CHOLERA, BY C. F. HOFFENDAHL, M. D. ON THli HOMOEOPATHIC TREATMENT / OF f f: CHOLERA. BY C, F. HOFFENDAHL, M. D. BOSTON: PUBLISHED BY OTIS CLAPF. 1849. PRINTED BT 8EA1.3 AND GREENE, 21 WATER STREET. PREFACE. My numerous friends in this city having requested me to publish the results of my practical experience in the treatment of Cholera, derived in Germany during the epidemic of 1831, I will attempt in the following pages to lay before the public an accurate description of the disease, and the treatment to be adopted according to homoeopathic principles. The utter failure of the Old School treatment in Europe, where from one-half to two-thirds of the patients have died, is acknowledged by the profession, and well known to the public; but the latter should also know, that according to the most authentic statistical accounts from Russia and Germany, the mortality under homoeopathic treatment has nowhere exceeded ten in a hundred, and frequently been less; facts which speak volumes in favor of the latter, and ought to open the eyes of the public. I must, however, request both of the professional and lay reader, a kindly indulgence in respect to any faults which he may find in the following pages; my numerous professional engagements, and the consequent haste and interruption with which I must of necessity commit my thoughts to paper, having rendered it impossible that I should bestow upon them the time and attention that 1 could have wished. C. F. HOFFENDAHL, M. D. Boston, Jan. 1, 1849. HOMEOPATHIC TREATMENT OP CHOLERA. If we consider the many centuries during which Homoeopathy remained in embryo, we cannot but be surprised at the rapidity with which it has, during the last twenty-five years, grown into an independent existence, and though yet young, so strong, so vigorous in its organization, as daily and totally to refute the prognostications of its early decease, expressed repeatedly by its opponents. But perhaps such embryo-life was necessary to usher the child into the world in a becoming manner, and to endow it from its birth with that degree of energy, which would enable it to withstand the many inimical influences with which it was destined to be surrounded: influences aiming directly at its destruction. Whatever is founded in nature, however late it may see the light, has stability, and its validity grows from generation to generation j whatever perishes, must have carried the germ of dissolution within itself, because it did not belong to nature, but was invented by man and forced upon her. If, then, Homoeopathy has not yet reached the period of general recognition by the profession, or the universal regard she deserves, it is undeniable that she is constantly increasing her domain by her intrinsic value, in spite of great and powerful opposition ; and will continue to do so all the faster, so soon as those shall gradually disappear from the stage of life, who, partly from mistaken conviction, and partly from prejudice, have felt themselves called upon to oppose her progress. Then we shall see the present arrogant denunciations give way to a calm and dignified criticism, 6 HOMCEOPATHIC TREATMENT which will endorse the truth, i. c. the fundamental principle of Homoeopathy; and, emancipating this from the speculative theories and fanciful hypotheses with which it is needlessly interwoven, allow the truth to stand forth in its naked excellence. Homoeopathy is yet young, and far from maturity. In comparison to her older sister, Allopathy, she appears as a child, but a healthy and vigorous one — no longer requiring a nurse, but yet a judicious guide to assist her through the various difficulties with which she is beset in her onward path. She cannot, like Allopathy, boast of a succession of celebrated men, or a pedigree traceable for two thousand years; nor can she show immense libraries in proof of the mental labors bestowed upon her cultivation ; qwing to her youth this is not to be expected : but though small in number, neither the men who have labored at her improvement, or the they have written, are by any means to be despised, either for* learning or practical usefulness. Such men as Moritz Muller, Rau, Griesselich, Wolf, Trinks, Schron, and a host of others, may well compare favorably with the ablest men in the old school. The Allopathic school, then, has undeniably antiquity on her side ; but this is a very relative advantage. Its method of treatment is anti^ quatedtoo ; superannuated, and mostly worthless. Historically only has it value. It is altogether too contradictory to admit of being compiled into a harmonious whole — into a system from which durability can be expected. If the number of medical works which have appeared for centuries, were less, and the difference of opinions thus less striking, we might anticipate less distrust against the whole science, and should not hear even the laity comment on the variety of opinions amongst the ablest medical men, which materially tend to shake the confidence of the public. If our ancestors had conceived the true nature and character of medical science, the correctness of their conception would have been substantiated by the result, by stubborn facts; instead of which they have bequeathed us but a mass of theories. We should have had a foundation to rest upon — to continue building upon — and not only enlarge the structure, but strengthen the foundation by additional pillars, instead of, as has been the case, demolishing the original foundation to substitute another, neither better or more durable. Though it is doubtful whether the healing art 7 OF CHOLERA. will ever attain that precision which mathematics have, it is like the latter, a science built on experience, and composed of a number of observations, which are to be collected into a system, all of which, thus far, have been imperfect ; thus practice has existed before theory, specialities before generalities. If what was presented in the name of experience, had been pure, the trodden path might have been forsaken sooner in search of a better; but at first the true spirit of observation was wanting, or fettered by superstition; subsequently it led only to the discovery of those things which the inquirer intended to find; or induced him to communicate merely so much as suited his purposes. If, moreover, we look at all the commentaries, Sic, intended to construe facts in such a way as to bear upon certain views, we shall find little else than a chaos, from which every ingenious interpreter can make out his own case, though he may make use of the most heterogeneous elements. On enquiring, then, if the present age is richer in genuine experience with reference to medicine than the last? if the mode of treatment is surer and more rapid? if we can rely with .more certainty upon the effects of our prescriptions? —we are with Hahnemann constrained to say No! though we are ready to acknowledge that this is no fault of the schools, not owing to any want of industry or perseverance of the scholars ; but that the reaping has not been commensurate with the sowing, because the fault laid deeper. The object which was pursued, and which it was intended to elucidate, was of such a nature that the solution of the problem was beyond the bounds of possibility. The above remarks apply to no particular system or method, and I therefore cannot be accused of attempting to disparage Allopathy, in order to put the stamp of infallibility upon Homoeopathy, which she neither claims or deserves. More than this, Ido not believe that she offers a certain healing method in all cases; but agree with all rational practitioners, that the triumph of art over disease will never be otherwise than limited, so long as life itself remains unchanged in its nature. As little as we can imagine physical life without its antipode, death, so little can we conceive of an organism without disease. To prevent the generation of disease, or to overcome every diseased condition at once upon its appearance, we should require a complete knowledge of the laws of life, 8 HOMCEPATHIC TREATMENT and be in possession, and have the control of all those chemical and dynamic powers, which can specifically counteract every abnormal change. Yet I am of opinion that the healing art may be advanced towards its ideal object: the decrease and simplification of disease, more than has hitherto been done, and under such circumstances, since no infallible system has yet been discovered, it is but fair and just to put to the test of reason and experience every new system, for the purpose of elucidating the question, whether the results are such as to encourage us to hope for an approach to the desired end. The question naturally arises, does Homoeopathy warrant such/ an anticipation ? I think she does. Her claims to respect and general recognition are based on the fact that in a very original manner, and a short space of time, she has advanced to a position, which it took centuries for her older sister Allopathy to gain; and further, in the circumstance that, unlike all previous systems, she is founded on a law of nature, immutable like nature, and is therefore unlike all previous systems, imperishable; they being merely the inventions of Man. They were built on theory and hypothesis on ly, attempting to discover the nature of health and disease, and from the solution of this problem, to deduce the mode of treatment ; whereas Homoeopathy, not stopping to speculate, strives after the main object, to wit, the comprehension of the disease in its image, i. c. the totality of the symptoms, and regards the cause, &c, as mere auxilaries toward the indication of the appropriate remedy. This mode of proceeding, giving her more certainty and popularity at the sacrifice of speculation, may be said to curtail the intellectual, the spiritual interest evoked by medical science. But suppose it were so, it by no means lessens her practical value at the bedside, but gives rise to the question whether this apparent intellectual nakedness does not divest her of the name of science? Science is an organic whole, which discloses to our eyes the laws of phenomena, which it has discovered and arranged by observation and investigation. It points forward to experience, and refers back to observation also ; it must prove its genuineness by harmony with the phenomena ; as it is taken from life, it will be judged according to life, and must be pronounced spurious if contradicted by appearances, and consequently impracticable. 9 OP CHOLERA It may be said that science has two sides : a physical and a spiritual ; the former is experience, the latter theory. An aggragate of experiences without a spiritual connection, can have as little claim to the name of science, as theories without reference to experience, and a,s little consequent practical value. Medicine has ever been intent upon deserving the name of a science, by following observation, and endeavoring to gain by experience. But unfortunately, theory has not always been connected with experience, and the attempt to establish a connection, has often led to a hopeless confusion. The spiritual side of Allopathy appears to be largely developed, but has nothing to hold upon, whereas the physical seems neglected ; the consequence is the want of a due foundation. With Homoeopathy it is just the reverse, only that the disparity between the two is not so great, theory being secondary, but by no means overruled by experience. All the more may we therefore expect from Homoeopathy, that those two elements will approach each other faster, and the idea of a science be sooner reached by her, than by Allopathy. As regards practicability, every unprejudiced person will acknowledge that Homoeopathy has reached her present position by her results, which have spured her adherents on to perseverance, and gained over many unwilling and bitter opponents. Neither Hahnemann or his disciples would have persevered in tilling barren ground ; and the new doctrine instead of gaining daily adherents from the ranks of the old school, and being more and more favored by the public for more than half a century, wonld long since have been abandoned, if it were not true. None of the seceders would have hesitated to publish to the world the fallacy and imposition practised upon the public, if such had been the case. And the many honest, able, learned men who stood high in the profession before they joined the Homoeopathic ranks, would long since have left them in disgust, had they been disappointed in the practical truth of Homoeopathy : similia similibus curantur. Homoeopathy could by no possible means attain a greater triumph, or pave its way more surely to the gratitude and esteem of mankind, than it would do, if proven to offer the only possible conquest over the Cholera ; 2 10 HOMOEOPATHIC TREATMENT which now again visits our shores, and utterly defies all the variety of treatment adopted by the old school ; with whom, in spite of the most scientific endeavours — it not unfrequently occurs that seizure, death and burial, take place in one and the same day. For proof that such is the fact, we have but to refer to history. By this it is not intended to be said that Homoeopathy can master every individual case of Cholera, but to assert, that the number of Cholera patients saved under Homoeopethic treatment, is vastly greater than under that of the old school. The statistics in support of this assertion are too numerous to be adduced here, still I cannot but refar to one instance. In 1882, the Bavarian government sent Dr. Roth of Munich, to Vienna, for the purpose of making inquiries respecting the results of Homoeopathic treatment in Cholera ; and he reported that of 1269 cases treated, 1184 had recovered and 85 died. The object of this pamphlet is not to write a dissertation on the pathogenisis of Cholera or the nature of the disease, its contagion, &c. My object is merely to bring under the notice of the public, and of those physicians who do not condemn without trial, an exact description of the treatment by which the Homoeopathic physicians in Europe have gained such brilliant results. My information on this subject was gained partly from my own experience during the first, and most severe epidemic of 1881, and likewise from repeated personal interviews with other and distinguished Homoeopathic practitioners ; and finally by a perusal of the best works on the subject. The origin of the Cholera, and its mode of propagation are as little understood as its character, although these subjects are of the utmost importance, on account of its immediate connection with the necessity or insufficiency of quarantine. Yet a mistake on this point is less injurious than one in respect to the treatment. May light on this last point be given us from above, and may we be preserved from a bigotted adherance to mere system. As it is indisputable that we cannot exclude the poisonous influence, whether it be founded in contagion or in miasma, it becomes our first duty to moderate, or as far as possible to extinguish the susceptibility of the body for the disease. This susceptibility in the individual, consists in his total bodily condition, and is hardly perceptible from without. It is only OF CHOLERA. 11 when the Cholera poison affects the outer skin, and the inward surface of the respiratory and alimentary canals, that we can discover a trace of that susceptibility. Consequently those persons who are much predisposed to catarrhal affections, indigestion, diarrhoea, cholics, and cardialgia, should be on their guard. Those on the other hand in whom all the functions are in their normal state, have but little to fear. For the purpose of preserving or obtaining an equilibrium of the functions of the body, no rules can be laid down which shall suit every individuality, because these are as much dependant upon the bodily peculiarities, as upon habits. Every person anxious for his own safety, should obtain such rules from his family physician. Those accustomed to a stimulating diet, who are in the daily habit of partaking of strong wines, spices, &c. should very cautiously abstain from these enjoyments, and but gradually assume a more natural mode of living. By a natural mode of living I mean : Ist. Temperance in all enjoyments ; eat at regular hours, never too much — never too late in the evening, avoid all acids, and all dishes prepared with acids, such as pickles, pickled cabbage, also pork, roast goose, salt or pickled meats, very young veal, fresh bread or such as is badly baked, rich pastry, sausages, old cheese, hard boiled eggs , stewed prunes, gingerbread, eels. Live on beef, mutton, venison, pigeons, chickens either roast or boiled, raw ham which is not too fat, rice., pearl-barley, farina, oatmeal, maccaroni. Be cautious in taking baked fruit, and avoid turnips and cabbages. Whoever is disposed to flatulence should eat nothing which causes it. Dram drinkers should reduce their usual quantity, or substitute weak spirits and water. Good strong beer is not objectionable. Weak tea with milk, or in place of milk a little rum, and good claret may be partaken of in moderation. Nothing should be drank too cold or too hot. 2dly. Avoid taking cold ; the head and chest require a lower degree of warmth than the abdomen, and feet, therefore flannel should be worn on the abdomen and woolen socks on the feet. Avoid a damp cold air, and also the early morning, or late evening air. 3dly. Avoid all mental excitements ; passions, anger, grief, envy and hatred act quite as injuriously, as hope, joy> confidence and cheerfulness do beneficially. 12 HOMdiOPATHIC TREATMENT 4thly. Cleanliness of the body and dwelling ; attention to the skin and lungs. Frequent washing of the body with cool water ; frequent change of the body and bed linen, which should be thoroughly dried. The air in the rooms should be very pure and well ventilated. Fresh air remains after all the best antidote to the cholera poison. Chloride of lime, or other disinfectants Ido not recommend. The former is injurious to the lungs, and its assumed usefulness is but doubtful ; the latter are worthless. But when the disease has broken out in a place, the sinks of the privies should be covered with the chloride of lime. The bedroom vessels should be always covered. It is imperatively needful to enjoy the fresh air out of doors daily. Remaining much in the house increases the susceptibility to the disease. Thus it is best to accustom oneself to a cool temperature, because by warmth the skin becomes over sensitive, and predisposed to catarrhs. sthly. Make sure of a good night's rest. The greatest predisposition to the cholera exists after a sleepless night. Those who are called by their avocation to the bedside of a patient, should previously take some nourishment, and never allow themselves to be actually hungry. A little wine is here in place. Quite as important as the above rules by way of preventative, and even more important than they are, is the total absence of fear. All accounts agree in the fact that the cholera appeared more fearful at a distance than near by. Its contagion is more and more universally denied by physicians and laymen ; and most certainly if the disease is contagious at all, it is only so when at its height, and with those who are individually peculiarly predisposed to it. It has undoubtedly assumed a much milder character than it at first had. The intemperate either in eating or drinking, and the uncleanly, and the poorly and insufficiently clothed, those whose dwellings are wretched, and who partake of indigestible and unwholesome food, and those who have become dibilitated by a loss of humours, have most to fear. I will not here examine what sham the absence of fear may have in protecting those who rest in full reliance upon some preventive 13 OF CHOLERA. which they have taken, and thus escape. This has however no small influence. Still Ido not hesitate to recommend the preservatives indicated by Hahnemann and others. Faith commences, where reason ends. The greater the susceptibility for a disease, the more of course does that susceptibility incline toward it 3 and may be looked upon as a distant and slight premonition of the disease itself. If there were remedies which cure the disease specifically, the same remedies would naturally be capable of eradicating the peculiar susceptibility ; thus we should possess positive preservatives. The number of preservatives which have been recommended shows how universal the faith in them is. Most of them have originated in quackery. The old school has sought in vain for preservatives against other diseases, whereas the new school has discovered several. I need only instance Belladonna as a preservative against scarlet fever, and Patsatilla against measles ; and Dr. Marenzeller in Vienna has recently given to 50,000 persons Veratrum as a preservative against cholera with the most satisfactery results. Cow-pox preserves against the small-pox according to Homoepaathic principles. Homoepathy accomplishes all her cures in accordance with the principle, that diseases are most easily cured by such remedies as are capable of producing a like disease or similar symptoms in the healthy organism : a proposition which is verified by daily experience. If the disposition in the body to a disease is the g-erm, which requires the specific influence only from without to assume the character of that disease, then the remedies which are capable of curing the cholera specifically, must necessarily possess the property of removing the susceptibility or disposition to it : in other words they must act as preservatives. There are several drugs which produce in the healthy body symptoms similar to those of the cholera. These, therefore, not only cure the cholera more easily and completely than other remedies, but will also be found useful as preservatives. The propositions of the Homoeopath are based no less on experience than on analogy. 14 HOMCEOPATHIC TREATMENT I advise those who wish to employ the Homoepathic preservatives, to take each day a powder of Cuprum in alternation with Veratrum, and not to drink any thing immediately after it. But this prophylactic treatment should not be commenced until the cholera is in the vicinity ; if then in spite of it the disease should attack them, it would not do so in a violent manner, but assume a much milder character. HOMOEOPATHIC TREATMENT With reference to Homoeopathic treatment we must bring the Ist 3d and 4th forms of cholera into one category, and the 2nd and sth under another ; and regard the 6th as totally different from the others ; because in the latter all the cholera symptoms, excepting the obstruction of the circulation, and the visible pulselesness are absent and the asphyxia alone is a prominent symptom. In all cases of the Ist, 3d and 4th form, whether the cholera appears in the promonitory stage, or in the stage of full developement, we find the following main symptoms, either all combined in one and the same case, or appearing gradually, or at least partially. These symptoms are vertigo, and dizziness ; unsteady staggering gait as of a drunken man ; coldness, almost like that of marbJe; anxiety, which often reaches a degree of desperation ; thirst of the most violent -kind ; oppression of the chest ; difficulty of respiration ; burning in the stomach, as if from hot coals ; violent spasms ; aching pain in the abdomen ; cataleptic spasms ; cramps in the calves, toes and , fingers, and in the masseter muscles ; nausea, vomiting ; diarrhoea of white mucous, and sometimes, but rarely greenish water ; hoarse anxious voice ;, lividity of the countenance, hands and feet ; dark rings round the eyes ; hippocratic countenance ; cool or cold tongue ; finally, in the 3d stage convulsions. Hahnemann thought that the treatment of the Cholera could be successful only in the commencement when tonic spasms were noticed in all the spheres of the organism, but that it would be very difficult if clonic spasms appeared, accompanied by actual convulsions of single muscles, watery discharges from above and below, or discharges of blood. OF CHOLERA. 15 This is not the case . Subsequent experience has shown that Cholera patients can be saved by Homoeopathic treatment, even if medical aid was not sought until twenty or thirty hours after the attack commenced. In the commencement of the disease, camphor is a most valuable remedy, and Hahnemann considers it the only one in the first stage, characterized by langour, anxious expression, sunken eyes, lividity of the countenance, coldness of the face, hands, and feet, despair, anxiety with a sensation of choking, dizziness, hoarse voice, burning in the throat and stomach, cramp in the calves and other muscles, pain in the pit of the stomach, but absence of thirst, vomiting and diarrhoea. When the above symptoms should appear in a patient, he should be put into a heated bed, and two drops of spirits of camphor should be administered in a teaspoonful of water. This dose should be repeated every five minutes. At the same time he should be rubbed with the same solution of camphor on the arms, hands, legs and feet, as much as possible under the bed clothes ; and also an enema given him, consisting of a teacup of cold water, and two drachms of camphor spiritus. So long as the patient is not thrown into a perspiration, the friction with the camphor spiritus should be continued. It is also well to put a bit of camphor on a hot shovel from time to time, in case the patient's mouth should be closed by a spasm of the jaw, for the purpose of causing him to imbibe the fumes of the camphor by breathing-. If the pains in the epigastric and umbilical regions should be great, light compresses of linen, dipped in spirits of camphor should be laid on those parts. In proportion as the above named symptoms which indicate camphor should moderate, and improvement appear, the dose should be given at longer intervals, i. c. once in six minutes, next one in eight, ten and fifteen, until all the symptoms have disappeared, when the medicine may be discontinued ; but should the symptoms reappear, the camphor should be given again every three to five minutes, and be continued until the disease vanishes, and leaves no traces excepting weaknesss behind. But not only in the first stage of the disease, and by the above symptoms is camphor indicated, but likewise when vomiting, purging and thirst, (and thus the second stage) have made their appearance. In this stage also camphor is often sufficient to accomplish a cure. But in this stage ice water should be administered by the teaspoon 16 HOM CEOPATHk: TI!KA TM ENT on account of the thirst. It .frequently happens in the second stage that oomphor produces a great change for the better, and yet leaves behind a diarrhoea of a greenish watery liquid, which annoys the patient, reduces his strength, and is frequently followed by spasms, convulsions in the muscles of the face, fingers and toes. As soon as the spasms appear, which should be closely watched for, the camphor should be immediately discontinued and cuprum metallicum should take its place. In the second stage of Cholera, first third and fourth forms, provided there be no spasms present, but vomiting, diarrhoea, unquenchable thirst, utmost anxiety, and all the other symptoms described above, and characterizing the fullest development of the disease, the tincture of veralrum album will be found a reliable remedy, which has proved itself to be such in a countless variety of cases. Experience has moreover shown that veratrwtn is capable of removing all the symptoms in the first stage also, and of restoring the patient to perfect health, without the addition of any other remedy, rendering the employment of camphor unnecessary. The dose of camphor must be administered every five minutes, but vcratrum usually acts beneficially after the administration of a single dose. — This valuable remedy which like all others should be taken from some Homoeopathic physician, should be administered in a little water, or in the form of a powder dry on the tongue. Not till a quarter of an hour after the patient has received' the dose, (unless the thirst should be intolerable, when it may be in five minutes) the patient should receive a couple of teaspoonsful of ice water. He should be covered, but not too warmly, and be kept in a warm room ; no tea allowed, or any thing of a medicinal nature ; but the ice water may be repeated as often as the violent thirst should demand it. Under this treatment we may quietly abide the effect of the veralrum for an hour or two, meantime giving nothing but the small portions of ice water. Should diarrhoea, nausea and vomiting occur once or twice meantime, they will gradually disappear. A gentle warmth of the whole body, cheeks and tongue will return. Gentle perspiration will break out, sweat and quiet follow. Thirst and vomiting cease frequently in one half, one or two hours, rarely in three or four, accordingly as in the commencement of the disease or 17 OF CHOLERA. iater, say six, twelve or twenty hours, camphor or other fruitlessly employed remedies may have been given. Feratrum is the remedy which' according to all experience, is capable of bringing relief and salvation, even when after ineffectual resort to all other means, the patient should be on the brink of the grave, provided that no convulsions have appeared, but coldness, vomiting, &c, and rigidity, spasms and cramps were predominant.. If instead of the rigid tonic spasms, and the other symptoms, convulsions in the masseter muscles, fingers and toes are noticed, whether the other symptoms are improved or not, then cuprum metallicum is the most efficacious remedy, or cuprum ac. either of which should be resorted to, to the exclusion of all others; it should be given dry on the tongue, and washed down with a little water. The spasms frequently disappear after a single dose of this remedy. It frequently happens that after all the urgent symptoms of Cholera have been removed — and especially if the treatment has been by camphor — a diarrhoea of a greenish watery fluid remains, which disappears however, together with the spasms upon the employment of cuprum. If no spasms should be present, and consequently no employment of cuprum be indicated, and yet such a greenish diarrhoea remain after the removal of the other Cholera symptoms, or should such spasms have appeared and been quieted by cuprum, without a corresponding alleviation of the greenish diarrhoea, then phosphorus should be resorted to as in the second and fifth Cholera form, of which I shall speak hereafter. In the second point of view of the Homoeopathic treatment of Cholera, we find the second and third form, (as characterized by the symptoms of Choleradysentery,) and these two forms are embraced under the term of Cholerine, and are in fact Cholera with the symptoms of dysentery. The usual autumnal dysenteries have nothing in common in their nature with the Cholera-dysentery, because what is strictly called Cholera according to the totality of symptoms which I have given, frequently changes into Cholera-dysentery, and the latter again frequently into the former, whereas a transition of the common European autumnal dysentery into the genuine epidemic Cholera, or of the latter into the former doea not exist. The treatment for the two is also totally different. 3 18 HOMCEOPHTHIC TREATMENT Cholerine, so long as it retains its peculiar character, and does not change into the veritable Cholera, commences by a rumbling noise in the abdomen, apparently emanating from the region of the lower ribs ; this is soon succeeded by a diarrhoea, which is at first pappy, but soon becomes watery, greenish. The Cholera coldness does not generally appear. The tongue remains warm, but there is a general depression of the vital powers. The condition becomes nervous, and resolves itself either into an actual malignant typhus, or the genuine Cholera. Experience has shown that many such Cholerines, if neglected or injudiciously treated, there being no symptoms present excepting the diarrhosa, have changed into Cholera and rapidly terminated fatally in three or four hours, or killed the patient more slowly by typhus fever. Phosphorus or Phosphoric Acid are the remedies which control Cholerine. T had selected Phosphorus as the best remedy against this disease, long before I knew that others employed it, and was very much pleased subsequently to learn that Dr. Veit in Vienna had cured every case of Cholerine he met with by this remedy alone.. This remedy as well as Cuprum should be given in the third trituration, dry on the tongue, and not be repeated for twelve hours. — In the treatment of Cholerine likewise it is necessary to give (he patient an enema of ice water, a teacup full, with the yolk of an egg in it, as indicated by the symptoms once, twice, or thrice a day. These injections are very soothing to the patient ; at the same time he should receive ice water as a beverage in the small quantities mentioned above. All tea or other warm beverages should be denied the patient, excepting hot beef tea, in which there should be no vegetables or spices of any kind ; and the hot beef tea should be followed by cold injections to prevent its running off. In this manner, togecher with a moderately warm covering, the symptoms of Cholerine disappear in twelve, twenty-four or thirty hours as abundant experience has shown. The result is convalesence. There is neither transition into real Cholera, or Typhus fever, or relapse, or after-disease of any kind to be apprehended, if during convalesence the proper treatment is pursued. If the disease should last longer, and the pains in the abdomen be intolerable, if lienteria should 19 OF CHOLERA. set in, I recommend arsenic. Patients who are convalesent should be treated with the utmost care ; all external influences, such as grief, anxiety and anger should be carefully avoided, and the strictest diet be attended to. Warm beef tea is the best nourishment at the commencement of returning appetite, but care should be taken not to allow it to run off by the bowels. For the purpose of invigorating the stomach and bowels of a person recovering from the Cholera or Cholerine, it will be well to give him occasionally a small wine glass full of ice water, especially after partaking of hot broth. Gradually and cautiously gruel may be given, or chocolate without spice, or a spoonful of light good wine which is not acid ; but all this by way of experiment and in small quantities to guard against a relapse. On the fourth day only the appetite of the patient may be somewhat more indulged.* Under such treatment the third stage will seldom or never appear, or at least not in such a degree as to render all remedies fruitless by tho appearance of cold sweat in the face and complete agony. The third point of view for the Homcepathic treatment is the sixth form of Cholera. lam not acquainted with any cases which have come under Homoeopathic care. Hydrocyanic acid would probably be the sheet-anchor in this form, if given in the third trituration, and injections. We may likewiseexpect curative effects of Str ammonium 3, but most of all from Lachesis 12, injected into the jugular vein. But such remedies have not yet been tried ; Dr. Rummel's experience is that Secale cornutum of the 4th is very beneficial in the acute stage of Cholera, characterized by dizziness, anxiety, spasms or cramps in the calves, rumbling in the belly, nausea, diarrhoea, either of a brownish color, or watery w r ith white flakes, rapid prostration, sometimes coldness of the extremities. He has seen the diarrhoea vanish as if by a charm after a dose of Secale. These are the main features of the method which I shall resort to in case of the appearance of the Cholera. * If the Cholera or Cholerine should pass into Typhus, and this should be characterized by a generally increased sensibility of the whole condition, Bryonia 3, Rhus 3, CoeeiUu3 3, are the best remedies; against the nervosa stupida Phosphoric acid, and according to circum- stances Hydrocyanic acid ; and against intermittant, Arnica; China, Ipecac, and JVUr, 20 HOMCEOPATHIC TREATMENT OF CHOLERA. In conclusion I venture upon cautioning the younger members of our profession against the use of the high attenuations in so formidable a disease as Cholera, which 1 feel myself competent to do after twenty years practice of the new method. These emanations of medical transcendentalism are well L enough to amuse the fanciful theorist in his study, but should not be in the hands of the practical physician at the bedside, especially in diseases which threaten life.