of the skin, accompanied by smarting, itch
ing, and afterward by burning; a swelling is de



MEASLES.                 127
veloped around it; the redness changes to a brown
color, and upon looking closely, a yellow point is perceived in the middle, which when it approaches its
termination, breaks and discharges a lump of thick
pus, called the core.  The pain, until then intense,
and often even accompanied by fever, soon ceases.
When the boil is large, and the sloughs numerous and
confluent, the disease receives the name of carbunucle.
Boils and carbuncles are almost always coincident
with a more or less marked derangement of the digestive organs.
TREATMENT.-(Cina, from tile ninth to the fifteenth
dilution, two drops in four ounces of vehicle, administered three or four times a day, until resolution takes
place.
Dulcamara and sulphur are sometimes necessary,
in cases where the periodical reproduction of boils
gives reason to suppose the existence of a particular
diathesis; but cina, even in this last case, will almost
always suffice. It may, however, be necessary to
have recourse to rhus, in cases where the boils are
complicated with erysipelas. Lastly, ledunr palutstre
is preferable to any other medicine, when the disease
appears upon the feet or upon the fingers.
MEASLES.
Among affections of an incontestably miasmatic
nature, measles figures as one of a type the most
known and best characterized.




128          ACUTE EXANTHEMATA.
It seldom  attacks the same individual twice, and
appears epidemically, more especially in the spring
and autumn. Although neither adults nor old people
are exempt from it, it is, with reason, considered as
one of the diseases peculiar to children.
According to Rosen, the virus of measles, which
impregnates the body and the clothes of the individuals whom it attacks, does not pervade the atmosphere; so that during the course of an epidemic, one
can be sure, by absolute separation, of protecting children from infection. Unfortunately, this opinion appears to us ill-founded.
Measles is commonly a mild disease, but it sometimes, however, assumes such malignity as to prove
fatal in a majority of cases. This is why the ancients
called it morbilli; that is to say, little plague; but it
may be affirmed without exaggeration, that the discovery of Homceopathy has reduced to one-tenth, the
danger from the most serious epidemics of measles.
This disease presents three distinct periods: the
catarrhal, the eruptive, and the period of resolution.
We shall point out the symptoms which characterize
each of these.
Catarrhal period. This generally lasts three days,
but occasionally longer. It commences by prolonged
chills, which are. soon followed by febrile reaction.
From the second day the fever becomes continuous.
There is redness, heat and painful sensibility of the
eyes, with dread of light, and partially closed and




MEASLES.                 129
swollen lids, lachrymation, frequent sneezing, coryza,
headache, and dry, short cough, with pain in the
throat, chest and loins; vomiting, sometimes in the
day, sometimes in the night; white, moist tongue,
thirst, disgust for food, colic, relaxation of the bowels,
anxiety, chagrin, and sometimes continual drowsi
ness; such are the synlptoms which precede the cutaneous eruption, but which do not disappear as in
variola, when the eruption takes place.
Eruptive period. There appear, first upon the
face, a great number of small, bright red spots, of an
oblong, square, semilunar, but not very distinct form,
slightly prominent, and having toward the middle a
small, hard point, upon which one may discover, by
the aid of a magnifying glass, a vesicle filled with
serum.
The number and size of these spots gradually
increase. They soon appear upon the throat, chest,
arms, shoulders, epigastrium, loins, and lastly upon
the legs, where they are perfectly smooth; that is to
say, without vesicles.
On the sixth day of the disease, two days after
the appearance of the first spots, they begin to disappear in the order in which they came, leaving
behind them a little roughness of the skin. On the
eighth or ninth day they are entirely gone. The epidermis scales off, and the entire body is covered with
a scurfy powder.
But it is important to remark, that things do not




130          ACUTE EXANTHEMATA.
always pass exactly as we have here related; for if
the cutaneous eruption is a characteristic phenomenon
of the disease, it is not an essential condition of
its existence, as we often see, during epidemics of
measles, general affections, evidently produced by the
miasm, without any affection of the skin.
Period of resolution.  The greater part of the
time, a sort of crisis, consisting either of diarrhea,
sweat, or a bleeding from the nose, follows immediately after the disappearance of the exanthem, and
dissipates, in a few days, what still remains of the bron..
chial inflammation, and of the febrile symptoms.
Sometimes, however, this crisis does not take place,
or occurs irregularly, and great danger may then be
apprehended.
Ist. If the diarrhea continues too long, some weeks
for example, we may fear, not only dropsy, but the
formation of tubercles in the mesentery, hectic fever
and consumption.
2d. If the fever and cough continue, and if the respiration becomes frequent, difficult and burning, at
the samne time that one or both of the cheeks becomes
injected with blood, pneumonia is impending, if it
has not already taken place.
3d. And lastly; if there remains a slow fever, recurring daily, with hurried respiration, emaciation, and expectoration of pus, there is certainly disease of the lungs.
"In measles," says M. Rapon, " the cutaneous
eruption is valueless as elucidating the prognosis; the




MEASLES.                  131
worst symptoms appear only after its total disappearance. Such are otorrhcea, chronic inflammation of
the eyelids, etc.; but that which is undoubtedly most
to be dreaded, is the development of pulmonary
tubercles. This deplorable influence of measles, is so
marked, that it may serve as a criterion by which to
judge of the state of the chest."
TREATMENT.-The principal medicines called for in
the treatment of measles, are aconitum, pulsatilla,
bryonia, belladonna, phos/phorus, nux, ignatia, cinnabaris, mercurius, causticumr, and sulvphur.
Aconiturn. "' The efficacy of this plant, in measles, says Ilahnemann, is almost miraculous."  Acoatumrn then should be prescribed from the commencement of the disease, at a medium dilution, (the twelfth
for example) two or three times a day, during the first
two days at least of the first period, and it will be
well to return to it during the progress of the disease,
as an intercurrent remedy, whenever the febrile symptoms become severe. In vigorous children, of a sanguine temperament, aconitumn is, during the entire
course of the disease, the medicine upon which we
should principally depend.
T-ulsatilla.  According to M. Auguste Rapou, the
fundamental remedy for measles ispulsatilla.
" This substance," says he, " constitutes its principal therapeutics.  It prevents the consequences of the
virus, destroys every germ of it, and preserves those
who are exposed from its attacks." I confess that this




132           ACUTE EXANTHEMATA.
assertion appears to me very unreserved. It is incontestable, however, that pulsatilla is clearly indicated
after a few doses of aconite shall have abated the violence of the inflammatory symptoms.
The predominance of vomitings calls particularly
for its use, and its administration, in a majority of
cases, should succeed to that of aconitum. The two
medicines, during the second period, may be taken
alternately at six or eight hours' interval, if nothing
appears to contra-indicate this medication.  A continual and ardent thirst would be a reason for excluding pulsatilla.
Bryonia, several times repeated, at a few hours' interval, is the best means of recalling the eruption to
the skin, when it is accidentally suspended or repelled.
Belladonna is indicated after aconite, either by a
strong constriction of the throat and chest, or by extreme agitation, and lastly, and above all, by delirium.
When these symptoms succeed the abrupt disappearance of the eruption, belladonna and bryonia
should be administered alternately. But, excepting
under the circumstances indicated, belladonna is, in
the treatment of measles, but an accessory remedy,
whose use should not be prolonged more than one or
two days.
PPAosphorus is rarely called for if the disease has
been properly treated from  the beginning.  It corresponds to pneumonia, always very serious, whiclh
sometimes manifests itself after the eruption.




MEASLES.                  133AVux and ignatia are indicated by the persistence of
a hoarse cough, with constriction of the chest, without
great friequency of the pulse.  Iynatia suits especially
little girls, and children of a mild and tranquil character.
Cinnabaris corresponds, toward the end of the
disease, to cedema of the glottis, with indolent tumefaction of the palate, uvula, and tonsils.
iifercurius serves to moderate the excessive sweats,
and to combat the relaxation of the bowels, if it
should continue more than a few days after the disappearance of the eruption.
Cadusticum is a precious medicine when there remains a dry cough, with constipation, but no fever;
or when there is swelling of the epigastrium, or symptoms of gastralgia.
Selphiur, very rarely indicated in the treatment of
measles, is sometimes, however, indispensable in combating its consequences, such as otorrhcea, (which the
opportune administration of pulsatilla will almost always prevent,) inflammation of the eyelids, etc.
The treatment of measles does not call for the excessive hygienic precautions with which it is but too
common to harass the little patients.  Nothing is
more dangerous, for example, than to load them with
blankets, with the idea of keeping them warm. Currents of air, especially cold air, are certainly fatal; but
there are no surer means of exposing them to a chill
than to make an oven of their chamber.




134            ACUTE EXANTHEMATA.
From sixty-two to sixty-four degrees of Fahrenheit is
the temperature adapted to their state.
Complete abstinence for one or two days, and a very
light diet during the whole course of the disease, is
the proper regimen. If measles is methodically treated, children may, after ten or twelve days at the
utmost, return with impunity to their habitual mode
of life, and expose themselves to the external air,
whatever be the temperature.  Such are the results
attained by Homceopathy.
RO SEOLA.
Roseola is a name given to a very superficial affection of the skin; it is never as extended as erythema,
has some points of resemblance with measles, and is
very often complicated with other eruptions, such as
variola, vaccinia, etc. It is frequently observed in
children.
It is especially during the summer that this slight
disease shows itself. Its duration is extremely variable. It consists, most frequently, of little spots of a
delicate rose color, irregular, and not prominent, and
which are seen to come and go every instant in the
day.
Roseola, which is rarely accompanied with sore
throat, and more seldom  still with gastric affections,
would often pass unperceived, were it not for the cries
and wakefulness it occasions. It shows itself principlally during first dentition.




SCARLATINA.                   135
TREATMENT.-A  few  doses of coffea-mercurius,
if there is angina; belladonna, if, as an exception,
there should appear cerebral symptoms.
SCA RLATINA.
Scarlatina is a contagious and epidemic disease,
rarely occurring sporadically, attacking persons but
once in their life, variable in its character, and most
frequent in children of from five to twelve years.
This disease does not, like measles, seem dependent
upon prevailing temperature. We see it in all seasons,
in the depth of winter, as well as in the heat of summer.
As an epidemic, it is always propagated slowly, does
not attack all individuals, and is, beside, rarely seen
at the present day. ~
Scarlatina has, like measles, with which it has been
sometimes confounded in the beginning of the epidemic, three marked periods, of which we here give
the description:
First Period. —There is, from  the beginning, a
soreness in the throat, followed by depression, and an
extreme sensibility of the whole body, disgust, bilious
vomiting, chills and cephalalgia. During the whole
* This remark, as must be well understood, is not at all applicable to the United States, in which it forms one of the most frequent,
as well as most dreaded, scourges of childhood; neither is it always
true, although generally so, that it occurs but once in the lifetime of
an individual, well authenticated cases having been observed of its
occurrence a second and even a third time.-Tr.
12




136           ACUTE EXANTHEMATA.
of the first day, the drowsiness is sometimes insurmountable.  It is frequently accompanied with delirium, much more rarely with convulsions, during the
two following days. The angina, which rapidly acquires a great intensity, is, with an excessive acceleration of the pulse, the dominant symptom of the period
immediately preceding that of the eruption.  This
period, much more limited, as we see, than the corresponding period in measles, does not manifest itself
by the watering of the eyes, nor by fluent coryza, nor
by the frequent cough which characterizes the latter
disease. There is dyspncea, and great frequency of
respiration in the majority of subjects, especially on
waking in the morning, but this is principally in consequence of the fever and the swelling of the tonsils.
These symptoms only precede two or three days, at the
utmost, the appearance of the eruption.
During this first period, and sometimes during the
whole course of the disease, the bowels are constipated,
and the thirst bears no relation to the violence of the
fever.
A bad sign, and one indicating that the disease
will be very serious, is the smallness, as well as the
extreme frequency, of the pulse.
Second Period.-The eruption commences in accordance with the particular character of the reigning
epidemic-sometimes on the face, sometimes upon
the hands and fore-arms. It consists in little red
spots, smooth, that is to say, without the vesicles pre



SCARLATINA.               137
sented by those in measles. These spots deepen in
color, and enlarge rapidly, so as to become contbunded. They soon cover almost the entire body;
but as they disappear, as in measles, in the order in
which they came, it happens that the parts of the skin
where they first appeared, begin to pale, when the
other parts are but commencing to redden.
The angina and the fever persist during the whole
time of the eruption. On the fourth or fifth day, it is
often accompanied by fatiguing hiccup.  The voice of
the patient becomes hoarse and nasal, he no longer replies to questions addressed to him, or replies with
great difficulty.
An abundant glairy expectoration, a bleeding of the
nose, or a slight diarrhea, phenlomena which frequently supervene toward the sixth day of the disease,
appear to give great relief.
Inflammatory affections of the internal organs frequently manifest themselves at this epoch of the
disease, especially when the exanthem has disappeared
abruptly, which require the prompt attention of the
physician.
A fact worthy of remark, is the absence of all
moisture upon the surface of the scarlatinous spots.
The patients absolutely perspire only through the
portions of the skin which still remain white.  M.
Auguste Rapou attributes to this circumstance the
disposition to the subcutaneous serous effusions, which
forms one of the characteristic phenomena of scar



138            ACUTE EXANTHEMIATA.
latina.  This opinion of Rapou is at least very
specious.
Third Period. —The fever and angina disappear
with the desquamation.  This commences from the
sixth to the ninth day; but it does not take place as in
measles: the epidermis, instead of falling off in scurfy
scales, detaches itself in large plates; this continues
for several days, and is often several times repeated.
It is at this period that the critical phenomena of
which we have spoken, commonly occur, sweat, epistaxis, etc.
The slightest chill is then to be dreaded. Dangerous
lesions of the eye, of the ear, of the ganglionic
system, and especially dropsy, might be the consequence.
"There is not," says Hartmann, "a more insidious
disease than scarlatina. In some epidemics, it is so
mild that there is not a single victim, while in others,
notwithstanding its apparent mildness, and in spite of
the most desirable manifestations of the exanthem, it
often compromises life, and frequently proves fatal by
metastasis to the brain. It is complicated with all
kinds of fever, and acquires thus the danger which
belongs to them.
TREATMENT.-When scarlatina is free from all complication, which unfortunately rarely happens, a few
simple hygienic precautions will almost always suffice
to bring it to a happy termination. Allopathy has no
right to boast of curing scarlatina, since in reality the




SCARLATINA.                  139
curative force in nature, is the sole cause of the success to which it lays claim. The treatment of the Old
School is as absolutely useless in modifying the severity
of this disease, as in other miasmatic affections. Allopathy has never abridged one hour the duration of
these affections.
This is far from being the case with IIomceopathy.
Its triumph is in the treatment of the essential diseases.
The salutary modification that it exercises over
their symptoms is so evident, that only the grossest
bad faith would affect to deny them.
It is true that, in unusual and complicated cases,
the imperfection  of our materia medica, still in its
infancy, does not always leave us free from uncertainty
upon the choice of the best medicine to prescribe.
But what does that prove, if not that science has
not yet made to us her last revelation, and that
medicine is, of all the arts, the most difficult to
practice?
HIomceopathy would proceed, we may affirm, with
a mathematical precision, if the correlation of the
remedy and of the symptoms was as definite and clear
in all diseases as it is in simple scarlatina.
-Belladonna is literally the specific for this eruptive fever. It is appropriate to it in all its periods;
it adapts itself to all its symptoms and corresponds
even to the greater part of its consecutive effects,
such as indurations of the face or of the extremities,
painful swelling of the parotides, discharge from the




140           ACUTE EXANTHEMATA.
ears, etc.  Some authors assert. that bellado;
administered in high dilutions and very small c'
every two or three days, is a certain preventive
against the scarlatinous infection.
Belladlonna, then, should be prescribed from the
beginnihg of the disease. The doses should be
stronger, more frequently repeated, and of lower dilutions, in proportion to the intensity of the precursory
inflammatory symptoms. The amendment of "the
symptoms will soon become a reason for lengthening
the intervals between the doses, and for the use of the
higher dilutions. In fact, one might often treat scarlatina, from the beginning to the end, with belladonna
alone, and obtain from this medicine, the same success
that some homceopathic physicians have met with in
the exclusive use of aconite in epidemics of measles.
Unfortunately the frequent complications presented
by scarlatina, forbid us to count always upon a treatment so simple.
It is beside, like all serious fevers, subject to irregularities, which require each a special treatment, and
exact on the part of the physician, a precise and ever
present idea of all the pathogeny recorded in the
n-ateria medica.
To avoid the confusion and vagueness of doubtful
indications, we shall content ourselves with pointing
out those medicines which answer best to the anomalies, or the secondary symptoms, the most generally
observed in the epidemics of scarlatina.




SCARLATINA.                141
These medicines are: Aconiturn, baryta cfrbonica, opium, ipecacuanha, cinnabaris, spongia tosta,
hepar 8uZph., acidaum nitri, dulcamara, lycopodium,
calcarea and sulphur.
Aconitunz should be prescribed at a low dilution,
and in frequent doses before belladonna, when one
is not yet very certain of the nature of the disease;
if the fever is very intense; if the pulse is more
remarkable for fullness than frequency, and if in short
the miliary fever of which we are about to speak, is
complicated with scarlatina. In this last case, aconite
and belladonna should be administered alternately
during the whole course of the disease, always taking
care however, to leave belladonna some hours longer
than aconite to exercise its influence.
BBaryta carbonica, from  the twelfth to thle eighteentlh dilution, is preferable to belladonna in the case
of lyrlphatico-nervous children, disposed to chills,
when there exists a considerable turmrefaction of the
tonsils, at the same time that these glands are rather
rose-colored than of a vivid red, with frequent expectoration of mucus, pressing and lancinating pain in
swallowing.  Baryta succeeds, especially when there
is joined to the preceding  symptoms incomplete
stools, at first hard, afterward soft, small in quantity,
without form, and light-colored without being absolutuly white.
If a burning heat supervenes, with stupor, somnoklnee, agitation, vomitings, diarrhea or constipation




142           ACUTE EXANTHEMATA.
and convulsions, opium will be found of the greatest
utility.
If there is increase of fever toward evening, wakefulness, nausea, total absence of appetite, great disposition to weep, ipecacuanha is indicated.
It there are cedenma and swelling of all the tissues
of the neck, visible externally, with a tainted breath
and tendency to bloating, cinnabaris is a precious
medicine, and much preferable in such a case, to all
other mercurial preparations.
Spongia and hepar suclh. are called for, each in
their sphere of action, in symptoms of croup occurring
incidentally.
If the angina is accompanied by nervous fever; if
there are numerous little fetid  ulcerations in the
mouth and throat, with general depression, great dryness of the mouth, and continual thirst, acidunz nitri
is indicated.
Dulcamara corresponds to the rheumatic pains,
which sometimes succeed the eruption. Lancinating,
beating or pinching pains in the chest, the region of
the liver and lower abdomen, with dry cough, hard,
rumbling stools, and congestion of blood toward the
head, call for the use of lycopodium.
calearea and sulvpur are the principal remedies
for dropsy, engorgements, ulcerations and the greater
part of the secondary symptoms of scarlatina; but
it is very important not to repeat the doses too frequently.




PURPURA.                  143
PURPURA.
Purpura, or miliaria purpuralis, is an eruptive
fever, which very much resembles scarlatina, but
which, nevertheless, differs from it enough to be considered as a special affection.
This distinction is even so much the more important, as the two cases demand a very different
treatment.
Instead of proceeding, as in the eruptions of scarlatina and measles, the spots of purpura develop themselves irregularly, now here, now there, and sometimes
simultaneously over distant parts of the body. Instead of being smooth, temporarily rendered white by
pressure, and especially, dry like those of scarlatina,
they are interspersed with little papula, of a dark
color, remain red under the pressure of the finger,
and are almost always moist. The patient only perspires through these spots, and, in consequence, does
not perspire much, excepting when the body is covered
with them.
Purpura has not a regular and determinate course,
like other exanthematous fevers. It often persists for
several weeks, and no particular sign indicates an approaching termination.  It may suddenly disappear,
and thus place the life of the patient in great danger;
its malignity has no relation to the abundance of the
eruption.
This disease may attack the same person several
13




144 ALACUTE EXANTHEMATA.
times, and even return again in the course of the
same epidemic.  The angina which precedes the
appearance of the eruption, returns when the lattel
has disappeared.
Aconite is the specific for purpura.
M ILI A RI A.
Miliaria is characterized by an eruption of whitish,
pearly vesicles, of the size of a millet seed, which develop themselves in great numbers, and exists as an
epidemic; it is accompanied by fever, gastro-intestinal
inflammation, extreme agitation, sometimes delirium
and spasms, fetid and abundant sweat, and lastly, by
great irritation of the skin.
The premonitory symptoms of this disease, are those
of typhoid fever; its course is very irregular, and one
cannot specify, in a precise manner, the epoch of the
eruption, which commonly, however, manifests itself
between the third and the sixth day.
Abandoned to itself, or treated by allopathic methods, miliaria is always a serious disease.  Many
patients sink and die after a prolonged attack of
delirium.
Arsenicum, administered from the beginning, every
three hours, at a high dilution, is the principal remedy
against this disease. It should be given of the twelfth
dilution, if the diarrhea is abundant; at the thirtieth,
if the nervous symptoms predominate over the in.
testinal.




SUDAMINA.                 145
Belladonna should be administered, as an intercurrent remedy, if there is delirium with congestion
to the head, puffing of the face, and red and
brilliant eyes.
Bryonia and chamnomnilla are the best medicines
against a sort of sporadic miliaria, which sometimes
attacks women in child-bed, and infants at the breast.
Ardent thirst, anorexia, throbbing pain in the temples, dry tongue, yellow  at the base, epigastrium
painful to the touch, constipation; such are the symptoms which indicate the employment of bryonia.
Chamomilla would be preferable, especially in little
children, if, in addition to the eruption, there are
green, watery stools, like beaten eggs, which corrode
the anus.
In cases where the use of chamomilla is not followed by prompt improvement, it will be necessary to
have recourse to sulphur, thirtieth dilution; sometimes, also, to arsenic.
S UDAMINA.
It is thus we name little pearl-like vesicles, whether
transparent or opaque, that are observed in new-born
children, especially in those of a weakly constitution,
and during the warm season.
This eruption, which, the greater part of the time,
is caused only by too warm clothing, is rarely accompanied by dangerous symptoms; a few warm baths,
and, at most, a small dose of aconite, dulcamara,




146           ACUTE EXANTHEMATA.
bryonia, rhus, or ceamomilla, according to circumstances, suffice to dissipate it.
v A RIO LA -S M AL L - PO X.
It is difficult to conceive the terror which must have
been felt, before the discovery of vaccination, by the
the epidemics of small-pox. Perhaps no disease has
made greater ravages upon the human race. At each
of its invasions, the number of its victims was enormous, and the hideous scars left behind it, when it
spared the life even of the patient, inspired, especially
in women, almost as much horror as death.
The small-pox, like all the great epidemics, comes
to us from the East. We are unable to trace its history farther back than the seventh century. We know,
without, however, being able exactly to fix the dates,
that it passed fiom Arabia into Egypt, in 622 or 640,
and from Africa to Spain in 714. Rhazes, an Arabian
physician, describes it in his Treatise of the Plague,
toward the end of the ninth century. A short time
after this epoch, it ravaged the south of France. In
1280, it was generally known in England, from whence
it passed to Denmark, and, a little later, into the
other countries of the North.
We find, in fact, that the most ancient date of
variola in Sweden, does not go farther back than 1578.
Benedictus Olai, physician to Eric XIV, and to Jean
III, mentions it under the name of measles; but the
description that he gives of it, proves beyond a doubt,




VARIOLA - SMALL-POX.            147
that he is speaking of variola, and, what is more, even
of its different species.
At length, in exchange for the syphilis, of which,
according to popular opinion, the sailors of Christopher Columbus brought us the germ, Europe bequeathed the small-pox to America, where it has since
shown itself in almost all latitudes.
Small-pox, like all the other eruptive fevers, seldom
attacks the same individual more than once. It is
not precisely a disease peculiar to childhood, for it
attacks equally individuals of all ages. It is, however,
more frequent in the second period of childhood, than
in infants at the breast, or in adults. The diversity
of age, beside, produces no other differences in it
than those which belong to the nature and seat of its
complications, for the character of the eruption remains
always the same.
The history of this disease contains nosological
details of the highest interest; and the labors to which
pathologists have devoted themselves in tracing its
origin, and in endeavoring to appreciate the real
nature of its varieties, would of themselves make the
subject of a long monograph. But I shall content
myself, in the cursory glance I am able to give.it here,
in stating the facts most generally admitted. Let us
observe, beside, that since the first descriptions of
small-pox left us by the Arabian physicians, the essential phenomena of this disease have not changed.




1.48          ACUTE EXANTHEMATA.
It shows itself, in our day, the same as in the time of
Rhazes.
In the eighteenth century, the persuasion that an
attack of small-pox was for all men without exceptiona fatal necessity-suggested to physicians the monstrous idea of inoculating this disease. Their object,
they said, was to protect communities from its immediate dangers and consequences, by producing the
disease in individuals at a favorable time, and in preparing the patient for it by a regimen and appropriate
remedies. This folly, which characterized the medical spirit of that epoch, (and of almost all epochs)
was rapidly propagated from the schools of the north
to the schools of France, and gained, one knows not
how, the assent of the most intelligent men. Rosen
of Rosenstein, whom I have already often cited,
because his name gives authority, expresses himself in the following manner on the subject of inoculation:
" The sure means of avoiding the danger of smallpox, is to inoculate children when they are young,
and beside, to perform this operation as it is done in
England. It is in fact, disagreeable, at each epidemic, to take, as long as it lasts, Ethiop's mineral,
preventive pills, or tar-water; and it is risking too
much to expose one's-self to be surprised b)y so fatal
a disease, without being prepared for it. The older
one grows the more dangerous it becomes.




VARIOLA -SMALL-POX.            149
"One is always liable to be attacked with it in traveling, or in places where there is no physician within
call, or where it is even difficult to procure medicines
and the attendance required. One may take it during
the heat of summer, after being already exhausted by
another disease, or by labor, or long watchings, and
when other diseases are prevailing, as purpura, pleuritis, inflammations of the lungs, or typhoid fevers;
or perhaps even when fire has been carried into the
body by incendiary drinks, or overloaded with a superabundance of food.
"Women, especially, should not fail to be inoculated. They see every day how much their beauty
suffers from natural small-pox. Beside, they are liable to be attacked during pregnancy, or in child-hed,
so that they and their offspring are in danger of their
lives. The numerous examples of persons who have
lost their sight, hearing, the use of speech or a limb,
in consequence of this disease, should induce all to
avail themselves with avidity and gratitude of the
means of avoiding these dangers, and even a premature death."
Thus, then, in order to avert these dangers and a
premature death from a child who is in perfect health,
the physician takes possession of him, keeps him
apart for two or three weeks, nourishes him with light
meat and vegetables, to cool his blood, gorges him
with purgative pills, generally made of calomel and
camphor, and lastly, inoculates him with small-pox,




150           ACUTE EXANTHEMATA.
which the unfortunate child would perhaps never
otherwise have had.
This barbarous practice, excusable only in a people
in its infancy, was nevertheless in vogne for several
years in all the capitals of Europe.
At last, however, it began to be suspected that the
advantages of inoculation were not so great as to be
absolutely incontestable. A few physicians, at the
head of whom we should cite Van Swieten, bethought
themselves of submitting to the test of rigorous statistics, the results of cases of natural small-pox, and
those of inoculated small-pox, terminating fatally.
They found that, notwithstanding the advantages of
the choice of season, the favorable age of the patient,
diet and calomel, that the number of the victims of
inoculated small-pox was very nearly in the same
proportion as that of the disease, spontaneously contracted.  The good sense of the public did the rest,
and the inoculation of small-pox fell into disuse.
However, to be just toward these physicians, we are
compelled to acknowledge that this disastrous sophism
maintained its place in science, and would perhaps
have done so to the present day, but for an admirable discovery which overturned it from its very
foundation.
An English physician had the good fortune to
imagine that, in order to preserve men from the smallpox, it was not necessary to give it to them —which
was plunging them into a river to protect them from




VARIOLA - SMALL-Pox.             151
the rain-but only to inoculate them with an analogous
affection, incomparably more mild. This ingenious
conception was, as we see, an anticipated glimpse of
the great law of Ilomceopathy. Experience soon
verified the theory of Jenner, and inoculation with
vaccine succeeded, at last, in supplanting inoculation
of the small-pox.
Since this discovery, small-pox has lost more than
three-quarters of its inauspicious prestige. With the
exception of the inhabitants of those countries where
prejudice and ignorance still oppose a free access to
vaccine, nobody is disturbed at its approach.  It
sometimes traverses our cities almost without leaving
a trace. Nevertheless, we sometimes see it appear
with a certain degree of violence, and attack even
vaccinated subjects; but, in these cases, especially
if they are children, it rarely assumes a serious
character.
I confess, it is not absolutely the same with respect
to adults. I have several times seen, especially a few
years ago, in the practice of Professor Rostan, men of
from  twenty-five  to thirty, very seriously attacked
with small-pox, although they had been vaccinated
in their infancy.  Can it be that at the end of a
certain number of years the principle of the vaccine is
exhausted in the economy, and is divested, little by
little, with the renewal of our organs, of its preservative virtues?  This opinion, which is that generally
entertained by German physicians, merits, it must be




152           ACUTE EXANTHEMATA.
confessed, experimental proof. I have, myself, vaccinated in 1846, a dozen persons already vaccinated
eight or ten years before, in none of whom did the
eruption make its appearance. It is, in consequence,
extremely probable that in these dozen persons, the
aptitude to receive the variolous infection was completely destroyed, or at least had not yet been reproduced.  I saw, the following year, however, the
vaccine take again very well in a young girl of
seventeen, who bore upon both arms the scars of a
vaccination made, as I was told, in 1832. The important question of re-vaccination remains, then, up
to this time, in the most complete uncertainty.
The characteristics of variola are extremely marked.
After the symptoms of a, gastro-pulmonary and
intestinal irritation, which lasts two or three days,
the pustules begin to appear, at first pointed, but soon
becoming umbilicated, sometimes few and distinct,
and at others numerous and confluent. At the same
time that these pustules acquire the umbilicated form,
and their center the puriform aspect, the skin reddens
and tumefies in a remarkable manner. At the end
of eight or ten days the pustules begin to dry, and are
covered with yellow or blackish crusts, after the fall
of which we find upon the skin circular spots of a
brownish-red color, then scars more or less regular:
there sometimes supervenes an abundant salivation.
In general, the duration of these pustules is from
ten to twelve days.




VARIOLA - SMALL-POX.             153
" Variola," says Hartmann, " cannot be mistaken; at most, it can only be confounded with
varicella, from which only this disadvantage could
result, that as, in general, persons have the small-pox
but once in their lives, one might believe themselves
thenceforth safe from it while in fact they would
not be so."
This disease presents, in its course, four periods
more or less distinct.
The first, or febrile period, commences by a simple
irritative fever, and terminates when the first spots
appear upon the skin. The fever, at first slight,
increases from  day to day in the form  of a remittent
continued; there is headache, ill-humor, lassitude,
disposition to sleep, a marked congestion of the blood
toward the brain and face, epistaxis, sometimes delirium, nausea and bilious vomiting, a peculiar and
disagreeable odor of the breath, and of the urine,
epileptiform convulsions in little children, colic,
drawing pains in the limbs, stretching, pain in the
loins, etc.
"The precursory signs of small-pox," says Rosen,
"are not as decisive as some have thought; thus one
can almost never affirm, with certainty, that a subject
is on the point of having it. The following circumstances, however, will commonly enable us to foretell it:
"1st. If the disease exists in the vicinity of the
patient:




154           ACUTE EXANTHEMATA.
"2d. If the patient has never had it; if he has
been in an apartment where some one has had it;
if he has been near a person who has been with
one of these patients, or has touched their clothes or
linen:
"3d. If we observe the symptoms which ordinarily
precede eruptive fevers; as, a certain languor; enerva
tion without manifest cause; a chill, followed by heat;
pain in the loins, an oppression of the chest, sighs.
"4th. If the face is bloated, the eyes heavy, with a
slight flow of tears, especially fri-om the left eye, the
tears not so hot as in measles; if the patient feels pain
in the pit of the stomach upon slight pressure of the
finger; if there is desire to sleep at unseasonable
hours; if he is agitated during sleep and vomits
often: if. I say, we observe these different symptoms,
we may presume, with confidence, that the patient will
have small-pox.  The fever continues, but not with
the same force, up to the moment of the eruption.
At this period, some patients, especially little children, are attacked with epileptic convulsions; and if
dentition contributes nothing to it, it is commonly the
sign of a favorable form of the disease. This, the
first period of variola, lasts as long as seventy-two
hours, and even four days."
I do not know how far epileptic convulsions, in
children, may be considered, as Rosen asserts, of
good augury.  The truth is, that Kirkpatrick and
Van Swieten  have seen some patients, after this




VARIOLA - SMALL-Pox.             155
symptom, remain speechless, or with paralysis of a
limnb, for several weeks.
We know, at least, that these symptoms, frequent
enough in children attacked with typhoid fever, have
hardly ever bad consequences, and disappear of themselves after a certain time, which, beside, may be
abridged by appropriate remedies.
The second period is that of the eruption. It is
immediately preceded by a febrile exacerbation, but
which abates from the moment that the first pustules
appear. These appear first upon the face, more particularly on the upper lip, and on each side of the
nose, in the form of little nodes, which cause under
the finger, says Ilartmann, the same impression as
grains of millet. These papuloe enlarge rapidly, almost while we look at them, and assume the appearance we have described. From the face, they spread
over the neck, chest, arms, loins, and inferior extremities. They rarely appear on the abdomen, still
more rarely on tile soles of the feet. The eruption is
completed in three or four days, at the most; the
febrile excitement, although less than at an earlier
period, continues, nevertheless, during the whole time
of its appearance, but does not persist longer, excepting in anomalous cases. Sometimes, even, when the
variola is mild, the eruption takes place without
fever, the patient then only complains of itching and
burning of the skin.




156           ACUTE EXANTHEMATA.
When variola appears during dentition, there is
always a more or less violent fever, which does not
cease with the appearance of the pustules, and which
is liable to assume a variety of forms. There are frequently congestions to the head or chest; in the first
case, there is delirium, accompanied with great thirst,
wakefulness, and constipation, the hands may be
cool, or of a normal temperature, but the rest of
the body is burning: in the second case, there is a
short and fatiguing cough, with great thirst, pulse
strong and frequent, and extreme agitation; pneumonia is to be feared.
It is at this period, small-pox has the greatest
tendency to become malignant; that is to say, to become complicated with ataxic symptoms, or to disappear suddenly, and fix itself upon the internal viscera;
a circumstance which is always very serious, and calls
for the most prompt attention.
The third period, or period of suppuration, commences from the sixth to the eighth day; that is, from
the time when the eruption appears on the face, and
continues to the time when the first pustules begin to
dry. The commencement and the termination of this
period is no more marked than those of the others.
because, as the eruption is not effected all at once,
but spreads, little by little, from region to region, it
results, that the first pustules are almost dry, when
those on the legs but just begin to show themselves.




VARTOLA - SMALL-Pox.             157
When these pustules have attained their perfect
development, the transparent lymph which fills them,
becomes, soon, opaque and yellowish; and this, if
the disease progresses regularly, is a veritable stage
accomplished.  The base of each pustule is red and
painful. The swelling of the face is then so considerable, that the patient can hardly open the eyes, and
appears blind. The febrile affection commonly increases a little at this period, constituting the suppurative fever; it manifests itself, however, only when
the pustules are numerous. The more violent it is,
the more thick and turbid is the urine; and if this,
ordinarily of'a brick-red color, becomes bloody, it
must be regarded as a serious symptom. It only accompanies an eruption of bad character; that is to say,
one in which the pustules are flaccid before their time,
not umbilicated and filled with blood instead of serum.
It is during this third period that the peculiar odor
of variola is strongest; and persons not remaining constantly with the patient, find it almost insupportable.
The period of desiccation and of desquamation
terminates the disease; with it, all the symptoms of
the preceding period, progressively diminish.
The humor contained in the pustules, gradually
dries into a brown crust, which afterward falls off,
leaving behind a cicatrice, whose depth and extent
depend upon the suppuration, more or less considerable, of which the skin has been the seat; and this
latter, for a long time, remains marked with large red




1 58          ACUTE EXANTHEMATA.
spots, and very sensitive to the impression of the atmosplleric air.
"When the desiccation is once achieved on the
face,' says IHartmann, " there is no more danger.
But the beginning of this operation marks one of the
most serious periods of the disease; for it is then that
the greatest number of deaths occur, by putrid dissolution, gangrene of the pustules, hemorrhages, inflammations of the lungs, of the brain, of the abdomen, etc."
The sequelae of small-pox are frequent and varied.
Independently of the cicatrices, which time only to a
certain degree effaces, this terrible disease leaves often
after it chronic ophthalmia, deafness, large and very
painful furuncles, which are liable to be reproduced,
and sometimes, in short, pulmonary tubercles, whose
softening immediately succeeds, in many subjects, the
disappearance of the cutaneous eruption. Each of
these secondary affections calls for the special treatment appropriate to it.  The treatment of variola
proper, must alone occupy us here:
TREATMENT.-I am  happy in being able to point
out to practitioners, against the different phases of
variola, indications which are absolutely new, and
whose efficacy will, I venture to say, astonish those
who put them in practice.
"In following the course of natural variola," says
Hartmann, " I perceived, what has not escaped other
homzeopatllic physicians, that this disease, especially




VARIOLA- SMALL-POX.              159
at the beginning of the second period, bears a strong
analogy to the itch, and that it would not be without
reason, if we should call it acute itch. This remark
started with me, the question, whether it was not
possible that a dose of su7phzur, administered after
the febrile symptoms had been diminished, during
the first period, would preserve the subject from the
complete eruption of the variola, and whether it might
not also be emplo(yed as a preventive for other members
of a family, who had not had the small-pox, and who
had never been vaccinated, and who would not now
have time to have recourse to it. Circumstances have
not yet permitted me to put this idea into practice;
but I propose to embrace the first opportunity of
doing so.
I am sorry to be forced to predict for our estimable
colleague, that when the occasion shall present itself,
of putting this idea to the proof, he will be but
very moderately satisfied with the result.
But I confess that I ask myself in vain, what relation M. Hartmann and those of our brethren, who he
says, coincide in this opinion, have been able to find
between the itch and variola. Of these affections, the
one is essentially acute and febrile, the other is essentially chronic and non-febrile. The one is pustulous,
the other vesiculous. Variola manifests itself first on
the face; the itch, on the hands and bends of the arms.
The contagion of the first invades the entire economy
before breaking out in an eruption; the second shows
14




160           ACUTE EXANTHEMATA.
itself primitively on those parts of the cutaneous
envelop, which have been exposed to the infecting
contact. Lastly, the itch is, above all, characterized
by the presence of an acarus, which although it
escaped, one knows not how, the microscopic researches of doctors Alibert and Biett, is very easily
to be discovered with the naked eye. Variola and
the itch have then, between them, no other points of
r:esemblance, than that both are contagious; but this,
as we know, is also common to a host of other diseases.
Admitting, however, for the moment, the hypothesis
that variola is really an acute itch, as Hartmann says,
is this a reason why sulphur should act as its prophylactic, or be capable of arresting its progress? Sulphur is by no means the specific for true itch; we
see at least, that if it cures it, it cures it very slowly.
The medicines I shall point out for it, demonstrate an
incomparably greater efficacy than those of any sulphurous preparations whatever; so that, if suLphur
has its place in the treatment of small-pox, I venture
to affirm, that it is not the first period of this disease,
which calls for its use.
But there is another remedy of which M. Hartmann incidentally speaks, and praises for the convulsions of children during the eruptive period, which,
if he will consent to make trial of, upon the indications we give, will realize the hopes he has founded
upon sulphur; it is ZINcuM.




VARIOLA - SMALL-IOX.             161
Yes, when during an epidemic of variola, a patient, whatever be his age, presents evident premonitory symptoms of this affection, zincutm administered three or four times a day, not of the third or
fourth dilution, but of the thirtieth, will in all probability, arrest the development of the eruption. The
disease will be throttled, to speak after the manner of
certain Allopathists, but it will be effectually accomplished, and above all, without danger to the patient.
Let us remark, however, that although the patient
shall take the medicine I indicate, for a couple of days
only, he ought to observe, for a week at least, the
same hygienic precautions as if the eruption had
taken its course; he should above all, avoid exposure
to cold air.
But though zincurn be the real preservative from the
variolous eruption, when it is administered before its
development, it ceases to be efficacious from the moment when the first pustules have made their appearance. It, in a word, is not the specific for variola.
This specific, nevertheless exists, or at least, we
have the right to consider as such, those means which
we are about to indicate. But let us, beforehand, cite
a few important lines from M. Rapou:
"In the beginning, (it is of variola he speaks), it
is proper to administer a few doses of aconite; but
as soon as the papulse are developed, we should have
recourse to mercurius, at one of the lower potencies,
and adhere to it as the remedy constituting principally




162            ACUTE EXANTHEMATA.
the therapeutics of variola.  Jlercurius is but little
recommended in this case; but the results obtained
in the practice of my father, convinced him that this
substance was the specific, above all others, for simple
variola.  Under the influence of this remedy, the
eruption is regularly effected; no serious complication
intervenes; its evolution is greatly accelerated, and
the suppuration is not abundant. In a word, if the
disease is taken in the beginning, it always shows
itself mild, and loses the dangerous character which
has made it dreaded up to this time."~
Thus, of the divers medicines tried, without doubt,
by M. Rapou, the father, mercurius is beyond comparison, the one which has succeeded best.
Ilartmann also speaks of mercurius, but in much
less explicit terms. Ile only recommends it for the
third period, and as a means of combating salivation:
M. Rapou is much nearer the truth.
Jfercurius, in fact, or at least one of its combinations, was ordained by destiny to play an important
part in the treatment of variola.
Jfercurius corrosivus, (but not the mletallic mercury recommended by Rapou) is, with the aid of cau.
ticum, a heroic remedy for small-pox.  Let us prescribe, for example, either on the appearance of the
first pustules, or in the course of the second, or
* Vaccinin, 200d potency, is, according to our experience, the true
specific against Small-pox in all its stages. Ed. 2d edit.




VARIOLA - SMALL-POX.            163
even the third period, if one is not called until that
time:
1st. Caustic. 30th, eight glob., in four ounces of
vehicle, two teaspoonfuls to be taken in the course of
the morning at an interval of three or four hours.
2d. ih3erc. corrosiv., 30th, eight glob., in the same
quantity of vehicle, two teaspoonfuls at the same
intervals, in the afternoon:
And we shall see, in an immense majority of cases,
that under the influence of this medication, the exanthem, and all its concomitant symptoms, will be
extinguished as if by magic.
When the disease pursues an irregular course;
when the eruption exhibits a tendency to disappear
from the surface; when the pustules, instead of
being transparent, or yellow, are green, purple or black;
when the blood with which they are filled announces
a decomposition of this fluid, and threatens the
approach of putrid symptoms, it is not to arsenicurn
we should have recourse, but to sulphul/r.
In this case, causticurn should be continued in the
morning, and sulphur at a high potency, 30th, for
example, should replace mercurius corrosivus, in the
afternoon; but we should return to the latter as soon as
the symptoms have resumed their normal course.
These three medicines: caustic., merc. cor. and
sulphur will almost always suffice for the treatment
of variola. The two first will abridge more than
half the whole duration of the disease, and prevent




164            ACUTE EXANTHIEMATA.
the secondary symptoms, which it would be the mission, principally, of sulphur to repair.
Belladonna, which has been much  extolled for
small-pox, is not, nevertheless, appropriate to it, except as an accessory, and only in cases where cerebral
symptoms manifest themselves.
When, on the contrary, there is no tendency to delirium, belladonna has the disadvantage of exciting,
and that without any benefit, a painful degree of
agitation.
Lastly, under very rare circumstances, it is possible
we may be obliged to have recourse to lachesis,
arsenicum, and to muriaticuan acidurn.  The well
known symptoms of these medicines sufficiently indicate the circumstances which would call for their use.
VARIOLOI D.
Varioloid is a mild and modified variola; it passes
through the same periods, but leaves no scars.
M. Moreau de Gones (in a memoir read at the
Academy of Sciences, in October 1827,) asserts that
the varioloid is distinct in its symptoms, its effects
and its origin, from common variola; that one is not
preserved from its contagion either by that of
ordinary small-pox, or by the power of vaccinia;
the vaccine-virus, however, modifies its pernicious
influence.
I have seen varioloid declare itself in children recently vaccinated; but it is probable that, without the




VARICELLA - CHICKEN-POX.           165
influence of the vaccine, it would have been the smallpox.
"It is in fact proved," says M. Billard, " that the
kinds of variola which occur in spite of vaccine, do
not differ, in their anatomical character, from those
which attack patients not vaccinated; that they frequently even offer the same complications, and that
in general they have neither appeared more mild or
more fatal." This last observation, I venture to say,
has no foundation excepting in relation to individuals
who had been vaccinated many years before.
Be that as it may, varioloid does not differ essentially from variola, and the same treatment is adapted
to botlh.
VARICELLA - CHICKEN-POX.
Varicella differs somewhat fioln variola, in its pathological character.  The fever which precedes the
eruption of this exanthem is never prolonged beyond
thirty-six or forty-eight hours. In combination with it
there are more or less marked symptoms of gastro-intestinal irritation. The pustules, instead of being regularly umbilicated, like those of small-pox, are sometimes
conoid, sometimes globular, sometimes, in fine, umbilicated, but present the same type in the different periods.
I have reason to believe that vaccina does not act
as a preventive from varicella; and that, in turn, varicella offers no protection from the small-pox; it is for
this last reason, especially, that it is important not to
confound them together.




166          ACUTE EXANTHEMATA.
Varicella is one of those diseases that are left, the
greater part of the time, to the efforts of nature alone.
Nevertheless, if it appears during dentition, it might
give rise to cerebral, or nervous symptoms, which
would require, according to circumstances, the use of
belladonna or coffea.
When varicella is a simple, non-complicated disease, a dose of pulsatilZa, administered in the begin
ning, greatly abridges its duration. It is also recommended as a prophylactic.
VACCINA AND VACCINELLA - COW-POX, AND SPURIOUS
COW-POX.
The name Vaccina is given to the eruptive disease,
which results from the insertion, under the epidermis,
of the vaccine virus.
Vaccinella, or false vaccina, is a minor disease,
nearly resembling it, and consecutive, also, to inoculation, but which does not possess, as does the first,
the virtue of preserving from variola.
TWe see, then, how important it is not to confound
vaccina with vaccinella; and the more readily to distinguish them, let us recall here the characteristics
of the two affections.
Characteristics of vaccina.-Eigqht days after inoculation reddish pimples appear, which soon become filled
with afluid,first transparent, then turbid; the centers
of these pustules become depressed, their base inflamed
and swollen, and lastly, the humor they contain is




VACCINA AND VACCINELLA.          167
transformed into a brownish crust, which detaches
itself at the end of two or three days, and leaves after
it a cicatrice.
Characteristics of the vaccinella.-After the insertion of the vaccine in subjects already vaccinated, or
who have had the small-pox, or indeed, when the
virus inoculated is not in a proper state, we see also
developed pustules, but which appear from the third
to the fourth day, whose centers are not depressed,
and whose,flattened and unequal edges are not
swollen. The humor contained in these pustules is
of a limpid yellow color. An insupportable itching,
accompanies them toward the seventh or eighth day.
Crusts are also formed, but they fall without leaving
scars.
We may vaccinate at all ages. However, the congestion of the integuments, during the first days of
life, seems to contra-indicate vaccination at this period.
" I have several times seen," says M. Billard, " at the
hospital of the Enfants-trouves, where they vaccinate
children very young, a very intense erysipelas developed upon the vaccinated limb."
Hartmann has made, on the subject of vaccine, an
observation which deserves to be cited: "The vaccine," says he, " does not preserve subjects to whom
the contagious principle of variola has been already
communicated, and who are susceptible to the action
of this principle. But as one cannot know the period
of this infection, because, (luring its incubation, the
15.




168         CHRONIC EXANTEIEMATA.
person feels well, so we cannot fix upon any time, up
to which only, it will be useful to vaccinate. In the
instance where a member of a family is attacked with
small-pox, and the family contains several individuals
who have never been vaccinated, the vaccination of
these would be of no use: experience has taught me
thils. But this is not saying that vaccination would
be useless for the whole community: far from  it;
recourse should be had to it at once, in order that
many may be protected from the contagion. This is
rarely propagated with such rapidity as to make it
impossible to preserve those who do not come in
contact with the persons affected."
CHRONIC EXANTHEMATA.
CHRONIC eruptions are external manifestations of
probably very different essential diseases, which, when
they do not reveal themselves under the eruptive
form, are only the more to be dreaded.
Sooner or later, in fact, they break forth internally,
and then cause ravages, so much the more difficult to
arrest because it is nearly impossible to penetrate their
nature, and to ascertain the remedies appropriate to
them.
This is what often happens in cold and damp countries, where the skin performs its functions imperfectly, and where cutaneous diseases are rare, but where,




CHRoNIC EXANTHEMATA.           169
by way of compensation, we meet, at every step,
tuberculous affections of the lungs, of the mesentery,
of all the internal organs, and a host of other analogous lesions, having each, without doubt, its special
character, but of which no one suspects the principle.
Now, it is extremely probable, that all these impenetrable, and so often fatal, hidden diseases, correspond to those which, in warmer climates, manifest
themselves under the exanthematous form.
The determination of these morbid entities, internal
or external, according to the latitude, and especially
the determination of the signs, by which we may
recognize them, when they do not show themselves on
the skin, or when one has had the imprudence to repel
them, would, assuredly, be an immense acquisition,
for medicine and humanity.
But, unfortunately, up to the present time, the
closest, the most assiduous, and the most persevering
observation, has afforded us, with respect to them, but
very vague notions, from which practice has hardly
been able to derive any advantage.
However it may be, it results from what precedes:
1st. That we can scarcely attach too much importance to the treatment of chronic exanthemata; since,
in abandoning them to themselves, or in treating them
improperly, we infallibly expose the patient to the
most dangerous metastases.




170          CHRONIC EXANTHEMATA.
2d. That it is absurd, monstrous, to treat these
diseases with local applications, which, in despoiling
them of their only apparent symptom, leaves to the
practitioner, not even the resource of following their
progress. So, it is with the most profound disgust,
that I go over, (as I still occasionally do,) the allopathic therapeutics of the diseases of the skin.
In consequence of the opinion I have formed, not
precisely upon psora, in the absolute sense in which
Hahnemann understood it, but upon the multiple and
polymorphous nature of chronic miasms, I am not
indisposed to regard, as a happy circumstance, the
appearance of cutaneous affections in children.
I do not suppose, according to the vulgar opinion,
that, in having this eruption, they thus pay nature a
tribute, by which they are thenceforward, forever
affranchised from her; but, what appears evident to
me, is, that when they have been once cured, by sure
means, of a tinea, of a herpes, or impetigo, they will
be forever delivered from malignant principles, which
might have remained latent for a series of years, and
finallv have shown themselves in an incurable fbrm.
During the five years that I was resident physician at the baths of Bagnoles, in Normandy, I
treated a very considerable number of chronic eruptions.
Independently of the bathers, submitted to my
daily observation, I had, in the country, an extensive
practice, which gave me an opportunity to test, aside




THE ITCH.                 171
from the action of the waters, the curative properties
of the remedies I employed.
Thanks to the co-operation of some friends, who
were good enough to aid me in my pathogenetic
researches, touching several new medicines, or medicines yet but little known, I have succeeded in discovering, for chronic exanthemata, a treatment, far
superior to that in general use.
To make known, without reserve, the results of my
experience, is, for me, a duty full of charms.
It is my intention to publish, some day, in extenso,
the homceopathic treatment of cutaneous affections;
but it is evident, that I must here confine myself to a
limited view, and especially speak of the eruptions
peculiar to children.
THE ITCH.
This exanthem, almost always apyretic, consists in
an eruption of vesicles, very slightly elevated above
the level of the skin, sometimes of scarcely any
marked color; transparent at the top, and accompanied
with an itching, which forces the patient to scratch
continually, and generally developing itself in the
folds of the joints.
The itch commonly first shows itself between the fingers, upon the wrists, and at the epigastrium. Thence
it extends, little by little, until it covers the whole
body, with the exception of the face, where it never
appears.




1 72         CHRONIC EXANTHEMATA.
When it is communicated from the nurse, which
often happens, it is on the breech and thighs of the
child that it first appears, because these parts come in
contact with the arms of the nurse.
The itch has this peculiarity, that it is never spontaneously cured. As the vesicles ripen and disappear,
new ones appear.
The change from cold to heat, especially the heat
of the bed, increases the itching and renders it almost
insupportable.
When the patient, in scratching himself; has torn
open the vesicles, as almost always happens, at least
in children of a certain age, there issues a mixture
of blood and serum, which in drying, forms rather
thick crusts of a dark red, and which give the patient
the appearance of having been scourged.
When the disease is recent, and its nature has not
been changed by an external treatment, it is easy to
perceive, especially between the fingers, little regular
red lines, of which each beginning in the vesicles, is
prolonged under the epidermis, and terminates in a
little brown point. If, on introducing the point of a
needle under the epidermis, we extract this point, we
discover the acarus or sarcopte of man.
This animalcule is about one two-hundredths of an
inch in diameter. Its body is rounded and compressed on the sides; seen through the microscope,
its form  reminds one of that of the tortoise. It is
white, striated, bristling upon the back with rigid




THE ITCH.                 173
paplilllef. Its feet are eight in number, four anterior
and four posterior. The former, placed on each side
of the head, and, as it were, webbed, are furnished
with  cup-shaped  caruncles.  The four posterior,
fixed to the abdomen, are shorter and more separated
than the anterior, cylindrical and unprovided with
the cups. The front feet and the head can, by bending,
be hidden under the body.
The itch is essentially contagious. Some authors,
among whom I will cite Miorgagni, attribute its development exclusively to the presence of the acarus, and
regard, in consequence, this insect as the only vehicle
of contagion. I am ignorant as to how far this opinion is tenable.
According to Hahnemann, the psoric or itch miasm,
is the most contagious of all the chronic miasins.
" It is communicated," says he, " with such facility,
that in passing from one patient to another, to feel the
pulse, a physician often inoculates several persons
without knowing it. Linen washed with the clothes
which had been worn by one who has the diseasegloves, new, but which an itch-patient had already
tried on; a towel used for the purpose of wiping-have
sufficed to communicate the principle of infection. It
often happens that a new-born child contracts it in
passing the external genital parts of its mother, who is
affected with it, or that it receives this baleful present
fiom the midwife, who had caught it in attending
another woman in labor, or contracts it, either at the




174          CHRONIC EXANTHEMATA.
breast of the nurse, or in the arms and through the
caresses of those who have charge of it, without enunlerating the thousands of other occasions to be met
with in lifb, of touching objects invisibly sullied with
this miasm."'*
Notwithstanding the authority of Hahnemann, it
is impossible to admit that the itch is communicated
with the facility he asserts. But, it is well known,
that in his theory of psora, the itch plays the important
part, or rather the only part. The itch-eruption,
according to him, was the primitive form of psora.
Now as he referred to psora, all the chronic diseases
not syphilitic, he war forced to admit that the majority
of men had had the itch; an hypothesis which could
only be sustained by supposing, in this exanthem, a
prodigious tendency to communicate itself.
Thus Hahnemann, under the influence of his fixed
idea, saw the itch everywhere.
"In  1817 and 1818," says Ilartmann, "I was
present almost daily, at Halhnemann's consultations,
and I very often heard him ask his patients if they
had ever had the itch. At last he would say to them,
in a very positive manner:' You have at some time
had the itch.' I was very much surprised at the affirmative reply of a majority of the patients. Since that
time, I never fail to put this question to those who
* Doctrine et Traitment Homceopathiques des Maladies Chron
iques, tom. i, page 56, et suiv.




THE ITCH.                175
come to me for advice, and before Hahnemann had
published his Traite' des faladies.Croniques, I had
very often found in sulphur and in hleppar sulph. the
appropriate remedy."
1 do not know whether the patients, so affirmatively
interrogated by Ilahnemann, perfectly comprehended
his question, when they replied that they had actually
had the itch. I do not know either if the itch is more
common in Germany than among us; but what I can
affirm is, that in France, especially among the rich, or
even among those in easy circumstances only, out of
every ten interrogated, nine positively declare that
they have never had the itch; which however does not
prevent them from complaining of chronic affections.
I have seen, on the other hand, a great number of
individuals, who have had the itch, and who have
never been treated, except by external means, enjoying
excellent health.  Hahnemann could have found
many, and striking proofs of this assertion, among our
sailors.
But if, instead of asking patients this explicit question: Have you had the itch? we content ourselves
with simply asking, if they have had any disease of
the skin, almost all reply in the affirmative. Must
we consider all cutaneous diseases but transformations of the itch?  I am quite convinced that this is
not the case.
However it be, HIahnemann did not fail to attribute
to the repercussion of itch pustules, however little




176          CHRONIC EXANTHEMATA.
apparent they might have been, and even when there
was no proof that they had ever existed, the immense
majority of the diseases submitted to his observation.
The state of vague suffering that physicians are in
the habit of naming cacochymy, was equally, for him,
but the result of repelled itch, or a latent psora, of
which he thus traces the principal symptoms:
"Frequent excretion of worms; insupportable itching in the rectum, especially in children; in many
cases, swelling of the abdomen; sometimes, insatiable
hunger, and sometimes, no appetite at all; paleness,
and flaccidity of the muscles; frequent ophthalmia;
styes; swelling of the glands of the neck; sweat on
the head; bleeding of the nose in young girls and
young boys, more rare in adults; hands generally
cold, or moistened with perspiration, or burning heat
in the palms; feet bathed in a fetid sweat; frequent
numbness of the limbs; frequent cramps in the
muscles of the arms and hands; subsultus of certain
muscular parts; frequent catarrhs; dry or fluent
coryza; obstruction of the nostrils; painful dryness
in the nose; ulceration of the nostrils, frequent angina; frequent hoarseness of the voice; short, hacking
cough; frequent attacks of asthma; liability to be
chilled; great tendency to sprains in the back; frequent headache and toothache, of one side; frequent
flashes of heat; falling of the hair; scales upon the
scalp; tendency to erysipelas; disorder of the menses;
convulsive movements'of the limbs, at the moment of




THE ITCH.                   177
falling asleep, lassitude after sleep; perspiration during
the day; tongue white, or, at least, very pale, and
cracked; a great deal of mucus in the throat; fetidness of the mouth, acid taste; nausea in the morning,
feeling of emptiness in the stomach; repugnance tor
warm food, dryness in the mouth; frequent pains in
the bowels, hard or loose stools, hemorrhoides dry, or
bleeding; urine, dark colored; veins swollen with dilatation in the legs, (varices); chilblains, even in summer; pains in the corns, without external pressure of
the shoe; extreme liability to dislocation of the joints,
cracking in the joints during movement; drawing
pains in the nape of the neck, the back, the limbs,
and especially in the teeth; renewal, during rest,
of the  pains  dissipated  by  movement; renewal,
or aggravation, of a greater part of the symptoms,
during the night, when the barometer is very low,
during north and northeast winds, in winter, and
toward the spring; too vivid and agitating dreams;
unhealthy skin, frequent furuncles, whitlows; skin
dry in the limbs, often, even, in the cheeks; desquamation of the skin, in different places, sometimes
accompanied with burning and itching; appearance
of isolated vesicles, which fill with pus, and occasion a voluptuous itching, followed  by burning
heat." ~
* Doctrine et Traitement Homceopathique des Maladies Chroniques,
tome i, page 66, et suiv.




178          CHRONIC EXANTHEMATA.
I have no doubt whatever, that these minor disorders, as well as the more serious affections, of which
they are commonly but the precursory signs, are the
consequences of congenital, or contracted miasmatic
infections.   But, that these  morbid  phenomena
have all one common origin —that they may be
all referred to the same principle, and that that
principle is the itch —is what, I repeat, very
far from being proved, is extremely improbable.
The itch is the disease of the poorer classes; or,
rather, of uncleanly people.  Thus, a sort of disgrace is connected with it.  I do  not mean to
say, that persons of an elevated condition, and
who take great care of themselves, are;altogether exempt from its attacks: but they are,
it will be admitted, much less likely to contract it.
May the itch be spontaneously developed? It is a
question not easily answered. The causes of infection, in fact, are so diverse, and so numerous, that it
is nearly impossible to be certain of having avoided
them all. As for myself, it is my inmost conviction,
that even, without necessarily admitting the intervention of a congenital virus. the itch exanthern may
result spontaneously, from a miserable alimentation,
joined to the sad necessity of wearing always the same
linen, and other garments.




THE ITCH.                 179
What is there astonishing in the idea, that the
acarus, like so many other animalcnlue, should be
developed from the decay of dirty wool?
This is so much the more probable, because greasy
wool, or even the woven wool, but more particularly
greasy wool, seems endowed with the property of engendering this insect: a circumstance which explains
the frequency of the itch among workmen-tailors,
drapers, scourers, spinners, etc.
What is incontestable, is, that if the itch was only
transmitted by contact with those affected with it, no
persons in the world would be more exposed than
physicians, who pass their whole lives in touching
patients of all conditions.  Now, is this exanthem
more frequent among our brethren than in any other
class of society?  I venture to affirm  that it is
not.
I admit, then, as origins of the itch exanthem:
1st. Certain hygienic conditions, to which misery
too often condemns the unfortunate;
2d. The itch infection, proceeding from immediate
contact with one affected with it;
3d. Its transmission through objects, principally
linen, sheets, or infected garments;
4th. The spontaneous formation of the acarus in
woolen stuff, and some other substances, such, it is
said, as copal varnish, pitch, and hemp;
5th. And lastly, The vicinity, and above all, the
contact of domestic animals, having this disease.




180          CHRONIC EXANTHEMATA.
Whatever be the origin of the itch, its pathological
characteristics offer little difference.
They take constantly one of the two forms, known
under the names, papulous itch and purulent itch;
forms beside, scarcely sufficiently distinct to constitute
true types, and to which the same homceopathic
treatment is applicable.
The papulous itch, (common dry itch), is characterized by elevations, which produce an intolerable
itching at every change of temperature. It shows
itself more particularly in the dorsal region, on the
arms, thighs and abdomen.
The purulent itch, whose pustules are more developed than in the preceding form, is also more violent.
It shows itself more especially on the fingers, and the
metacarpo- phalangial articulations.  I have never
met with it in children.
The prognosis of the itch, depends upon its origin,
and especially upon the degree of its development.
The spontaneous itch, and that which has been communicated by animals, are the slowest in being cured.
Upon the whole, the itch is not a serious disease;
it can only become so by being indefinitely abandoned
to itself, or worse still by being repelled. But is it
not absolutely the same with the greater part of the
diseases of the skin?
TREATMENT.-" When the physician, says Hahnemann, " has recognized the symptoms of the itch, it
suffices, avoiding all external application, to administer




THE ITCH.                   181
one or two globules of sugar the size of a poppy seed,
saturated with tincture of sulphur, dynamised, to
completely cure a child, in two, three, or four weeks,
of the entire psoric disease; that is to say, of the
eruption, and of the internal psora. In some cases, a
dose of carbo-vegetabilis, properly dynamised, may be
necessary; in others, a similar doze of sepia." *
The respect I feel for the genius of Hahnemann,
retains, on the point of my pen, the reflections with
which this passage inspires me; but, let one of his
pupils speak:
" Ilahnemann devotes but a few lines to the treatment of the itch. From this, we should be tempted
to believe, that nothing was more easy than the cure
of this infection.  In fact, it is very natural that the
disease, regarded by Ilahnemann as the primitive
form of all chronic diseases, excepting those derived
from syphilis and from sycosis, should be dissipated
in the surest and most prompt manner, in order to
save Homceopathy from the charge of insufficiency,
which, without that, one would have a right to make.
But, it is not altogether so; at least, the homceopathists will do well, not to follow too rigorously the
precepts of Hahnemann, in order not to discouratge the
patient, by the excessively slow progress of the cure.
It is precisely in the itch, as the primitive form of
~ Doctrine et Traitement Homewopathique des Maladies Chron.
iques, tome i, page 139.




182           CHRONIC EXANTHEMATA.
chronic diseases, that it should be indifferent to the
physician, whether it is of recent or ancient origin;
he should know how to cure it, and the cure should
not be prolonged to infinitude, though it requires
much more time in this case than the other." X
Thus, M. Hartmnann confesses, that, under the
influence of the treatment recommended by Hahnemann, the cure of the itch is prolonged almost indefinitely. My own opinion, on this subject, is still
more decided.
Nevertheless, while counseling practitioners to distrust a little the precepts of the master, M. Hartmann
still considers sulphur as the specific for the itch:' The use of it," says he, " should be continued,
until the eruption that it induces, as well as that
which preceded it, gives place to the characteristic
sensation of sulphur."
M. Hartmann uses the tinctuzre of sulphur, and its
dilutions, in recent itch, and sulphur in itch of long
standing, when the first is insufficient; "that is to
say," says he, "if, at the end of fifteen days, it has
not produced at least, an appearance of improvement."
In children under five years, he generally prescribes
tinct. sulph., in doses of two or three globules, repeated every other day, and whole drops, once or
* Hartmann: Therapeutique Hornm. des Maladies Chr., tome ii
page 21.




THE ITCH.                 183
twice a day, if there is no change in the state of the
patient.
In short, M. Hartmann confesses, that he frequently
unites, with the internal treatment, "frictions, with
an ointment, composed of a half scruple of flour of
sulphur, and one ounce of hog's lard;" an accessory,
not very orthodox, to use his own expression, but
which  proves the insufficiency, admitted  by the
author, of dynamised  sulphur, administered internally.
Thus, I believe I have already declared, although I
am not in any case, and less, perhaps, in the treatmnent of cutaneous diseases than in any other, the
partisan of external remedies,' nevertheless, I do not
believe these remedies are always as dangerous as has
been supposed.
When, for example, the itch, recently communicated
by the accidental adhesion of an acarus to the skin
of a healthy man, is, as yet, whatever IHahnemann
may say, but a local affection, what can be the
danger, in stopping the disease, by killing the insect
which propagates it, by the use of lotions, or sulphur
frictions?
I know, that the greater part of the time, the acarus
is the product, and not the cause, of the itch eruption,
the same as lice are the product of favus; but, in
short, when we have reason to believe that the contrary
is the case, must we then necessarily admit, out of
respect to the theory ofpsora-a chimerical theory, (in
16




184          CHRONIC EXANTHEMATA.
my opinion)-that, from the appearance of the first
vesicle, the disease has become generalized, and absolutely requires an internal treatment? Frankly, I do
not think so.
I declare, however, that I employ no other; but, at
the same time, feel very much inclined to absolve
those homceopathists, who, after the example of lM.
Hartmann, have recourse to sulphur ointment, in
consideration of results so equivocal, and always so
slow, from sulphur taken internally.
Sulphur, I say it boldly, is a medicine, of which an
abuse is made; and this abuse is founded upon a
strong prejudice.
The theory of psora has made of sulphur the antipsoric, par excellence; and the various properties of
this medicine, extremely precious, beside, and essentially polychrest, have naturally contributed to prolong
this illusion. But, it is time that we admit, that,
though sulphur, in numerous cases, is one of our most
powerful agents, this is no reason why it should be
always prescribed, (as it is every day,) in preference
to all other medicines, when the symptoms presented
by the patient, are not, clearly, in the known sphere
of the symptoms it produces.
The medicines that I prescribe, against the itch,
whatever its origin, form, or duration, are LOBELIA
INFLATA and CROTON TIGLIUM, administered alternately,
and continued seven or eight days after the complete
disappearance of the exanthem.




ECZEMA - HUMID TETTER.             185
The tincture of su7phlir, I only use in case of consecutive ulcers, with or without loss of substance of
the skin; and then its use should be preceded by that
of the two medicines, that I signalize as specifics for
the itch.
Lobelia, at the sixth dilution, should be given, in
water, of which the patient will take three teaspoonfuls the first day.
Croton-tigliur7n, of the twelfth dilution, should be
administered, the next day, in the same manner.
The third day, we should return to lobelia; the
fourth, to croton, etc.
From the third to the fourth day, at the farthest,
the itching will have almost entirely disappeared.
The total duration of the eruption, in ordinary cases,
will not be prolonged beyond a week.
ECZEMA - HUMID TETTER.
Eczema, which nearly resembles the itch, and with
which it has sometimes been confounded, differs
from it, nevertheless, in certain well marked peculiarities.
1st. It is not contagious.
2d. As it is not complicated, by the production of
the acarus, we do not see, in the intervals between the
vesicles, the little red lines traced by them.
The vesicles of eczema are more resistent than
those of the itch. The limped serosity they contain,
is very often re-absorbed. They present themselves,




186          CHRONIC EXANTHEMATA.
closely grouped together, upon a circumscribed part,
most generally on the front part of the wrists and the
fore-arms, the inner and upper part of the thighs,
and on the heel. If the eruption ever shows itself
between the fingers, it is only as a single vesicle or
two, and, most frequently, we see it appear, in this
isolated way, on the palms of the hands, -where it
excites an incessant itching.
It is not uncommon to see the eczema suddenly disappear from one part of the body, to show itself upon
another. Sometimes it even entirely disappears for a
time, so that the patients believe themselves quite rid
of it, and then returns, worse than ever, in consequence
of some change of diet, or a few days of heat. I have
seen ecezemas which had lasted, in this way, for ten or
fifteen years, and even longer.
I am, then, inclined to believe, that this exanthem,
always spontaneous, is rooted in the economy, at least,
as profoundly as the itch.
It is not uncommon to see its disappearance accompanied by symptoms of metastasis, such, especially,
as rheumatic pains, neuralgia, hoarseness, and dry
cough.
Eczema is more frequently met with in adolescents
and adults, than in children. I have, however, seen
it in children at the breast, who, probably, were born
with it.
The tingling itching caused by this disease, in the
evening, and during the night, is insupportable.




HERPES -TETTER.               187
Children and adults, attacked with it, lose their sleep,
in  consequence of it, for months together.  The
former cry incessantly, and weary extremely their
nurses.
The Allopathists treat eczema with sulphurous and
alkaline baths.
The last, when they are highly charged with carbonate of soda, cauterize, in a manner, the vesicles,
and allay, momentarily, the itching, which the sulphur
baths but increase; but, neither one nor the other
cures eczema.
HIomceopathy, up to the present time, had not found
the specific for this exanthemn: I have been fortunate
enough to discover it.
R_4us and ledurm palustre, administered alternately,
in the same day, the one (ledumn) in the morning, the
other in the evening, constitute a sure means, heroic
in all cases, and followed by immediate success.
I prescribe these two medicines at the fifteenth
dilution, and in intervals longer than stated atcie.
Ed. 2d edit.
It is well to continue the use of these remedies for
several days after the disappearance of the eruption,
which, in fact, almost instantaneously disappears.
HER P E S -TETTER.
Willan, Baterman and M. Rayer have designated
under this name of hexpes, an affection different from
that which bears the same name in the works of Lorry
and Alibert.




188           CHRONIC EXANTHEMATA.
In conforming to the definition given by these three
nosologists, I mean here by herpes a disease characterized by globular vesicles, filled with a colorless or a
lemon-colored liquid of the size of a millet seed, aqppearing in  groups more or less numerous upon
different parts of the body, accompanied by tingling,
and separated by intervals where the skin is often in
an erythemrato-us state, which only spreads in the interstices of the vesicles forming each group.
The groups of vesicles are irregular, or disposed in
circles. Thence, the distinctive characteristics of the
different species of herpes, of which varieties have also
been established from the regions they occupy.
Herpes, with the exception, perhaps, of the variety
known under the name of herpes circinnatus, is
not more common to childhood than to other ages
of life.
The herpes phlyctcenodes, is characterized by vesicles disseminated, colorless, yellow or brownish, upon
small erythematous spots, whose appearance, which
commonly precedes that of the eruption for one or two
days, is almost always accompanied with a little
fever.
The liquid contained in these vesicles, at first
limped, becomes after a few days yellowvsh and
turbid.  It thickens little by little, an&  forms yellowish or brown crusts, which at the end of a week or
a little more, fall off; leaving a red, and very irritable
surface, which assumes but slowly its normal aspect.




IIErPES - TETTER.              189
This form of herpes is never serious; the upper lip,
and the corners of the mouth are its most habitual
seat. The disease, generally, disappears spontaneously, although it is sometimes sufficiently obstinate
to require treatment.
Ferrum chlor. and ruits tox. are the two medicines
whose alternate use has given me the most satisfactory results.
Ferrum cilor., twelfth or fifteenth dilution,-a few
globules, in about four ounces of water,-will at first
be administered, two days in succession, a teaspoonful
morning and evening.
]rhus tox., same dilution, and prepared in the same
manner, will be given the two following days, three
teaspoonfuls in the twenty-four hours.
This course may be several times repeated, in the
same order, in those cases which I affirm will be very
rare, where the four first days of treatment shall not
have very sensibly modified the eruption.
Herpes circinnatus, or ringworm, which is very
common, even in infants at the breast, bears much
more than the preceding variety, the stamp of a primitively chronic affection
The specific nature of the eruption, is also more
clearly implied: it seems derived from the singularity
of its form.
Herpes circinnatus, although we sometimes see it
spontaneously disappear at the end of a few weeks,
has also a tendency, in general, to last a long time,




190          CHRONIC EXANTHEMATA.
and above all to be reproduced. Like eczema, it
sometimes disappears during the winter to return with
the heat of summer.
This tetter manifests itself in circular spots on the
circumference of which is developed a row of vesicles.
These opening at the end of four or five days, discharge a lemon-colored liquid, which in drying form
little brownish scales around which soon arise a new
crop of vesicles, similar to the first, and which run
through the same periods.
This process is continually renewed, the herpes
increases in extent, and presents at its center a kind
of islet, where the skin, wrinkled, cracked, and of a
violet red, at length scales off.
The groups are more or less numerous; I have seen
a child of five years whose whole body was covered
with it. Sometimes, on the contrary, there will be but
one group, and in certain cases even it is so little
apparent that the disease might pass unperceived.
Baryta carbon., of a medium dilution, the doses
repeated several times a day, is the specific for this
tetter. I need only observe that it is necessary to
omit one day in three the use of this medicine.
Herpes prceputialis only differs from the preceding
in the region it occupies. It is important not to confound it in the new-born with a syphilitic affection.
Having never had occasion to make a special study
of this affection, I borrow from  M. IHartmann, the
treatment he proposes for it.




CRUSTA LACTEA.               191
"Cleanliness," says he, "is here of the first importance. If the herpes is on the external surface of
the prepuce, it should be protected from friction by an
envelope of linen spread with an ointment of marsh
mallow; if it is on the internal surface, repeated injections should be made of warm milk or a decoction of
marsh mallow, and the parts be carefully washed after
each evacuation of urine.
JI/rcurius prcecipitatus rulr., 2d or 3d trituration, morning and evening, is a capital remedy in an
advanced stage of herpes of the internal surface of the
prepuce; if after three days, this remedy has not dissipated the disease, and it produces a violent itching,
it should be succeeded by acidum nitri.
Acidurnm phosphoricurn, will be preferable when
the eruption is principally concentrated around the
freenum.
Hepar sulph., silicea and sepia, are indicated
when the eruption occupies the external surface, and,
in this case especially, petroleum, if it is accompanied
by a continual diarrhea.*
CRUSTA LACTEA — MILK CRUSTS.
This exanthem, to which the vulgar have given the
name milk crusts, and in certain countries milk itch,
is described by authors under the denominations of
achores, porrigo and tinea mucosa.
* Hartmiaiin, Ouv. Cit., tome ii, page 66.




192          CHRONIC EXANTHEMATA.
It is characterized by little pustules disposed in
irregular grotups, developing themselves upon the face
and the scalp, and furnishing abundantly a viscid fluid.
These pustules, at first white and very slightly elevated, are surrounded by a red, inflammatory areola.
The yellow or greenish humor discharged from them,
is transformed, in drying, into thin and yellow scabs,
which by their successive accumulation spread sometimes to such a degree as to form a veritable mask.
Tinea mucosa is very frequent in children at the
breast; it commonly appears at the age of three, five
and eight months. It is neither dangerous nor contagious, and  it is very seldom, among the great
number of children affected by it, that one dies.
The vulgar, perhaps, with reason, regard this affection as a salutary depuration.
"I have seen," says M. Billard, "a great number of
children at the breast attacked with tinea mucosa, at
the hospital of Enfants-trouves; very few among them
died, and the greater number of them, after the disappearance of this inflammation, acquired a freshness and embonpoint which confirmed the popular
belief.*
Crusta lactea, generally shows itself first upon the
forehead and cheeks, whence it spreads over the rest of
the face, to the ears, scalp, sometimes to the neck and
shoulders, seldom beyond.  I have seen it exist simuli Billard, Ouv. Cit., 151.




CRUSTA LACTEA.                193
taneously with various other exanthemata, and especially with herpes phlyctenodes.
The pruritus it occasions, is relatively inconsiderable, at least, when it does not occupy the scalp, and
becomes complicated with the existence of lice, which
rarely happens in very young children. The greater
number of children affected with this disease, neither
lose sleep, appetite, or even their gayety, in consequence; but their condition does not fail, greatly to
annoy their mothers and nurses, on account of the
disagreeable appearance they present, and the rancid
and fetid odor they exhale.
TREATMENT.-Hartlaub extols, against tinea mucosa, aconitum, followed by a single dose of viola tr.,
of the third dilution.' This treatment," says he,
" soon ameliorates the condition of the child; and the
disease, commonly, entirely disappears at the end of
a fortnight. If the progress of the cure is arrested,
a second dose of viola should be administered; and,
in case this does not procure as complete a restoration of health as was expected, it will be infallibly
obtained by means of a dose of sulphur, of the 30th
attenuation." *
Hartmann recommends viola tricolor, when there
is an insupportable burning itching, especially during
the night, with the characteristic odor of the urine.' Before I was acquainted," says he,'" with the
superiority of this medicine, I obtained, although
~ Hartlaub: Le M,;decin Homeopathe des Enfants, page 59.




194          CHRONIC EXANTHEMATA.
much more slowly, the cure of the disease, with other
medicines, principally with stcphysagria, rthus, and
sulphur."
As for myself, experience has proved to me, that
the several medicines mentioned by MM. Hartlaub
and Hartmann, may be, in almost all cases, replaced
with advantage, by a single substance, which I have
reason to consider the specific for tinea mucosa. I
speak of sepia, which I prescribe at the 30th dilution,
and in doses repeated three times a day.*
ORUSTA  SERPIGINOSA.
This eruption, ranged by Wichmann in the class of
herpetico-syphilitic exanthemata, by the side of psoriasis, and considered by Hartmann, with Autenreith,
as being of a scabious nature, presents the greatest
resemblance to the one I have just described. But it
is more painful, more obstinate, more essentially
chronic. The itching accompanying it, is extremely
troublesome.
The vesicles which form these crusts, almost always
show themselves in front of the ear, in the neighborhood of the parotid. They are surrounded with an
areola, of a clear red color, and cause, from the first,
great itching, especially during the night.
These vesicles are smaller than those of crusta lactea. They are constantly renewed under the scabs.
Lastly, (distinctive characteristic,) crusta serpliginosa' Has been found practically correct. Ed. 2d edit.




1MPETIGO.                  195
is constantly developed in cacochymic, thin, debilitated
children, the reverse of crusta lactea, which most
commonly attacks the robust. We have seen it last
for years: it is never cured spontaneously.
TREATMENT. —Alth ough crusta serpiginosa is considered as one form of the itch exanthem, sulphur is
absolutely without effect in this disease.
Sepia sue., at repeated doses, sensibly ameliorates
the state of the patient, but does not always cure
the disease.
The fundamental remedy, the one we would especially point out to the attention of physicians, the
only one, perhaps, upon which we can depend, is
silicea.
IMPETIGO.
"Impetigo," says M. Billard, " is a disease, much
more frequent in adults than in children.  Authors,
nevertheless, range among the predisposing causes of
this disease, the first and second dentition. I have
never seen it in children at the breast, who are, on
the contrary, very subject to different species of tinea,
and principally to tinea mucosa, between which and
impetigo sparsa, it is very difficult to trace a distinct
line of demarcation." *
The truth is, that impetigo sparsa, which does not
differ essentially from impetigo Jiqvrata, is exactly
* Billard: TraitW des Maladies des Enflnts Nouveaux-nis, p. 145.




196          CHRONIc EXANTHEMATA.
the same disease as tinea mucosa, modified only,
either by the age of the patient, or by the part of the
body affected.
If, in effect, tinea mucosa is almost always, in
children at the breast, limited to the face and scalp,
it is not so with older children and with adults. It is
not uncommon to see it appear upon the shoulders,
upon the arms, and even upon the lower extremities
of the two latter. It shows itself then in the form of
spots, circumscribed and of different dimensions;
those of the upper limbs are usually small and round;
those of the lower, on the contrary, large, oval, and
irregular. These spots, which are of a dark-red, have
appearing  upon them  numerous yellow  pustules,
which, at the end of a few days, open, and discharge
an acrimonious sanies, which corrodes the surrounding
parts, causes an intense and painful itching, and
forms afterward, yellowish  or dirty-green  crusts.
These crusts fall off within three or four weeks, and
leave a rough surface, which is disposed to crack, and
become excoriated, in such a way as that the disease
may be prolonged for several months.
TREATMENT.-Although tinea mucosa and impetigo
are fundamentally, as I have just said, identical affections, the different conditions under which the two
forms of this disease are produced, call for some
difference in their treatment. Dulcamnara and clematis
are the medicines which have succeeded best with us
in the treatment of impetigo. The use of these two




TINEA FAvosA.              197
medicines should be simultaneous. They should both
be prescribed at a medium dilution, and the doses be
frequently repeated. Dulcamara should be administered twice, in the forenoon, and clematis once, in
the evening.
Silicea will be necessary in the case of lancinating,
very intense itching pains, and in abundant suppuration.
IMPETIGO RODENS.
This affection is unknown to childhood. I only
mention it here, in order to have occasion to point out
to practitioners three medicines, whose successive use,
continued for several weeks, (eight days for each), has
procured me the most happy results, in the treatment
of this exanthem. The three medicines are, in the
order in which I have used them, (in doses repeated
several times a day). copaivae balsamum, cuprurm,
and digitalis.
TI NE A F AV O SA-S CAALDH lE AD.
Tinea favosa is characterized by an eruption upon
the scalp, and sometimes, but very rarely, upon other
parts of the body, of numerous small red pimples,
which hardly rise above the level of the skin, to
which promptly succeed little yellow pustules, of
which the summits become almost immediately covered with very adherent, irregularly circular crusts,
at first yellow, then brownish or gray, anld always




198           CHRONIC EXANTHEMATA.
depressed in the center, in the form of a cup. These
pustules are sometimes isolated, sometimes agglomerated. The crusts, when taken off, exhale a penetrating and disagreeable odor>
This disease is much more frequent in children of
seven or eight years of age, than in infants at the
breast.
Like tinea mucosa. it may exist with all appearances
of general good health; but I have found that the
greater number of those affected with it were pale,
feeble, languishing, and suffering from a sort of cacochymia, that in many among them might, perhaps, be
attributed to defective or even insufficient nourishment.
As to the temperament or constitution, which predisposes children to tinea favosa, I confess that I have
no fixed opinion upon the subject.
"We have but seldom seen," say the authors of a
voluminous work upon the diseases of children,*
"tinea developed in consequence of; or during the
convalescence from, a serious disease."
We remember, however, several cases in which a
febrile disease had temporarily checked the progress
of favus, or even caused it to disappear; but no
sooner was the internal inflammation cured, than that
of the scalp returned with the same intensity as
* MM. Rilliet et Barthez: Trait6e linique et Pratique des Mala
dies des Enfants, vol. 3, Paris, 1848, page 125.




TINEA FAVOSA.               199
before. It has been generally asserted, that scrofulous
subjects were especially liable to favus. We cannot
confirm this remark. The greater part of the children,
who occupied the scrofulous wards, were not affected
with tinea; and the greater part of those who occupied
the tinea wards, were not scrofulous."
Tinea favosa, is at least as contagious as the itch.
Not only is it transmitted by immediate contact, but
by the dress, linen, combs and brushes used upon the
heads of affected children.
M. Rayer has reported an observation of Gallot, of
a child inoculated with tinea, by means of a cataplasm, which had been used upon another child, and
to which still adhered the crusts of the favus.
When this disease continues for a long time, (as it
always does when badly treated, or when left to itself)
it at length affects the bulbs of the hair, so as to
produce its fall.  The portions of the skin thus
denuded, remain white and smooth.  As with all
other obstinate ulcerations of the scalp, tinea favosa
gives rise to more or less considerable engorgement
of the ganglions of the neck, and sometimes even to
abscesses, it is not uncommon to see it complicated
with ophthalmia, coryza and irritation of the digestive
organs.
The untimely disappearance of this exanthem,
when produced either by injudicious treatment, or
occurring spontaneously, is always a serious symptom,




200          CHRONIC EXANTHEMATA.
though its consequences are not in all persons imrnediately manifested.
TREATMENT.-It is not absolutely with tinea as with
the itch. The first may be cured, or at least disappear spontaneously. This even often happens with
children upon a change of regimen, as in returning
home, for example, from boarding-school.
Notwithstanding, it is far from being always so. It
has been supposed, that tinea acquired by contagion,
was, in general, more tenacious than that which was
spontaneous.
The treatment of this affection is the triumph of
Homceopathy.
When one is so fortunate as to have to treat children, who have not been gorged with allopathic
remedies, the rapidity with which infinitesimals cure
favus, is at times marvelous.
There are, however, cases where the disease resists
and demands the successive use of several medicines.
Su7phur, du7camara, viola tricolor, oleander,
hepar su/,7ph., form the basis of the therapeutics appropriate to the different shades of this exanthem.
Among these first medicines, the first two have
especially succeeded with me, and in cases precisely
similar. They are both adapted to the humid form
of the disease in children of blond and fresh complexions. I prescribe sulphur, in very small doses, and at
the thirtieth dilution; dulcamara, in a little stronger




TINEA FAVOSA.               201
doses, and at a medium dilution. It has seemed to
me several times, that. sulphur, even so attenuated,
irritated the chest, an effect never produced by dulcamara.
Viola tricolor may be alternated with sulphur or
dulcamara when the itching is very violent.
Oleander is, according to M. Hartmann, a medicine upon whose efficacy we may rely; " if the eruption, which has a great resemblance to the vesicles of
the itch, is characterized by an intense itching, and by
an insupportable nocturnal burning after scratching
the head; and if at the same time, the inesenteric
glands appear to be affected, which is seen in the
swelling, hardness and tension of the abdomen, as well
as in the stools, which are sometimes hard, more frequently loose and undigested, like a sort of lientery.."
fepar s7ulphur corresponds to cases where the
exanthem, instead of being limited to the scalp,
extends to the nape of the neck or the face; and to
cases also, where ophthalmia supervenes, with or
without ulceration of the cornea, etc.
TINEA GRANULATA.
Tinea granulata consists in little pustules, superficial and irregularly disseminated over the scalp.
These pustules, at first humid and irregular, give
place to gray or brou'nissh crusts, which are never depressed in the center, and whose fragments are often
found scattered through the hair. When the crusts




202          CHRONIC EXANTHEMATA.
agglomerate and dry, they harden and adhere strongly
to the hair.
Authors say that tinea granulata is not contagious.
This exanthem, which never attacks children
before their fourth year, seems to show itself in preference, in brunettes, and in subjects of a dry constitution.
I believe that this form of tinea does not differ essentially from favus, and that the same treatment is
appropriate to both.
TINEA ANNULARIS.
Tinea annularis, first described by Alibert, under
the name of favus squarrosus, and since, under that
of favus scut formis, is only, as well as tinea granulata, a variety of tinea favosa.
" It presents in the beginning," says Doct. Baumes,
" elementary crusts, rounded, yellowish, depressed in
their center, precisely like those of favus vulgaris.*
" But here, the depression in the center soon disappears, and the crusts, ranged circularly, are more
crowded and more prominent on the circumference
than in the center. They are very dry, of a yellowish
white, and form by their union in round spots, a kind
of incrustation sometimes much elevated above the
skin.
"When one continued crust covers the whole head,
* Tinea favosa.




TINEA ANNULARIS.              20O
forming a kind of cap, in the favus vulgaris,'we
always perceive here and there a few cup-like depressions, while in the favus annular., it is all one grayish yellow crust, clearly circumscribed by a line, or a
group of circular lines."
This variety of tinea, fortunately rare, is one of the
most obstinate affections with which I am acquainted.
In the month of July, 1847, I was consulted for
three little boys of the same family, all affected with
an eruption of the scalp, of which I dared not positively state the precise nature, but which probably
belonged to the variety of the tinea, of which we
are now speaking.
The oldest of these children was thirteeni, the
youngest, nine.
The three brothers were strikingly alike. They
were rather tall and thin, not lymphatic, quick, alert,
gay, and apart from the railleries of other children of
their village, were, to all appearance, very little concerned about the disease for which their parents had
called me; a disease which caused them no pain, no
uneasiness, not even, as they assured me, the slightest
itching.
It was a sort of cap, of a greenish yellow, resembling dried honey, gluing down the hair to such a
degree as to leave it free only at the temples and the
occiput, presenting a regular surface, hardly wrinkled,
thinning at the circumference, and presenting the
greatest thickness at the top of the head.




204          CHRONIC EXANTHEMATA.
This irregular crust, which prolonged lotions only
detached in great scales, and which were reproduced
in a few days, appeared to be rather the product of a
uniform exudation, than the concretion of a humor
furnished by pustules. There were, beside, no traces
of pustules.  The skin beneath was red, slightly
inflamed, but not ulcerated.
This disease was certainly neither an eczema, an
impetigo, nor a favus.
I at first supposed that it might be the disease that
Alibert has described, under the name of tinea amiantacea; but I have since recognized my error.
Some one, more skillful than myself, may give it its
true name, or a new  name, if they think proper.
What I have to do. is to point out to practitioners the
medicines that effected the cure.
Dulcanmara, sullphur, staphysagria, and  baryta
carb., administered by turns, for several weeks, had
produced absolutely no effect, when, guided by considerations which it would take too long to explain
here, I prescribed successively, spigelia, tabacum,
and, lastly, ferrum magneticum.
Spigelia and tabacum were each administered for
one week, the first at the twelfth, and the second at
the sixth dilution, in doses repeated four times a day.
From the third week I gave ferrum magnet., at the
sixth dilution, for fifteen days, morning and evening.
aThe  me nlesaYtnmt ra sn eekeei wievn my'tsree YitYe
patients. In less than six weeks, every sign of crust




PITRIASIS    STROPITULUS.        205
had disappeared from the head, and the hair began to
grow abundantly. I have not seen these children
since; but I heard from them the following summer.
Their tinea, (was it tinea?) had not re-appeared.
Perhaps the same treatment, which succeeded with
them, would be applicable, or would deserve to be
tried, in other analogous and intractable affections of
the scalp.
PITYRIASIS.
The desquamation of the epidermis is thus named.
It is the herpes furfitraceus of Alibert, and the scaly
tetter of the vulgar.
No one, assuredly, would call a physician for so
trifling a disease; and yet light as it is, the disease
might embarrass more than one conscientious physician; for, when seated on the scalp, where its presence
is excessively annoying to young females who are
affected with it, it obstinately resists the greater part
of the known remedies.
Reiterated experiences have, however, convinced
me, that cantharis is the specific for pityriasis.
A few globules, of the thirtieth dilution of this
medicine, in a glass of water, of which a teaspoonful
should be administered, morning and evening, for
three or four days.
STROP H ULUS.
We so call an eruption of little pimples, that are
hard to the touch, compact. red or whiti.sh, developing




206          CHRONIC EXANTHEMATA.
themselves, first on the face, then on the limbs, never
terminating in pustules, crusts, or ulcerations, but
sometimes leaving behind them a slight efflorescence,
which is commonly accompanied by great itching.
These pimples may be rare or numerous, disseminated
over the whole body, or accumulated together upon a
part, and are sometimes intermixed with erythematous
spots.
Strophulus, a disease very common among children,
shows itself, principally, on the face of children at the
breast.
This exanthem almost constantly coincides with a
more or less marked irritation of the digestive organs,
an irritation on which the affection of the skin seems
exclusively to depend; so that a judicious treatment
of the former, is certain to be followed by the disappearance of the latter.
The medicines from which we have to choose, are,
consequently, according to the nature of the case,
ipecacuanha, pulsatilla, rheum, antimonium crudum,
and, more especially, causticum and chamomilla.
PRU RIG O.
Prurigo is an exanthem, characterized by hardly
visible papule, accompanied by a severe itching.
Authors distinguish two species: the prurigo of old
people, and the prurigo of children-a badly founded
distinction, since it rests only upon the age of the
patient, and not at all upon the anatomical character




PsoRIAsIs  - SCROFULA.           207
of the disease.  M. Billard thinks that prurigo, in
young children, may arise from want and uncleanliness.
It is, indeed, rare that this disease manifests itself
in children who have good care and suitable nourishment. It is, like the greater part of the affections of
the skin, simple, or complicated, spread over the
whole body, or limited to a single part.
TREATMENT. — Calcarea, mercurius, hepar sulphur,
etc., have been recommended for prurigo; the remedies from which I have obtained the best results, are
causticum and mercurius solubilis. (Coniumr, Ed. 2d
edit.)
PSORIASIS.
Psoriasis, is not a disease peculiar to children; I
shall, therefore, abstain from giving a description of it
here. It has, nevertheless, been seen in children at
the breast. I would suggest to practitioners, should
such a case present itself to them, the use of mercurius
solubilis, a medicine whose remarkable efficacy I have
proved but upon adults only.
SCRO FULA.
Some readers will perhaps be astonished to see
scrofula figuring among cutaneous diseases, from
having for a long time been accustomed to consider it
a disease essentially general and constitutional.  The
impression is so strong, that when it shows itself on
the skin, it is only accidentally, that in these latter
18




208          CHRONIC EXANTHEMATA.
times nosologists have purposely blended it with
tuberculation of the lungs, of the mesentery, and of
all the internal viscera.
But, in recalling what I have said in my introduction of diseases in general, and more particularly
chronic diseases, one cannot but concede that all the
exanthemata are in exactly the same case as scrofula.
All, in fact, as well as this last are but the efflorescence of morbid principles deeply rooted in the
economy, and hence, capable of exercising their
ravages elsewhere, as well as upon the cutaneous
envelope. I am equally well convinced that they have
often a large share in the development of internal
diseases, that, for want of more precise information,
nasologists attribute without distinction to scrofula.
There are even among them, those, who are not far
from referring in mass to the principle of which we
speak, all affections of a protracted nature, whether
internal, or external, of which no inflammatory symptom marks the existence, and which they, nevertheless,
name (antiphrastically, no doubt) chronic phlegmasia.
Thus, for many physicians, impetigo, herpes, all
the forms of tinea, etc., are, as well as rachitis, dropsy
and tubercles, only particular forms of scrofula.
This bold generalization of incongruous phenomena,
a sort of abstract and conjectural synthesis of which
psora is after all but the broadest expression, has had
little other result, up to the present time, than to fill
with doubt and confusion the minds of practitioners.




SCROFULA.                  209
What matters it to us, in fact, that the different
manifestations of the same disease are called by the
same name, if inexorable experience every day proves
to us that each of these manifestations requires a par
ticular, and quite as special a treatment, as if it really
constituted a distinct affection? What matters it to
us that the gout, breaking out in the great toe, in
the knee or anywhere else, does not cease to be the
gout, if we are ignorant of the treatment it calls for,
according to the region it occupies?
Similar considerations had in the beginning, so
forcibly struck the founder of Homceopathy, that in
publishing his doctrine, he commenced by suppressing
all morbid individualities admitted before him. Ile
eventually saw that he had gone too far, and retraced
his steps; but psora led him astray.
I have, however, expressed  the thought (and I
cannot rctract it), that it would be fortunate for medicine and for humanity if all the pathogenetic miasms
were sufficiently known to be classed according to a
complete ensemble of their respective symptoms.
I do not doubt, in fact, that such a classification,
from the instant that it should present in all its parts
the criterion of certainty, would cause great progress
in therapeutics. But we are yet a great way off from
this.
Let us not forget, beside, that the specificity of our
remedies corresponds, perhaps, still less to the actual
properties of morbid agents, than to the idiosyncratic




210          CHRONIC EXANTHEMATA.
nature of the disorders they produce. Let us not
forget, above all, that the modifying power of each of
our medicines has its sphere of activity, and its seat
of election; such a one acts upon the skin, and produces no effect upon the bones, nor upon the nervous
centers.
Thus then, scrofula, in the limited sense it suits us
to regard it, is an affection essentially chronic, affecting especially the lymphatic ganglions, and more particularly those of the neck, the armpits and the groins.
The external and general habit of the subjects who
are attacked with it, is characterized by the following
signs:
Scrofulous subjects have large heads, especially
behind; the temples depressed; the neck thick and
short; the face puffed, the nose and upper lip frequently swollen. Their skin is white, fine and rosy,
transparent, or muddy. They have commonly light
hair and blue eyes, with dilated pupils.
A kind of embonpoint of a bad quality, seems at
first sight, to indicate in them a rich nutrition; but
upon closer observation, we soon recognize a defective
structure. Beside the flesh being soft, flabby, and as
it were spongy, the hips are too large in proportion to
the chest, and the abdomen too prominent.
Lymph is superabundant in all parts of the body.
All the mucous membranes secrete beyond measure,
and if these subjects chance to wound themselves, the
wound suppurates, and is long in healing.




SCROFULA.                 211
They are subject to epistaxis, and catarrhal affections of the nasal fossae, of the bronchiae, or of the
digestive organs, upon the slightest cold.
It is not necessary to say that these general signs
are not absolutely constant in scrofulous subjects.
I have seen those of this class, who had well-formed
bodies and dark, or even absolutely black hair, and
who in a word, presented only the local symptoms of
the disease.
These consist in the presence, more or less appreciable to the touch and sight, of glandular indurations
in front of the ears, under the jaws, on the neck, in
the armpits, more rarely in the groins, and other
parts of the body, largely provided with lymphatic
glands.
These tumors, which are almost always developed
very slowly, are at first isolated, movable under the
finger, soft, and with but little sensibility.
The skin which covers them  is of a normal color.
They are, in the same region, solitary or multiple.  It
is not uncommon to find them, in the neck, for example, united in great numbers, and forming a sort of
subcutaneous necklace.
If the disease makes progress, these tumors enlarge,
little by little; sometimes several uniting in one,
harden, cease to be movable, and become painful.
Lastly, the skin reddens, corrodes and ulcerates, often
in several places at once.




212           CHRONIC EXANrHEMATA.
Scrofulous ulcers have no end, when left to themselves. If, at length, one closes, another soon succeeds to it.
The discharge from them is rather a thin and turbid
serum, than true pus.
These abscesses always leave behind them cicatrices,
more or less apparent, but always greatly to be
dreaded, because, always bearing with them the seal
of their origin, they often become, subsequently, even
for the most radically cured patients, a subject of
reprobation, in important circumstances.
The majority of families, in fact, have a great repugnance to an alliance with a scrofulous person;
and, I confess, to be sincere, that this repugnance is
not ill-founded, for, of all hereditary diseases, scrofula
is, perhaps, the one parents the most infallibly transmit to their offspring.
It is rare, however, that children bear, from their
birth, the flagrant signs of this sad inheritance.
They seldom present the first symptoms of it before
the second or third year. But, it is especially between
the period of the second dentition and puberty, that
scrofula most frequently shows itself.  We may, then,
consider it an affection peculiar to second childhood.
Both sexes are equally exposed to it. When it is not
very intense, when, especially, it has not impressed its
stamp upon all the systems of the organism, the epoch
of puberty sometimes cures it. I believe, beside, that




SCROFULs.                  213
this disappearance of scrofula, under the influence of
sexual evolution, occurs more frequently in girls than
in boys.
There are scrofulous children, who appear of a
remarkable intellectual precocity. But, perhaps this
observation, made by the majority of writers, arises
from the surprise experienced by the contrast of an
even ordinary mind, with an infirm body, which
would seem to belong to a more tender age than that
the little patients have really attained.
I believe, on the contrary, with HIufeland,* that
scrofula, at all advanced period, impairs the intellectual faculties. I would cite, as a proof of this, the
Cretins of the Valais, who are certainly only scrofulous subjects.
It is true that in these last, the disease is no
longer limited to engorgernent, or ulceration of a few
ganglions: it has taken possession of the whole econ-:
omv, and reached even the brain.
It is, in fact, the characteristic of scrofula, when
art does not arrest its progress, when, above all, a
humid atmosphere and bad nourishment favors its
development, to spread its ravages, not only to all
parts of the body where lymph circulates, but to carry
disorganization into organs the most dense, and which
would seem the least liable to its attacks.
It is thus that, like the syphilis, it attacks the
osseous system, and produces, at length, softening,
* Traite de la Maladie Scrofuleuse: Paris, 1831.




214           CHRONIC EXANTHEMATA.
distortion, and caries. Rachitis, of which we shall
have, in the sequel, but a few more words to say, is
very often one of its consequences. But, setting aside
for the present, these secondary symptoms, which
require each a special treatment, we shall only here
occupy ourselves with the primitive form of this terrible disease; that is to say, with hypertrophy, and
ulceration of the subcutaneous ganglions.
Etiology. —Those of our brethren who perfectly
agree with the ideas of Halhnemann, relative to psora,
seem to me inconsistent, in seeking, in surrounding
conditions, the first cause of scrofula. As for myself,
I confess that I cannot look upon this disease as a
mere transformation, however far removed, of the itch.
I believe, on the contrary, that if scrofula is, as I have
already said, very often hereditary, it may also, (although, perhaps, more rarely,) result immediately,
either from accidental circumstances suddenly affecting
the health of the individual, or from hygienic influences, which gradually undermine the constitution.
We see, for example, scrofula succeed eruptive
fevers, especially variola and scarlatina, in subjects
who, until then, had shown no symptom of it.
As to humid cold, want of cleanliness, the exclusive
use of unfermented fecula for nourishment, or melted
snow for drink; poverty, in short, with all its concomitants, it is impossible not to see, in all these
circumstances, so often united and accumulated, a
sufficient cause for the development of this disease,




SCROFULA.                  215
without the necessity of explaining it by the intervention of a congenital miasm.
What, in fact, after all, is scrofula, if not an exaggeration of the lymphatic temperament? but the
lymphatic temperament, which consists solely in the
relative preponderance of the white vessels, is not a
disease, although one may easily conceive that it may
become such, under the permanent action of a dissolving medium.
Lastly, authors mention, in addition, as causes of
scrofula: the misfortune of being born of parents,
infirm, aged, or exhausted by excess; the deprivation
of the maternal milk, of pure air, of light and exercise; the over-excitement, in children, of the intellectual faculties; the presence of worms in the intestines,
(which is, perhaps, to take the effect for the cause),
etc., etc. It is certain, that if these causes do not engender scrofula, they must, at least, greatly facilitate
its development.
"But there is one last point upon which, I am far
from having a fixed opinion, and which merits, in my
opinion, a serious analysis, for in a dogmatic view at
least, it is of the first importance:
Is it true, or not, that syphilitic non-scrofulous patients, may sometimes transmit to their children scrofula, without a mixture of syphilis? In other words:
is the syphilitic miasm, in passing from one generation to another, transformed to such a degree as to
19




216           CHRONIC EXANTHEMATA.
serve as the germ of a disease essentially different
from the venereal disease. This, I repeat, is an important question, and I would bespeak for it the attention of philosophic physicians.
TREATMENT.-Scrofula, whether viewed in the manner I have just indicated as a pure and simple exaggeration of the lymphatic temperament, or considered
as a morbid entity, having as well as the itch and the
syphilis, its peculiar individuality, scrofula is not the
less in the two cases grafted, so to speak, upon a particular state of the organism, which, if it does not
constitute the disease itself, is at least the condition
sine qua non of its existence.
It follows then, that the treatment of scrofula implies, from the first, two orders of means to be employed, since there exists in some sort, a double end
to attain: to modify the temperament and extinguish
the disease.
Now, if the medicines succeed in curing the disease, the change of the temperament can be but an
affair of time and regimen.
The radical cure of scrofula, can then only be
slowly obtained.
The kind of life to be adopted by these patients, is
extremely simple. Frequent exercise in the open air;
the habitual use of broiled meats; abstinence, on the
contrary, from preparations of milk, from pastry, from
badly-cooked bread- particularly the soft part of




SCROFULA.                 217
bread-from green fruits, watery food, highly-flavored
condiments, and above all, pure wine and strong
liquors; such is the basis of their regimen.
But we are not to imagine that these little patients
must eat more than if they were in good health.
This is a sad prejudice, and the bad consequences of
which I have often had occasion to combat. Experience has proved to me, that abstinence, is less injurious to scrofulous subjects than a too abundant
nourishment.
The regimen I have just pointed out, and which
should be rigorously followed through all the periods
of the disease, constitutes, almost alone, the treatment
of the scrofalous diathesis; that is to say, of scrofula
before its local manifestation.
Medicines, however, have been administered with
success in this first period of the disease, and those
whose efficacy is especially extolled by some practitioners, are: cina, arsenicum, sulphur, calcarea,
azurum, dulcamara, bovista and silicea.
Sepia, is particularly called for by the swelling of
the nose and upper lip.
Lastly, M. Hartmann praises very highly, a medicine which has not found place in the homceopathic
materia medica, but which allopathic physicians have
used for several years past; it is Cod liver oil.
"I have given it," says he, "with great advantage,
for the scrofulous disposition, when, as yet, there
existed no decided affection of any particular organ,




218           CHRONIC EXANTHEMATa
and where the only appreciable symptoms were
paleness, an air of suffering, flaccidity of the muscles,
disposition to emaciation, aversion to all nourishment
animal or vegetable, with the exception of bread and
butter. I prescribed it in the dose of a medium-sized
spoonful, morning and evening, and, after a certain
time, I almost always succeeded in obtaining a cure.
I obtained the same result in disease of the bones,
but much oftener in the other forms of the malady."
But the physician is not generally called to prescribe for a scrofulous child, until after the disease has
declared itself, and the medicines to which he should
then have recourse, are, in the proper order of their
use: Rhus toxicodendron, mercuriu.9 solubilis and
tincture of sultphur.
The second volume of the Homrnopathic Therapeutics of Acute and Chronic Diseases, had not yet
appeared in France, and I was consequently ignorant
of the great importance attached by M. Hlartmann, to
rhus toxicodendron, in the treatment of scrofula,
which certain inferences, drawn from the pathogenesis
of this medicine, had already led me to prescribe for
this disease; and the success I obtained justified, in
my eyes, the eulogy of our colleague.
"Rhus toxicodendron,"  says he, "is superior
to all other medicines, when a gland of the neck,
of the nape or of the lower jaw, is inflamed,
swollen and hard as a stone, while other neighboring
glands are less appreciable to the touch. Often after




SCROFULA.                  219
only a few days' use, all inflammatory redness disappears, the gland becomes softer, and at the end of a
few weeks, entirely disappears.  While this is taking
place, the adjacent glands become more palpable;
but these disappear with  the other.  Some time
since, I succeeded, with a single dose of ritus, in
procuring within the space of six weeks, the complete
resolution of a gland, hard as a stone and large as a
nut, in a child about five years old. Three days
after the use of this remedy, the amelioration began
to manifest itself, and continued until the complete
disappearance  of the gland.  This cure  proved,
like  many  others, the  value  of the precept of
Hahnemann; never to give a new  remedy before
an  amelioration  was  sensibly  arrested.  On  the
other hand, the excessively long duration of rhus in
this case, confirms the opinion I have elsewhere
expressed upon the duration of action of medicines
in general."*
I use rhus at the second dilution and in solution,
to be taken by teaspoonfuls three or four times
a day.t
It is by the administration of this medicine, that
we should invariably commence the treatment of
developed scrofula.
* Therapeutique Homaeopathique des Maladies Aigues, etc., tom
ii, page 82.
t In adults, rhus is advantageously replaced by colchicum.




22)0         CHRONIc EXANTHEMATA.
As soon as there supervenes a marked cessation in
progress of the amelioration, that it almost invariably
produces, I suspend its use, and prescribe in its place,
mercurius solubilis, thirtieth  dilution, in  doses
repeated several times a day, sometimes for several
weeks.
Lastly, sulphur, or still better, tincture of sulphur
if there is ulceration, completes the treatment.
Some years ago, I was in the habit of prescribing
sulphur at the outset, and obtained some advantage
by the use of it; but, in the great majority of cases,
it happened that at about the eighth or tenth day of
an extraordinary amelioration, this apparent progress
toward a cure, was suddenly arrested, and I in vain,
insisted then upon the same medicine, from which I
endeavored to obtain new effects, by varying the dilutions and the doses: the patients remained thenceforth refractory to its action, and left me discouraged.
The idea of previously using rhus and mercurius
solubilis, was fortunate for me; but it was only after
several unavailing attempts that I bethought myself
of doing so.
Dulcamara, belladonna, baryta carbonica, aurum
foliatum, lycopodium, conium  maculatum, and
spongia marina tosta have been extolled against
various secondary symptoms of scrofula. The pathogenetic study of these substances, can alone guide the
physician in his choice of them, according to the circumstances of the case.




SYPHILIS OF NEW-BORN CHILDREN.       2o1
SYPHILIS OF NEW-BORN CHILDREN.
Boerhaave was among the first who admitted the
hereditary transmission of syphilis, as well as its
communication by the maternal milk. Gardane and
Doctor Bertin, who shared upon this point, the opinion of their celebrated predecessor, think beside,
that the infection may take place during labor, when
the child, whose skin is tender and delicate, comes in
contact with the parts of the mother affected with
gonorrhea or venereal ulcers.
Bell has observed cases of children born with syphilis, although there was no external appearance of it
in the father or mother. The same author thinks, as
well as Boerhaave, that the mother's milk is often a
means of its transmission, which may happen, he
says, " without the disease manifesting itself by any
previous local symptoms, but the infection of the
entire system."  This is also the opinion of Dr.
Cullerier.
M. Richond, who has written three volumes upon
the non-existence of the venereal virus, (in how
many volumes was it not proved that the blood did
not circulate!), M. Richond is, nevertheless, a partisan of the hereditary transmission of syphilis.  " It
is easily conceived," says this author, "that a father
or a mother, who present well characterized venereal
symptoms at the moment of the fecundation of the
germ, may transmit the disease to the fcetus; many




222           CHRONIC  EXANTHEMATA.
affections, in fact, beside those attributed th. this
virus, are transmitted in the same manner., Thus, M.
Broussais says, "that he possesses a host of facts,
which authorize him in believing, that mothers suf.
fering from chronic gastritis, communicate this affection to their foetus; that it is the same with catarrhs,
herpes, leucorrhaea, non-venereal ophthalmias," etc.
This question, however, is now settled, and the
examples of congenital syphilis are so numerous, and
so incontestable, that it would be absurd to deny its
transmission.
I know nothing more sad, more humiliating, more
heart-rending for parents, than to give birth to a child
infected with syphilis.
Unfortunately, the new-born child does not always
bear marked signs of this infection; I say unfortunately, fbr the disease, escaping then the necessary
treatment, will infallibly reveal itself subsequently,
but, perhaps under a form less easy to recognize, and
consequently less easy to cure. It is affirmed, that
syphilis acquired hereditarily, may develop itself at
all periods of life; that it waits for its manifestation,
the circumstances which, by a reaction impressed
upon the organism, are capable of reproducing it in a
palpable manner. Some physicians, among them,
Bell, have asserted that the disease might renmain
latent until puberty, and even until the epoch of rtarriage, or of a confinement, which they regard as a)  nd
of crisis likely to cause its appearance.




SYPHILIS OF NEW-BORN CHILDREN.        223
These opinions relative to the venereal infection,
are exactly those we profess with regard to all the
miasmatic affections, that is to say, to an immense
majority of diseases.
However this be, it is indubitable, that the earlier
we recognize in a child the existence of a hereditary
miasm, and especially that of syphilis, the greater
will be our chance of avoiding its terrible effects.
Among the signs by which we recognize congenital
syphilis, there are some which are conclusive; but
there are others, which may leave us long in uncertainty.  "As a general rule," says MM. Rattier and
Cullerier, "we should be circumspect in pronouncing
upon the existence of syphilis in the new-born. In
times past, it sufficed that a child was small, thin,,
with a withered skin, and presenting the appearance
of old age, to induce the declaration of the presence
of hereditary syphilis: especially if there were a few
red spots on the breech, or near the sexual parts.
Purulent ophthalmia, to which children are subject,
was still another reason for the anathema. At present,
when we make our observations with a little more
care, we know that frequently children having this
unpromising appearance, have been sick during
intra-uterine life, and that this aspect no more
characterizes syphilis, than a beautiful carnation
and unusual embonpoint excludes the idea of it,
when there exist other characteristic symptoms of the
disease."




224           CHRONIC. EXANTHEMATA.
Now, these characteristic symptoms, at the time of
birth, are almost entirely reduced to the signs furnished by an examination of the skin. This is then
of a beautiful uniform red, or of a dirty straw color.
The epidermis is easily detached, as in the commencement of putrefaction, or is elevated by serosity, and
forms pustules, more or less numerous and voluminous, but almost always surrounded by a violet or
copper-colored areola.
Exceptional cases aside, children affected with congenital syphilis, are feeble, thin, of a.wretched, and,
in some manner, old appearance. Their muscles are
thin and flabby; their cry is tremulous. The greater
part have the nostrils obstructed, and the commissures
of the lips eroded.
But, if the disease does not declare itself until after
birth, it, according to M. Hartmann, commonly does so
about the second month, and almos~t always manifests
itself under the form of red or copper-colored spots,
succeeded by little pustules, confluent or discrete, whose
humor is soon converted into scales, so thick, that the
eruption might be taken for leprosy or psoriasis.
The pustules show themselves upon the face, trunk,
and breech; where, in infants badly nourished, and
badly cared for, they rapidly degenerate into ulcerations.
" When the affection shows itself still later," says
Wallace, "we perceive condylomata upon the genital
parts, cracks in the corners of the mouth, an artificial




SYPHILIS OF NEW-BORN CHI DREN.    225
suppuration upon the mucous membrane of the lips
and the mouth, ulcerations in the pharynx, and almost
always an alteration in the voice. The frequency of
tile condylomata, of the cracks in the corners of the
lips, and of the ulcerations in the pharynx, and upon
the buccal membrane, is in direct proportion to the
age of the child."
The prognosis of congenital syphilis, always serious,
is beside dependent upon the nature of the symptoms,
and above all upon the strength of the child.
TREATMENT.-The necessity for mothers or nurses
to take themselves the medicines demanded for the
health of the child, is, I repept, once tbr all, an allopathic prejudice, from which it is time we were delivered. It is impossible for me to admit, in fact, that a
nurse in good health can take, with impunity, for whole
months, an active substance of M hich she has no need.
The medicine I shall point out, as the specific for
syphilis in nursing children, whether congenital or
contracted from the mother's milk, is not a mercurial
preparation-it is kreosote.
I can easily conceive that practitioners, ignorant upon
what grounds this recommendation rests, will receive
it with reserve. I believe I have already said that I
should some day explain by what association of ideas,
experiments, and clinical observations, I have arrived
at the therapeutic innovations recorded in this work.
We assuredly do not find in the pathogenesis of.
kreosotum, as published by M. Wahle, and reproduced




226           CHRONIC EXANTHEMATA.
by M. Jahr, in his manual-a pathogenesis, undoubtedly conscientiously recorded-indications sufficiently
marked to justify the use I propose to make, and have
myself made, with the greatest success, of this medicine.  But what does this prove, except that the
pathogenesis of kreosotum is still incomplete, as well
as that of many other precious medicines, such as
coralia rubra, chelidoniumn majus, lobelia inflata,
copairce balsamum, and several other medicines, destined, when they shall be better known, to play in
practice most important parts.
KREOSOTUM is certainly a capital remedy in the
treatment of syphilis of the new-born, when this disease manifests itself under the exanthematous form.
It suffices, alone, and without the intervention of mercury, for a radical cure..Kreosotum  is then administered, of the twelfth
dilution, and in mild doses, once a day, for several
weeks.*
I have reason to believe, but without, however,
oeing certain of the fact, that it will also effect the
cure: 1st. Of syphilis in the scrofulous form; 2d. Of
condylomata: 3d. Of mercurial stomatitis.
Acidum  muriaticum  is, however so efficacious in
this last case, that one would do wrong to try any
other medicine.
* Kreosotum also cures pustulous syphilitic eruptions in adults,
orut with the aid of mercurius corrosivus. The two medicines are
administered alternately, one, one day; the other, the next.




SYPHILIS OF NEW-BORN CHILDREN.    227
It is to be remarked that in cases of congenital
syphilis, and of eruptions resembling syphilis, homceopathic physicians, when they have been preceded in
the treatment of these little patients by the practitioners of the old school, have often much more to do
to repair the mischief caused by them, than to make
themselves masters of the primitive disease. The
effects of mercury in large doses are, in fact, little less
to be feared than syphilis itself. One should then
never fail to inform himself carefully, and if necessary
to insist upon the question, whether the child has already been treated-if it has taken mercury, and if the
disease was aggravated under the influence of this
medicine. There is no doubt, in this last case, of the
presence of a mercurial disease.
It is my conviction that kreosotum will one day, in
these cases, be fully appreciated. I do not hesitate,
for my own part, to prescribe it in cases of angina, of
mercurial salivation, and of congestion of blood to
the face. We, furthermore, would be at liberty to
give the preference, in the same circumstances, to
aurum foliatum, third dilution, as recommended by
M. Hartmann.
"When," adds the same author, " there exists a
disease of the periosteum, especially of the superficial
bones, or already, even caries of the bones of the
nose, gold is less specific than asafoetida."
To sum  up; 1st. JVercurius corrosivus, in mild
and repeated doses, corresponds, in preference to all




228    DISEASES OF THE DIGESTIVE ORGANS.
other forms of mercury, to clearly defined syphilitic
symptoms different from the exanthemata to which
kreosotum is exclusively adapted.
2d. Acidurn muriaticurn, aurum, asafoetida; then
in the second rank, belladconna, dulcamara, pulsatilla, nitri acidum, china and silicea are the principal medicines called for by mercurial symptoms.
DISEASES OF THE DIGESTIVE ORGANS.
THE mUCOUS membranes which line the intestinal
tube, as well as- that of the respiratory organs, seem
to fill, in our diseases, as well as in the normal order
of the great functions of the economy, a role correlative to that of the skin.
They both take an active and constant share in all
the general perturbations which take place in us.
The immense majority of pathological symptoms,
which show themselves in the mouth, stomach, or
other parts of the digestive tube, are only then like
the greater part of the exanthemata, tbe local efflorescence of diffused affections, whose veritable seat is
the entire organism.
The intestinal exanthemata, if I may so speak, are
perhaps as numerous as the cutaneous exanthemata;
but, for a very simple reason, are much less known.
Among the affections probably so diverse, and so
multiplied, whose dominant symptoms show themselves in the digestive organs, but a small number




STOMATITIS.              229
are peculiar to childhood, and of these only I shall
speak.
STOMATITIS - INFLAMMATION OF THE MOUTH - MUGUET.
This disease, confounded by many pathologists with
aphthse, is characterized by the concretion of the
mucus upon the surface of the inflamed mucous membrane, whether these membranes have an epithelium,
or not.
This concretion may be observed in the mouth, the
oesophagus, stomach, the small and large intestines.
The symptom is always serious in proportion to the
extent of surface it occupies.
This species of stomatitis may manifest itself under
three different aspects; 1st. Under the form of very
small white points, scattered over the tongue, or the
sides of the mouth; 2d. Under that of shreds, more or
less large; 3d. Under the form of a membrane, which
entirely covers the tongue, or extends over the other
parts of the buccal cavity.
The dotted, caseous or membraniform excretion of
which we speak, is commonly preceded by an ervthematous inflammation of the surface of the tongue, or
the sides of the mouth. "I have given the closest
attention," says M. Billard, "to the examination of
the seat of this excretion, and I have never found
it below the epithelium, upon the surface of which
it is always seated.  It is external to the mem.




230    DISEASES OF THE DIGESTIVE ORGANS.
brane, and coats it over like the mucus, of which
the muguet is, really, but a morbid concretion."
When the disease makes progress the white points
unite, and enlarge, and thus form little patches,
either on the surface of the tongue, or on the internal surface of the lips and cheeks. These patches
thicken more and more, and finish by exfoliating or
detaching themselves, and leaving in their place an
inflamed surface, which is soon covered with a new
concretion, until at last the disease disappearing, the
production of which it was the cause is' no longer
renewed.
If; lastly, the muguet acquires a high degree of intensity, the patches of which I have spoken, unite in
one and form a pellicle more or less large, and more
or less thick, which spreads over the whole tongue,
the sides of the mouth and velum palati. Under these
circumstances, as under the preceding, the mnuguet is
called confjuent or malignant.
This disease has hardly any general symptoms in
very young children, especially if the seat of the local
inflammation is not extended. There is rarely in this
case much fever. However, the skin is comnmonly
warm and dry.
It is, especially, during early infancy that muguet
is developed. Infants at the breast are much more
subject to it than children at a more advanced age.
It is above all severe among children assembled




STOMATITIS.               231
together in great numbers, who are born feeble and
miserable, or lack an appropriate alimentation.
M. Baron affirms that muguet is not contagious,
and M. Billard says, "that he has seen children not
affected with muguet, drink from the same spoon with
children who had it, without contracting the disease."
TREATMENT.-When muguet arises from a vicious
alimentation, the first thing to be done, is to submit the
child to a suitable regimen. If there is reason for
attributing the disease to the scarcity or bad quality
of the milk, the nurse should be changed. If, on the
contrary, the child is fed with the sucking bottle, it
will be still more easy to make the necessary modifications in its food by conforming to the precepts laid
down in the first part of this work. (Page 72.)
I do not know of anything in our homceopathic
literature, which has direct reference to muguet;
authors in general, confound this affection with
aphthee, which does not demand precisely the same
treatment.
Cinnabaris, at a high dilution, and in mild and
repeated doses, is perhaps, of all the mercurial preparations, that which best corresponds to muguet of the
mouth and oesophagus. ifercurius solubilis may be
administered in the same manner, and later, china, if
there is reason to believe that the disease has invaded
the stomach and intestines.
20




232    DISEASES OF THE DIGESTIVE ORGANS.
A P II T H 1 -T H R U S H.
Aphthae differs essentially from mugnet in this
respect, that in the latter, the buccal mucous membrane remains always intact, while in the former, veri
table ulceration is present.
Pathologists are still far from being of the same
opinion with regard to the anatomical seat, and real
nature of aphthse. Whether or not, as some modern
authors assert, it consists in congestion, and subsequent
ulcerations of mucous follicles, is a question of minor
importance to the practitioner.
What is certain is, that aphthse may be produced
upon different points of the gastro-intestinal mucous
membrane, and occupy, in certain cases, almost the
entire extent of this membrane, front the mouth to the
rectum inclusively.
It most commonly shows itself only on the mucous
membrane of the mouth, in the form of little lardaceous ulcers, with borders sometimes cut perpendicularly, and secreting a whitish cheesy humor, more or
less adherent to the surface.
When the aphthy are' isolated, they commonly
occupy the internal surface of the under lip, the freenum of the tongue, the internal surface of the cheeks,
and the summit of the gums. when the teeth have not
yet pierced them.
When the aphthoe are numerous and closely approximated. their edges unite -the matter which they




APHTHE- THRUSH.               233
secrete, extends from one to another, and forms a
layer more or less broad and thick. It is then that
the aphthee might be confounded with muguet.
However, M. Billard affirms, that even in this case,
one may still distinguish the two diseases, by taking
into account the mode of development of the inflamed
follicles and the solution of continuity, which does
not exist in mugyuet.  Beside, says he, the excretion
which accompanies aphthae is always consecutive to
the ulceration, and is almost always observed on the
internal part of the lips and cheeks, while the white
points of muguet appear first upon the lateral
parts, and toward the point of the tongue.
Notwithstanding these differential signs, I am
forced to admit, that in certain stages of these diseases,
aphthae is very apt to be confounded with muguet.
The aphthoe, even when they are in small numbers,
almost always cause severe pain. They suffice consequently, to hinder children from nursing, and to
bring on, if they persist, serious derangements of the
health. But they only constitute a really serious disease when they have a tendency to become numerous,
and especially to penetrate into the trachea, the
esophagus, the stomach, etc.
When they occupy the pharynx, they render deglutition extremely difficult. They are then alm.ost always
accompanied with turns of vomiting, and an almost
continual hiccough. These symptoms are especially
observed when the disease has its seat in the stomach.




234    DISEASES OF THE DIGESTIVE ORGANS.
As to aphthe of the intestines, when there are
none in the buccal mucous membrane, it is extremely
difficult to diagnose their presence, for the relaxation
of the bowels they occasion, may easily be attributed
to any other cause.
Fortunately, the disease usually commences in
the mouth, if it is not always limited to this part;
it may be considered extremely serious when it follows
a contrary course, that is to say, when instead of being
propagated from the mouth to the other parts of the
digestive tube, it mounts from the digestive tube to
the mouth.
Aphthae is not, like muguet, a disease belonging
exclusively to the first period of childhood; adults
even are exposed to it. We observe it more particularly in very feeble, pale, lymphatic children some
months of age.
" I have observed in the hospital of the Enfantstrouves," says M. Billard, "that while muguet prevailed very generally in children newly born, aphthee,
on the contrary, showed itself more frequently among
those who had attained the period of the first
dentit.ion."
As in muguet, the febrile phenomena accompanying
aphthoe, have rarely any intensity.  We may even
affirm, that in the majority of cases the pulse presents
no sensible alteration
Gangrene is the most fatal termination of aphthoe,
but is happily also the most rare. Gangrene of the




APHTHA- THRUSH.                235
mouth, of which we shall soon treat, is almost
always developed under especial conditions, having,
with the disease of which we at present speak, but
remote and fortuitous relations.
TREATMENT.-BoraX  is generally considered by
homceopathists as the specific for aphthae.  It is in
fact, a good medicine, and one whose curative action
is sometimes very prompt, especially when it is
administered at the beginning of the disease.
Borax suits best, according to M. Ilartmann, when
the child is very cross, cries and weeps much, starts
in his sleep, and seizes objects around him; when the
complexion is pale and earthy, the skin soft and
flabby; when he refuses the breast, and the mucous
membrane of the palate and tongue, upon which are
perceived red vesicles and aphthae, appears as if
shriveled.
The same author extols acid. sulyh., in large doses,
(a few drops to an ounce or an ounce and a half of
water), or at high dilutions; mercurius solubilis,
if the disease occupies the throat especially, and
lastly su7plur.
For myself, if I decided to prescribe for the aphthae,
an acid in large doses, I should certainly not give the
preference to acid. su7ph., but rather to hydrochloric
acid, which I have heretofore used in similar cases
with the greatest success.
A few drops of this acid, mixed with a teaspoonful
of honey, form a mixture with which (taking care




236    DISEASES OF THE DIGESTIVE ORGANS.
that the child does not swallow it), the aphthoe may
be lightly washed, by means of a little pencil made
of lint; this relieves the smarting almost instantaneously
Lastly, the same acid, but dynamised, is the only
medicine I use internally, in all cases, that is to say,
wherever the seat and whatever the intensity of the
disease.
It is not necessary to have recourse to very high
dilutions of this medicine.  I generally prescribe
it in water, from the third to the sixth dilution; a
few globules in a tumbler of water, a teaspoonful to
be given every three or four hours.
GANGRENE OF THE MOUTH.
Of all parts of the body, the mouth is certainly the
one most subject to be invaded by gangrene. An
affection peculiar to childhood, and almost necessarily
fatal, gangrene of the mouth is justly the terror of all
those who have occasion to see it.
According to Doctor Baron, it is never primitive,
and only manifests itself in children already enfeebled
by previous disease.
Measles is, perhaps, of all diseases the one to which
it most frequently succeeds. It appears, nevertheless,
but much more rarely, as a sequel to scarlatina, variola, pneumonia and hooping-cough. Lastly, it is beyond a doubt that this serious affection may be immediately produced by an untimely or excessive use of




GANGRENE OF THE MOUTH.            237
mercury. Doctor Bretonneau reports several cases of
this kind in his Traite de la Diphtherite.
We borrow  from  MM. Rilliet and Barthez, the
picture, as true as it is striking, which these authors
have drawn of gangrene of the mouth, in the second
volume of their Traite des Maladies des Eifants.
" Gangrene of the mouth begins, during the course
of convalescence from another acute or chronic disease, by ulceration, aphthae, or more rarely by cedema
of the part where the gangrene is about to be developed. At this time the face is pale, the breath fetid,
the fever not very intense, unless there also exists a
febrile disease, and then the pulse may be considerably
accelerated; the child becomes more sad, ordinarily
complains little, or none at all of the mouth; sometimes, though rarely, he suffers severe pain.
" The ulceration, slight at first, and with a grayish
base, situated upon the middle of the internal surface
of the mouth, or in the fold between the gums and
the cheek, or the gums and the lips, is soon covered with
a grayish putrilaginous excretion of a fetid and peculiar odor. At the same time an infiltration of the
diseased cheek, or lip, takes place; the cedelna is soft,
rather regularly circumscribed; it soop becomes increased; and, there is formed deep in its center a
hard, regular, round nucleus.  Then the cheek becomes tense, shining and pale, or marked with a
violet-colored marbling, more decided upon the promninent parts of the tumor; in the interior of the mouth




238    DISEASES OF THE DIGESTIVE ORGANS.
the eschar has taken a brown color; it has spread
considerably, has reached the gums; it is sometimes
surrounded by a violet-colored circle.
" The child is seated in his bed, and occupies himself with the objects around him; sometimes, without
strength, he lies in a state of indifference; his face
puffed, and without expression on one side, is sad and
depressed on the other; a bloody, or already blackish
saliva flows from his half open lips; he asks, however, for food, and takes with avidity what is offered
him, and swallows together, his food and the putrid
matter detached from the gangrenous parts. His skin
is cool, and his pulse but little developed, and of
moderate frequency, unless there exists some serious
febrile complication; his mind is clear, but sometimes, during the night, he has a more or less intense
delirium.
" From the third to the sixth day of the disease,
the scene changes; an eschar is formed upon the most
purple and prominent part of the tumor, either upon
the cheek, or upon the under lip; small, black, and
dry, this eschar extends itself from day to day, and
sometimes attains considerable dimensions, invading
almost the whole side of the face, or even descending
upon the neck; at the same-time, that of the mucous
membrane is increased in the interior. The aspect
of the enild is as sad as it is hideous to the sight;
sometimes, in a sitting posture, and availing himself
of all his strength, he tears from the interior of his




GANGRENE OF THE MOUTH.            239
mouth the gangrenous fragments; sometimes, lying
dejected and depressed, he allows to flow out and
cover him, a blackish and fetid sanies.
"This appearance, however, may become still
more repulsive, when the slough is partially detached,
and the mass is seen hanging from  the cheeks, or
even worse, when, falling off, it leaves a perforation
through which the bare and loosened teeth, and the
blackened maxillary bones are visible. The odor is
then of the most offensive character; the child still
retains some strength, and asks for food, or, in the
last state of prostration, he refuses all nourishment;
there is always great thirst, and the patient drinks
with avidity; he does not vomit, but there is great
relaxation of the bowels; he becomes rapidly more
and more emaciated  his skin is dry, but not very
warm; his pulse, very small, becomes insensible,
and death arrives without other phenomena."
It most commonly takes place before the deterioration is so profound, and before the perforation is
effected, in firom eight to fifteen days.
Gangrene of the mouth, very rare in adults, and
perhaps still more rare in infants at the breast,
usually attacks children between the ages of two and
ten.
It is not contagious, and never prevails epidenmically. It is one of those diseases which physicians
have less frequent occasion to observe in their private
practice than in hospitals.
21




240    D)IEASES OF THE DIGESTIVE ORGANS.
In the rare, and, we may even say, exceptional.
cases, where a cure is effected, it is always in the first
period, before the manifestation of the cutaneous
esclhar, and by the separation of the mortified portion
of the mucous membrane.  There then remains an
ulceration, with a grayish bottom, whose tumefied
borders subside little by little, and whose cicatrization
is accomplished at the same time that the general
symptoms anlend and disappear.
TREATMENT.-Hoinceopathy as yet knows no specific for gangrene of the mouth, which seems, however,
to enter into the sphere of action of several medicines
known; at the head of which, Hartmann places
secale cornut'im.
I have seen the disease arrested in the beginning by
ipecacuanha, at a low  dilution, and in doses frequently repeated, (a teaspoonful every hour, of a
solution of three drops of tincture, third dilution, in
four ounces of water).
In a more advanced period of the disease, 1 should
not hesitate to prescribe, alternately, acid. muriaticum and kreosotum, at low dilutions, and at short
intervals, and even, if necessary, slight cauterizations,
with muriatic acid, diluted with a little honey.
DENTITION.
In one of the chapters upon the hygiene of children,
(see p. 77,) I have already mentioned the medicinal
agents called for by the majority of the sympathetic




DENTITION.                241
affections occurring during the period of dentition.
There remain for me, but a few words to say on this
subject.'' The greater part," says M. Guersant, "of the diseases of children, are attributed to the process of dentition. The difficulty in observing the diseases of
early infancy, and the little positive knowledge we
possess upon this part of pathology, have contributed
to propagate this opinion; and this prejudice, resulting from our ignorance, has eventually become popular, like all other prejudices in medicine."
The notion has this mischievous effect, that it
often imposes upon physicians with regard to the real
existence of diseases independent of dentition; diseases which they allow to take root under the false
persuasion, that they are but normal manifestations
of a purely physiological phenomenon.
The first teeth (the incisors) commonly appear
toward the end of the fourth month, sometimes a
little sooner, but sometimes also a little later.
The importance and sort of vain-glory that mothers,
and especially nurses, indulge in on account of the
precocity of children in this respect, seems to me illfounded. 1 have in fact, remarked, that the teeth had
far more permanence when the period of their eruption was somewhat delayed.
However this be, it is certain that the evolution of the
teeth, which is sometimes accomplished without causing any serious trouble, becomes also in certain cases,




242    DISEASES OF THE DIGESTIVE ORGANS.
a real disease, and a sufficiently serious one to require
all the attention of the physician.
This takes place, especially in nervous, irritable
and debilitated subjects, when several teeth are about
coming through at the same time. It is then, common enough to see high fever, with almost continual
wakefulness, extreme agitation during the rare intervals of sleep, spasmodic movements of the eyes, convulsions of the limbs, cough, hiccoughs, and even
letnargy, if things take a bad turn; for this last
symptom is of very bad omen; the gums are red,
swollen, hot and very painful; the inflammation of
which they are tue seat, extends itself to the tonsils,
cheeks and the whole face. In short, if this state is
prolonged beyond a certain time, even the germs of
the teeth undergo a notable alteration; they soften
and corrode to such an extent, that the destruction of
the teeth is, as it were, consummated before their
appearance; at least such seems clearly the result
of several anatomo-pathologica] observations, made
by Dr. Billard, in the hospital of the Enfantstrouves.
As to the diarrhea, which is almost always added
to the other symptoms of dentition, and which Rosen
seems to regard as the result of the acrid saliva,
which the child almost necessarily swallows, it
is evidently like the cough, amygdalitis, etc., but
a sympathetic phenomenon'of the buccal irritation.




GASTRITIS.               243
To sum up, it is not then impossible that dentition
may constitute in itself, as I have just said, a real
disease.
Now this disease has its specific, and I am happy
in being able to sustain myself by numerous facts, in
pointing out to practitioners, the medicine which
answers explicitly to all the symptoms it is susceptible
of presenting.
Kreosotum, which will certainly one day be considered as one of the most precious and reliable medicines of our materia medica, is the substance to which
I now allude.
I prescribe it at the twenty-fourth dilution, in mild
and repeated doses.
Kreosote, which I recently saw completely arrest,
in the course of a few weeks, a painful caries of the
incisor teeth, in the case of a lady forty years of age, is,
in children of all ages, as well as in adults, the chief
remedy for odontalgia, when it is caused by caries
of the teeth, especially when the pain is accompanied
by turgescence of the gums and facial congestion.
GA STRITIS.
Time has executed justice upon the sophisms of
Broussais. It is hardly twenty years since gastritis, a
multiform monster invented by the physiological school,
controlled the whole of pathology. It-was the prototype of inflammation-the primitive phenomenon of




244    DISEASES OF THE DIGESTIVE ORGANS.
all other diseases, which were, it was asserted, but its
more or less certain consequences.
The public even, which commonly troubles itself
but little about the names of the diseases which decimate it, talked about gastritis, as it has since done
about cholera. From the eloquence of a man of
genius, this bugbear assumed the appearance of reality, and made people believe in the existence of a
fact that every day's observation belied!
It is now universally admitted, that if the stomach,
like the other parts of the digestive tube, takes a
sympathetic part in all the somewhat acute affections
of the organism, primitive gastritis is a rare disease.
Thus it occupies a very small space in modern nosographies. It is to be remarked, however, that it is
rather more frequent in children than in adults.  It is
from the third to the twelfth year that it is most frequently observed.
Inflammation of the stomach, or, to speak with
more precision, erythema of the mucous membrane of
the stomach, (for gastritis is nothing else), is recognized by the following signs:
Frontal cephalalgia; fever, with fullness of the
pulse; acrid heat of the skin, especially in the forehead and in the hollow of the hands, to which succeed
abundant sweats; sensibility of the epigastric region;
burning regurgitation; bilious vomiting, with loss of
appetite; thirst, more or less intense; disgust for




GASTRI'IS.                245
warm or alcoholic drinks; great desire for acid and
cold drinks; mouth bitter; tongue moist, white or
yellowish, at the base, with bright red dots at the
point and on the borders.
The patients are generally constipated; but often,
also, as the vulgar say, the disease takes its course
downward, and two or three evacuations, at short
intervals, announce the termination of the disease, or
a change in its character.
The common causes of gastritis are:
1st. Overloading the stomach with food, taken
either in too great quantities at a time, or at too frequent intervals; 2d. The introduction into this organ
of crude substances, such as grease and acids; 3d.
A sudden fright, vexation or anger; 4th. A chill;
5th, and lastly, The introduction into the stomach of
inert foreign bodies, refractory to the gastric action,
and, for a stronger reason, all irritating or actually
poisonous substances.
I find, in reference to this last cause, in the work
of MM. Rilliet and Barthez, an avowal, which does
more honor to the frankness of these writers, than to
the therapeutics of the school to which they belong:
"One of the principal causes," say they, " of gastritis and of softening of the stomach, has been, in
the children who have come under our observation,
the use of an energetic medicinal action, upon the
gastro-intestinal mucous membrane."   I add with
pleasure my testimony to that of the two physicians I




246    DISEASES OF THE DIGESTIVE ORGANS.
have just cited: the majority of the cases of gastritis
I have had occasion to treat, were the direct work of
Allopathy.
Gastritis, like other diseases, has its degrees of
intensity, and its symptomatic shades.  The precursory symptoms of the eruptive fevers, or of typhoid
fever in its commencement, are the only pathological
conditions with which it would be possible to confound it; and yet, with the history of the disease that
we have under our eyes, and the recital of the facts
anterior to its manifestation, it is very rare that all
error in diagnosis is not avoided.
TREATMENT.-Gastritis is generally a disease of
short duration, and one which the curative force of
nature alone, almost always suffices to cure. However, it might be dangerous to abandon it to itself.
and I am  convinced that in treating it properly
serious affections have often been prevented, of which
it was only the precursory sign, or rather the first
symptom.
Gastritis, whatever its cause, is one of those affections which the most imperiously exact a few days of
diet.
Patients so much the more willingly resign themselves to this, as they feel a repugnance to food. To
wean a child at the breast will often suffice to
effect an instantaneous cure. A little gruel may
for a day replace the milk of which he is deprived.




GASTRITIS.                247
As to children more advanced, they may be put
upon the use of sweetened water, of the temperature
of the apartment.
If the stomach is still surcharged with food, or if
some poisonous substance has been swallowed, the
patient should be made to vomit, either by means of
tepid water, or tickling the fauces; after which we
may prescribe, according to the circumstances, aconitum, yulsatilla, nux, arsenicurn, chamomilla, bryonia, ph2osphorus, or causticam:
Aconitum, if the dominant symptom is a high, full,
and frequent pulse, with heaviness of the head,
pain in the forehead, and considerable heat in the
face; especially if the indisposition has succeeded a
fright;
Pulsatilla, if greasy food, such as goose or pork,
has provoked the indigestion, or if the patient is tormented with frequent sour, and watery regurgitations;
if he vomits without effort; if he experiences vertigo,
or in short, and above all if these symptoms occur in
the evening and night;
Nutx vom., if the child is of a nervous, dry, and
irritable temperament; if the pain at the epigastrium,
and the agitation are very intense; if there is constipation and but little sweat; if in short the disease has been caused by coffee, wine, or any other
alcoholic drink, or again by a fit of passion;
Arsenicurn, if the gastritis is in consequence of a
chill, or of an indigestion of fruits, raw roots or herbs;




248    DISEASES OF THE DIGESTIVE ORGANS.
CAamonzmilla, if there are bilious vomitings, and
especially if the patient is a little girl, or an infant at
the breast;
Bryonia, if the indigestion has been produced by
cabbage; if the epigastrium  is very sensitive to the
touch, and if the slightest movement increases the
pain, and if there is constipation;
Phosphorus, is indicated when there is a pressing
and cutting burning in the stomach-a sensation as if
a warmn gas was escaping from the mouth; ardent
thirst; burning in the precordial region; anguish; convulsions of the face; violent chills, or when the limbs
are cold, the eyes clear and tearful, the lips pale,
the pulse accelerated, small and feeble, the strength
prostrated;
C7austicum, whose use in the treatment of affections
of the stomach, seems to me susceptible of being much
extended, is the specific for stfocative gastritis; a
form  very rare in children. The symptoms which
call for its use, are: spasmodic distention of the epigastrium, with burning and inodorous eructations;
bilious coloration of the face; absence of sweat; and
even of heat in the forehead and hands; constipation;
lastly, tickling in the throat, which provokes a dry
cough.
The different medicines I have just mentioned, are
administered stronger, and in doses more frequently
repeated, in proportion to the intensity of the symptoms. The nature of these last, as well as the kind




ENTERITIS.                 249
of medicine to which we have recourse decides, as
usual, the choice of the dilutio: s.
In general, aeon., pulsat., and chamom., are prescribed from the sixth to the eighteenth; pho.ph.,
arsen., and caust., from  the eighteenth to the thirtieth. With the exception of the cases to which causticum and phosphorus correspond, it is seldom that
gastritis requires a treatment of long duration.
ENTE  RITIS.
Enteritis is the inflammation of the intestines.  It
manifests itself as a sympathetic affection of almost
all the organic and functional lesions of the economy;
but as a primitive disease, it is rare. In children,
however, it is more common than gastritis, to which
beside it often succeeds.
Authors have described a multitude of varieties
of enteritis. Some have founded those they have
admitted upon the different degrees of intensity,
which this disease may present without changing its
nature; others, more logical, no doubt, have deduced
theirs from notions furnished by pathological anatomy.
It is thus that these last have admitted'
1st. Erythematous enteritis, or inflammation of
the mucous membrane;
2d. Philegmonous enteritris, or inflammation of the
muscular tissue of the intestine;
3d. Follicular enteritis, or inflammation of the
follicles;




250    DISEASES OF THE DIGESTIVE ORGANS.
4th and last, Serous enteritis, or perienteritis; in
other terms, inflammation of the peritoneal envelop
of the intestine.
Of these four varieties of enteritis that I willingly
adopt, with the exception of the last, which appears
to me problematical, if we consider it otherwise than
as representing the highest degree of intensity of the
others, I shall only speak here of the first —rnucous
enteritis. The second, in fact, is evidently only a
more violent degree of the first, as phlegmonous
erysipelas is only the aggravation of simple erysipelas.
As to folliculous enteritis, which constitutes, as
everybody knows, the characteristic lesion of typhoid
fever, I shall speak of it later, under the head of this
iatter disease.
iMiCcous enteritis, an affection often disregarded,
may be observed from the earliest period of life. It
commonly begins without appreciable fever, by a simple relaxation of the bowels; but the stools soon
become more frequent, and undergo a change. They
are preceded by moaning and anxiety. cries, and even
convulsions. The moaning and crying are renewed
during the evacuations.  The evacuations soon lose
their normal color and odor. They are of a reddish
brown, or green tint, sometimes aqueous or slimy,
sometimes bloody, purulent, and containing pieces of
membrane. and sometimes, finally, of a dark color,
and mixed with indigested food.




ENTERITIS.                251
Excoriation and cedema of the anus, often, even
falling of the rectum, add to the discomfort of the
child. It experiences alternations of tenesmus and
constipation; the skin is burning, the pulse frequent.
The tongue, white and moist in the beginning, becomes dry, and sometimes passes from a dark-red to
a blackish brown; the patient drinks incessantly; the
abdomen is distended; his strength diminishes; the
features change, shrivel up, and take the appearance
of old age.  Soon he has no longer strength to cry,
but continues a plaintive moan; lastly, the stools
stop, the meteorism increases, feeble convulsive movements manifest themselves, and the patient dies, if
art has not succeeded in arresting in time the progress
of the disease.
This form of enteritis, always very serious in infants at the breast, is more to be dreaded in proportion as the children are young.
Generally more benign in children of from five to
ten years, mucous enteritis rarely assumes in them
the alarming character I have just described. In
cases at this age, it has two ways of beginning:
In some instances, a child is taken with a not very
abundant diarrhea, which does not seriously affect
him. He continues to play and amuse himself; his
appetite continues, or only insensibly diminishes.
This state lasts eight or ten days, sometimes longer;




252    DISEASES OF TIE DIGESTIVE ORGANS.
then supervene acute symptoms; fever, pain in the
bowels, thirst, anorexia, augmentation of the diarrhea.
At other times, the commencement is abrupt, and
characterized by cephalalgia, vomiting of food or bile,
epigastric or umbilical pains, thirst, and loss of appetite.
We have then, during an interval of from four to
ten days, the following symptoms: The face has some
color, the features are drawn; there is heat, and often
moisture in the skin; the pulse is frequent, a hundred
or a hundred and twenty pulsations to the minute:
the abdomen is sensitive to pressure, either in the
umbilical region, or in the sides and iliac fossoe,
rarely in the epigastrium; it is large, sometimes a
little tense, warm, and sonorous; very rarely one may
perceive gurgling; the stools are sometimes very abundant, very numerous, very liquid, and seem then to
come from the small intestine, or they are more rare,
less liquid, and vary from two to six in the twentyfour hours; they are mucous and bilious, rarely
green, more frequently various shades of yellow or
brown.
The vomitings that take place in the beginning,
discontinue after one or two days, and are, at the
most, replaced by nausea. The t-,ngue is moist, very
rarely dry, red at the point and upon the sides, covered at the base with a white or yellowish coating,




ENTERITIS.                 253
more or less thick; the mouth is sometimes offensive,
the breath sometimes fetid.
The child does not sleep, or sleeps badly; its sleep
is agitated; he does not, however, complain of headache. The delirium, always flying and of shorl duration, is an exceptional and very rare phenomenon.
It may, nevertheless, manifest itself without being
any proof that the disease is degenerating into typhoid
fever.
There are sanguine-nervous children so liable to
delirium, that they present this symptom  in almost
all their diseases.
This state continues for a few days, when the fever
abates, the skin returns to its normal temperature, the
pulse falls, according to the age, to seventy or eighty
pulsations a minute; the face becomes pale, and even
emaciated; the child is a little enfeebled, but the
appetite returns; the looseness of the bowels still
continues, but gradually diminishes; the bowels recover their elasticity, and lose their sensibility. All
the symptoms, in short, gradually disappear, and tle
child returns to its natural state, after an illness of
from twelve to twenty days, retaining no other trace
of it than a little feebleness and emaciation.
Such is the normal course of primitive mucous
enteritis, during the second period of childhood.  It
is easily understood, that the constitution of the patients, the more or less judicious attention they
receive, and perhaps, above all, the influence, always




254    DISEASES OF THE DIGESTIVE ORGANS.
so marked in all our diseases of the hygrometrical
and barometrical state of the atmosphere, may vary
almost infinitely the intensity of the symptoms and
the duration of this affection.
Finally, the intimate cause of the disease, that
which the most frequently escapes us, necessarily impresses upon it a particular stamp, so that between
ephemeral enteritis, the accidental consequence of an
indigestion, and typhoid enteritis, there exist innumerable shades.
Should enteritis be classed among essential dis
eases? This question, to be explicitly answered,
requires more precise notions than we yet possess
upon the disease in question. It is clear, on the one
hand, that a sudden chilling of the skin, or the passage into the intestines of a badly elaborated chyme;
that is to say, of substances which have resisted the
dissolvent action of the stomach, may cause immediately, and without the intervention of any miasm,
erythema of the intestinal mucous membrane.  But,
on the other hand, it appears to ime not less evident,
that certain forms of enteritis, that, for example, of
children at the breast, which develops itself, and
passes through its different stages, to a fatal termination, in spite of the lnost judicious hygiene, and the
most rational treatment, depends upon a cause more
active and profound than a temnporary suppression of
the perspiration, or the transient contact of indigested
food. What physician has not seen several children




ENTERITIS.                255
>f the same family die successively, at the same age,
of this disease? Was it the mother's milk which was
fatal to them? This is not impossible: nature has its
caprices. However, I have seen in families where the
children had succumbed in this manner, two cases in
which the milk of a good nurse was vainly substituted
for that of the mother, for this precaution did not
prevent a new catastrophe. The children, then, bore
in their blood the germ of the disease of which they
were to die.  Such facts are not, unhappily, as rare
as might be supposed.
TREATMENT.-The following medicines have been
recommended against enteritis in children at the
breast: aeonitum, chamomilla, pulsatilla, belladonna, hyoscyamus, etc.'Numerous observations," says Hartmann, "have
taught me that aconite should always be given at first
in the diseases of children, from the moment that there
exists in them the least trace of vascular irritation."
This is perfectly just.  "I have, in fact, observed,"
adds the same author, "that aconite, given at the
commencement of the majority of the diseases of children, not only calms the violence of the symptoms,
but often entirely dissipates the disease." To this
again, I have no serious objection to make, if it is not
that the physician is far from being always called at
the commencement of the disease, that he is often in
fact, only consulted at a period when aconite ceases
to be indicated.
22




256    DISEASES OF THE DIGESTIVE ORGANS.
"COhamomilla," continues Hartmann, "merits a
place after aconitum, if the stools are watery, or
slimy, whitish or green, and are passed with violent
pains, especially if they are more frequent at night,
and if the light sleep of the patient is often interrupted by sudden starts;
"Pulsatilla is equally indicated when heat alternates with sudden chills; when there is wakefulness,
or simply a little sleep in the mnorning, with continual
moans, diarrheic, mucous, acrid, and fiequent stools,
with vomitings;
" Nux and bryonia, in cases where the patient
is constipated; the latter, especially, when the abdomen is very sensitive to the slightest pressure;
"Belladonna and hyoscyamats, when, instead of
actively marked inflammation, the disease presents a
sub-inflammatory state: these medicines, also merit
consideration, if to these inflammatory symptoms are
added, spasmodic symptoms, which are especially
distinguished by their periodicity.
"Cocfrea is an indispensable remedy, when the
nervous system greatly predominates over the vascular system." After this quotation, which embodies
nearly the whole of the therapeutics, followed by
homeopathic physicians in the treatment of enteritis
in infants at the breast, I will in turn, give the result
of my own personal experience.
Now, it is with the profound conviction, left me by
the painful recollection of the many reverses I have met




ENTERITIS.                 257
with, that I venture to affirm, that in serious enteritis
in children at the breast, aconite, chaniomilla, pulsatilla, bryonia, nux vomica. belladonna, ltyoscyan8us
and coffea, are medicines absolutely powerless, hardly
modifying the course of the disease, never arresting its
progress, and much less preventing its fatal termination.
There exists in my knowledge, against serious enteritis of infants, but one really efficacious remedy upon
which we may depend. I have the consciousness of
rendering to art, and to humanity a real service in
pointing it out: this medicine is lycopodinum.
Thus then, when the enteritis of which I have
given the description, does not immediately yield to
chainomilla, which seems indicated by the dominant
symptoms, we should hasten to suspend this and prescribe lycopodium.
An important remark is, that this medicine will
only be followed by good results, when given in
extremely feeble doses. We should prescribe two or
three globules of the thirtieth dilution, in four ounces
of rain water, of which one teaspoonful is to be given
to the child in the morning.
It is useless to add to this treatment, either injections or poultices; but what is naturally indispensable
to its success, is a proper regimen; great care then
should be taken in this respect. We may judge from
this specificity of lycopodiutm, how dangerous and
deplorable is the abuse made of this substance in
using it as a powder for children.




258    DISEASES OF THE DIGESTIVE ORGANS.
Lycopodium does not correspond to enteritis in
children, of from five to ten years. It is against this
form that we may, according to the symptoms, use the
medicines indicated by HIartmann; medicines to which
arsenicum  should be added, which is the specific for
enteritis, with mucous diarrhea, caused by a chill.
GRIPINGS IN INFANTS AT THE BREAST.
" A child," says Rosen, " has gripings when it is
agitated, unquiet, cries much, agitates its feet, smiles
in his sleep, or seizing the breast when it is presented
to him, immediately lets it go again. The stools
are then green or soon become so. IHis swaddling
clothes are tinged with a greenish color, when they
are dry. The child has a sour smell, as well as his
occasional eructations. If this state continues for a
certain time, dysentery is to be feared."
These pains almost always depend upon an imprudence in regimen committed by the nurse (see p. 61,
chapter on Nurses, etc.); but they also often proceed
from leaving the child in the linen wet with his urine.
Whatever be their cause, we should hasten to relieve
them by administering a few teaspoonfuls of a glass
of water, in which has been dissolved three or
four globules of chamomilla of the twelfth dilution.' It is remarkable," says Rosen again, "that a child
who has these pains and will not suck, takes the
breast willingly and sucks without difficulty to satiety,




CoLIc.                  259
when some one holds him in an upright position before
his nurse."
This is perfectly true. It is, perhaps, because the
vertical position of the child keeps the acid humors
contained in the stomach, away from the cardiac
orifice, and makes them fall into its lower part.
But it is understood, that especially in the cases
where the pains have been caused by the nurse's
milk, it is important that the child should not receive
the breast immediately.
CO L I C.
Colic, like diarrhea, forms a part of the symptoms
of enteritis, and like it, yields to the treatment which
cures the latter. But colic, in second childhood, may
exist without enteritis, and even without diarrhea.
It often, for example, shows itself in consequence of a
chill in the feet. The child tries, but in vain, to go to
stool. At the most, he succeeds in the expulsion of
gas, and incomplete stools, which give him nq relief.
The principal seat of the pain is a fixed point
above the umbilicus. The pulse is normal, sometimes a little frequent; but the face is pale and
pinched.
Cina, is the specific for this sort of colic. It should
be given from the ninth to the twelfth dilution; a few
globules in a glass of water; four teaspoonfuls in the
space of an hour.




260    DISEASES OF THE DIGESTIVE ORGANS.
CO N S TI PAT ION.
This again is a symptom rather than a disease. A
bad diet, either in the nurse, or child, is generally its
cause. Thus it is frequent in children raised with the
sucking bottle, without conbforming to the precepts I
have laid down (see p. 72).
It is not impossible that it may also be an effect of
lycopodium, when the nurse is so imprudent as to use
this substance as a powder for cracks.
When this is not the case, lycopodium., thirtieth dilution, in feeble doses once a day, or every other day
for a week, is one of the best modes of combating
obstinate constipation, even those forms which do not
yield to a change of regimen. Tepid baths, when
nothing contra-indicates their use, conduce to the
same end. As to the injections of milk and honey,
recommended by Hartmann, they are real purgatives,
to which I would have recourse, in cases only of the
mrost pressing necessity, and when homceopathic means
had positively failed.
Constipation may be within certain limits a natural
state. Children of nervous temperaments are subject
to it, but they should be always watched, for it is a
serious symptom in the greater part of the diseases
of children.  When accompanied by fever, there is
danger of cerebral symptoms. BqByonia is one of the
surest means of combating the accidental consti



LIENTERY.                 261
pation in children, of all ages, which coincides with
sourness of the stomach and heat in the forehead.
LIENTERY.
We thus name a sort of diarrhea whose existence
is most commonly dependent upon another disease,
aphthse for example, in infants; but which may also
constitute an independent affection, of which the following are the symptoms:
Excretion of solid or liquid alirnents, a short time
after their reception into the stomach, without their
having undergone any alteration, either in their consistence, color, or even odor;
The patient experiences, immediately after the repast, a sensation of coldness in the epigastric region,
which swells, is distended a little with flatulence,
and soon subsides. Iliccoughs, soon succeeded by
loud borborygmus, and a few gripings announce that
the food has cleared the pylorus and is passing through
the windings of the small intestine. Soon, in fact,
the pain moves about, here and there in the abdomen,
and at the same time the patient experiences a sensation of emptiness in the stomach, and almost immediately a desire to go to stool;
The evacuation is effected without pain, or at the
most, with slight colic; but it is followed by great
prostration, some moments of vertigo, and an excessive
desire for food, which soon produces syncope, if it
is not immediately satisfied; the tongue is clean,' a




262    DISEASES OF THE DIGESTIVE ORGANS.
little whiter than in the normal state. The thirst is
great.
Lientery may last several days, weeks, months,
years even. I saw in Oct. 1849, a poor tailor, who
had been afflicted with it since 1832, when he had
had the cholera.
When the disease has passed into a chronic state,
the general health is profoundly affected; the patients
have a yellow, harsh, and wrinkled skin.  In the
majority, the emaciation is extreme; the strength is
so much exhausted, that they can hardly sustain themselves; they have three, four, or even five and six
stools in the twenty-four hours, which exhausts them
so much the more, as a part of these stools occurs in
the night. They have beside, no sleep; the mind
becomes very much affected; they are sad, taciturn,
irritable, hypochondriac. I know of nothing, in fact,
more discouraging than their condition; yet there
are, nevertheless, some who seem to pay but little
attention to it.
Lientery certainly depends upon a particular idiosyncrasy: I have many times observed it in children
addicted to onanism. Was the irritation of the intestine, in these cases, the cause or the effect?
Authors cite, as causes of this disease, the habitual
use of indigestible and unsubstantial food; such as
raw, fermentable vegetables, acid wines, the abuse of
purgatives, humidity of habitations, or of certain
climates. They add, in short, what is very true, that




LIEN rERY.                2 (3
lientery may succeed to mucous enteritis; to typhoid
fever, and especially to cholera. It is observed at
all ages.
TREATMENT.-The first condition for the cure of this
disease is, a substantial regimen, and especially the
abstinence from roots, milk food, and above all, from
dried vegetables, unless prepared in a meat soup; still,
meat itself, especially roast meat, is always preferable
for them. It results from this, that lientery is almost
incurable among the poor. I saw it once, about five
or six years since, yield rapidly and without the aid
of any medicine, to a fortifying alimentation, and the
moderate use of old Bourdeaux wine, in a patient, who
had been kept for a year on low diet, and for two
months on ass's milk, which was a little less absurd,
but which was still a contradiction.
Arsenicum, china and oleander are almost the
only medicines which ought to enter into the treatment of lientery.
Arsenicum  is the remedy par excellence; but it
only shows itself truly efficacious when administered
in rather low dilutions, at the twelfth, for example, or
even at the sixth. At the higher attenuations, arsenicurn acts more upon the nervous system, than upon
the intestinal mucous membrane.  Thus, in the last
cholera epidemic, the homceopathists who made the
mistake of' prescribing it at the thirtieth dilution, had
occasion to remark, that it was badly borne by the
23




264    DISEASES OF THE DIGESTIVE ORGANS.
stomach, and that it produced but imperfectly the
hoped-for results.
A rsentzcau, in the treatment of lientery, should be
prescribed in drops, with water, (two or three drops to
four ounces of water), of which the patient will take
two or three teaspoonfuls a day. It should be continued until the stools are reduced to a normal consistency.
If there still remains thirst, acrimony and styptic
taste in the throat, with indifference to food, china
will procure the immediate disappearance of these
symptoms.
The amelioration produced by arsenic, is instantaneous and nearly constant; but it is not always durable: relapses are frequent, especially when the disease
has already existed for years.
There will then be occasion to have recourse to oleander, of which Hartmann recommends the administration from the beginning; and which he seems to
prefer to arsenic.
May not this predilection arise from the provings
made by Hartmann upon oleander?  "This medicine," says he, " is the sovereign remedy for lientery."
I am assuredly far from denying this specificity of
oleander, which seems beside, justified by what we
know of its pathogenesis; but I confess that I have
not yet verified it for myself.




DYSENTERY.                 265
DYSENTERY.
Dysentery is an inflammation of the rectum, with
increased secretion of mucus, and an exudation of
blood. It is either sporadic, or epidemic, primitive,
or secondarly: in this last case, it almost always
succeeds enteritis.
Primitive dysentery commonly shows itself in the
latter part of summer, while the days are still very
warm, and the evenings and nights begin to be cool.
This alternation of heat and cold, seems to be the true
cause, or at least the most frequent cause, of dysentery,
for this disease prevails principally in countries where
this perpetual contrast of warm days and cool nights
characterizes the climate. Thus, dysentery is epidemic in Algeria.
Children are more subject to this disease than
adults. It always presents a certain gravity, but is
hardly ever fatal, except under the influence of a
viciou3 treatment.
When dysentery succeeds to enteritis, the mucous
or bilious stools of the latter, become sanguineous,
and tenesmus takes the place of diarrhea.
Primitive dysentery begins with a violent chill,
followed by strong febrile reaction, with a dry and
burning skin, thirst, dry tongue, extreme desire for
cold  drinks, urine  scanty, burning, reddish, and
depositing a sediment.
Bilious vomitings soon supervene, which are often




266    DISEASES OF THE DIGESTIVE ORGANS,
renewed during the course of the disease; then appear
the local symptoms: tumefaction of the abdomen,
whose sensibility is so great, that the patient cannot
support the weight of his coverings; violent griping
pains; continual and never satisfied desire to stool.
The child, who would remain almost indefinitely on
his close stool, if left there, only evacuates, each time,
a little bloody mucus, or a few drops of pure blood:
he experiences an extremely painful sensation of burning in the anus; sometimes, in short, the efforts he
makes to go to stool, produce prolapsus of the rectum,
an occurrence, beside, which is frequent enough in
children at the breast, and which we also see produced,
although much less frequently, during the course of a
simple mucous diarrhea.
The duration of dysentery is very variable. When
the termination is to be favorable (which most commonly is the case), it almost always happens that a
few days of mucous diarrhea succeed the tenesmus,
which itself rapidly diminishes. When on the contrary death supervenes, its approach is announced by
the sudden cessation of the severe pains felt by the
patient, by the sinking of the features, coldness of the
extremities, smallness and intermittence of the pulse,
the involuntary emission and extreme fetidness of the
evacuations.
TREATMENT.-TWO  medicines control the therapeutics of dysentery, whatever be the age of the
patient, or the cause and intensity of the disease;




DYSENTERY.                2 6
these two medicines are ipecacuanha and petroleurnm.
One or two doses of aconite, at the utmost, might
precede their use in case of intense fever. It is almost
always more advantageous to prescribe them from the
first, together; that is to say, one (ipecacuanha) in
the morning, the other in the evening.
I commonly use ipecac., at from  the sixth to the
twelfth dilution, and petrol., at from the twelfth to
the twenty-fburth. I prescribe of each seven or eight
globules in four ounces of water, to be administered
by dessert or teaspoonfuls, according to the age of the
child. The same medication is renewed every day,
until the disease is completely cured.
It is to be remarked that among the numerous medicines extolled for dysentery, no practitioner, that I
know, has mentioned petroleum.  Those to which,
until now, the preference has been given, are: mercurius corrosivus, colocynthis, nux vomica, carbo
vegetabilis, sulphur, hepar sulphur, belladonna, arsenicum, veratrum, capsicum, china, and lastly aloes,
which few persons, I believe, have used with success.
I shall only say a few words of the two first.
Merc. corros., is indicated by the following symptoms: almost continual pains, day and night; frequent,
but scanty, bilious, fetid, green or brown stools;
insatiable thirst; white tongue, with a tendency to
become dry on the edges; anxiety; heat; wakefulness;
feeble and frequent pulse.
Colocynthis may be prescribed, if the stools are




268    DISEASES OF THE DIGESTIVE ORGANS.
yellow, aqueous, mucous and mixed with pure blood;
if the colic, which accompanies them, disappears
immediately after, but returns as soon as the patient
takes any food or drink whatever; it; finally, the heat
is moderate and the pulse almost natural.
However, in conforming to our indication touching
ipecac. and petrol., we shall hardly ever have occasion
to have recourse to any other medicinal agent.
The regimen required by dysentery is almost complete abstinence from food (excepting in children at
the breast), for a day or two, after which the patient
may be put upon the use of thin soup-then soup of a
better quality, and lastly light meats, such as poultry
and lamb chops.
TYPHOID  FEVER.
Typhoid fever, which in many respects, may be
considered as the correlative of variola, is a serious
disease, essentially constitutional, and whose anatomical characteristics consist; 1st, in turgescence, then
in ulceration of the follicles of the small intestine,
especially the glands of Peyer; 2d, in the sympathetic
engorgement of the mesenteric glands, and sometimes
of the spleen.
Typhoid fever, whose contagion is, it seems to me,
only transmitted by the atmospheric air, prevails
almost always epidemically.
Children are much more exposed to it than adults.
It is especially frequent between the ages of nine and




TYPHOID FEVER.                269
fourteen, less frequent from five to eight; rare in the
first years of life. It oftener attacks boys than girls.
The general symptoms of this disease are nearly
constant; but, like all other miasmatic affections,
they present themselves to the eyes of the observer
under a multitude of different aspects, which evidently
only results from its greater or less intensity.
It follows from this that it is impossible to point out,
in absolute terms, its- duration, which may limit itself
to a few days, or be extended to a month. But it is
to be remarked, that mild typhoid fevers have the
same relation to the serious forms of the disease, that
varioloid has to variola; the same symptoms are
present in each case, but in the former are attenuated
in severity, and limited to a shorter time.
Relapses, during convalescence from typhoid fever,
and even the reproduction of this disease at short
intervals, in the same subject, are not without examples. These instances, however,'are very rare, as
rare, perhaps, as the relapses of variola.
To facilitate the description of typhoid fever, I shall,
after the example of MM. Rilliet and Barthez, admit
three different forms of this disease; but this distinction, be it well understood, is purely arbitrary, and implies no essential difference, either in the nature, or as
we shall soon see, even in the treatment of this disease.
Mild Typhoid Fever, is sometimes announced by a
few days of depression, of general lassitude, of want
of appetite, and ill-humor; sometimes it begins ab



270    DISEASES OF THIE DIGESTIVE ORGANS.
ruptly with moderate fever, slight headache, anorexia,
thirst, slight diarrhea,. abdominal pains, and very
rarely with constipation and vomitings. The tongue
is moist, covered with a not very thick whitish coating; the abdomen is soft. The child is prostrated, his
strength is gone; there is a darkish. circle round his
eyes; the nostrils are dry; his nights are good, sometimes, however, troubled with transient delirium; his
face presents, when he awakes, a sort of dull and
unusually stupid  expression, and  the forehead  is
bathed in perspiration.
This state continues from four to six days without
observable change; but from the sixth to the eighth
day the headache ceases, and a few red spots appear
upon the abdomen, and the internal parts of the
thighs; then, but not constantly, sudamina upon the
sides of the neck, or upon the abdomen. The tongue
is now a little less moist, the gums a little swollen,
and covered with small white patches; the abdomen is
prominent and sonorous; gurgling is felt in the right
iliac fossa. If there is a cough, it increases, and we
hear a distinct sibilant rale on the posterior part of
the chest. These symptoms remain stationary for several days, then successively disappear.  The tongue
again becomes moist; the abdomen recovers its pliancy; the diarrhea ceases; the fever diminishes; the
agitation disappears, and the patient enters upon his
convalescence, after an illness of from fifteen to
eighteen days, sometimes even much less.




TYPHOID FEVER.               271
Serious Typhoid Fever.-It commences sometimes
after several days of indisposition; sometimes unexpectedly by an  intense fever, severe cephalalgia,
constipation and bilious vomiting. Diarrhea soon
succeeds to constipation, especially in very young
children. The tongue is thickly coated, often dry, and
red at the point. The abdomen-is painful, especially
at the umbilicus, or in the [right] iliac fossa; sleepiness
during the day, agitation and delirium at night; the
sudamina are proportionally more numerous than the
red spots; the cough is very severe; the sibilant and
sub-crepitant rale are very extensive, sometimes there
supervenes one or several attacks of epistaxis.
After a longer or shorter duration of these divers
symptoms, they either diminish little by little, or
become complicated with an organic lesion, such as
otitis, pneumonia, pleurisy, perforation of the intestine, etc., which carries off the young patient.
Very serious Typhoid 1'ever. —This form  sometimes begins like the preceding, and the symptoms it
presents, are but the progressive exaggeration of those
I have just described. But at other times, it reveals
from the first, by the violence of its invasion, the
gravity of its nature. Thus, from the beginning, the
fever is very violent; the skin burning; the cephalalgia intense; the prostration extreme. Constipation
is then a constant phenomenon, as well as abundant
vomitings.  "The face," say MM. Rilliet and Barthez, "expresses extreme dejection; after a few days,




272    DISEASES OF THE DIGESTIVE ORGANS.
there supervenes the most intense delirium, an
extreme agitation soon followed by profound depression; new exacerbations of delirium and agitation;
the head is then bent backward, the eyes are sometimes shut, sometimes half open, sometimes turned,
convulsed, upward; the pupils sometimes dilated,
sometimes contracted; the lips are agitated with
movements and tremblings; the face red and pale by
turns; the countenance changes expression every
instant; there is sometimes a very wild expression, at
other times the child appears sleepy; the eyes are
shut; a few moments after he arouses from this lethargy, to utter the most piercing, prolonged, and plaintive cries; he changes every instant the position in
which he lies; sometimes on the back, sometimes on
the side; his cries increase: abundant evacuations
fill the bed of the young patient; the urine is passed
involuntarily.  Complete  prostration, and insensibility finally prevail; the trunk has the rigidity of a
bar of iron; intelligence is abolished, the face is
covered with a cold sweat, and death supervenes at
the end of from seven to nine days. But the disease
may be prolonged to a much later period; there then
persists a very active delirium, alternated with drowsiness-the pupils are dilated; we sometimes observe
subsultus tendinum or carpologia; the tongue is
covered with a thick fuliginous coating; the teeth are
incrusted; the lips red, excoriated and blackish; the
nostrils dry; the features drawn; the pulse small and




TYPHOID FEVER.               273
wiry; the stools are always involuntary; the abdomen much distended, or on the contrary, retracted.
Eschars are produced on the sacrum, and death occurs
from the fifteenth to the thirtieth day." *
I venture to affirm, that it is infinitely rare, I will
say, almost unknown, that under the influence of a
well-directed homceopathic treatment, typhoid fever
pursues such a course.
To sum up, the dominant symptoms of this disease,
are vomitings in the beginning, (although they are
sometimes wanting); diarrhea, which is constant;
pains and tension in the abdomen; general stupor and
delirium.
Of all diseases, that with which typhoid fever may
be most easily confounded, is meningitis. In fact,
fever, vomitings and cephalalgia, are the symptoms
which belong to the beginning of both diseases; but
the abdominal symptoms present remarkable differences. Thus, in meningitis, the abdomen, instead of
being distended, flatulent and prominent, is almost
always retracted, hollowed even in the form of a boat.
On the other hand, it very rarely happens, in typhoid
fever, that we see manifested in the beginning, the
extreme agitation and the delirium which mark the
commencement of meningitis. Lastly, the cough and
the sibilant rale, which we observe almost constantly
* Rilliet et Barthez: Trait Cliniqwe et Pratique des Maladies des
Enfants, tome ii, page 377.




274    DISEASES OF THE DIGESTIVE ORGANS.
il typhoid fever, is hardly ever seen in the cerebral'.ffection.
TREATMENT.-The treatment that I myself have
adopted, and which I most earnestly recommend to
other p)ractitioners, because it has constantly succeedel with me, rests upon three medicines only:?pene litanha, belladonna, acidum muriaticum.
4)J.cacuanha is administered from the beginning,
evenr when there are no vomitings. I give it at firom
the, sixth to the twelfth dilution, three times in the
day, and renew this prescription on the next day if
no cerebral symptoms are yet manifested. But generally the use of ipecacuanha should not be continued beyond the third day.
Afterward, administered concurrently, belladonna
and acidum muriaticum, the first at from the sixth
to the twelfth dilution, twice in the morning; the
second, at a, low dilution-the third for example-once
only, in the evening.
Belladonna corresponds to the affection of the
nervous system; acid. muriaticuar  to the intestinal
ulcerations, for which it is the specific.
The use of these two medicines, should be continued until a decided amendment occurs, I will almost
say, until the resolution of the disease. However, if
after the first few days, the agitation, delirium and
stupor completely disappear; if there is no constipation, cough, or angina; if the face, instead of being
injected, resumes its normal color, we may at first




TYPHOID FEVER.               275
reduce belladonna to a single dose per day, then discontinue its use.  Acid. mur. may then 5ie administered alone, morning and evening, for one or two
days.
But as the violence of the cerebral symptoms is in
direct proportion to the intensity of the intestinal
affection, the alternation of bellad. and acid. mur.
will hardly ever need to be interrupted.
When, toward the termination of the disease, the
diarrhea no longer exists, or has almost disappearedif the patient still has dryness of the tongue and lips,
with a brownish tint upon the latter-we may prescribe
chi/na for one or two days.
One need not be anxious about the partial paralysis
which may still persist during convalescence. Deafness, for example, loss of speeck, or paralysi8 (f a
limb, are, in these cases, unimportant phenomena;
and beside, a few doses of nux vomica will effect their
prompt disappearance. The suspension of taste and
smell, (phenomena which it is very difficult, not to say
impossible, to verity in children,) calls more especially
for the use of causticumn.
Lastly, cases may present themselves when it would
be proper to administer bryonia, rtus toxicodendron,
phosphorus, and sulphur.
It is for the sagacity of the physician to decide, according to the totality of the symptoms, when the use
of one or other of these medicines is demanded.




276    DISEASES OF THE DIGESTIVE ORGANS.
IC TERUS-JAUNDICE.
By the name of icterus, or jaundice, is designated the yellow coloration of the skin and of the
tunica albuginea, with or without disturbance of
the circulatory apparatus. New-born infants are subject to it; but it is then of no importance, and commonly disappears of itself, at the end of seven or eight
days, by copious evacuations.
When icterus is accompanied with fever, it lasts
longer, and there is danger of its degenerating into a
chronic affection of the liver, with emaciation of the
body, dropsy, or tuberculation of the mesenteric glands.
TREATMENT. - Aconitum, chamomnilla, bryonia,
and nux vomica are the principal medicines called for
in the treatment of icterus.
We prescribe:
1st. Aconitum, during the febrile period. This
medicine will often suffice to cure the disease;
2d. Chamomilla, if the icterus is without fever; if
it is in consequence of a fit of anger; if it is accompanied with bilious diarrhea;
3d. Bryonia from the first, but most commonly
after aconitilm, if we observe gastric symptoms,
thirst, heat in the forehead and palms of the hands;
4th. Lastly, nux vom., under circumstances nearly
analogous to those which call for bryonia; but
especially if there is constipation, with hot and dry
skin.




PERITONITIS.                277
Dr. Hering recommends, in addition, against icterus, mercurius vivus, sulphur, lachesis, and ipecacuanha; perhaps the last of these may be preferable
to bryonia, in the cases where this has been proposed
by me.  Having had no experience with it, I am unable to affirm anything in regard to it.
PERITONITIS.
Peritonitis is a general or partial inflammation of
the peritoneum. It is a disease rarely occurring in
children, especially as a primitive affection. Its characteristics are: intense pungent pain in the abdomen;
pulse small and frequent; great paleness of the face.
The vomitings, which almost always accompany peritonitis in adults, are very rarely observed in the peritonitis of children.
The pain in the abdomen, at first circumscribed,
soon spreads over all the surrounding region; the
abdomen is then distended, tympanitic, and the least
movement, the slightest change of position, causes
the patient to cry out with pain.
Peritonitis, frequently mortal in a few days, sometimes, also, passes into a chronic state. An effusion
of serum then takes place in the abdomen, of which it
is easy to perceive the fluctation. Chronic peritonitis
is not essentially incurable, but it requires time, and
great care.
TREATMENT.-Aconitum, in repeated doses, during
the acute period; spongia tosta, lachesis, causticum,




278    DISEASES OF THE DIGESTIVE ORGANS.
calcarea carbonica, and, lastly, china, in chronic
peritonitis.
INTESTINAL WORMS.
Intestinal worms are, like the other parasites of the
economy, the products of certain morbid states, existing previously to their formation. Hence it follows,
that the existence of entozoa should be considered as a
symptom, not as a disease. This consideration is important, in a therapeutic point of view. It is easily
understood, that it cannot be a matter of indifference
whether we direct the treatment against the disease
itself, or against the product it engenders. I believe
I have already made the importance of this distinction felt, apropos of tinea and lice, and again, farther
on, of the itch and the acarus.
The digestive tube, in children, is susceptible of engendering the different species of intestinal worms described by writers on the subject; but the proportional
frequency of these parasites is very different. Thus,
we observe the ascaris lumbricoides, and the ascaris
vermicularis, more frequently in childhood than at
any other period of life; the trichocephalus exists, indifferently, in children and adults; lastly, the bothriocephalus, and the teenia, are extremely rare in children.
As the symptoms which correspond to the presence
of trichocephlalus are very vague, very obscure, and
very little known, we shall abstain fiom describing




INTESTINAL WORMS.             279
them, and speak only of ascaris lumbricoides and
ascaris vermicularis.
Ascaris Lumbricoidos.-The ascaris lumbricoides,
[long round-worm,] has a length of from six to sixteen inches, and a diameter of from one-fifth to onethird of an inch.  It is cylindrical, almost equally
tapered at the two extremities; a little more, however,
toward the head, which is distinguished from  the
rest of the body by a circular depression. Above
this depression are seen three little elevations, or rather three valves, which are capable of opening and
closing; when they open, we discover between them,
a tube, which is, in fact, the mouth of the animal.
These worms are of a more or less dark rose color;
according to the nature of the food with which they are
gorged. Their alimentary canal, recognized by its
brown color, is terminated by a transverse slit situated a little forward of the posterior extremity of the
body.
The two sexes are separate; the male is distinguished from the female by its curved tail, upon
which are visible its organs of generation The genital organs of the female are whitish ducts, easily to be
perceived by the transparency of the envelope; and
the contrast of their color with that of the intestinal
canal.
The small intestine is the favorite locality of ascarides lumbricoides; but they traverse all parts of the.24




280    DISEASES OF THE DIGESTIVE ORGANS.
alimentary canal. They are found in the large intestine, from which they are often expelled by stool.
They sometimes rise into the stomach, aesophagus,
and even the pharynx, and it is not very uncommon
to see children eject them by vomiting. Finally,
authors cite examples of their presence in the trachea,
bronchia, nostrils, frontal sinuses, and even under the
skin of the abdominal parietes, where they form abscesses, upon the opening of which they are thrown
out externally.
The number of ascarides in the intestines is infinitely variable. We sometimes see them accumulated
by hundreds and forming balls of the size of the fist.
MM. Rilliet and Barthez report on this subject an
observation inserted by Daquin, in the thirty-fourth
volume of the Journal de  Je'de'cine, Chiruryie et
Pharmacie, which deserves to be quoted. " We first
opened the stomach," says the author,'and found
there a single round-worm, almost as long as the forearm, extending through the cardia and along the
cesophagus. From thence coming toward the pylorus
and following the duodenum, we found it crammed
(if one may be permitted the expression) with the
same worms, great and small, to such a degree as to
have become hard and resistent, and distended to
a much greater volume than it naturally possesses.
The worms were mixed with a greenish substance,
which I recognized as herbage, and which, judging




INTESTINAL WORMS.             281
from the fetid odor it exhaled, must have been a long
time in the intestine.
"We continued our search through the rest of the
canal, and the jejunum, the ileum, and the caecum
were so filled that I could compare it to nothing but
force-meat; it seemed as if they had been stuffed in.
We found some in the colon, mixed with the fecal
matter, but in less quantity."
In the post-rmortem examination of children, who
have died of verminous affections, we almost always
discover traces of erythematous enteritis, that is to
say, a vascular injection of the intestinal mucous
membrane, which in certain cases, rare it is true, had
lost sensibly its natural consistence. As to perforation of the intestines, coincident with the existence of
lumbrici, MM. Scouteten, Cruveilhier, and  Jules
Cloquet, do not hesitate to attribute them to a morbid
state, independent of the action of these worms; an
opinion which coincides with that of all homeopathic
physicians.
It is especially between the ages of three and ten
that children are subject to verminous affections.
According to authors, little girls are more subject to
them than little boys; I am not aware how far this
opinion is well-founded; but what I believe to be certain is, that these worms are more common in blond
children, of a delicate and rosy complexion; to those,
in a word, who present the signs of the lymphatic
temperament.




282    DISEASES OF THIE DIGESTIVE ORGANS.
We will not stop here to seek for the cause of verminous affections. They are, like the majority of other
diseases, the result of a specific and hereditary miasm.
It is nevertheless certain that a miserable alimentation; an exclusive milk diet; sweet or feculent dishes,
herbs and fruits favor their development. It is not
impossible, lastly, that certain atmospheric states, as
yet little understood, or perhaps even a real miasm
pervading the air is sometimes the first cause of verminous enteritis.
On this subject MM. Rilliet and Barthez say that
"intestinal worms have been observed complicated
with certain diseases which prevail epidemically; and
it has been thence concluded that there exists an epidemic verminous disease. While we deny the justice
of this conclusion, we ought, nevertheless, to acknowledge that the conditions under the influence of which
certain diseases prevail epidemically, and perhaps
even the nature of these affections, evidently contribute to the multiplication of worms."*
The symptoms to which the presence of ascarides in the intestines, or the disease which produces them, may give rise, are so various and so
numerous, that it is difficult to present summarily
a general view  of them.  I may add, that in
consequence of the great number and diversity of
these symptoms, it is less easy than may be sup* Ouv. cite, tom. iii, page 628.




INTESTINAL WORMS..            283
posed to point out the certain and pathognornonic
signs of verminous enteritis. Perhaps the only irrefragable sign is the presence in the stools, or in
matter vomited, of one or more lumbrici; but as
this circumstance is very far from  always presenting itself, except in cases where there exist enormous masses of worms in the small intestine, we
here give the groups of symptoms which render the
existence of this disease the most probable:
Sudden and frequent changes in the color of the
face, which is sometimes red, sometimes pale, sometimes lead-colored; bluish semicircles circumscribing
the lower eyelid; increase or diminution of the brilliancy of the eyes; uncertainty or momentary fixedness of the look, dilatation of the pupils; itching of
the nostrils, bleeding of the nose, cephalalgia after
meals; flow of saliva in the mouth, especially during
the night; tongue a little dry, with red dots upon the
point and edges; insipid, acid, or fetid odor of the
breath; thirst on waking; capricious appetites, great
hunger, or dislike to food; uneasiness increased by
abstinence; enlargement of the abdomen, from time
to time a pinching pain, or twisting sensation in the
abdomen; frequent borborygmus, sudden vomitings
without apparent cause; slight diarrhea; from time
to time very abundant and fetid stools; itching in the
anus; short dry cough, or even violent attacks of
cough like that of a severe cold, with or without
glairy expectoration; sorrowful, unequal and fantastic




284    DISEASES OF THE DIGESTIVE ORGANS.
humor; attacks of fainting, which may return a great
number of times in the same day; disinclination for
labor; agitated sleep, talking in the sleep, nightmare,
somnambulism; aggravation of the -symptoms in
the morning, especially when fasting; propensity to
onanism; leucorrhcea; lastly, convulsions, delirium,
epileptiform attacks, etc., etc.
It is not necessary that children attacked with
verminous affections should present all the symptoins I have described, but in taking care to proceed
with prudent reserve, as to the exclusion of other diseases, represented by some of these symptoms, it is
rare that we do not succeed in clearly establishing the
diagnosis of verminous enteritis.
TREATMENT.-A multitude of medicine_ kave beei
recommended against ascarides lumbricki.des, in the,
number of which I shall cite from Hering, isec., cardj
veg., pulsat., china, nux vom., aeonl., ), Kcrcur. viv.
sulpy., bellad., lach., and above all cina, which realrj
possesses the properties of a vermifuge, t ut which is
not, as is generally supposed, the remedy par excellence, for verminous affections.
Mly whole therapeutics in this respect turns almost
exclusively upon two medicines, of which one is very
little known, and the other but little used, so far
as I am aware, in similar cases, except by our worthy
and learned friend Doctor Petroz.  The two medicines of which I speak  are  viola  odorata  and
stannum.




INTESTINAL WORMS.             285
Viola odorata, of which cina (the pathogenesis of
these two medicines offers many points of analogy) is
only for me the succedaneum, suits in all cases without exception, in which we are certain of the existence
of the lumbrici. I give it at the sixth dilution, doses
repeated several times a day.
Stannum, is a capital medicine if the verminous
enteritis is complicated with nervous symptoms, such
as melancholy, violent cough, sudden faintings, tetanic
rigidity, partial or general convulsions, epilej tic attacks, etc. I only use stannum at the thirtieth dilution, and always with a certain reserve. I think, for
example, that the doses of this medicine should not be
repeated more than once a day.
Neither viola odorata or stannum, will always
produce the expulsion of worms, but they will not the
less dissipate all the symptoms which mark their
presence. It is hardly necessary to add that a suitable regimen, above all, the complete abstinence from
all preparations of milk, green fruits, confectionary
and pastry, is an indispensable auxiliary to the remedies I have pointed out.
Ascaris Vermicularis.-The name ascaris vermricularis is given to a little worm, observed exclusively
in the inferior part of the rectum, ordinarily known
as pin-worm. Bresmer, in his ibraite des Vers Intestinaux, gives the followinb, description of it:
"The male is a line or a line and a half in length,
its body slender very elastic and of a white color.




286    DISEASES OF THE DIGESTIVE ORGANS.
The anterior part is obtuse and surrounded by a
transparent membrane, through which we perceive,
forming a species of bladder, a straight tube, which is
the cesophagus, and which becomes club-shaped at
the place where it is lost in the globular stomach.
The intestinal tube extends through the whole length
of the body, which becomes gradually larger, and
assumes a spiral form toward the tail.
"The female is larger than the male, and attains a
length of four or five lines. The conformation of the
anterior part resembles, in its internal and external
construction, that of the male, up the place where the.esophagus terminates.  From  this point the alimentary canal is surrounded on all sides by the
oviducts."
This species of worm, which is generated with an
astonishing rapidity, is the despair of the allopathic
physician, who, never attacking, by the agents directed against them, the true cause of the reproduction, leaves them to exercise their ravages for years.
The itching, caused by the ascarides, is especially
felt in the warmth of the bed. It is insupportable,
and sometimes causes very violent nervous symptoms.
As these symptoms occur every night almost at the
same hour, they are sometimes taken for fevers, or
intermittent nervous affections. But, on examining
with care the anus of the patient, we easily discover,
in the folds of the mucous membrane, the worms of
which we speak. They are seen movin(g with vivacity




INTESTINAL WORMS.              287
entering the rectum, reappearing, and then again
disappearing.
It is these worms, above all, which cause in young
girls a vaginal discharge, and provoke masturbation
in children of both sexes.
The therapeutic agents extolled by homceopathists,
against the affection which generates the ascarides,
are of more than doubtful efficacy. We may judge
of it by this passage from Ilering:
"When the itching in the anus is caused by ascarides, and nux vom. does not suffice, if the children
are very restless at night, if they are fearful, give,
morning and evening, aconite, and if that does
not suffice, ignat. in the  morning; mar. ver.,*
sometimes succeeds, but still more frequently urt.
urens; but, if from time to time children are tormented by this affection, especially at the full and
new moon, give stulph. at every full moon, and silic.
at each new moon; if one dose has not been sufficient
give it the next time in dilution, by teaspoonfuls,
seven mornings in succession. If at the following full
moon there is no amelioration, give in the same manner calcar. carbon., which may be repeated for seven
days in succession.  The children -should not be permritted to eat pork or pastry. If all this is without effect,
givefer. acet., every other day; if a diarrhea comes on
stop the medicine, if the diarrhea persists, give china.
* Teucr. mar. ver.
25




288    DISEASES OF THE DIGESTIVE ORGANS.
"There is no objection beside to giving a little injection of oil, and if that even does not yet suffice,
injections of cold water every evening: there is nothing
in this to interfere with the action of the remedies.
This treatment having no effect, we may try, especially
in children who have inherited this affection, injections
of water slightly salted; if they do not suffice, and occasion diarrhea, we may give acidulated injections.
In case of a new failure, we have seen frictions, repeated morning and evening, with the half of a lemon,
give relief."*
Let us be frank, and confess, that an allopathist
who should read this fragment, would have a right to
say to us, that our treatment was still more miserable
than their own.  Happily, this apparent impotence
of IIoinceopathy in no way compromises the excellence
of its principle; it only proves, that the inductions
furnished by the pathogenetic study of remedies, need
to be completed by clinical experience, which can only
be done with time; but, let each one bring his stone,
and the edifice will be completed.  As for myself,
here is mine:
Three medicines are required to cure the affection
which generates the ascarides; they are, iycopodium,
veratrurn albumn, and ipecacuanha.
The first should be administered for two days only,
at the thirtieth dilution, three dessert-spoonfuls, or
* lIering: ~M decine Homeopathique Domnestique, page 251.




INTESTINAL WORMS.              289
three teaspoonfuls, (according to the age ot the patient,) of a potion in which has been dissolved seven
or eight globules to four ounces of vehicle.
Veratr. alb. may be prescribed in the same manner, (at from the fifteenth to the eighteenth dilution,)
during the four following days.
Lastly, ipecac. should succeed to veratr., at the
ninth dilution, for three or four days, at the most, and
all will be finished.
In the majority of cases, the itching will have been
removed by lycopodium, but we should, notwithstanding, make use of the two auxiliaries of which I have
spoken.  Nineteen times in twenty, at least, this
treatment will succeed. If one should be so unfortunate as to fail in this treatment, we have still, as a
resource, the interminable series of means collated by
Hering; but, for myself, I confess, if I had in perspective the necessity of running such a round, to
arrive at last to injections of salt water and frictions
with the half of a lemon, I should prefer to abandon
myself at once to the frictions of' mercurial ointment,
practiced by Professor Cruvelhier in such, cases, or
even to the injections of olive oil and mercurial ointment, recommended by M. Jules Cloquet, in his
Clinical Lessons




290    DISEASES OF THE DIGESTIVE ORGANS.
TABES MESENTERICA - ATROPHY OF CHILDREN.
The name tabes mesenterica, or phthisis mesenter.
ica, is applied to the scrofulous engorgement, or, still
better, to the tuberculation of the mesenteric glands.
Tabes mesenterica is only then, properly speaking,
one of the internal forms of scrofula, whose general
symptoms, as we have described them, (p. 207,) characterize, in fact, the external appearance of children
affected with phthisis mesenterica.
Tabes mesenterica, which is very rare in children
under three, and over twelve years of age, is most
common between the ages of five and ten.  Statistics
seem to prove that it affects boys more than girls.
Like all other forms of scrofula, it is frequent in cold
and damp countries, and almost unknown in dry
and warm climates.
It is a very serious disease; so much the more
serious, that it is often not recognized until it is
already far advanced.  I am, at the same time, far
from considering it incurable, even when it has already
produced extreme emaciation. My opinion, on this
subject, is based upon unquestionable facts.
I admit, however, with all other practitioners, that
it is very unfortunate that we cannot diagnose this
disease from the beginning, for it would be then
almost always easy to arrest its progress. But it reveals itself by such obscure symptoms, and progresses
so slowly, that it may for months, and even for years,




TABES MESENTERICA.             291
escape the most attentive observation.  Its general
symptoms, in fact, are common to the majority of
chronic diseases, and its local signs only become really
characteristic at a period when the disease has already
made great progress. Nevertheless, here is a summary of the symptoms which properly belong to it,
but which, however, are not always equally evident:
Stools more frequent than in healthy children;
sometimes liquid, often colorless, whitish, slimy,
looking like clay mixed with water; acid odor, not
only of these evacuations, but also of the breath and
perspiration of the patient; insatiable hunger, but
with repugnance for nourishing food, such as meat
and soup; great appetite, on the contrary, for sour
and farinaceous food; urine turbid, whitish, as it were
mucilaginous; tumefaction of the abdomen, which is
soft enough at first, but which gradually hardens,
presenting, when examined, isolated tumors, or tumors
in groups, varying in size, from that of a pigeon's
egg to that of the fist of an adult; the abdomen
finally acquires an enormous volume, in proportion to
the rest of the body; gradual increase of feebleness
and emaciation; lancinating pains, from time to time,
in the abdomen; the child is gloomy, silent, apathe.
tic, and weeps upon the slightest occasion. Lastly,
when the disease approaches a fatal termination, hectic fever supervenes, exacerbated during the night,
and accompanied by ardent thirst, wakefulness, and




292    DISEASES OF THE DIGESTIVE ORGANS.
anxiety. The fever remits during the day, although
the pulse always preserves a certain frequency: but,
in the evening, the face of the patient is very much
flushed. A colliquative diarrhea exhausts the strength,
and the disease terminates in marasmus and death.
TREATMENT.- Chamomilla, sulphur, hepar sulphur,
cina, china, n ux vomica, bryonia, belladonna, arsenictlm, pulsatilla, rhus, mercurius, magnesia carbonica, phosphorus or phosphori acidum, baryta
carbonica, conium maculatum, sepia, petroleum, and
iodium, have all been recommended in the treatment
of tabes mesenterica.  Certainly, many of these
medicines, and perhaps all, correspond to some
of its symptoms, but neither of them is its specific.  Tabes mesenterica is, however, one of those
diseases, whose principle is sufficiently well known
to be attacked in its essence even; that is to say,
in such a manner that the virtues of the remedies
opposed to it, should arrest its development, whatever
the diversity of the accidental symptoms it produces;
at least, it was with this conviction that I commenced
the search  for a therapeutic combination, which
might be considered as its specific, in all cases; and
I am happy in being now able to affirm, that I almost
feel the certainty, based upon numerous facts, of having attained my object.
Whatever be the age of the patient or the intensity
of the disease, I combat it with three medicines:




TABES M ESSENTERICA.                     293
sarsaparilla,   aloej  and  in  the  last place, colceiI administer sarsapar. at the eighteenth, aloe, at
the sixth, colchicum, from  the twelfth to the fifteenth
dilution; each two or three drops to eight ounces of
water.
* I have experimented with sarsaparilla and aloe upon myself and
upon six other persons, for several months. Sarsaparilla is a pre.cious medicine.  As for aloe, whose pathogenesis is very poor, I
do not believe that, with the exception of tabes mesenterica, ill which
it plays a chief part, there exist malny diseases in which its employment would be useful.
These two medicines both exercise a very singular modification
upon the coloration of the hair. When a child with red hair takes
sarsaparilla for three months (three teaspoonfuls a day of a solution
of four ounces of distilled water, with three drops of the tincture at
the eighteenth), his hair absolutely changes color.  From red, that
it was, it becomes a light flaxen. It is to be remarked that sarsaparilla in such a case causes no appreciable organic trouble:  the health
of the child is in no way affected. Aloe, in stronger doses (twelve
or thirteen drops of the sixth solution, to a pint of common water,
four teaspoonfuls a day), produces and cures falling of the hair in
adults. Upon one of the persons who lent himself to my experimentation, this phenomenon was so marked, that a lock of white
hair that this person had on the top of his head, in consequence of
a blow received on this part twenty years before, completely recovered its black hue, like the rest of his ha;r. But, in compensation,
the temples were garnished with white hair, which, however, disappeared the following month. Upon the whole, hair which had remained white for a long time, became black, but there remained
some white hairs here and there, where there were none before. I
give these facts for what they are worth; they seemed to me strange
enough to merit publication.




294    DISEASES OF THE DIGESTIVE ORGANS.
These three medicines are administered alternately
for one week or-a little more, commencing with sarsaparilla and finishing with colchicum. It is indispensable that the doses, proportioned beside to the
age of the patient, should be renewed three or four
times a day.
Such is the basis of the therapeutics by means of
which I have obtained for several years past the most
surprising results.
Perhaps this medication would not always prevent
the subsequent transformations of scrofulous disease;
but I can at least affirm that there exists nothing superior for the treatment of tabes mesenterica.
Phthisis peritonealis, of which some authors have
made a separate disease, and different from tabes mesenterica, does not require a different treatment. It
is, however, well understood, that the treatment of
such contingencies as may arise is left to the sagacity
of practitioners. As to the regimen, it is evidently
the same as that called for in the scrofulous diathesis.




CORYZA.                  295
DISEASES OF THE RESPIRATORY ORGANS.
ALTHOUGH children do not suffer as seriously from
the affections of the respiratory organs as from those of
the abdomen, they, as well as adults, are frequently
subject to their attacks.  Some of these, however,
such as phthisis pulmonalis, are far from being as
frequent in early infancy as in adolescence, or at a
more advanced period of life; but others, on the contrary, such as croup and hooping-cough, belong to an
early age.  We shall, therefore, dwell more upon
the latter than upon the former, to which we shall
devote but a few passing lines.
cORYZA.
Coryza is, in adult age, so slight an affection, that
a physician is seldom called upon to prescribe for it.
But it is not absolutely the same with early infancy.
Independently of the coryza which makes a part of
the premonitory symptoms of measles, scarlatina, and
hooping-cough, there exists an idiopathic form of this
disease sufficiently grave to cause death, and consequently to be worthy the attention of the practitioner.
I speak here of purulent and pseudo-membranous
coryza, which, without being a very common affection,
nevertheless sometimes manifests itself, principally in
the new-born, or in very young children. It commences, like simple coryza, by sneezing and stoppage




296  DISEASES OF THE RESPIRATORY ORGANS.
of the nose, soon followed by a discharge from the
nostrils of mucosities, at first ropy and clear, then
yellow-greenish, and at last puriform. The child,
who was in the habit of sleeping with the mouth
closed, can no longer sleep without holding it open;
his respiration is noisy and accompanied by a whistling in the nasal fossae. The mucosities, by thickening and drying, aggravate the symptoms. Then the
agitation, the cries, and the physiognomy of the child
express the excessive discomfort he feels. When the
breast is presented to him, his anxiety and suffocation
are redoubled; he abandons the nipple, immediately
after taking it, because breathing but by the mouth,
he can no longer suck, and continually tormented by
hunger without being able to satisfy it, he soon sinks
exhausted with fatigue, suffering, and inanition, and
perishes even before having arrived at an advanced
stage of marasmus. The progress of this affection is
sometimes very rapid: a child may die of coryza in
three or four days; the disease is always more serious
in very young children.
The formation of false membranes, which does not
cause different symptoms from  those I have just
described, has hardly ever been discovered before the
post-mortem examination.
TREATMENT.-The child, first of all, should not be
in the least exposed to the cold air, or permitted to
remain wet with his urine. In the second, place the
mother should cease to nurse the child because the




CORYZA.                   297
action of sucking is very painful, increases the difficulty of respiration, and may augment the gravity of the
general symptoms which accompany the inflammation
of the nasal fossue.  "Beside," says M. Billard, " a
child in this case, sucks so badly that the quantity of
milk it takes is always insufficient for its nourishment;
so that it is in danger of dying of hunger and exilaustion." One should try then to make them drink by
pouring, with precaution into the mouth, teaspoonfuls
of cow's milk mixed with water and meat broth.  If,
at length, deglutition becomes too difficult, one may be
obliged to have recourse to nutritive injections, that
is to say, injections composed of meat broth (without
milk). The popular custom of greasing the nose with
some fat substance, such as tallow, is positively advantageous. We should then have recourse to it. for
according to the precept of Hippocrates, nothing is to
be despised; but it is especially upon the action of
medicines that we must depend. Those called for by
coryza are, according to the circumstances: aeonitum,
belladonna, dulcamnara, and ipecacuanfha; aconite
during the period of obstruction, especially if there
is heat in the skin; bellad., it' there is turgescence of
the face, fever and great agitation; du7camara during
the fluent period; ipecac., if the obstruction resists
aconite and continues after the disappearance of thefever. All these medicines should be given at repeated doses; dulcamara is the one which we have oftenest occasion to use.




298   DISEASES OF THE RESPIRATORY ORGANS.
EPISTAXIS — BLEEDING FROM THE NOSE.
Nasal hemorrhage is extremely common in chilA
hood, but is never serious; when, however, it assumes a sort of periodicity, it deserves attention.
The medicines to which we should have recourse are
arnica and phospltorus.  The first is given in potion
or in globules, two or three days in succession, firom
the sixth to the twelfth dilution; phosphorus should
only be prescribed in the case where arnica has
failed. In very abundant and prolonged epistaxis,
the two medicines should be administered alternately
in the same day.
ANGINA.
We comprehend under the generic name of angina,
the diseases that authors, and especially the physicians of the Paris school, designate by the words
amygdalitis, pharyngitis, laryngitis and even tracheitis-denominations which seem to specify essentially distinct affections, but which are really applied
to one and the same disease, occupying neighboring
regions, and deserving sometimes even simultaneously
all the names given to it, on account of its seat. I
call angina, in a word, the erythematous inflammation of the tonsils, pharynx, larynx and of the superior
part of the trachea.
As with coryza, angina is sometimes primitive,
sometimes, and more frequently, secondary. It most
commonly succeeds to coryza, precedes bronchitis, or




ANGINA.                   299
Exists concurrently with these two diseases.  In certain cases, however, it manifests itself alone, and even
limits itself to one or another of the different parts it
is susceptible of invading. Angina presents, in this
last case, certain symptomatic shades naturally dependent upon the organ more especially affected;
shades almost always readily appreciable. Thus the
enlargement and redness of the tonsils announce
amygdalitis; the redness of the pharynx, difficulty
of deglutition, and the engorgement of the submaxillary glands, characterize pharyngitis; hoarseness,
larlyngitis, etc.
Angina, unless it assumes the serious form of which
we shall hereafter speak under the name of.Meembran ous Angina, or Croup, is rarely accompanied
with much danger; I will even say that it may be
considered as a slight affection, if it is purely local
and not the precursory sign, or the consecutive syrnptom of an essential disease, such as measles, scarlatina, etc.
The most common cause of this affection is cold
and dampness, and more particularly taking sold in
the feet. It rarely shows itself primitively in children
at the breast, and hardly begins to be common before
the age of five years. A congenital predisposition,
the lymphatic, or sanguine-lymphatic temperament,
render it very frequent in some children, who are
beside so much the more disposed to contract it as
tlhey have been before xmore or less frequently affected




300   DISEASES OF THE RESPIRATORY ORGANS.
by it. In this last case, the pharynx remains some.
what red; this permanent redness is accompanied
with increased mucous secretion; the amygdalae have
more volume than in their normal state: it is chronic
angina.
TREATMENT. — Aconitum, belladonna, dulcamara,
pulsatilla, ipecacuanha, baryta carbonica, causticumrn,
copaiv. balsam., hepar sulphur, and lycopodiumn, are
the medicines called for in the treatment of angina.
Aconite; administered at a medium dilution (from
six to twelve), in doses frequently repeated, very often
arrests angina at its commencement, when it is accompanied by a febrile action, when the weather is dry
and cold, and the subject rather sanguine and nervous
than lymphatic.
Belladonna suits under circumstances nearly similar, if there is great agitation and vivid redness and
constriction of the throat. Its use will almost always
be more efficacious if preceded by one or two doses of
aconite.
Dulcamara frequently cures slight angina, caused
by moist cold, extending without particular swelling
of the tonsils to the bronchia, and threatening to degenerate into bronchitis.
When angina, more intense and not less extended, is
characterized by a vivid redness of the affected parts,
with obstruction of the nose, cephalalgia, burning
fever without much thirst, voice hoarse or nasal, when
above all, there is sympathetic irritation of the storn



CROUP.                   301
ach, which is manifested by regurgitation or vomiting
of aqueous or bilious matters, pulsatilla is indicated.
If the swelling of the mucous membrane is suc!h
that the difficulty of breathing is very considerable;
if suffocation is threatened, with excretion of caseous,
white, thick, and fetid matter in the throat; if, in
short, there is imminent danger of gangrene, and even
a commencement of it, we must have recourse to ipecacuanha.
I have indicated, in the chapter on Scarlatina (see
page 141), the circumstances which call for the use of
baryta carbonica.
Copaiv. balsam., causticum, hepar sulphur, and
lycopodium are to be tried in the treatment of chronic
angina.
Copaiv. balsam. frequently succeeds, if the disease
consists only in a slightly increased mucous secretion,
with or without hoarseness. I have seen causticum
and hepar sulphur, administered by turns, bring back
the tonsils to their natural volume, although in this
case I prefer to these medicines baryta cad'bon.  Lycopo. corresponds to the hoarseness of nervous, habitually constipated persons.
C ROU P.
All the mucous membranes are susceptible of becoming the seat of a peculiar inflammation, during
which there takes place an exudation of plastic matter,
organizing itself in pellicles, or in false memnbranes,




302   DISEASES OF THE RESPIRATORY ORGANS.
more or less dense, more or less thick, and more or
less adherent to the inflamed mucous membrane, and
under which this last presents, on a post-mortem examination of the body, a red, smooth surface, rarely
granulous, and almost always destitute of ulcerations.
Muguet, whose history we have given (see page
229), is the most familiar type of these kinds of inflammation, to which the mucous membrane of the
intestine is not less exposed than that of the mouth,
as is proved by the fragments of membrane, abundantly mixed with the substance of the stools, in certain
forms of enteritis.
But if the formation of the false membranes is only
an accessory and comparatively unimportant phenomenon in the buccal and intestinal phlegmasia, it is
quite otherwise when these morbid products develop
themselves in the respiratory organs, and especially on
the surface of the laryngeal mucous membrane; that is
to say, the narrowest part of the windpipe. Dyspneea,
aphonia, a convulsive cough, and even death, it the
disease is not arrested in time, are, in this case, consequences easily enough comprehended.  Such is the
nature of the croup, and such the very simple mechanismn of the formidable symptoms which characterize it.
It is to be observed that the false membranous
exudation is much more frequent in the digestive tube
than in the respiratory organs, during early infancy;
that is to say, nursing children are much more sub



CROUP.                   303
ject to attacks of muguet than to croup, which is
hardly to be feared before from two to eight years.
Croup, which seems sometimes to prevail under an
epidemic form, is most common during the spring and
autumn, and appears concurrently with other epidemics, such as measles and hooping-cough, with
which it is sometimes complicated. In this case it is
seldom so violent or so rapid in its progress, as when
it constitutes a primitive affection.
In this last case it is of the first importance that the
physician should recognize it in time.
It unfortunately too often happens that its characteristic symptoms only appear at the period of its
greatest intensity; there are, however, almost always
premonitory symptoms which, according to the point
the disease first attacks, are more or less obscure, or
more or less manifest.
Croup, or the plastic exudation which is its dominant circumstance, sometimes begins in the throat,
sometimes in the larynx, sometimes in the trachea,
or even in the bronchia.
In the first case, beside the probability of the disease being  limited  to the  pharynx, and running
through all its periods without extending below the
epiglottis, there is the great advantage of its being
visible almost from the moment of its commencement.
In examining the pharynx, traces of the false membrane are soon perceptible, first on the tonsils, then
upon the neighboring parts. These false membranes
26




304    DISEASES OF THE RESPIRATORY ORGANS.
commence by yellowish-white, sometimes, but more
rarely, grayish spots, which extend and assume a
lichenoid or lardaceous aspect.
There is sometimes fever at this period, but not in
all subjects; the strength and appetite of the patient
is not sensibly diminished; he complains of a pain
in the throat, but it is not severe; the thirst is moderate. Deglutition, however, soon becomes painful and
difficult; saliva flows abundantly from the lips; the
ganglions of the neck increase in size, and the neck
becomes at last considerably swollen. This state lasts
from two to six days, when the symptoms begin to
amend by the fall or disappearance of the false membranes, or is suddenly aggravated by its invasion of
the larynx. The disease, in this last case, presents
alarming symptoms, which I shall soon describe.
When the false membranous angina begins in the
larynx, the examination of the throat offeirs nothing
abnormal. The child is first taken with hoarseness,
he loses his gayety and becomes morose and
depressed. The face has more color than usual and
seems a little bloated; there is beat in the skin, but
without thirst or great frequency of the pulse; the
patient complains of pain in the larynx or indicates
it by his gestures. He often puts his hand to his
neck, which appears a little prominent and sensitive
to the touch, especially below the os hyoides; there
are, from time to time, little attacks of a hoarse cough,
of which each concussion is preceded by a peculiar




CROUP.                   305
whistling.  Authors mention the expulsion by the
cough, of fragments of the membrane; but this sign
is not always present, and never occurs except at an
advanced stage of the disease.
When the inflammation begins in the trachea the
symptoms are very nearly the same as those I have
just described, with the exception of the alteration of
the voice, which does not yet exist.
Lastly, if it is developed primitively in the bronchia, there is from the beginning an intense fever, a
considerable acceleration of the pulse and respiration, and a purple color of the face.  The sub-crepitant rale is heard upon both sides behind, upon auscultation; then, after a variable time, comes hoarseness, aphonia, and the croupy cough.
The obstruction of the larynx constituting, in all
cases, the principal fact of the disease, it is understood
that its progress must be so much the more rapid as
this organ is primarily affected.
The character beside, of the prevailing diseases, decides the greater or less promptitude with which the
pathognomonic symnptoms of croup are manifested.
These sometimes only declare themselves after five or
six days of premonitory symptolns; sometimes they
make their appearance upon the second or even the
first day of the disease.
It is commonly during the day, and not the night,*
that the first attacks of suffocation occur.  They arl
terrible to witness.  The fever is very violent, the
* We know the reverse to be true. Ed. 2d edit.




306    DISEASES OF TIIE RESPIRATORY ORGANS.
voice is extinguished, the cry, properly speaking, is
no longer heard, or only returns for an instant, or if it
continues it is entirely changed. Its sound is only
perceptible during the inspiration: it is shrill and
abrupt, like the crowing of a young cock; sometimes
even it is stifled and muffled.  " The dyspncea," says
Jurine, "'is fearful, the respiration is stertorous and
the suffocation, with all its fearful agony of anxiety
and suffering, threatens every moment the life of the
child.
" During these moments he in vain throws his head
backward, in order to lengthen the trachea and thus
open a larger passage for the air; his neck swells, his
pulse is feeble and intermitting, his eyes sunken in
their orbits and liis body covered with a cold perspiration."  We will add, to complete this picture, that
the child, at the instant of the attack, suddenly
assumes a sitting posture; his face, purple and swollen, expresses extreme anxiety; the eyeballs, rolling
to the right and left, are sometimes turned upward in
convulsions. Lastly, if the attack is prolonged, the
respiration becomes slower; the little patient exhausts
all his strength in making a few feeble inspirations,
the extremities become cold, the pulse smaller and
smaller, and asphyxia impends.
Death, occasioned by croup, is exactly similar to
that by strangulation.  Thus we commonly find upon
the bodies of children, who have died of this disease,
traces of cerebral congestion or even of acute hydro



CROUP.                  307
cephlalus;-dangerous complications which are manifested in the patient by a sort of sleepiness or coma
in the intervals of the attacks.
Croup, however violent it be, almost always presents longer or shorter and more or less complete
remissions. At the same time the hoarseness and the
aphonia persist during these remissions, and the difficulty of respiration continues considerable.
It is not even very rare to see the patient, during
this suspension of the most alarming symptoms, suddenly grow pale and swoon, the pulse then diminishes,
the extremities become cold, and death ensues. Sometimes all this passes very rapidly. "A child," says
Rosen, " was running to and fro in the apartment; his
mother took him upon her knees-he died in her arms."
When, after great effort and a violent fit of coughing, the child succeeds in expectorating a quantity of
false membranes, there generally succeeds a very
marked, but unfortunately often an illusory remission.
"The febrile action," say MM. Rilliet and Barthez,
" is then diminished; the respiration is more easy, the
face is more natural, the venous congestion has in
part disappeared; the child returns to his play, everything seems to indicate a happy termination. But
most commonly the symptoms soon re-appear in the
order we have assigned them; the voice, which had
become momentarily clear, is again completely extinguished; the cough is very hoarse; the laryngotracheal whistling approximates a veritable stertor;




308    DISEASES OF THE RESPIRATORY ORGANS.
the attacks of suffocation become more frequent, more
intense, and arrive, at last, at their greatest height
Asphyxia is threatened, the pulse is extremely small,
often impercel)tible; the eyes are convulsively turned
upward or oscillate in their orbits; sight disappears
and the body is covered with a cold perspiration.
These attacks, however, are again suspended, and
return with less intensity; the child exerts all his
strength to breathe, makes a few difficult inspirations
and dies."
When croup terminates favorably, it sometimes
happens, although seldom, that the cure is suddenly
effected by the expectoration of a tube of false membrane. In the majority of cases, the greater intervals
between the attacks, joined to the amelioration of the
general symptoms, give notice of the termination of
the disease. Relapses are to be feared as long as
cough remains, and the breathing and voice have not
resumed their natural tone. The voice sometimes
remains changed for a long time. There are examples of aphonia, in consequence of croup, which has
continued for imonths.
TREATMENT.-" This dreadful disease," says Hering,' may, in the majority of cases, be easily and promptly
cured by homewopathic remedies. We hardly lose a
fifth of the number of those who die under the old
treatment."
I consider this assertion of Hiering as very true, and
fully justified by facts; and nevertheless, I do not




CROUP.                  309
hesitate to say, that the homceopathic medication for
croup, is by no means definitely fixed: almost every
practitioner has his own exclusive mode of treatment.
Fortunately, all these modes are comprised within a
certain numnber of analogous means, so that in using
one instead of another, there is no danger of a capital
error. It is, nevertheless, beyond a doubt, that if
homceopathic physicians chose always the best of the
various modes in use, the results, already so satisfactory, would become still more brilliant.
A German homceopathist, Dr. Attomyr, in a treatise upon croup, of which M. Aug. Rapou has given
us an analysis, considers bromine as the specific, par
excellence, of this disease. Attomyr founds his opinion upon this, that bromine is the only medicine
which produces the false membrane in the larynx and
trachea of the healthy; hepar sulpih., spongia tost.,
and iodium, only produce, according to the German
physician, the symptomatic phenomena which characterize the croup angina.
According to Elwest, (another German homceopathist,) the efficacy of the following treatment against
croup, is more and more confirmed: Acon., 1st, alternated with iod. or spongia, 1st, dissolved in a few
ounces of water, and administered, at the outset, a
teaspoonful every ten minutes.
Gross asserts, that in twenty-five years' practice, he
hlad not lust a single case of croup, which was taken
in timce, (what did he mean by taken in time?) IIe




310   DISEASES OF THE RESPIRATORY ORGANS.
begins with hepar sulphur, from the first to the third
trituration, which he follows with acon., 3d; he then
administers, alternately, hepar and spongia tosta.
" When the cough is hollow and whistling," says
tiering, "hepar sulphur is always the best remedy ~
afterward we administer samb. nig.,'hyosc., cina;
sometimes, also, nux voin., veratr. alb., chin., droscra."
Hlering recommends these medicines only during
the first period of the disease.  When the attacks of
suffocation come on, he prescribes tart. emetic., in
large doses, followed by spongia; then an arm-bath
of very warm water; then acon., then spongia, then
hepar sulphur, then, arsenic, bellad., carb. veget.,
aconit., etc.; in despair, a few leeches to the trachea.  I ask his pardon; but this treatment is miserable. (We say so too: Ed. 2d edit.)
Hartmann uses, during the first period, the medicines prescribed by Hering; after which, he administers, at the moment of the attack, acon., spongyia,
hepar sulph., iod.,phos., mercur., rthus, etc.
As for me, I shall give my treatment of croup in a
few words: it is very simple, VERY SURE, and comprises but a limited number of medicines.
First, having never used bromine, I can say nothing of it.
Aconite is only indicated in croup in the rare cases
of violent fever in the beginning; from the moment
that the febrile symptoms diminish a little, or when,




CRouP.                   311
after one or two doses, it seems to produce no effect,
it should be discontinued, and that finally, under
penalty of losing precious time, when often the minutes are to be counted. Aconite is not a specific for
false-membranous angina.
The good effects of spongia marina tosta, are
incontestable;  but they have been  exaggerated.
Spongia corresponds to the first period: I do not
use it.
Cinnabaris covers the greater part of the symptoms
of false-membranous pharyngitis; but its action is
slow. I used it a few years since; but have since
enounced it.
iepar sulph. corresponds to the commencement of
croup in the bronchia or trachea; it is powerless at
the moment of the exacerbations, and beside, exerts
no modifying influence upon the plastic secretion,
which constitutes the real danger of croup.
Jpecac. and bryonia, (bult given concurrently, for
both would be inert alone,) are in all cases, whatever
be the form of the attack or intensity of the disease,
the great modifiers of croupal angina.
These medicines need not be prescribed at very low
dilutions: from six to twelve will suffice.
The two solutions prepared, they should be administered alternately, a teaspoonful every two hours,
during the period of invasion; every ten minutes
during the exacerbations, and at intervals gradually
increased, when these are passed.
27




312   DISEASES OF THE RESPIRATORY ORGANS.
It may be necessary, in place of these solutions, to
substitute globules, which may be easily introduced
into the mouth of the child when deglutition has become imlpossible.
It would take me too long to explain here, by what
course of experience I have come to adopt, exclusively,
this combination of bryonia and ipecacuanha, in the
treatment of croup; but practitioners who will venture
to use it upon my testimony, will acknowledge that it
is good. If, however, they would avoid reverses, they
should be careful not to confound croup with the
disease of which I am about to speak.
ASTHMA OF MILLAR.
This disease, first clearly described by Millar, and
to which he gave his name, differs essentially from
croup; with which, nevertheless, it presents such
symptomatic relations, as to cause them to be sometimes confounded.
The asthma of Millar, the spasmodic or stridul'us
lacryngitis of some authors, is only, properly speaking,
the suffocating asthma of adults, aggravated in children by the narrowness of the trachea, and especially
of the larynx. In a word, the asthma of Millar, instead of being, like croup, a special inflammation, is
only a nervous affection.
It is, beside, easily understood, that the general
symptoms of this nervous disease, are very similar toc
those of croup, since, in both cases, the symptoms




AS,'rRTA OF MILLAR.           313
have the same cause-suffocation.  But that which
constitutes the symptomatic difference in the two
affections, is the almost complete absence, in asthma, of the premonitory symptoms of croup, and so
entire a suspension of all the symptoms during the
intervals of the attacks, that the little patient often
enjoys, during these periods, the most peaceful
sleep.' The distinction between these two morbid states,'"
says M. Rapou, " is very easily established when one
discards all ideas of systems, and is satisfied with observing. Thus, croup is more common in healthy
and well-nourished children; asthma, inl fbeble, delicate, nervous and excitable subjects; in those disposed
to scrofula, or who have badly-formed chests. Croup
gradually increases in intensity; it is generally epidemic and  accompanied with fever.   Asthma is
sudden in its attacks, is always sporadic, and unaccompanied by fever. In croup, there is a dry cough,
a characteristic tone of voice, not presented by spasmodic dyspncea; and this latter is also without the
sensibility of the larynx. Croup offers all the general
characteristics of inflammatory affections, and the
asthma of Millar but the phenomena of nervous excitability.
The following are the differential signs of the croup
and asthma of children, arranged in tabular form, as
presented by Millar himself:




314    DISEASES OF THE RFSPTRATORY  ORGANS.
ASTHMA.                          CROUP.
1st. Its attacks are sudden,    1st. It comes on slowly and
and the first attack occurs gen-   gradually: the first attack comerally in the night.            monly occurs during the day.
2d. It is always sporadic.      2d. It generally prevails epidemically, and is seldom sporadic.
3d. The cough, when it ex-      3d. Layers of puriform matter,
ists, is dry, and without any   or cylindrical concretions, are
expectoration.                  expelled by the cough and vomiting.
4th. There is no pain; this     4th. There is pain in the air
is replaced by a constriction of   passage, and we discover, by the
the whole thoracic cavity.      touch, a slight tumefaction, on a
level with the painful spot. The
tumefaction is not perceptible to
the sight.
5th. The voice is hoarse and    5th. The voice has a very pehollow.                         culiar whistling tone.
6th. There is,no fever.        6th. There is fever.
7th. The  attacks  alternate    7th. The symptoms continue,
with  intermissions,  during   without interruption, so  that
which the child has the appear-  there are no perceptible interance of perfect health.         missions.
8th. The disease is of a con-   8th. The disease is of an invulsive nature, and requires an   flammatory nature, and calls for
antispasmodic treatment.        an antiphlogistic treatment.
To tell the truth, I am obliged to declare, that the
line of demarcation between the symptoms of croup




ASTHMA OF'MA ILLAR.          315
and asthma, is not so well defined as M. Rapou and
Millar seem to consider it; and I would not venture
to assert, with our estimable colleague of Lyons, that
" the distinction between these two morbid states is
very easily established." Croup, as we have seen, is
often without premonitory symptoms, almost apyretic,
and presents marked remissions. As to the other
contrasting symptoms, several of them are sometimes
wanting-almost all are inconstant. It would then require great experience, tact, and circumspection —I
may almost say, good luck-to avoid, in badly-defined
cases, mistaking one for the other of these two diseases. As a general rule, however, a good observer
will succeed in doing so.
The asthma of Millar is, like croup, a very serious disease, but one over which we are certain
to triumph, by means of the treatment I shall point
out.
Coralia rubra and opium, administered in exactly
the same manner as bryonia and ipecac. in croup, are
heroic agents against this disease.
I prescribe coralia at the thirtieth, and opium at
the third dilution. The last is given alone, every
six hours, for a day or two after the resolution of the
last attack.




316 DISEASES OF THE RESPIRATORY ORGANS.
BRONCHITIS.
The majority of children are very subject to irritation of the bronchia; but this irritation is commonly but a sympathetic symptom of another affetion. Thus, we see dentition, or the presence of
worms in the alimentary canal, occasion cough. This
cough, in the first case (dentition), yields to kreosoturn
in the second, to viola odor., or to stannum.
As to primitive bronchitis, almost always caused
by a chill, it presents the same general symptoms as
erythematous angina, and requires the same treatment.
This disease only becomes really serious when it
attains a high degree of intensity. There is then an
intense fever, a burning skin, great thirst and no appetite. The cough recurs frequently, in short fits;
sometimes, but not always, followed by a slight whistling; after a few days there is a yellowish expectoration, difficult to verify, in very young children. We
perceive by auscultation a mixture of the sonorous
and mucous, and sometimes a suberepitant ronchus.
There is considerable oppression, frequent pulse, pale
or purple face after the cough: pneumonia is then to
be feared. But even without this complication, bronchitis, in this degree of intensity, is dangerous, and
may become mortal.
TREATMENT.-The medicines upon which we may
most safely rely in the treatment of acute bronchitis




PEhlMONIA.                317
are dulcamara and pulsatilla, preceded, if necessary,
by aconitum, and followed by ipecac. and hepar
sulph. Silicea is recommended in chronic bronchitis.
PNEUMONIA.
Pneumonia, or inflannmmation of the parenchyma of
the lungs, is seldom a primitive affection in childhood;
but it often supervenes as a complication, either in
typhoid fever, eruptive fever, or finally in hoopingcough, of which we shall soon speak. Its general
symptoms are the same as those of very acute bronchitis; it is not always easy to distinguish between
these two diseases. The continual crying and moaning
of children often render the signs furnished by auscultation very obscure; beside, the rusty-colored expectoration, which, in adults, constitutes one of the distinctive features of pneumonia, almost never takes place in
children. We know that very young children never
expectorate by the mouth, and it is consequently impossible to draw any inductions from the nature or
consistency of their pulmonary secretions.
When, however, one can succeed in obtaining
a few moments of calm  and silence in these little
patients, auscultation, and above all, percussion, are
the best, or, perhaps, rather the only means of establishing the different diagnosis of bronchitis and
pneumonia. TIn the latter, the crepitant ronchus is
distinctly mixed with the.sibilant and mucous, the
respiratory murmur ceases to be perceptible in divers




318   DISEASES OF THE RESPIRATORY ORGANS.
points in the thorax, especially behind, where it is
sometimes replaced by the bronchial respiration. By
percussion we discover the hepatized portions of the
lungs by the dullness of the sound.
In an immense majority of cases, pneumonia succeeds to bronchitis, and the existence of the two diseases are simultaneous.
Both, fortunately, require very nearly the same
treatment. However, if the engorgement of the pulmonary parenchyma is clearly defined, we run great
risk of an unfortunate  termination, if we do not
hasten to employ the special therapeutics called for in
pneumonia.
Dr. Tessier, who has just published the result of
a clinical experience of great interest, upon the treatment of this disease,* combats it principally with
aconite, bryonia, phosphorus, sulphur, belladonna,
arsenic and iodium.
Certainly these various substances correspond to the
different symptoms of pneumonia; but neither of them
contains them  in their totality.   I would then earnestly recommend M. Tessier to substitute for his
therapeutics, which is also that of the majority of
homceopathists, the medicines I am about to make
known, and whose prompt efficacy will surprise him
if he consents to make trial of them.
* Recherches Cliniques sur le Traitement de la Pneumonia et du
Cholera. suivant la MWthode de Hahnemann; par le Doct. J. P. Tessier, M6deoin de l'HSpital Sainte-Marguerite, in 8vo., Paris, 1850.




PLEURISY.                 319
The first of these medicines is chelidonium majus;
it alone replaces aconite, belladonna and phosphor.
Chelidon. maj. should be administered from the
first, whatever be the intensity of the symptoms, but
only for a few hours, and in doses repeated at very
short intervals. Seven or eight globules of chelidonium, of the sixth dilution, may be dissolved in four
ounces of vehicle, of which the patient may take a
teaspoonful every quarter of an hour, but for one hour
or an hour and a half only. This done, we shall, in
an immense majority of cases, observe a marked,
sometimes an astonishing, remission of all the local
as well as the general symptoms. This remission once
obtained, we should discontinue chelidonivm, and
administer alternately, every two hours,pulsatilla and
spongia marina tosta —puulatilla, from the sixth to
the twelfth; spongia, from the twenty-fourth to the
thirtieth. These two medicines, whose use should be
continued until the resolution of the disease, should
be given at lengthening intervals, as the amelioration
is more apparent; and this, I venture to predict, will
not be long delayed, excepting in cases of unusual
complications. (This treatment has been found very
efficacious. Ed. 2d edit.)
PLEURISY.
Primitive inflammation of the pleura is so rare in
the first years of life, that it cannot be considered as
a disease of childhood. I shall not, therefore, stop to
describe its symptoms, which are beside the same in
children as in adults. Spong. marin. tost. and lache,




320  DISEASES OF THE RESPIRATORY ORGANS.
sis, both at the thirtieth dilution, are the medicines
which control the therapeutics of pleurisy. I should
not know how to recommend too earnestly the employment of these two substances. They should be
administered simultaneously; spongia once in the
morning; lachesis once in the middle of the day and
once in the evening. We may remark, by the way,
that this treatment, which is also that of peritonitis,
seems adapted to inflammation of all the serous membranes, with or without effusion.
HOPIN G-COUGH.
Hooping-cough is a disease incontestably essential,
contagious, epidemic, commonly apyretic, and is char
acterized by a convulsive cough, recurring in paroxysms at irregular intervals. This cough consists in a
series of abrupt and very short expirations, followed
by a long whistling and sonorous inspiration; it is
accompanied by a considerable congestion of the face,
and terminates by the expectoration of a ropy mucosity. Very frequently, especially after eating, these
fits of coughing produce nausea and even vomiting;
but these are epiphenomena, which are by no means
characteristic, and which may occur in all violent
irritations of the bronchia, and whenever there exists
much dyspncea, whatever be its cause.
Hooping-cough is an affection peculiar to childhood,
and especially frequent from the second to the sixth
year. Statistics seem to prove that girls are more




-ooPING-COUGH.              321
subject to it than boys. Like all other epidemics, it
passes from one country to another-braves all climates, and shows itself in all seasons of the year.
However, it is especially in the spring and autumn,
that is to say, in the most humid months in the
year, that the epidemics of hooping-cough habitually
appear.
This disease, however unimportant it may be in
itself, when not complicated, is nevertheless one of
those which most clearly show the inadequacy, or
rather the complete impotence of the allopathic routine: which never abridged one week the duration of
this disease.
Hooping-cough sometimes commences by a catarrhal state (coryza, watering of the eyes, bronchitis,
etc.), which continues, according to the idiosyncrasy
of the patient and the kind of epidemic prevailing
from twenty-four hours to six days and more, some
times by spasmodic fits of coughing at the outset.
Symptoms of simple bronchitis mark the decline of
the disease. Hence the three periods of the disease,
pointed out by authors. But of these three periods
the second only is characteristic, as the first may be
wanting, and the two others are often confounded.
The old school physicians are as far from being
agreed upon the duration of each of these periods,
as upon the total duration of the disease, or uponl
the treatment best adapted to it. What is certain
is, that hooping-cough, left to itself, or treated by




322 DISEASES OF THE RESPIRATORY ORGANS.
Allopathy, which comes to about the same thing (with
the exception of symptoms caused by antiphlogistics),
lasts always from three to four months and often longer.
If the coughing-fits in this disease vary but little in
form, it is not the same with regard to their number
in a given time. Laughing, eating, drinking, or walking-every species of movement-odors, mental emotions, reproduce them the more readily in proportion
as the disease is near its height.  "We have seen
them broken or cut in two," say MM. Rilliet and
Barthez, " in such a manner, that a complete fit was
formed by the two half-fits, separated by a very short
interval, during which the respiration was natural.
This form must be rare, as I have only met with it
once."
Lastly, in very young subjects, the coughing-fits
often provoke convulsions, in consequence of which,
or during which, infants sometimes die with cerebral
congestion; but these accidents are fortunately rare.
Spasms of the glottis, pneumonia, and lastly, tuberculation of the lungs, are, with the convulsions of
which I have just spoken, the most frequent complications of hooping-cough.
As- to bronchitis, we may consider it, as it were, inherent in the disease; it marks its beginning and its
termination. It is not always easy to distinguish
bronchitis from hooping-cough; however, the spasmodic form of the cough, the whistling sound which accompanies the inspirations, the ropy expectoration,




HOOPINO-COUGH.               323
the ordinary absence of fever, lastly, the freedom
and the preservation of the normal rhythm of the respiration in the intervals of the cough, sufficiently characterize the latter to prevent the attentive observer
from falling into error.
TREATMENT.- Ipecac., dulcam., bellad., cuprum,
drosera, ambra, arnica, etc., have been recommended
for hooping-cough.  Now, with the exception, perhaps, of belladonna and drosera, whose pathogenesis
one may consult at need, none of these medicines
have a direct influence upon this disease. But there
are in our materia medica two substances which control the therapeutics of hooping-cough. I speak of
coralia rubra and of chelidonium  majus.  I have
already mentioned chelidonium maj. as the specific
for pneumonia, at the height of its acute period. Experience has convinced me that it will find its place,
though in the second rank, in the treatment of
hooping-cough.
From the moment that the coughing-fits have assumed the convulsive form, and even before that time,
that is to say, during the catarrhal period; as soon, in
a word, as one is sure of having to deal with a hooping-cough instead of simple bronchitis, we should immediately prescribe coralia rubra of the thirtieth dilution, for three or four days in succession, four doses
in the twenty-four hours.  l"It is like water thrown
uvpon fire," said one of my patients to me, one day,
after I had given him this medicine for attacks of a




324  DISEASES OF THE RESPIRATORY ORGANS.
convulsive cough which had passed into a chronic
state.
As soon as the amelioration produced by coraliac
ceases, that is to say, at the end of four or five
days at the most, it should be discontinued, and
chelidonium majus administered, of the sixth dilution, three doses in twenty-four hours, and continued,
unless there is a renewal of the violent spasmodic coughing-fits, or convulsions in little children,
or spasms of the glottis (all of which circumstances
would call for a return to coralia), until the evident
transformation of hooping-cough into simple bronchitis.
At this period of the disease, neither coralia nor
chelid. should be employed, butpulsatilla.
Lastly, if we add to these three medicines, causticurn, in the decline of the disease, when there remains only a dry cough; then lachesis, if with the
bronchial cough there is extreme depression, which
sometimes happens, we shall have completed, apart
from absolutely unforeseen accidents, the therapeutics
of hooping-cough.
PHTHISIS PULMONALIS-PULMONARY CONSUMPTION.
Phthisis pulmonalis, so common and so much to
be dreaded during adolescence and in adult age, cannot be classed among the diseases of children. We
see, it is true, especially after measles, variola, typhoid fever, etc., children die of marasmus, following




PHTHISIS PULMONALIS.             325
abscesses formed in the lungs; but these abscesses do
not proceed, like those of consumptives, from the softening of tubercles. Their seat is the base or the middle lobe of the pulmonary parenchyma, and hardly
ever the superior lobe, the most frequent location of
tubercles. They are, in a word, the immediate consequences, and without necessary preliminary tuberculation of an active or congestive inflammation of the
respiratory organs.  Chelidonium, phosphorus, and
carbo vegetabilis, are the appropriate remedies for
these symptoms.
But if children rarely die of phthisis pulinonalis, it
is not the less certain that it is from childhood that
this terrible disease silently prepares itself.  Unfortunately the process of pulmonary tuberculation is affected in so slow, so hidden, so completely latent a manner, that it is hardly ever possible to affirm its existence until it has burst out in very often incurable
symptoms.  The following are the most common
signs of this morbid condition:
Narrowness of the chest, paleness of the face, with
slight coloration of the cheeks, general emaciation,
frequency of the pulse and of the respiratory motion,
dry cough, oppression, great disposition to bronchitis,
perspiration upon the least exercise and at night;
obscurity of the respiratory murmur and more or less
marked dullness on percussion of one of the two sides
of the thorax, especially at the summit of the lungs;
vaginal discharge in little girls, habitual constipation




326 DISEASES OF THE CIRCULATORY APPARATUS.
or frequent return of slight diarrhea, irritable and
capricious humor.
A good regimen, gymnastics in the open air, daily
cold bathing; and if there are times of a marked
exaggeration of this state: chelidon., carbo. veget.,
lycopod., etc., administered with great reserve and
according to the totality of the dominant symptoms,
are the principal hygienic and therapeutic means to
combat an unfortunate diathesis, which, when hereditary is but too often rebellious to the most skillful
treatment.
DISEASES OF THE CIRCULATORY APPARATUS.
As fever in an immense majority of cases can only
be considered a secondary, and symptomatic phenomenon of an affection, more or less appreciable, but
primitively independent of the vascular system, there
are properly speaking no other diseases of the circulatory apparatus than arteritis, phlebitis, endocarditis
and vicious conformations of the heart, or of the principal vessels. Arteritis, phlebitis and endocarditis,
are almost unknown in childhood. Vices of conformation, such as non-obliteration of the foramen ovale
in children newly-born, or aneurism, either of the
heart, aorta, or of the large branches of this artery,
are diseases against which art is often only too evidently powerless.




CIRCULATORY APPARATUS.           327
With regard to aneurisms, I give here what I find
in the notes prepared by myself, and for my particular
use, some years since: "Castoreum, rkus and sambucus, are the best remedies for the treatment of
aneurisms. But these diseases being always essentially chronic, require great caution in the use of medicines. Castor. should be prescribed, in the commencement, of the ninth or tenth dilution, a few
globules in a glass of water, a teaspoonful morning
and evening. Then after an interval of two or three
days, rhus toxic. may be administered in the same
manner, and lastly sambuc., which will allay the
sometimes very acute pain, occasioned by aneurism.
The regimen required in these diseases is very severe;
absolute abstinence from wine and all fermented
drinks is indispensable.
As for the inflammatory fever, the constant precursor of all the phlegmasias, everybody knows that
aconite, our antiphlogistic par excellence, is the sovereign remedy.
28




328 DISEASES OF THE CEREBRO-SPINAL APPARATUS.
DISEASES OF THE CEREBRO-SPINAL APPARATUS.
IT is well known that the relative predominance of
the encephalic mass in children singularly predisposes
them to cerebral affections. However, these affections
are much more rarely primitive than is generally believed. Encephaaitis, that is to say, inflammation
and softening of the brain, properly speaking, is undoubtedly less frequent hi childhood than at any other
time of life. As to meningitis, it is the greater part
of the time a secondary symptom; in other words, the
sympathetic complication of a disease, whose principal
seat is not in the membranes. Nevertheless, in certain cases, they are first affected, and of all the primitive affections of the cerebro-spinal apparatus, we
may consider it as the one with which children are
most frequently attacked.- It is beside almost impossible to distinguish it from encephalitis, and it is very
frequently only by a post-mortem  examination, that
we discover whether death has been caused by an
inflammation of the cerebral pulp, or by an inflammation of its envelopes. I shall then describe, under
the generic name of cerebral fever, which does not
prejudge as to the anatomical seat of the disease, the
totality of the symptoms common to encephalitis and
meningitis; a so much the more legitimate mode of
proceeding as the two affections, the greater part of




CEREBRAL FEVER.              329
the time simultaneous and confounded, do not require
an essentially different treatment.
CEREBRAL FEVER.
Cerebral fever commences with considerable disturbance of the circulation, violent headache, frequent
bilious vomitings, thirst, absolute loss of appetite,
generally constipation. From the first day a profound
alteration takes place in the expression of the face
and in the intelligence, alternations of drowsiness and
uncontrollable agitation, coma and very acute delirium. The disease generally progresses with great
rapidity. The violence of the symptoms increases
with the progress of the disease. There may, however, occur remissions of the febrile action; but the
pulse remains irregular. The respiration is sometimes
accelerated, and sometimes retarded. The face is distorted, extremely pale, or with a purple color in the
cheeks. The abdomen is retracted, constipation is
permanent; there is carpologia, subsultus tendinum,
rigidity of the trunk, of the jaws or of the limbs;
strabismus, dilatation of the pupils; lastly, sensibility
becomes obtuse, the pulse increases in frequency,
becomes imperceptible, and coma, or a last paroxysm
of convulsions terminates the scene, after a total duration of thirty-six hours at the least, or nine days at
the most.
The absence of intense cephalalgia, vomitings, constipation and the retraction of the abdomen, distin



330 DISEASES OF THE CEREBRO-SPINAL APPARAT'US.
guishes secondary meningitis from idiopathic meningitis. The former, when it supervenes in the course
of a febrile disease, presents no remission of symptoms
and continues until the death of the patient, if art
does not succeed in preventing the catastrophe.
The causes of cerebral fever are not always apparent; it has been known to prevail epidemically.
It is said that onanism predisposes to it, which is at
least probable. Many times, in short, as I have already said, apropos of erythema (see page 116), it has
been brought on by insolation.
But the most frequent cause of cerebral fever is,
without doubt, the presence of tubercles in the brain,
or in the membranes. The disease, in this last case,
is incurable.
Tuberculous meningitis, (the acute hydrocephalus
of authors,) is slightly distinguished in its symptoms
from simple meningitis.
It commonly begins at a time of apparently perfect
health, by cephalalgia, vomiting, constipation, and a
slight acceleration of the pulse, much more rarely by
agitation and delirium. The turns of vomiting are
not very numerous, and rarely last beyond two or
three days. In rare cases, however, they may continue for several weeks.  The constipation persists,
the pulse becomes slower and irregular. The child is
sad, depressed, and occasionally grinds his teeth;
his look, which shuns the light, is uncertain, and
as though astonished. sometimes fixed, and  this




CEREBRAL FEVER.               331
appearance of the face contrasts in a remarkable
manner with the clearness of intelligence, which almost always remains intact.
Delirium finally comes on, but it is rather tranquil
than agitated; drowsiness and comla-predominate, and
become permanent as death approaches. The pulse
is then small and quick; the skin warm, often covered
with perspiration; the respiration is irregular; the
eyes sunken, the sight extinguished, the cornea dull;
the nose pointed, and the abdomen so depressed that
we can feel the beating of the aorta through its
parietes; the urine and stools pass involuntarily:
the patient generally dies in an attack of convulsions.
This species of meningitis is very insidious. In its
beginning, especially, it is liable to be mistaken for a
slight affection; it is very different, in this respect,
from cerebral fever, so clearly inflammatory, and the
violence of whose first symptoms reveals the serious
nature of the disease. The progress of tuberculous
meningitis is also less rapid than that of simple
meningitis. The first never lasts less than seven
days, and is sometimes prolonged to fifteen, twenty,
and even forty days.
The existence in the patient of the tuberculous diathesis, the persistence of constipation, the severity of
the cephalalgia, the slowness of the pulse shortly after
the commencement, lastly, the retraction of the abdomen-such are the signs which distinguish tuberculous




332  DISEASES OF THE CEREBRO-SPINAL APPARATUS.
meningitis from typhoid fever, with which it has been
sometimes confounded.
TREATMENT.-Cerebral fever calls for prompt and
energetic means. Two medicines control its therapeutics: they are belladonna and bryonia.  We may
even assert, that these two medicines are the only
ones upon which we can depend.
Belladonna is administered from the beginning,
at from the twelfth to the fifteenth dilution, in solution,
of which the patient should take a teaspoonful every
two or three hours, according to the violence of the
delirium.   From  the second day, bryonia  may be
given with it, at from the 6th to the 12th. Two doses
of belladonna, given in the morning, two doses of
bryonia in the evening, and a single dose of belladonna in the night.
This treatment will almost always succeed in simple
meningitis. 
* We woald earnestly recommend to practitioners, in the meningitis of children, of from six to eighteen months, the treatment
adopted by Dr. J. H. Pulte. As soon as the first symptoms of
oppression, drowsiness, and sleep with half-opened eyes, announces
an impending effusion, he prescribes bryonia and helleborus nig., in
alternation. Of the third dilution of each of these remedies, he dissolves ten or twelve globules in half a teacupful of water, and gives
a teaspoonful alternately from the solutions every two hours. As
the symptoms improve, which they are generally observed to do,
within the first twenty-four or thirty-six hours, the frequency of the
doses is diminished, and the solutions are madle weaker, by the addition of a larger quantity of water to each preparation.]-ED.




SPINAL MENINGITIS.            333
As to cold ablutions upon the head, sinapisms upon
the legs, etc., etc., we make no use of them. We do
not prescribe them, not because they belong to the
allopathic methods, but because they are, at the least,
useless, if not dangerous.
SPINAL MENINGITIS.
Primitive inflammation of the membranes of the
spinal cord, is certainly a very uncommon disease, in
the first as well as in the second period of childhood.
Convulsions, and especially tetanic rigidity of the
trunk, are almost the only symptoms which characterize it; and, as these symptoms may exist without
organic lesions, it follows that the diagnosis of spinal
meningitis is always very obscure.
The most that we can say is, that the febrile action
which accompanies it, and the persistence of the nervous attacks which it produces are of such a nature
as to distinguish meningitis from an essential or sympathetic nervous affection.
TREATMENT.-Belladonna, from the 12th to the
1.5th, in water, a teaspoonful every hour during the
first day.
Belladonna and thuja, taken alternately, from the
second day, lengthening the intervals between the
doses as the symptoms improve.




334 DISEASES OF THE CEREBRO-SPINAL APPARATUS.
MYELITIS-INFLAMMATION OF THE SPINAL
MARROW.
Myelitis is, perhaps, still more rare in childhood
than spinal meningitis: its symptoms are, paralysis
of the abdominal extremities; and convulsions, when
as almost always happens, it is complicated with
meningitis.
The treatment of this disease is the same as of the
preceding.
HYDROCEPHALUS.  (CHRONIC.)
By hydrocephalus is understood an  accumulation of water on the brain, with a more or less
considerable separation of the bones of the cranium.
This disease is sometimes congenital —is sometimes developed several months, and even several
years after birth. The children attacked with it, seldom present any other morbid symptom than the
abnormal, and, in certain cases, enormous volume of
their heads. The disproportion of this part to the
face and the rest of the body, gives to the young patients a strange aspect. Some of these children are
remarkable for mental precocity; but, after a certain
time, their sensitive and intellectual faculties simultaneously decline. This alteration of the cerebral functions, is first observed in the senses of hearing and
sight. The patient may become completely blind and




IHYDROCEPHALUS.             335
deaf, before any other symptoms give notice of the
progress of the disease. Soon; however, paralysis of
motion, and of sensibility in various parts of the body,
are added to these symptoms. At last, the patient
takes to his bed; a febrile action sets in; somnolence,
coma, convulsions, or attacks of tetanus, and death
succeed. The duration of this disease is extremely
variable.
Hydrocephalus is not an incurable disease; the
curative force of nature alone has been sufficient
to restore to health children affected with this malady, some of whom afterward became distinguished
nen.e
TREATMENT. -It requires time and perseverance.
Staphysayria, ferrum chlor., and carnphora, are the
medicines upon which we must depend.
The first two medicines may be administered simultaneously for two weeks, two doses of stayphysag.,
from the twelfth to the fifteenth dilution, in the morning, and a single dose of fer. chlor., from the 6th to
the 9th, in the evening.
Camnphora, at a medium dilution, should succeed
these two medicines, and be continued, at three doses
a day, for several weeks.
In case the disease should take an acute form, the
treatment for meningitis should be adopted.
* George Cuvier had hydrocephalus in his childhood.
29




P336 DISEASES OF THE CEREBRO-SPINAL APPARATUS.
Arnica may be given intercurrently, in the treat.
ment of hydrocephalus; but the three medicines I
have indicated are infinitely preferable.
CO NvULSIONS
Convulsions and worms formerly constituted the
pathology of children; but we now know, that convulsions, far from always being a separate affection, are
only, in an immense majority of cases, a symptom, or
a complication, of another disease; so that an efficacious treatment of the latter is the only way of removing the former. Thus, we see convulsions result:
1st. From difficult dentition; 2d. From lumbrici in the
small intestine, or ascarides in the rectum; 3d. From
severe hooping-cough. We have seen them, in short,
show themselves in eruptive and in typhoid fevers, as
a first symptom in meningitis, and terminating the majority of mortal maladies, Convulsions do not in any
case call for a special treatment; the only one adapted
to them is that of the disease which produces them.
There exist, however, essential convulsions: epilepsy is of this nature, when it is not occasioned by
an organic lesion. It is very important to distinguish
essential from symptomatic convulsions, but it is not
always easily done. The age and general health of
the subject, are the first circumstances to be taken
into account. 1st. Symptomatic convulsions, excepting the cases of very marked cerebral affections, are




CONVULSIONS.               337
rare after seven years; 2d. The disease upon which
they depend, is more or less evident. Consequently,
when a child over seven years, and, to all appearance,
in perfect health, is attacked with convulsions, without appreciable cause, we have every reason to believe
that it is a first attack of epilepsy. But if, on the
contrary, we learn that for several weeks, or even for
several months, the child has been losing color, flesh,
and strength; that it has had a capricious appetite,
irregularities in digestion, and occasional vomitings;
if we know at the same time that it is born of phthisical parents, the prognosis is serious, for nothing is
more probable than the existence of a tuberculous
meningitis.
Sympathetic convulsions are always a highly unfavorable complication; they may cause death by
asphyxia. As for epilepsy, everybody knows what a
legitimate terror it inspires; but it is far from being
always incurable, especially when it is not hereditary.
TREATMENT.-I have pointed out the cases in which
convulsions should be combated by kreosotum, (see
page 243,) by coralia rubra, (see page 323,) by stannum, (see page 285).
When convulsions in nursing children appear to be
idiopathic, the only medicine to oppose to them is
helleborus niger, from the ninth to the twelfth dilution, at small and repeated doses.  (Prefer 2d dilut
Ed. 2d edit.)




338 D)ISEASES OF THE CEREBRO-SPINAL. APPARATUS.
When, lastly, we have to combat a declared epilepsy, that is to say, idiopathic convulsions, and in a
chronic state, our principal agents are belladonna,
opium, and secale cornutum.  Opium  and belladonna should be given first, for an entire month,opium twice in the morning, belladonna twice in the
evening; the second month, opium and secale cornu.
turn; the last, replacing belladonna. The result of
this treatment will astonish those who employ it.
CHOREA-ST. VITUS S DANCE.
Chorea, or St. Vitus's dance, is rather a disease of
youth than of infancy; I shall not describe it here, but
I recommend to practitioners the use of coqffa and
colchic., in the treatment of this disease, whether
acute or chronic; to be followed by cocculus. In a
chronic chorea, for example, coffea should be taken in
the morning, and colchic. in the evening, for one or
two weeks; after which, coccul. should be administered, morning and evening.
B A L B UTIES-STA M M E RI N G.
This infirmity, almost always congenital, and often
hereditary, proceeds from a fault of innervation, for
the cure of which, Allopathy has found nothing better
than various surgical operations, whose stupid barbarity and continual failures have scarcely yet disabused
the credulous. The proof that it is a functional aber



BALBUTIES.                339
ration of the brain which produces stammering, is,
that all moral emotions, that is to say, actions purely
cerebral, instantly increase the infirmity of which we
speak. For myself, I venture to affirm that stammerers can be cured, provided the treatment is applied in
infancy, or at least before the age of puberty. The
use of a single medicine, stramronium, constitutes the
whole treatment. It should be administered at the
ninth dynamisation, eight or ten globules to four
ounces of water, a preparation that may be renewed
as often as necessary, and of which the patient should
take three teaspoonfuls a day for six or seven weeks
at least.




340    DISEASES OF THE ORGANS OF SENSE.
DISEASES OF THE ORGANS OF SENSE.
As these diseases offer nothing which is peculiar to
childhood, I shall say very little concerning them.
Ophthalmia and otitis are frequent complications of
variola and measles, their treatment is then that of
these diseases.
Simple ophthalmia of the new-born (redness of the
conjunctiva, photophobia, then agglutination of the
lids), quickly give way to a few doses of cethusa.
Camnphora or cofea are the specifics for ophthalmia,
caused by a contusion of the globe of the eye. These
two medicines are, in this case, preferable to arnica,
which is generally used.
Kireosotum, in doses repeated at short intervals,
should be given to the new-born, attacked with syphilitic ophthalmia.
Otitis is an inflammation of the auditory canal. It
is sometimes very painful. Belladonna is the principal medicine for the acute period. Lycopodium is a
precious remedy against chronic otitis, with purulent
discharge; sepia would, however, be preferable, if
there was a relaxation of the bowels.




DISEASES OF THE LOCOMOTIVE APPARATUS. 341
DISEASES OF THE LOCOMOTIVE APPARATUS.
As it is not my intention to treat of vices of conformation and external lesions, which require surgical
operations, I shall here speak only of hernia and
rachitis.
Hernia is most commonly caused by the efforts
made by children in crying.  A simple band generally suffices for the cure of umbilical hernia but
inguinal hernia, in little boys, requires internal remedies. Nux. vom., and if this medicine fails, coccul.,
are the substances to be prescribed. The same treatment is adapted to the falling of the rectum.
Rachitis, an affection very common in childhood, is
undoubtedly a form of scrofula, and presents all'the
general characteristics we have assigned to that disease. (See pages 207 and following.)
The predominant symptom in rachitis, is the softening, and consequent deformity of the bone.  The
spongy bones, such as the vertebrae and the articular
extremities of the long bones, are more particularly
the seat of this morbid action. Hence, the impossibility of walking, and the curvatures of the spine of
rachitic children.
When the disease has made great progress, the
bones may ulcerate, and if this caries takes place in




342 DISEASES OF THE LOCOMOTIVE APPARATUS.
the vertebra of the cervical or dorsal regions, the pus
that is formed makes for itself a passage along the
vertebral column, and forms an abscess in the soft
parts of the pelvis, an abscess' which finally opens
and does not close again. (Cold abscess of authors.)
The causes of rachitis are those of scrofula in general: the most common of all is hereditary transmission.
Rosen devotes a long chapter of his Traite des Maladies des Enfants, to prove that rachitis is of syphilitic nature. For my part, I have already expressed
my- doubts upon this transformation of the venereal
disease. I have also pointed out, in the chapter on
Scrofula, the regimen to which scrofulous children
should be rigorously subjected, whatever be the special
form of the affection.
Mercur. solub., colchic. and sulphur, are the fundamental remedies for the treatment of rachitis. The
doses should be frequently repeated (several times a
day), each in the order in which I have mentioned
them, for a longer or shorter time, according to the
circumstances of the case. Their efficacy is notorious, and with their aid I do not regard rachitis as
incurable.
THE END.




INDEX.
Acute Exanthemata, 116         Dentition, 240
Angina, 298                    Diseases of the cerebro-spinal
Aphthie, 232                         apparatus, 328
Ascaris lumbricoides, 285          of children, 115
Asthma Milleri, 312                of the circulatory apparatus,
Atrophy of Children, 290             326
of the digestive apparatus,
Balbuties, 338                       228
Bleeding of the Nose, 298          of the locomotive apparatus,
Boils, 126                           341
Bronchitis, 316                    Nature of the, 45
Burns, 118                         of the organs of sense, 310
of the respiratory organs,
Cerebral Fever, 329                  295
Chicken-Pox, 165               Dynamization of medicines, 28
Childhood, second period of, 85  Dysenterya 265
Children, Diseases of, 115
Chorea, 338
Chronic Exanthemata, 168
Education, importance of, 53
Constipation, 260              Enteritis 24
Convulsions, 336
Coryza, 295                    Erysipelas, 122
Cow P~ox,166           Erythema, 116
Cow Pox, spurious, 166         Exanthemata, acute, 116
Cracks, 118
Cries of Children, 73          Fever, typhoid, 268
Croup, 301                     First care of new born, 56
Crusta lactea, 191             Frost-bites, 120
Crusta Serpiginosa, 149        Furuncles, 126




INDEX.
Gangrene of the mouth, 236    Onanism, 100
Gastritis, 243                Ophthalmia, 340
Gripings in infants at the breast, Otitis, 340
258
Pemphigus, 126
Herpes, 187                   Peritonitis, 277
Homceopathy, What it is, 11    Phthisis pulmonalis, 324
Humid Tetter, 187             Pityriosis, 205
Hydrocephalus, 334            Pleurisy, 319
Hygiene of children, 53       Pneumonia, 317
Prurigo, 206
Icterus, 276                  Pulmonary consumption, 324
Importance of education, 53   Purpura, 143
Impetico, 195                + Psoriasis, 207
Impetico rodens, 197
Inflammation of the mouth, 229  Rachitis, 341
Inflammation of the spinal mar- Regimen during homeopathic
row, 334                      treatment, 110
Inflammation of the Lungs, 317  Roseola, 134
Introduction, 11
Intestinal worms, 278         Scald head, 197
Itch, 174                     Scarlatina, 135
Scrofula, 207
Jaundice, 276                 Second period of childhood, 85
Shingles, 125
Measles, 127                  Similia similibus curantur, 15
Miliaria, 144                X Small-pox, 146
Milk-crust, 191               Spinal meningitis, 333
Mouth, inflammation of, 229   Spinal marrow, inflammation of,
Mouth, gangrene of, 236             334
Muguet, 229                   Stings, 121
Myelitis, 334                 Stammering, 338
Stomatitis, 229
Nettlerash, 126               St. Vitus's dance, 338
New born, first care of, 56   Sudamina, 145
Nose, bleeding of, 298        Syphilis of the new born, 221
Nurses, their duties and regimen,
61                      Tabes mesenterica, 290
Nursing bottles, 69           Tetter, 187




INDE X.
Tetter, humid, 185           I Vaccinella, 166
Tinea annularis, 202          Varicella, 165
Tinea favosa, 197             Variola, 146
Tinea granulata, 201          Varioloid, 164
Thrush, 232
Typhoid Fever, 268            Weaning, 79
Worms, intestinal, 278
Urticaria, 126
Vaccina, 166                  Zona, 125