HBBngaag HOMOEOPATHIC DOMESTIC MEDICIIE. BY J. LAURIE, M.D., MEMBER OF THE ROYAL COLLEGE OF SURGEONS, EDINBURGH. ■ ENIOR PHYSICIAN TO THE WESTMINSTER AND LAMBETH HOMOEOPATHIC MEDICAL INSTITUTION AND DISPENSARY. ARRANGED AS A PRACTICAL WORK FOR STUDENTS- CONTJAININGif , K % » "jTV ,\ 5'V\/" 1 IPC A GLOSSARY o£ ^lE^K&L, TERMS, r}Ai'«• ^eri" : /Hi Or! UH^s FIFTH AMERICAN EDITION, ENLARGED Afrp^IMPROVED, '. / ......Z_6 d :'')" j ' BY A. GERALD HULL, M. D. NE W- YORK: WILLIAM RADDE, 322 BROADWAY. PHILADELPHIA:—RADEMACHER&SHEEK, 239 ARCH-ST. BOSTON:—OTIS CLAPP, 12 SCHOOL-ST. ST. LOUIS:—FRANKSEN & WESSELHOEFT. 18 5 0. ✓ I ENTERED According to Act of t'oiiKrcas in the year 1847, by WILLIAM RADDE, III the Clerk's Office of the District Court of the United Statei for the Southern District of New-York. ■ . ITTDWIO AM) C«^PRl»TI»i, H.Y. PREFACE TO THE AMERICAN EDITION. The editor recommends laymen who make use of this book, to resort to lower dilutions in the treatment of acute attacks of dis- ease in preference to those set down in the text. For example : where Aconite, Belladonna, or Chamomilla of the 24th or 30th attenuation, are prescribed by Dr. Laurie, the editor would put one drop of the tincture of either of these remedies in a tumbler full of water and give a tablespoonful at a time ; but in chronic maladies the editor earnestly recommends the doses set forth in the text. The editor considers the tinctures, and the first, second and third, dilutions, when used in water, as nearly of the same medical power; perhaps, however, it is best to put two or three drops of these dilutions to the tumbler of water when they are applied in the place of the tinctures. When the triturations are contained in a medi- cine chest,—instead of the higher dilutions, which are preferred to them,—one grain of any of them can be dissolved in a tumbler of water, and used as above indicated. In general, it may be best to repeat the doses of these solutions at the same intervals of time as are prescribed in the work; but the editor respectfully suggests, that in very severe cases of acute diseases, as in convulsions, or rapidly exhausting diarrhoea, or hemorrhage, it is proper to make the intervals much shorter than the author prescribes. It is quite probable that the water solutions can be repeated at shorter intervals, ceteris paribus, than the pel- lets or powders ; and for this reason physicians often dissolve the pellets themselves in water, and repeat the spoonful doses twice or thrice as frequently as they would give them dry. IV PREFACK TO THE AMERICAN EDITION. The editor's mode of using this work in acute diseases, then, ia to put one drop of the tincture, or two drops of a first, second, or third dilution, into a tumbler of water, and to administer of this so- lution a tablespoonful to an adidt, and a traspoonful to a child as a dose. Or, again, when a trituration (a dry powder) is preferred, to stir one-third of an ordinary penknife blade full (about equal to one grain in weight) of it in a tumbler of water, and use the same doses. Ami finally, when the pellets are good, and are preferred by the prescriber, the editor recommends that five or six of them be dis- solved in a tumbler of water, and that they be repeated twice as frequently, as a general rule, as the dry pellets are ordered in the text. The water should be very pure, and the glasses and spoons should be scrupulously cleansed before using them for medicines. In all instances of additions made to this volume by the Ameri- can editor (as, indeed, with all the foreign works edited by him), where he has not specified his own experience or given the au- thorities, he wishes to be understood to have compiled the same from the best practical results of the school at large, without formal signs of quotation. A. G. H. PREFACE TO THE THIRD EDITION. From the favourable reception, and the rapidity of sale, of the last edition, the Author at first contemplated making little or no alteration in the contents of the present one, concluding that the aforenamed circumstances might be held as satisfactory indications that the work had been found sufficiently copious for domestic purposes. As, however, on the preceding occasion, he entered upon the experiment of bringing out the work in such a form, that it might prove of some slight service to the medical man com- mencing to make a practical inquiry into the homoeopathic system, and having since had reason to determine that his hopes have not been disappointed, he has on that account been induced to change his original intention, and will feel amply rewarded for the addi- tional labour which he has bestowed, should he thereby be the means of leading an increased number of his professional brethren to become converts to the all-important reformation in medicine effected by Hahnemann. In compiling this, and the past editions, the Author has derived considerable aid from Jahr's 'Manual' (Nouveau Manuel de Me- dicine Homceopathique), and Hartmann's Acute and Chronic Dis- eases, as also from Constantine Hering's ' Hausarzt,' or Domestic Physician. It being impossible to give minute and infallible directions for the treatment of all the various forms that diseases, even of daily occurrence, are so liable to assume, the author has added, at the termination of most of the chapters, a few of the medicines which the medical reader may, in many cases, either complicated or otherwise, find useful to refer to in the Materia Medica and Chro- nic Diseases of Hahnemann, — which every student who wishes to acquire a proper knowledge of Homoeopathy ought to possess, and make a constant habit of carefully studying and consulting, if he wish to avoid falling into an indolent and unsafe method of practice. J. L. 12 Lower Berkeley Street, Portman Square. PREFACE TO THE SECOND EDITION. In offering to the public a Second Edition of this work, of which an impression of upwards of one thousand copies has been sold in less than eighteen months, the Author feels that a few words of explanation are required. On a comparison with the first edition, the reader will find a great number of serious and acute affections added, some others more deeply entered into, several alterations in the potencies prescribed, and more explicit directions given for the administration and repe- tition of the different remedies. When the Author first committed this work to the press, it was simply intended to be, what its name implied, a Treatise on Domestic Medicine, by which individuals might be enabled to treat themselves or their families in slight affections, or even, in case of necessity, in more serious diseases, subject to the restriction mentioned in the preface to that edition. Since that time, however, the Homoeopathic system has been daily attracting more attention from the medical world, and the want of a work which might serve for a practice of Physic for be- ginners, has been repeatedly a subject of complaint. In order partially to supply this want, the Author has materially added to the number of diseases treated, and prescribed the potencies found most useful in practice in the more severe forms of disease ; he has also given the book a more medical character by the addition of the diagnosis of disease, causes, &c, and the employ- ment of medical terms; but in order not to interfere with the utility of the work, a glossary has been added for the non-profes- sional reader. The non-medical public who confine themselves to their proper sphere, viz., the treatment of slight and ordinary ailments, will still find this Treatise useful as a Domk.stic Medicine ; in such cases the globules at medium and high potencies are amply sufficient. It may be remarked, moreover, that the globules are much better adapted for keeping than the tinctures, and, with proper precautions, will retain their medicinal virtues for viany years. At the request of several friends, directions have been given PREFACE. VII for the administration and repetition of the medicines in each disease; some remarks, also, are made upon this important point, in the Introduction, to which, and the article upon the Potencies of the medicine, the attention of the reader is particu- larly requested. PREFACE TO THE FIRST EDITION. In presenting this little work to the public, the Author may be allowed to state, as briefly as possible, the motives that have led him to the undertaking. Of these, the principal are, the present paucity* of homoeopathic practitioners; the refutation, by a plain statement of the treat- ment of acute disease, of the too prevalent idea, that Homoeopathy is available only in Chronic affections ; and the hope that this work may, under proper restrictions, prove of service in cases of ordi- nary derangement, or where the advice of a homoeopathic physician is unattainable ; and by assisting in the selection of the proper re- medy, save many from having recourse to allopathic modes of relief, such as aperients, &c-, which are so calculated to under- mine the strongest constitution, and convert trifling affections into permanent maladies. From the first-mentioned motive, (the present want of homoeo- pathic practitioners,) the Author has found himself compelled to include many acute diseases, which fall more particularly within the province of the physician ; in so doing, he has given a range of treatment that will meet a great variety of cases, and in almost all so far obviate immediate danger, and place the malady in such a position, as to give time, when imperatively necessary, for seeking suitable advice. In cases that require prompt and decided measures, such as " Convulsions," " Croup," &c, the treatment has been pretty fully * I have sincere gratification in remarking, that even since the first publication of this work, this want has been, to some extent, dimin- ished, by the great number of medical converts who are daily join- ing our ranks, and whose extensive practice, wherever they have settled, holds out most cheering prospects for the future. Still, in many of the great towns and densely-populated districts of this empire, as well as in our possessions abroad, a homoeopathic practitioner would be eagerly welcomed. Much has been, but more remains to be done.— Author. viii PRETAOE. gone into. In others, such as "Inflammation of the Train and Lungs," the course to be pursued to ward off all immrdiate danger, has been briefly, but it is to be hoped, clearly pointed out. Other acute or dangerous maladies, silch as " Puerperal Fever," " Phleg- masia Alba Dolens," (puerperal tumid leg,) "Epilepsy," "Can- cer," eve, have been slightly glanced at, or wholly omitted ; con- vinced, that to do justice to their several treatments, would carry the work far beyond its intended limits and purpose, and that an imperfect sketch would be rather productive of injury than benefit. In many instances Domestic Medicines do considerably more harm than good, by inducing individuals to rely too fully upon their own resources, and to omit having recourse to those who have made the diseases of mankind their peculiar study ; but still greater injury results from an ill-regulated perusal of elaborately written medical works, which require the previous education of the physician fully to comprehend, and his practical experience pro- perly to apply. To the Student, still at the threshold of our science—to the Allopathist, willing by fair experiment to put the system to the test — it is hoped that this little work may prove peculiarly valuable. It may be here remarked, that the beautiful simplicity and har- monious uniformity of the homoeopathic system, conjoined with its invariable rule of administering only one medicinal substance at a time, have misled many into tha idea, that it is so much easier of practice than the old system, as scarcely to require the qualification of a medical education ; acting upon these false premises, many amateurs, after having studied a few of the leading medicines, al- though wholly destitute of other physiological or pathological knowledge, imagine themselves qualified to prescribe for every va- riety of ailments, and their presumption is generally in exact ratio with their ignorance. No doubt, from the inherent excellence of the system, some of these zealous individuals have cured diseases that have defied allopathic mode : but generally, from the absence of a medical education, and of a perfect knowledge of the Materia Medica, by a circuitous route ; whereas the practised mind of the physician, frequently detecting the exact nature of the disease, and at all times carefully discriminating the primary from the purely sympathetic, or secondary symptoms, is thereby enabled to make a more ready selection of a specific remedy, and save the patient from a course of needless suffering. If such be the case in Chronic, how much more so in severe PREFACE. IX and complicated Acute diseases ; such, it is evident, no individual, not fully competent, should take upon himself the serious respon- sibility of treating, unless coerced by an imperious necessity, and then with the closest attention to, and most minute observance of, the symptoms. Under such conditions, the Author hopes that this work may prove useful; and when the symptoms are perfectly in accordance with those given under the different medicines, the administration of the latter will be always marked with decided benefit. In conclusion, it may be observed, that from the unfair impres- sions of the science, that have been so industriously propagated, Homoeopathy has been too frequently treated as a species of char- latanism, to which people resort only when every other mode of promised relief has utterly failed. After enduring with patience a long and ineffectual treatment under the old system, they feel disappointed if Homoeopathy does not work an immediate cure ; nay, in acute diseases, when danger appears to threaten, some individuals fall back upon allopathic measures, and undo all that the Homoeopathist has effected : perhaps again seeking his as- sistance when the mischief has been rendered irremediable by their own fatuity. Others, who have seen members of their fami- lies (whose diseases were beyond the power of medicine) die dur- ing homoeopathic treatment, reproach the science with failure; whereas their minds would have felt perfectly satisfied, had such a misfortune occurred under the old system ; forgetting that, in many instances, the patient only sought Homoeopathy as a last resource, in cases where the affection was of its own nature incurable, or had been rendered so by a long course of improper treatment. What Homoeopathy stands upon, is the simple fact of success in thousands of cases, in which every other mode has signally failed—upon the firm and irrefragable basis of a multitude of un- impeachable and incontrovertible proofs. Xll CONTENTS. Ulcerated Sore Throat. Angina maligna . Mumps. Parotitis. Angina parotidea Bilious Complaints Indigestion Dyspepsia Want of Appetite. Apepsia. Anorexia Derangement of the Stomach, Eructations, &c. Flatulence .... S|>umii^ of the stomach. Gastrodynia, Cardialgia Heartburn. Pip-osis Vomiting of Blood. Hematemesis Constipation. Obstructio Alvi Piles. 1 Itmorrhoids .... Protrusion of the intestine. Prolapsus Ani Colic. J-'nliralgia . . . . Looseness of the Bowel*. Diarrhata Dysentery. Dysenteria Suppressed Dysentery Cholera . >«fc-----Asiatic • f» > tnolcrinc ..... Liver Complaint Acute Inflammation of the Liver. Hepatitis . Liver Complaint. Hepatitis chronica Jaundice. Icterus .... Inflammation of the Spleen. Splenitis Inflammation of the Stomach. Gastritis Chronic ditto. Gastritis Chronica Inflammation of the Bowels. Enteritis Inflammation of the Peritoneum. Peritonitis Inflammation of the Kidneys. Nephritis Inflammation of the Bladder. Cystitis Worms. Helminthiasis S<) !»:! ib. 101 107 110 112 119 119 123 I2.S 132 13:5 137 111 148 149 152 155 ib. 156 160 161 162 165 168 168 175 177 180 181 DISEASES OF ORGANS CONNECTED WITH THE RESPIRATORY SYSTEM. Catarrh, or Common Cold Hoarseness.*" Raucitas Chronic Laryngitis. laryngitis chronica . Cold in the Head ...'*.. Cough Hooping-cough. Tussis convulsiva Croup. Angina membranacca . Influenza . Determination of Blood to the Chest. Congestio ad Pectus Inflammation of the Mucous Membrane of the Bronchial Tubes. —■---=■ Bronchitis . -------Bronchitis Chronica Inflammation of the Lungs. Pneumonia, Peripneumonia, Pneumo- nitis . ■ i w 187 191 193 ib. 196 204 210 219 221 225 232 234 CONTENTS. X1U Pneumonia Notha Occulta Typhoid, or Congestive Pneumonia Consumption, or Incipient Phthisis Inflammation of the Pleura. Pleurisy, Pleuritis Pleurodynia. Pseudo-Pleuritis Spitting of blood. Hemoptysis DERANGEMENTS OF THE CEREBRAL SYSTEM. Determination of the Blood to the Head. Congestio ad Caput Apoplexy. Apoplexia . . • • ■ Inflammation of the Brain and its Tissues. Brain Fever. Phrenitis Encephalitis ...... Tetanus ...•••■ CUTANEOUS DISEASES. Rose. Erysipelas Furunculus malignans. Pustula nigra St. Anthony's Fire. Boil. Furunculus Carbuncle Anthrax Chilblains. Perniones Corns. Clavi pedis Abscess. Itch. Scabies Whitlow. Panaris. Paronychia Initation of the Skin Ringworm. Herpes circinnatus Ringworm of the Scalp Ulcers GENERAL DERANGEMENT OF THE SYSTEM. Gout. Arthritis ...... Rheumatism. Rheumatismus . Lumbago ..••••' Inflammation of the Psoas Muscle. Psoitis 4. Sciatica . . , • Pain in the Hip. Coxalgia, coxagra . Hip-disease. Morbus coxarius • Determination of Blood to the Abdomen. Congestio viscerum abdomi- nis, congestio ad abdomen . • • • Acute Inflammation of the Eyes. Ophthalmitis Short Sight. Myopia. ■ Swelling of the Lip • • • • Scirrhus ..•••• Warts on the Face . Hordeolum, Stye . • • • Inflammation of the Ears, and Ear-ache. Otitis, otalgia Bleeding of the Nose. Epistaxes . Swelling of the Nose • Canker of the Mouth. Cancrumoris . . . . 239 240 241 242 251 252 260 266 271 276 280 283 285 ib. 287 2S8 291 293 294 296 297 301 307 310 314 315 316 318 320 323 324 331 ib. ib. 332 ib. 333 337 340 343 XIV CONTENTS. Inflammation of the Tongue. Glossitia Offensive Breath Face-ache. Xuiralgia facialis Palpitation of the Heart Cramp in the Legs Goitre Sweating Feet Sleeplessness. Agrypnia Nightmare. Incubus Acute Inflammation of the Spinal Cord and its Membranes. Palsy. Paralysis_ ■ Rupture. Hernia Fainting. Swooning. Syncope Headache. Cephalalgia Pains in the Loins. Xotalgia Delirium Tremens Potatorum Epilepsy. Epilepsia Asthma Myelitis CASUALTIES. Concussion, Bruises, Sprains, and Wounds, &c. Burns and Scalds Fatigue Stings of Insects . Sea-Sickness Apparent Death. Asphyxia Hydrophobia Poisons Mental Emotions PART III. TREAIMENT OF INFANTS AND CHILDREN, AND OF THEIR PECULIAR AFFECTIONS. Introductory remarks Treatment after Birth Asphyxia Swelling of the Head Navel Rupture in Infants Meconium. Expulsion of Suckling of the Infant Choice of a Nurse Diet during Nursing Supplementary Diet of Infants Duration of Suckling and Weaning Sleep. Sleeplessness Exercise CONTENTS. XV DISEASES OF INFANCY. Inflammation of the Eyes in New-born Infants Hiccough .... Cold in the Head Crying and Wakefulness Regurgitation of Milk Spasmodic Asthma Milk Crust .... Thrush, or Aphthae Constipation. Obstructio alvi neonatorum Bowel Complaints Diarrhaa neonatorum Excoriation Excoriationes neonatorum Jaundice. Icterus neonatorum Induration of the Cellular Tissue. Erysipelas neonatorum Lockjaw of Infants Trismus nascentium Derangement during Teething i n va lsion s in Children Water in the Head. Hydrocephalus Asthma of Millar The Rickets Rachitis Infantile Remittent Fever Atrophy. Atrophia. Vaccination 458 458 459 460 462 463 464 466 467 468 474 474 475 476 478 480 484 486 488 ib. 493 494 PART IV. TREATMENT OF FEMALES AND THEIR PECULIAR AFFECTIONS. Chlorosis. Emansio mensium . . . . 495 Amenorrhoea. Suppressio mensium . . . 498 Menorrhagia . .... 499 Dysmenorrhoea ..... 501 Hysterics. Hysteria . . ... 501 OBSERVATIONS ON PREGNANCY. Introductory remarks ..... 503 Air and Exercise ..... 505 Clothing . • • • -506 Diet . .... 508 Employment of the Mind and Habits . . . ib. Influence of External Objects upon the unborn Infant . . 509 Mental Emotions . . . . ib. DERANGEMENTS DURING PREGNANCY. Menstruation . . ... 511 Morning Sickness ..... 512 Constipation • ... 513 Diarrhoea .... . ib. Fainting and Hysterie Fits ... 514 XVI CONTENTS. Toothache Swelled Face Swelled Veins. Varices Pains in the Back Miscarriage. Abortus TRKATMKN'T BEFORE PARTURITION. Preparation of the Breasts Remedies before Labour False Pains Parturition Tedious or complicated Labours Spasmodic Pains, Cramps, and Convulsions TREATMENT AFTER DELIVERY. Introductory remarks After-pains Duration of Confinement 515 516 517 518 ib. 524 525 526 528 528 531 532 534 535 DISK ASES FOLLOWING PARTURITION. Suppressed Secretion of Milk Excessive Secretion of Milk Perspiration after Delivery M.Ik Fever Irregularities of the Lochial Discharge Diarrhoea in Lying-in Women Abdominal Deformity ("idling offof the Hair Leucorrhcea after Parturition Internal Uterine Swelling and Prolapsus Weakness after Delivery OBSTACLES TO SUCKLING. Disinclination of the Infant Excoriation of the Nipples Inflammation of the Breast Mental Emotions affecting the Milk Deficiency in the Secretion of Milk Deterioration and Discoloration of Milk Mothers wot Slckli.vg their Children Glossary Index 536 537 537 538 540 541 542 543 ib. 543 544 545 546 547 518 548 549 ib 550 562 N B— young meats—such as veal, lamb, &c.; and among poultry, ducks and geese—had better be avoided, particularly when derangement of the digestive function exists. Beef, mutton, venison, and most descriptions of game, if not too long kept (high), pigeons, larks, rabbits, are allowable at discretion. (Vide Synopsis.) Ham, and neats' tongues, under certain restrictions. Fish is a wholesome article of diet, and may in most cases be partaken of without scruple, with the exception of the olea- ginous species, such as eels, salmon, &c, or shell fish, as oys- ters, lobsters, &c. Eggs, raw, or soft boiled; butter, if free from rancid or un- usual taste ; cream, plain unseasoned custards, and curds. Stimulatinir soups and made dishes are so evidently opposed to homoeopathic regimen, as scarcely to require further notice. Beef-tea, veal, or chicken broth, &c, thickened with rice, mac- caroni. or sago, and seasoned merely with a little salt, are of course allowable. * The idiosyncrasies in some individuals in respect of diet are very remarkable; as for example, some cannot take the smallest quantity of milk without serious inconvenience : others throw out a rash after par- taking of fish ; and, again, others loathe the very sight of animal food. These peculiarities should not only be attended to in prescribing a suitable course of regimen, but should also be tnken into account in the selection pf the remedied. RF.GIMKN. 3 Among vegetables, all of a pungent, aromatic, medicinal, or indigestible description, or greened with copper, are prohibited; such as onions, garlic, eschalots, asparagus, radishes, horse- radish, celery, parsley, mint, sage, mushrooms, tomatoes, beets, artichokes, parsnips, etc. ; but others free from such qualities, such as potatoes, French beans, green peas or beans, cauli- flower, spinach, seakale, etc., may be used with the needful pre- caution of avoiding any particular article of diet, whether of the animal or vegetable kingdom, that may seem to disagree with the individual. Lemon or orange-peel, laurel leaves, bit- ter almonds, peach leaves or kernels, fennel, aniseed, marjoram, are objectionable; acids, and the ordinary condiments, such as pepper, mustard, pickles, etc., and salads, ought either to be sparingly partaken of, or entirely abstained from, particularly by the dyspeptic. Salt and sugar in moderation are admis- sible. Acid or unripe fruits are clearly objectionable, and even ripe fruits possessing little or no acidity, if fresh, or prepared by cooking, such as peaches, raspberries, sweet cherries, grapes, and dried or preserved fruits, as figs, prunes, apples, pears. should be used in moderation, particularly by dyspeptic indi- viduals ; and by those subject to colic or diarrhoea, not at all. Cold fruits, such as melons, and raw vegetables, such as cu- cumbers, etc., are inhibited; nuts of every description are forbidden. All kinds of light bread and biscuit, free from soda or pot- ash and such like, not new-baked; also simple cakes com- posed of flour or meal, eggs, sugar, and a little goo.d butter; or light puddings, such as bread, rice, sago, semalino, with- out wines, spices, or rich sauces, are admissible: but coloured confectionary, pastry, and also honey, are not so. Regularity in the hours of meals should be observed, and too long fasting, as well as too great a quantity of food at one time, should be avoided. During fevers and inflammatory affections, the patient must of course be kept upon a low regimen: gruel, barley-water, etc.; and at the commencement of convalescence a light pud- ding', with a little weak beef-tea or mutton or chicken broth, 4 INTKunrCTToN should form the whole of the nourishment given. Nature, however, is our h, st guide; and when she takes away appetite, thereby intimates the necessity of nut taxinjr the digestive functions. CLOTHIN remark upon the impropriety of wearing garments impervious to air, and fitting cl'sclv to the shape, and the custum of exposing the extremi- ties and ehe.-ts of young children to the chilling atmosphere of our peculiarly variable and humid climate, under the absurd idea of making them hardy. The evil consequences arising from the check given to perspiration, by the first mentioned practice, are too well known to require any particular com- ment; but as the other is an error widely prevalent, I consider it my duty to mention it; and feel assured, that if mothers will only reform their system, and clothe their children in a more rational manner, they will make no slight advance towards the prevention of serious affections, not only during childhood, but in after life. Linen, cotton, or even leather, worn next to the skin, is generally preferable to flannel. As regards habits, it may be briefly observed, that a syste- matic course of life, avoiding ill-ventilated apartments, late hours, dissipation, over-study, anxiety, and other mental emo- tion, and taking sufficient air and exercise^ are the best pre- servatives of health. The frequent use of hot-baths is injurious, and liable to re- tard the cure uuder homoeopathic treatment. The idea that sea. bathing is almost universally beneficial is exceedingly erro- neous ; there are many constitutions on whom it produces far other than a salutary effect. Medicated baths, either natural or artificial, are, it is scarcely necessary to observe, strictly forbidden. Bathing the whole frame daily with a sponge or wet towel, with cold or scarcely tepid water, and the use of the flesh-brush, are by no means objectionable, and frequently in- deed strongly to be recommended. POTENCIES OF THE MEDICAMENT8. 5 The use of any medicinal or aromatic substances in the arrangement of the toilet, such as camphorated or otherwise medicated dentrifices, lip-salves, smelling salts, or cosmetics, is detrimental to the action of the medicines, and had there- fore better be avoided. The deleterious gas that flowers emit during night, renders their presence in bed-chambers highly reprehensible. POTENCIES OF THE MEDICAMENTS. In homoeopathic practice there are three points which merit the most particular attention : the first and principal is the choice of the proper remedy ; the second the potency at which it should be exhibited, and the third its adminislration and repetition. I shall now proceed to the consideration of the second; the selection of the potency, attenuation, or dilu- tion, and give such directions as may serve for a guide in general cases, premising at the same time that much depends upon the discrimination of the administrator, and that it is im- possible in this case to give any rule to which there are not exceptions. The principal points to be attended to are, the susceptibility of the patient to medicinal influence, how far modified by cir- cumstances, the age, sex, temperament, and habits—the dis- ease itself, and further, the nature of the medicament em- ployed. As regards the first, the susceptibility of the patient, we find four classes: First class. Those who are comparatively insensible to medicinal influence, particularly at high potencies, upon whom the medicines show neither marked action nor re action. Such individuals are generally of what is denominated the leu- co-phlegmatic temperament; they require generally low po- tencies and frequent repetition—such cases are not without their parallel in allopathic practice. Also, in disease, we find some persons who appear to enjoy a peculiar exemption from infections and even contagious influence. To this rule, how- ever, of giving the low potencies in such cases, there-are ex- e INTRODUCTION. ceptions : I have found in practice, after a careful study of the individual, and a selection of a remedy suitable to tempera- ment, a marked action and re-action produced by .a very high potency, where a lower of the same medicament had failed to elicit any apparent effect, and rice versa. Second class. A marked susceptibility to medicinal action without a corresponding reflex action : such patients are gene- rally of a highly nervous temperament, exceedingly difficult to treat, and require particular study ; here the higher potencies are generally called for, although we frequently find benefit in resorting to the lower. Third class. Those in whom no marked or a scarcely per- ceptible medicinal action declares itself, but a well-marked re- action ; in such cases we must be guided by other indications in the selection of the potency; watch the effect carefully, and avoid too frequent a repetition. Fourth class. Those in whom the medicines show a well- marked action and re-action ; here, also, we must be guided by other circumstances in the selection of the potency, so as to ob- tain the greatest possible benefit without materially increasing the sufferings of the patient. We generally find a particular susceptibility to medicinal in- fluence, at any potency, in persons dwelling in the country, of robust frame, simple habits, and regular lives, who are not sub- ject to any peculiar dyscrasia. In towns, particularly in large, densely-populated cities, this susceptibility is greatly developed, but the re-action less evident; however much depending upon the individual's employment, habits, and pursuits, it is difficult to give any fixed rule. Age. In infancy and early childhood, we find a marked re- ceptivity to medicinal influence, a decided action and speedy re- action, consequently the higher potencies are the most applicable in their diseases, and they rarely require so frequent a repeti- tion ; however, in acute diseases of any of the more noble organs, we may exhibit lower potencies, particularly of some of the less energetic medicines : for example, Sambucus, Ferrum, Ipecacu- anha, Chamomilla, etc., a globule constituting the maximum THE MEDICAMENTS. 7 dose. Some further remarks upon this subject have been made in Diseases of Infancy. Sex. Females, for the most part, possess a higher degree of susceptibility than males, in which they approach nearer to children; for them the higher and medium" potencies are gene- rally most suitable; to this rule, however, there are many ex- ceptions, particularly in those who are engaged in laborious em- ployments. Temperaments. In the Sanguine temperament, there is considerable susceptibility to all the potencies, and a speedy re- action. In the Nervous, we find great susceptibility, sometimes without an equivalent re-action: here we should be cautious in administering, and generally use the higher potencies. In the Bi im/y, there is generally but little susceptibility, but the re- action, when roused, is powerful and prolonged; hence a neces- sity for low potencies, generally given at long intervals. The Lymphatic being the least susceptible of all temperaments, the medicines may be given at low potencies, and frequently repeat- ed till some effect is produced. Since these temperaments often occur in a mixed form, the rules above given must be modified accordingly. I may observe that the remarks above made refer principally to chronic and subacute diseases. The Disease. In severe acute diseases I am generally in the habit of resorting to the low potencies, and in tinctures, from the circumstance that I have usually found them more certain in their effect in such affections. In the cases of children, an exception may be made, as already observed. In ordinary cases the. best range is from the third to the twelfth potency j this rule should, of course, be modified according to the remedy itself, the disease, and the individuality of the patient. The Nature op the Remedy. Medicaments which in their crude state possess little or no appreciable medicinal property, but whose virtues have been developed by trituration 8 INTRODI'l'TION. and segregation of particles, such as Lyroj indium, Natrum muriaticum, Calcarea carbonica, Sepia, Carbo rcgilabi!is, Si- licea, etc., should generally be used at the higher potencies. Others also which have been found from experience to display considerable efficacy, even when greatly attenuated, such as Phosphorus, Sulphur, Lachesis, Acidum nitricum, Arsenicum, etc. On the contrary, some which have a short-lived, but well- marked action, may be used in some cases in the original substance; for example, Moschus, Valerian, and Camphor, but in exceedingly small doses. Others again have been found most useful at the first, second, or third potency, such as Tartarus emeticus, Ferrum, Ipecacuanha, Hepar sulphur is, Stannum, Rhus toxicodendron, Opium, and in many cases Cin- chona. Still, all these remedies in peculiar cases act well at the higher. Throughout this work I have given a variety of potencies, specifying those which the nature of the affection treated of seemed to require; but I beg it to be understood that I by no means insist upon a strict observance of what I have laid down, for it is undeniable that when a remedy is correctly chosen, whatever may be the potency, it will in most instances be fol- lowed by the desired results. From the tenor of the foregoing remarks, however, as well as from what will be found stated under the succeeding paragraph, the importance to practitioners and others who make an extensive use of the homoeopathic remedies, of being in possession of several potencies of nearly every medicine, will be rendered sufficiently obvious. In highly perilous acute affections, and, indeed, in all cases, our great point is to obtain as speedy an effect with as little suffering as possible; and when the physician succeeds in effecting this, he may rest satisfied with himself, even although it was by the as- sistance of a low potency, of a powerful drug, and given in drops. But I must warn the tyro in our system not to imagine that because with a minute dose he has done much, that by increasing it he may do more; the faults of most beginners is to fly too hastily to very low dilutions, and repeat too frequently —patience, coolness, firmness, and attentive observation, are ADMINISTRATION. 9 necessary to make a good homoeopathist. For my own part, I consider the whole range, from the first attenuation to the thir- tieth, and eren upwards* useful, according to the nature of the case, and the properties of the remedy, and moreover, that a rigid adherence to any particular dilution in all instances, savours rather of the empiric than of the professor of a liberal art. ADMINISTRATION AND REPETITION OF THE MEDICINES. Upon this subject I will offer a few remarks, premising at the same time that it is almost impossible to give any general rule that will serve in all cases, much more depending upon the * Hahnemann, in his lattir years, was much in favour of an extension of the scale of potencies ; and Grosse and other continental homceopath- ists of repute have recently spoken strongly of the striking results obtained from Arsenicum and other medicines at the 200th and even the 1800th attenuation ! Their opinions and recommendations, being derived from experience, are at all events well worthy of considerate attention and careful investigation, whatever the material-headed reasoners may say to the contrary. If tinctures are used, put one drop, or three or four drops of the first dilution, into a tumbler full of pure rain water, (or spring water, if very pure,; and give of this solution a teaspoonful for a dose, which is to be re- peated according to the rules. The dose may be increased to a dessert or tablespoon, or even more, if the patient be of a strong bodily constitu- tion, and especially if he be of an insusceptible temperament.—The dose is one or two grains of the powdered remedies, according to the strength and susceptibility of the patient ; and this quantity is to be mixed with twice or three times as much powdered sugar of milk. A grain is about as much as will lie on the point of an ordinary penknife blade. In cases of doubt, as to which of two or three remedies, named in this book in any given case, ought to be applied, we recommend a resort to Jahrs New Manual of Homoeopathic Practice. Turn to the Clinical Chapter, (al- ways in Vol. II ,) which precedes the tabular exposition of the effects of medicines upon the part affeated in the case, and find the disease under which the patient is labouring; this chapter alone will often contain the desired information. But if it do not, the table following the Clinical Chapter must be studied, and if this do not suffice to determine the choice satisfactorily, the notices of the remedies in question contained jn first volume may be read. 10 INTRODUCTION. discrimination of the administrator, and a careful ubservaneo of the symptoms, than routine. However, throughout this work I have given directions for the exhibition and repetition of each medicine ; these are in- tended, of course, to be modified according to circumstances, not blindly adhered to ; the following observations may, there- fore, prove useful: In acute diseases, we must carefully watch the symptoms, and when we feel a-sured we have chosen the proper remedy, if no perceptible medicinal aggravation or amelioration declare itself, but the disease seems to gain ground, repeal the medicine. In cases of high inflammatory action, Aconite has sometimes to be repeated every two hours, hour, or even less. If a medicinal aggravation take place, followed by ameliora- tion, we must let the medicine continue its action, until the amelioration appears to cease, and the di-easc again make head; if new symptoms set in, we must then have recourse to the medicine thereby indicated. Should, however, no per- ceptible medicinal aggrara'ion take place, but an amelioration follow, we may safely await its approach to its termination, ere we again administer. If any symptoms remain, from the remedy fiiX selected having afforded only partial relief, we must have recourse to some other medicine which seems best fitted to meet them; but refrain from changing the remedy as long as benefit results from ils employment. In chronic, sub-acute, and indeed almost all cases, when a very striking improvement takes place, it will generally be found advantageous to cease to administer the medicine as long as the improvement continues, and only to repeat as soon as the slightest symptoms of activity in the morbid phenomena re- appear. But when a sudden or marked improvement of com- paratively short duration follows the first dose of a remedy, and, on repeating the dose, the, symptoms of the complaint in- crease instead of subsiding, as they did in the first instance, it may be concluded that the medicine does not answer, and that another must accordingly be had recourse to, iu the selee tion of which it will be necessary to choose one related to the remedy first prescribed. ADMINISTRATION. 11 The distinguishing of the medicinal aggravation, from that of the disease, being a point of material consequence, we will here give the usual characteristics of each. The medicinal aggravation comes on suddenly and without previous amelio- ration; the aggravation of the disease more gradually, and frequently following an amelioration. Moreover, in the former, several of the medicinal symptoms, some of which we may meet under the indications for the remedy, and not before remarked, declare themselves. I feel I cannot lay too much stress upon the necessity of carefully watching the effects of each dose, as in addition to the temporary aggravation of the symptoms which sometimes sets in, a development of collateral or pathogenetic signs occa- sionally takes place, particularly after frequent repetition of different remedies in susceptible patients : by a want of atten- tion to this important point, we may incur confusion, and may be unconsciously treating a medicinal disease of our own creation. Such, unhappily, but too frequently occurs in allo- pathic practice, from ignorance of the real properties of the drugs employed. We must also guard against falling into the opposite extreme, and allowing the disease to gain head un- checked. Slight diseases are often removed by a single dose of well- chosen medicine, but more severe and deeply-seated disorders require a frequent repetition. In severe acute affections, we may often repeat the same medicine at the same dose, at regular intervals, as long as it does good ; but this rule has many exceptions, and the direc- tions already given at the commencement of this article should be borne in mind. In chronic cases, by a long-continued administration of the same medicine, the patient often becomes less susceptible; in such instances, if the improvement remain stationary, or pro- gress slowly, we may gradually increase the dose, or, still better, give at suitable intervals some other remedy or remedies of as nearly analagous medicinal properties to that first administered as possible, and then return to the original remedy, if needful; if, on the other hand, decided amelioration follows each adminis. 12 INTRODUCTION. tration, wo should allow a longer interval to elapse before repeating, by which means the system gradually recovers itself, and the susceptibility to the medicinal influence remains unim- paired until the cure is completed. In rare cases, this susceptibility increases; in such instances a higher potency should be selected,—provided the remedy still appears to be appropriate,—and the intervals between the exhibitions lengthened. This occasionally occurs when the medicine has been frequently repeated, and given in solution. When the beneficial effect of a medicine is interrupted by an attack of cold, diarrhoea, &c, some other medicine must be given for the new affection, on the removal of which, the medi- cine which was previously acting favourably must be recurred to. In the Selection of the Remedy, it is not necessary that all the symptoms noted should be present; at the same time taking care, that there are no symptoms not covered by the medicine, or more strongly indicating another. Remarks. When it is requisite to keep a medicine in solu- tion for some days, a few drops of proof spirit may be added to the water, which should be as pure as possible, in order to pre- serve it from decomposition. It may be scarcely necessary to explain the PHARMACEU- TICAL SIGNS used in this work, to signify the potency and quantum of the dose; but as the book may fall into hands otherwise wholly unacquainted with the science, we do so as a measure of precaution; it will therefore be sufficient to remark, that Belladonna 05°, means two globules of the third potency, f, six of the sixth, and the same with any other medicine. In conclusion, it is necessary to state that the medicines should be taken fasting, and food or drink, as also excessive bodily or mental exertion, abstained from for half an hour to an hour afterwards. The homoeopathic remedies should be kept in a clean, dry, dark place, free from odours. Every descrip- tion of allopathic medicine, patent or domestic, is prohibited; likewise bleedings, blisters, medicated fomentations, perfumery and everything containing camphor. In cases of obstinate con- list of medicines. 1 stipation, recourse may be had to an enema or lavement of cold, or of tepid water when the former disagrees, to which may be added, if necessary, a tablespoonful of olive oil. It has repeatedly been found that some remedies act very beneficially when administered after the previous employment of certain others. The subjoined list affords a few such examples, and may prove useful in the treatment of particular cases: the remedy to be selected must be in accordance with the symptoms. Acidum nitri. Calc, Petr., Puis., Sulp., are often used with success after Acidum nitri. Acidum phos. China, Lach., Rhus, Verat., are sometimes suitable after Acidum phos. Acidum sulp. Puis, is sometimes useful after Acid. su7ph. Aconite. Arn., Ars., Bella , Br yon., Cann., Ipec, Spang., Sulp., &c, will frequently be found of use after Aconite, whether given from the commencement or in the course of treatment. Alumina. Bryon. is often of great use after Alumina, when it is indicated. Ant. crudum. Puis, and Merc, sometimes answer well after Antimony. Arnica. Acon., Ipec, Rhus., Sulp. ac, are sometimes suitable after Arnica. Arsenicum. China, Ipec, Nux vom., Sulp., Veratr., will sometimes be found beneficial after Arsenic. Belladonna. China, Con. Dulc, Hepar., Lach., Rhus., Seneg., Strom., Valer., are sometimes the most appropriate medicines after Belladonna. Bryonia. Alum, and Rhu^ will sometimes be found suit- able after Bryonia. Calcarea carbonica. Lycopodium, Nilr. ac, Phos., and Silicea, will be found most useful after Calcarea. Carbo vegetabilis. Arsen., Kali., Merc, will often be found suitable after Carbo vegetabilis. Causticum. Sepia, and Stann., will sometimes be found of service after Causticum. 14 INTRODUCTION. Cinchona. Arsen., Bella., Puis., Veratr., are sometimes suitable after Cinchona. Cuprum. Calc. and Veratr. are sometimes of service after Cuprum. Hepar sulp. Bella., Merc, Mir. ac, Spong., Silicea, are sometimes suitable after Heyar sulp. Ipecacuanha. Am., Ars., Chin., Cocc, Ign., Nu.r, are sometimes suitable after Ipecacuanha. Lachesis. Alum., Ars., Bell., Carb. v., Caust., Con., Dulc, Merc, Nux rom., Phos. acid., are sometimes useful after Lachesis. Lycopodidm. Graph., Ledum, Phos., Puis., Silic, are sometimes serviceable after Lycopodium. Mercurius. After Mercurius, Bell., China., Dulc., Hepar, Lach., Nitr. acid., Led., Sulph., are sometimes suitable. Nux vomica. Br yon., Puis., and Sulp., will frequently be found efficacious after Nu.r vomica. Opium. Alter Opium, Calc, Pelr., Puis., will sometimes be found of use. Phosphorus. Petr. and jR/im.v will be found suitable after Phosphorus. Pulsatilla. Asa., Bryon., Nitr. ac, Sepia, are sometimes suitable after Pulsatilla- Rhus toxicodendron. Am. c., Ars., Bryon., Calc, Con., Phos., Phos. ac, Puis., and Sulph., are sometimes useful after Rhus tox. Skpia. After Sepia., Carbo v., Caust., Puis., are some- times suitable. Silicea. After Silicea, Hepar, Lach., Lyco., Sepia, are sometimes of service. Spongia. Hepar sulph. is sometimes suitable after Spongia, (in the croup.) Sulphur. Acon., Bell., Calc, Cupr., Merc, Nitr. ac , Puis., Rhus., Sepia, Sil., are sometimes suitable after Sulphur. Tartarus emeticus. After Tartar emetic, Bar-c, Ipec, Puis., Sep., are sometimes useful. Veratrum. After Veratrum, Ars., Am., Chin., Cupr., Ipec, are sometimes suitable. LULUS FOR DIET. 15 SYNOPSIS RULES FOR DIET, UNDER HOMOEOPATHIC TREATMENT. aliments allowed. Soup or broth made from the lean of beef, veal, and mutton; to which may be added, well boiled, sago, tapioca, vermicelli, rice, semolina, or macaroni, seasoned merely with a little salt. Meats. Beef, mutton, (poultry, rarely,) pigeons, larks, rabbits, (venison, and game in general, may in most cases be partaken of in moderation, but never when high,) plainly cooked and roasted, broiled, or stewed, in preference to boiled. Ham or neat's tongue rarely.) Fish.* Soles, whiting, smelts, trout and flounders, broiled in preference to fried; when cooked in the latter manner, the white must alone be partaken of, and the outer or fried por- tions rejected. Vegetables. Potatoes, brocoli, green peas, cauliflower, spinach, turnips, French beans, seakale, vegetable marrow, stewed lettuce, well cooked, and prepared with the gravy of meat, where required, instead of butter. Eggs lightly dressed; all kinds of light bread not new- baked, and biscuit free from soda or potash and the like. Light puddings, such as those made from vermicelli, semo- Una, fecula of potato, sago, arrow root, rice; simple cakes com- posed of flour or meal, eggs, sugar, and a little good butter. Fruit. Baked, stewed, or preserved apples or pears: also gooseberries, raspberries, grapes, or any other fruit not of an acid quality, fully ripe, preserved, or in the form of jelly, may occasionally be partaken of. « From the extensive varieties of American fish may be most safely selected-shad, king-fish, striped bass or rock-fish, Otsego bass (shad salmon,) lake trout (salmon trout,) halibut, haddock, sea bass or black- fish, sheep's head, pike, pickerel and perch.—En. 16 INTRODUCTION. Beverage. Water, milk, cocoa, chocolate, (unspiced), arrow- root, or gruel, made thin, toast-water, barley-water, milk and water, sugar and water, rice-water. Salt should be used in moderation. aliments prohibited. Soui>s. Turtle, mock-turtle, ox-tail, giblct, mulligatawny, and all rich and seasoned soups. Meats. Pork, bacon, calf's head, veal, turkey, duck, goose, sausages, kidney, liver, tripe, and every kind of fat and salted meat<. Fish. Crab, lobster, oysters* and shell-fish in general; and almost all other fish not specified in Aliments allowed. Vegetables. Cucumber, celery, onions, artichokes, radishes, parsley, horse-radish, leeks, thyme, garlic, asparagus; and every description of pickles, salads, and raw vegetables, or vege- tables greened with copper. Pastry of all kinds, whether boiled, baked or fried. Spices, Arom'ifics, and Artificial Sauces, of all kinds; as also the ordinary condiments, mustard and vinegar. Cheese. Chestnuts, filberts, walnuts, almonds, raisins, and indeed almost the entire complement of a dessert, except what has been mentioned in Aliments allowed, under Fruit. (See also Regimen, p. 1.) The above regulations are subject to considerable modifica- tions in particular cases; but only under the direction of the medical attendant. Regularity in the hours of meals should be observed ; and too long fasting, as well as too great a quantity of food at one time, should be avoided. * The inhibition of the European Oyster is justly demanded on ac- count of its flavour and effects ; but the American oyster, according to our experience, is one of the most valuable esculents that, at times, can be furnished either to the invalid or convalescent.—Ed. PART II. ON THE SYMPTOMS, CHARACTER, DISTINCTION, AND TREATMENT OF DISEASES. FEVERS. Febres. GENERAL CONSIDERATION OF FEVER. CAUSES, TREATMENT, AND DIET TO BE OBSERVED. Perhaps no form of disease has more occupied the atten- tion of pathologists, or given rise to a greater number of theories, than fever. Many authors consider fever and inflam- mation as synonymous terms, others as mere modifications of the same pathological state of the system. The investigation is certainly one possessing peculiar interest, but, fortunately, in the homoeopathic system, no theory can in the slightest degree affect the practice, since in the treatment of this class of disease, the external phenomena present sufficient indications for the selection of the proper remedies. Acute diseases have always been considered as the true touchstone of every system of therapeutics. Homoeopathy has been submitted to this test, and the results have at once proved the bold assertion of its founder, that its principle was a law of nature,—the minute doses in these cases act with a promptness and certainty scarcely to be credited, except by those who have either witnessed or experienced their power; under this system the disease is brought to a salutary crisis before any great expenditure of vital energy has taken place; from this, and the absence of debilitating measures, 18 KLVEllS. the period of convalescence is greatly shortened, and in many instances scarcely perceptible, the patient being, as it were, at once restored from a state of disease to one of perfect health. Although I shall avoid entering into any of the theories respecting fever and inflammation, I cannot but render the tribute of my admiration to the gifted men who have devoted so much of their time and energies to the elucidation of this difficult point, since every new pathological discovery serves to throw light upon the specific action of medicinal s-ubstances. Practically speaking, when we find a medicine produce a change of health resembling that present in fevers, we know that in such fevers it is curative-: still it would be a satisfaction to be enabled to trace the connexion more closely, and to show the perfect affinity between medicinal and morbid action. There is no doubt that, if a perfect theory of fever be ever given to the world, it will be found in perfect accordance with the homoeopathic law. In all forms of acute diseases fever is present; in fever, properly so called, there is generally functional disturbance. accelerated action of the vascular, with the participation of the nervous system, and a tendency to increased development of heat. The symptoms common to most fevers are—at first, a feeling of coldness or shivering, then heat, accelerated pulse, thirst, restlessness and languor. Fever also possesses the property of passing from one species into another. Thus in- flammatory fever may, by severe antiphlogistic measures, be altered into a low typhus; or, on the other hand, a simple fever, by injudicious treatment, into an inflammatory one, and that again assume the intermittent form ; also, one attack may pre- sent all these different phases. Fevers terminating fortunately and running a regular course, may be divided into five stages; the accession, increase, crisis, decrease, and convalescence. When the result is fatal, it may arise from a metastasis, the exhaustation of a vital energy of the patient, or the disorganization of some important function. The belief in critical days is of very ancient origin, though FEVERS. 19 there is some difference in the calculations of physicians upon that point; some counting from the day the shiverings de- clared the onset, others from the first hot fit; except in cases where a marked periodicity exists, as in quotidian and other forms of ague, such distinctions are of little value, inasmuch as the homoeopathic treatment is directed to forwarding the crisis, and thereby materially shortens the duration of the dis- ease. Statistics prove that the average continuation of acute affections is much shorter under the homoeopathic system than it is where they are treated allopathically, or left to nature; consequently, any calculations based upon other modes of treatment are not to be depended upon, and the best plan for the physician to follow is to watch attentively the disease before him, and apply the remedies his knowledge and expe- rience point out as best calculated to conduct it to a satisfac- tory issue. A crisis may declare itself by diarrhoea, profuse perspiration or increase or alteration of other secretions, or by the appear- ance of an eruption, after which, if salutary, the skin becomes moist and resumes its functions, and the pulse returns to its usual standard. Fevers have been differently classified by various medical writers. The arrangement we shall adopt is as follows : simple irritative fever, inflammatory fever, typhus, putrid, and gastric or bilious fevers, intermittent fevers, and then eruptive fevers, such as scarlatina, measles, etc. Although this mode of classification is adopted for the sake of convenience, the author has no intention of generalizing dis- ease : every febrile attack presents peculiar features, and is to be treated as an individual affection, and according to the nature of the symptoms presenting themselves, not by a blind adher- ence to the mere nomenclature of disease. Causes of Fever. It cannot be denied but that there ex- ists in certain individuals, a particular predisposition to acute diseases, and, as before remarked, in introduction, the sanguine, nervous, and bilious temperaments possess this susceptibility in a far more marked degree than the phlegmatic. 20 FEVER!*. The exciting causes are numerous. Miasms, epidemic in- fluences, contagion, powerful mental emotions, derangement of some important organ, external lesions, excess or errors in dirt, heat or cold, or alterations of temperature, exposure to cold or damp, repercussed exanthemata—in fact, anything that causes derangement of the equilibrium of the system may pro- duce fever. GENERAL TREATMENT IN FEVER, AND DIET. The great essentials in the treatment of fever are: Perfect rest, mental and bodily. Pure air and a cool apartment; the temperature of the patient's room should never exceed 55 degrees. Feather-beds .should be discarded, and mattresses substi- tuted, when practicable, and the bed-clothes be light but suf- ficient. Nature herself generally prescribes the regimen to be ob- served by taking away appetite, while the thirst present, as an eminent medical writer has well observed, may be considered as her voice calling for fluid. Water is the best diluent; no solid food, broth, or even gruel and the like, should be permitted in casts where the inflammation runs excessively high ; and the utmost caution is to be observed, in allowing gruel or weak broths during the decrease: an error in this respect often causes irreparable mischief, and it is always safer to err a little on the side of abstinence than on that of indulgence. A little toast-water, or weak barley or rice-water, sweetened with a little sugar, raspberry or strawberry syrup, may be allowed when the fever is somewhat abated, though then we must still carefully avoid incurring the risk of a relapse, by giving any aliment likely to tax, in however slight a degree, the digestive powers. SIMPLE OR EPHEMERAL FEVER. Febris Simplex. The disease seldom presents any distinct character, and gene- rally runs its course in twenty-four hours ; as, however, it FEVERS. 21 frequently forms the initiative of other more serious disorders, it deserves attention. Before attacks of scarlatina, measles, small-pox, etc., it is generally present, although occasionally showing itself as a distinct affection. Diagnosis. Shivering, followed by heat, restlessness, thirst, accelerated pulse, general uneasiness and lassitude, terminated by profuse perspiration. In allopathic practice, unless they could trace the immedi- ate csllse of the affection, for instance indigestion, the treat- ment is occasionally hazardous; for, if the simple fever was merely the commencement of an attack of severe inflamma- tion, they incur the risk of increasing it by using stimulants, under the idea of its being a precursor of typhus; or acting upon the opinion of its being a forerunner of inflammation, of weakening the constitution by antiphlogistic methods, if it should unfortunately run on to the former. In this case the safer plan was to await quietly the development of the affec- tion, to see if it would terminate in a crisis, or take upon it a more virulent form, and so deal with it accordingly. Therapeutics. Throughout this work the disease will be found treated of, when arising from indigestion or cold, and found as the precursor of other affections; but when it is en- countered along with the symptoms already detailed, and can- not be traced to any particular exciting cause, and particularly when hot, dry skin is present, Aconite may be adminis- tered* in a teaspoonful of water, which, if it be simple fever properly so called, will speedily dissipate all the symptoms ; and if it be the forerunner of any more severe disorder, either at once check its further progress or materially modify its malignancy. The former is more peculiarly the case with purely inflammatory attacks : the latter holds good as far as relates to typhus, exanthematic diseases, and some other af- fections which run a regular course. * In all cases where directions for the administration of a medicine are given, the attention of the reader is directed to the article on that sub- ject in the introduction. ■J 2- fkvi:k* INFLAMMATORY FEVER. Su;o~ha. Diagnosis. Shivering or chill (generally considerable) fol- lowed by burning heat; pulse strong, hard, and greatly ac- celerated; dryness of the skin, mouth, lips, and tongue; the latter generally of a bright red, in some cases slightly coated with white; thirst; urine red and scanty; constipation; re- spiration hurried, in accordance with the pulse; amelioration of symptoms as the pulse assumes a more normal staie. It runs its course with rapidity, rarely exceeding fourteen days, and progressing with regularity to a crisis, which shows itself in profuse perspirations, critical urine, diarrhoea, or haemor- rhages, principally epistaxis. The period mentioned is its ordinary average of duration, but under homoeopathic treat- ment, the perfect crisis is considerably hastened, without the long convalescence entailed by the usual antiphlogistic means. It is peculiarly apt, if not carefully treated, to change into typhus, or by metastasis to fix upon some important organ. Causes. Sudden chill or check of perspiration, exposure to damp or wet, dry easterly winds, violent mental emotion, high living, external injury or lesion, local inflammation, and slight febrile attacks mismanaged. Individuals of what is denominated a plethoric habit are particularly subject to this disease; it generally attacks be- tween the ages of 15 and 30 years. Under the diagnosis we have given the pathogonomic symptoms of synocha; we, however, find it complicated, in the majority of cases, with more or less cerebral disturbance, which we shall consider more in detail under Inflammation of the Brain and its tissues. Therapeutics. Although throughout this work the author purposes to confine himself to pointing out the remedies most valuable in disease, without entering into any disquisition upon their efficacy, or the principle of their employment, yet he cannot refrain in this instance, from briefly noticing a medi- cament which has so successfully superseded all the antiphlo- i INFLAMMATORY FEVER. 23 gistic measures of the old school, subduing inflammation with- out lowering the vital energy. No one who compares the pa- thogenetic symptoms of Aconite given in the Materia Medica Pura of Hahnemann, and carries in mind the principle of its application, can forbear being struck with the close resem- blance which they present to those of pure inflammatory dis- ease ; and by this powerful auxiliary the author has no hesita- tion in declaring, that disease of the said description is brought so fully under the control of the physician, as to be in a great measu™ divested of its malignancy, and in no case is the superiority of Homoeopathy more strongly evidenced. Administration.* When, therefore, the symptoms above mentioned are present, we should at once administer Aconite, six globules of the third potency, in an ounce of pure water, a dessert-spoonful to be given every quarter of an hour, every half or every two or three hours, according to the intensity of the fever, and the pulse carefully watched, lengthening the inter- vals according to the effect produced, till marked benefit results. A slight degree of delirium is frequently present in this affection, chiefly at night, whieh, unless it threatens to run on to inflammation of the brain, in which case Bellacronna must be had recourse to, Aconite is of itself sufficient to subdue. When, however, during the course of the affection other symp- toms besides those mentioned develop themselves, we may find it necessary to have recourse to different remedies, such as Bel- ladonna, Bryonia, &c. Belladonna. When there is great heat in the head, with violent cephalalgia, particularly in the forehead, and redness of the face; distention of the arteries of the neck and temples; nocturnal sleeplessness, with furious delirium; eyes red, shining and fiery; general internal and external heat; burning thirst, and agonizing restlessness. Administration. Six globules of the third potency in an ounce of water; a dessert-spoonful exhibited every four hours until amelioration takes place, or we observe unequivocal symptoms, of medicinal aggravation; in which latter case we * Vide note, page 21. 24 FEVERS. must cease to prescribe altogether until the reaction has taken place ; and in the former, lengthen the intervals of repetition aa the improvement advances. Bryonia. This medicament is indicated when, in addition to the usual symptoms ©f inflammatory fever already given, we find a heavy stupifying headache, with a sensation as if the head would burst at the temples, much aggravated by move- ment, vertigo and giddiness on rising up or moving; burning heat, redness of the head and face, with redness and swelling of the latter; delirium; oppression at the pit of the s&mach ; excessive thirst, sometimes followed by vomiting; constipation; aching or shooting pains in the limbs, dry cough, or cough with adhesive phlegm tinged with blood, stitches in the chest or side, and laborious breathing; when these latter symptoms are present, we may infer that the pleura or lungs are affected. In the latter case the practitioner should test the diagnosis by auscultation. Administration. Six globules of the third potency may be added to an ounce of water, and a de3sert-spoonful given every four or six hours; few cases are so particularly urgent as to require more frequent administration of the remedy; in- deed, when the virulence of the disease has been subdued, a single dose is generally found sufficient, and no further exhibi- tion should take place as long as the patient manifestly con- tinues improving. When inflammatory fever seems to arise from a primary in- flammation of some important organ, such as the Head, Lungs, Liver, or Stomach and Bowels, the treatment will be found un- der the head of Inflammation of the function most evidently the seat of the disorder. It is sometimes the result of severe lesion, in which case the patient is to be treated as prescribed under External Injuries. NERVOUS FEVER. Febris Nervosa. TYPHUS. It is sometimes extremely difficult, particularly when it arises from some local affection of the more important viscera, to discriminate at the commencement between a nervnus or nervous fever, or tvphds. 25 inflammatory attack, so as to give a decided prognosis. How- ever, in such cases, the marked advantages of the homoeopathic system is again shown: by exhibiting medicines in accord- ance with' the symptoms that declare themselves, we run no risk of weakening the vital energies, should we err in diagno- sis, and treat it on its first appearance as an inflammatory attack —or of stimulating the inflammation by what is commonly de- nominated an anti-nervous treatment, should the precursory symptoms lead us to consider it typhus, and it afterwards as- sume the inflammatory form. Diagnosis. Typhus rarely sets in with such marked symp- toms as announce the approach of inflammatory fever—in- stead of severe chill or shiverings, we first find a complaint of general uneasiness, a sensation of chilliness, occasionally followed by a greater or less degree of heat. The patient either complains but little, or of pains in his head, chest, and abdomen, and frequently an unusual degree of drowsiness is present, arising from a comatose state of the brain—there is also occasionally a slight dyspnoea; after various alternations of cold and heat, the former sensation predominates in the feelings of the patient, while to those around him he appears hot; the extremities, however, on examination, are found cold. Different characters of pulse present themselves; sometimes it is full and soft, at others accelerated, frequently about the natural standard or below it, or quick and weak, but not strong and hard as in inflammatory fever. The difference between the action of the pulse and heart is worthy of notice : the former may be so weak as scarcely to be perceptible, and the action of the latter strong; the pulse also may be hurried and the respiration natural. As the disease progresses, the tongue, at first moist, becomes thickly coated, dry, glazed, and • tremulous; there is faintness, cephalalgia, giddiness, and ver- tigo : the delirium, at first slight, and manifesting itself only at night, becomes unintermitted, and is characterized rather by wandering and low muttering, than fury and violence: we may also meet with spasms and convulsions. All these symptoms, if the disease is allowed to gain ground, increase 26 NERVOUS FEVER, in malignancy, the evacuations become involuntary, the weak- ness and lassitude excessive, and the patient sinks down to the bottom of the bed—an evidence of complete prostration of strength, while all endeavours to rouse him are fruitless, and he is perfectly blind to all around. Tenderness of the abdo- men or pain in the region of the coecum is also frequently met with. Some only of the above symptoms maybe present, or the fever may be complicated with others: when only a few of the less virulent symptoms declare themselves, it is called mild typhus ; when complicated with considerable disturbance of the vascular system, great heat and quick hard pulse, in- flammatory typhus: a distinction is also found in the type, as in continuous and intermittent typhus; in the accidental cir- cumstances or exciting causes present, as in the gastric and catarrhal complications, which, although generally treated as gastric or catarrhal fevers with typhoid symptoms, may be considered as modifications of this affection,—this difference in arrangement can, however, make none in practice, as we must be guided by the symptoms that present themselves in selecting our remedies. The congestive fever of some authors may be consi- dered as a variety of typhus, in which, from the balance of the circulation being destroyed, the blood is determined to some particular organ—the external heat of the body dimin- ished, and the pulse becomes slow and oppressed. The symp- toms vary according to the organs attacked. It may be re- marked, that in most forms of this malady, the course is ex- tremely irregular,—the precursory symptoms may precede the disease only a few days or several weeks, and its duration is also uncertain. Death may take place from exhaustion of the vital energies, paralysis of the whole system, or of the brain, apoplexy, dis- organization of some of the nobler viscera, or a change to the putrid form. Causes. Densely populated neighbourhoods, where a num- ber of individuals are crowded into small apartments, and the OR TYPHUS. 27 air rendered impure by exhalations from decomposed ani- mal and vegetable matter, stagnant water, and a want of cir- culation, are the very hotbeds of typhus; deficiency and im- proper quality of food are often added to the above, and are of themselves sufficient to produce it; other causes are, over- exertion, either of body or mind, or excesses of any kind, the prevalence of cold or damp weather, mental emotions, and contagion. In fact, anything tending to depress the vital energies may be productive of typhus; it may consequently arise after in- flammatory fever treated by bloodletting or other severe anti- phlogistic measures, or even by the reaction of the organism, or an imperfect crisis after the same affection. We shall now proceed to consider the treatment of this malady, and under the indications for the different medicaments used, will be found the symptoms that declare themselves under the various phases which the disease presents. Therapeutics. At the commencement, where gastric symp- toms set in, such as headache, giddiness, nausea, vomiting, wa- tery, yellow, or greenish, slimy evacuations; particularly when attended with slight chills, alternately with heat or considerable shivering with slight heat, or marked heat with but little shiver- ing, we may administer— Administration. Ipecacuanha £§a in a teaspoonful of water, and repeat it every three or four hours.* Or Pulsatilla may be selected at this stage of the disorder, when there is frequent shivering, bitter taste, whitish tongue, loss of appe- tite, nausea, vomiting of mucus, slimy evacuations, and par- ticularly when the above symptoms occur in phlegmatic sub- jccts, with extreme depression of spirits, and tearfulness. Two globules of the sixth potency in a little water every three to six hours. Nux vomica. Gastric or bilious symptoms, constipation with frequent, inclination and ineffectual efforts to evacuate. Nux vomica is further indicated when the spasms, which not unfrequently accompany this disease, are confined to the » Vide note, p. 21. 2S nervoi's rrvni, stomach and intestines, particularly the rectum, a frequent cause ol the ab ve-inentioncl constipation; painful prosure, and tension in the epigastrium and hypochondria; sensation as if the limbs were bruised; general nervous excitability, with great nocturnal restlessness and slight delirium ; weak- ness, and exacerbation of the symptoms in the morning. Temperament, sanguine or bilious; disposition, irritable and impatient. Administration. Two globules of the sixth potency every twelve hours. When the disorder assumes the asthenic form of ahilmninal typhus, or when the inflammatory diathesis is more lymphatic than arterial, from the occurrence of the disease in venous- lymphatic subjects, with pale or yellowish appearance of the face, s,.\ere headache, or sensation as if a tight band were across the forehead; thickly-coated tongue; bitter or foul taste; little thirst; sensibility of the scrobiculus or umbilical region to the touch, and distention of the abdomen ; evacua- tions copious, u-a'ery, flocculent, and even bloody, sometimes attended with tenesmus ; at first dry burning skin, followed by profuse debilitating sweats; depressed pulse, and great pros- tration; extreme restlessness and anxiety, with constant tossing about in bed ; disturbed unrefreshing sleep, with anx- ious dreams, — Mi:.ucuRirs will be found a most efficient medicine. Administration. Three globules of the sixth in a little water every two hours, until the evacuations become dimin- ished in number, and improved in appearance, and the tender- ness and pain in abdomen, ete., relieved. Cinchona. This remedy is frequently of service in the first stage, or when there is paleness of the face, lancinating, rending, aching, or pressive headache, cloudiness of vision, buzzing or roaring in the ears, dulness of hearing; yellow or white coating on the tongue, dryness of the mouth, insipid, clammy, or bitter taste ; inclination to vomit; sensibility and distention of the abdomen ; thin, yellow, watery motions, occasionally intermixed with undigested substances; urine scanty, pale, or dark coloured, and cloudy ; oppression at t!,e OR TYPHUS. 29 chest; dragging shooting pains in the limbs; anxiety, sleep- lessness, and general coldness and shivering. In an advanced stage of the disease, china is moreover occasionally of consi- derable value, especially when the attack has become length- ened and tedious, and the following symptoms have set in: nocturnal sweats, obstinate diarrhoea, but with clean tongue, and absence of abdominal pain; followed by Sulphur, should the sweats not yield. Administration. Three globules of the third potency every six hours, until benefit result. When inflammatory symptoms declare themselves from the commencement, Aconite and Belladonna are the best remedies; when the disease becomes more developed, and still retains the inflammatory character, Bryonia and Rhus will generally be found more useful. For the employment of Aconite, we have given the fullest indication under Inflammatory Fever; and in all cases where these decided symptoms are present, it is imperatively called for, and should be administered as there prescribed. The following symptoms indicate Bella- donna : Alternate heat and chills, or general heat externally and internally, with redness, burning heat or bloated appearance of the face; violent throbbing of the carotids, redness, spark- ling, and protrusion of the eyes, with dilatation of the pupils, extreme sensibility to light, and strabismus; singing or noises in the ears to a greater or less degree; wild expression of the countenance, with uneasy glancing around, as if from fear, sometimes attended with a marked inclination to run away; violent shooting pains in the forehead, or dull heavy pain, causing the patient to put his hand frequently to his head; furious delirium or loss of consciousness ; silent delirium and carphologia, or spasmodic or convulsive attacks; parched lips, soreness? of the corners of the mouth, redness and dryness of the tongue, which is sometimes also foul and covered with a yellow coating; skin hot and dry ; bitter taste in the mouth, intense thirst, difficulty of deglutition, especially of liquids, nausea, pressure at the pit of the stomach; meteorismus; and constipation, or watery motions; scanty and red or amber- 30 NERVOUS FF.VBR, coloured urine, rapid respiration, pulse full and accelerated, or quick", hard, and wiry; parotid glands inflamed and tumid. Stkamo.mi m may be given when, in addition to the above symptoms, we find twitching of the muscles of the face, sub- sultus, strabismus, trembling of the extremities, tremulous motion of the tongue on protrusion, burning heat of the body, suppression of the urine, fantastic gesticulations, and risus sardonicus. Hyoscyamus, with similar symptoms, and moreover, twitch- ing of the tendons, strong full pulse, fulness of the veins, burning heat of the skin, sensation of pricking all over the body, and constant delirium; frequent but ineffectual urging to urinate. Administration. Of the three last mentioned remedies, six globules of the third potency may be added to an ounce of pure water, and a dessert-spoonful given every three or twelve hours, according to the violence of the malady or the improve- ment that ensues. When the skin continues hot and dry, and the bowels relaxed, or the motions even passed involuntary; or when there is phlegmonous inflammation of the tonsils; the alternate administration of Belladonna and Aconite every two or three hours until the skin becomes moist, etc., will be at- tended with a desirable result. We will now proceed to the consideration of the two medi- cines, Rhus and Bryonia, whose value in typhus, in the form in which it appeared in Germany in 1813, was proved by Hahnemann's treatment of 183 patients, not one of whom died, while thousands perished under the means employed by the professors of the old system of medicine. The two medicines above mentioned possess many striking points of similarity, but also many of difference ; they may on some occasion be ad- ministered alternately with great advantage in the manner be- low described; for the several employments the indications are as follows : Bryonia. More particularly when the disorder assumes the character of a Fibris nervosa versatilis, or Ti/jihu.s cere- bralis, with violent sfupifying headache, as from a blow, and OR TYPHUS. 31 pain across the temples, as if the head would burst. Aggra- vi'ion of these sensations by movement—continued delirium, violent, with excessive febrile heats, foul thickly-coated yel- low tongue, with dryness of the mouth and great thirst, and vesicles on the mouth or tongue, furred lips, nausea, inclina- tion to vomit, or vomiting of mucous and bilious matter; ten- derness of the scrobiculus when touched; general heat of the whole body, dryness of the skin, redness of the face, and profuse perspiration during the fever; sensibility of the epi- gastric region, distended abdomen.—Constipation, or relaxed stools; urine of a deep orange colour or bright yellow, with yellow sediment; sensation as of a plug in the throat, with difficulty of hearing; stitches in the side; drowsiness or disposition to sleep during the day; sleeplessness, fugitive heat and excessive restlessness, or continued drowsiness or coma, with startings and unpleasant dreams; painful shoot- ings and soreness of the limbs, aggravated by movement, trem- bling of the hands ; pulse quick, soft, frequent; or irregular, small and intermitting. Petechiae, irritahility, irascibi- lity, despair of recovery. RiiTis toxicodendron. This medicine is more peculiarly suitable to the debile form or stage, the Febris,nervosa stupida, as is Bryonia to the inflammatory ; but will frequently be found serviceable in all the stages of the disease, particularly when there is diarrhcea, and congestion to the head and great weakness. The headache is generally of a stupifying nature, with a feeling as if from a bruise, but not so severe as that of Bryonia; the tongue presents nearly the same character, less nausea and inclination to vomit exists; violent pain is present at the epigastrium, especially when touched. Constipation as in Bryonia, but more particularly, copious yellowish or loose sanguineous evacuations; the symptoms of general heat, and those of the face, resemble those given under Bryonia, but without, the perspiration, or at most, a clammy feeling of the skin. The urine is hot, dark coloured, or at first clear, and afterwards turbid, the symptoms of the ears the same; sleep also the same; difficult deglutition of solids, as if from con- traction of the throat and oesophagus; general trembling, debi- 32 NLKVOI'S FKVF.R, lily and prostration, almost amounting to paraiy'tc weakness of the different limbs, shooting pains in various parts of the body, Qggrar i!ed when at rest or at night, and momentarily relirred by moving the part affected; pulse quick and small, or weak and slow. In the morale we may notice, excessive anguish, anxiety, extreme 1 >wness of spirits, and inclination to weep. Petechia-, as in Bryonia, are Inquoiitly present. Administration. As before remarked, Rhus is particularly suitable in the debile form or low typhus; we may add six globules of the third potency to an ounce of water. In M.ine extreme cases, however, the practitioner will find it necessary to prescribe a more frequent administration of the dose, and at a still lower potency, (such as the second dilution, or even the mother tincture,) and administer one dessert-spoonful every three to four hours in ordinary cases, lengthening the intervals as improvement ensues, and then quietly awaiting its action. The Bryonia may be given in the same manner when it appears indicated, and in many cases it will be found useful to give these medicines alternately at six hours' interval, a dessert-spoonful of the mixture above mentioned as a dose. Arsenicum. This is decidedly one of the most imprTrtant remedies in abdominal typhus, sometimes restoring the patient when almost beyond the reach of hope, and renovating the vital spark. The chief indications for its employment are extreme prostration of btrenctii, falling of the lower jaw, open mouth, dull and glassy eyes, burning thirst, and colliquative diarrhoea, pulse scarcely perceptible and inter- mittent. Administration. Six globules of the third, sixth, or twelfth potency may be added to an ounce of water, and a dessert-spoonful given every quarter, or half hour, until im- provement is perceptible, when the intervals between the doses may be extended. Carbo vegetabilis is another remedy of great utility in these desperate cases; it is indicated where we find drow- siness with rattling respiration, face pinched, sunken, and deathlike, pupils insensible to light, pulse scarcely percep- tible, and rapidly sinking, cold perspiration on the face and OR TYPHUS. 33 extremities, involuntary and offensive evacuations, deep r. d urine, with a cloud floating in it or rising towards the surlace. Administration. Six globules of the sixth potency in the same quantity of water as the preceding, administered in the same manner. An alternate administration of these two % medicines, at intervals of from four to eight hours, has been attended with the most furtun.te results. Acidum phosphoiucum. When at the very commence- ment of the disease, we find great exhaustion and prostration, with wandering even when awake; or in almost hopeless cases, either alone, or still better in alternation with R' us, when the patient is always found lying on the back in a co- matose state, and either gives no reply when talked to, or if he does it is in an incoherent manner; constant loquacious deli- rium, or low muttering ; carpologia, fixed look ; seeming ef- forts to escape from some alarming object; black incrustations on the lips; dry, hot skin, continued coiaous watery diarrhoea ; the motions are generally passed involuntarily; sanguineous evacuations; frequent, weak, and occasionally an intermitting pulse. Should the debilitating sanguineous evacuations con- tinue, Ariel, nitricum should be administered, or Cantharidrs, should strangury also be present. Administration. Same as the above. Sulphur may often be had recourse to with advantage when Bryonia, Rhus and Acidum phosphoricum have been fruitlessly administered; the following, however, are its cha- racteristic indications in this disease: pale and collapsed countenance, burning itching eruptions on the lips, dryness of the mouth; foul, dry tongue; bitter taste; slimy or bilious vomiting; tenderness of the epigastrium, and pain in the umbilical region increased on pressure; borborygmus; fre- quent watery, flocculent or yellow evacuations; cloudy urine, depositing a reddish sediment; stitches in the chest, oppress- ed breathing; dry cough, worse towards evening and at night; sleeplessness, or whining during sleep, dry heat during the day, with moderately quick pulse, profuse sweating at night. Administration. Six globules of the sixth in an ounce of water, a dessert-spoonful every six hours. 9* 34 NERVOUS FEVER, Opium. Great drowsiness, or coma with stertorous breath. ing, open mouth, half closed eyes, or fixed look, slight deli- rium or muttering; carpolooia; the patient is in a continual state of sopor from which it is extremely difficult to rouse him, and is scarcely aroused ere he relapses into his former state; dry offensive stools, which together with the urine are passed involuntarily. Administration. Six globules of the third potency in half an ounce of water, a teaspoonful every three hours. Calcarea c. may sometimes bo administered advanta- geously, alternately with Belladonna, Arsenic or Rhus, ac- cording to symptoms; it is further sometimes a most efficient remedy in cases in which debilitating diarrhoea or epistaxis will not yield to such remedies as, Ac phos., Rhus, Cin- chona, etc. : when the nasal hemorrhage does not yield to Calcarea, Hepar sulphuris is generally the most appropriate remedy to follow up with, provided the entire feature of the disease is not better embraced by Pulsatilla, Belladonna, Rhus, or Sulphur. Phosphor is. When the disease becomes as it were con- centrated in the lungs, and there is consequently congestion with extremely laborious breathing and excessive anxiety, dulness on percussion, mucous rale, stitches during respira- tion ; cough with copious expectoration of mucus mixed with blood, or even offensive pus; more benefit may be looked for from this than from any other remedy. Administration. Six globules of the third in an ounce of water, a dessert-spoonful every four hours. Acidum muriaticum. Weakness, with a constant ten- dency to sink down in the bed, with groaning during sleep, al- most paralytic, state of .the tongue, rendering it almost impos- sible for the patient to speak, even when in a collected state, and great dryness of the mouth. Administration. The same potency and in the same manner as Arsenicum. After severe cases of Typhus, a period of debility gene- rally supervenes of greater or less duration, according to the violence of the attack. In such instances Cinchona iilLSi 0 ' or typhus. 85 in a little water, repeated in five days, followed by Valerian in about four days to a week, according to the result produced. Of this latter medicine, three or four globules o# the third po- tency may be given in a glass of water, and repeated every two days, if necessary, until the desired result is attained.* An alteration of these two medicaments, at intervals of twen- ty-four hours, has also been found very useful in these cases. When debilitating sweats supervene, Cinchona should be admi- nistered, followed by Sulphur if required. Should symptoms of deranged digestion remain after the fe- ver has been subdued, Nux vomica and Pulsatilla will be found most serviceable according to the temperament of the in- dividual, and the symptoms present. (See article Indigestion.) The other medicaments mentioned under the head referred to, may also be advantageously consulted. Where a peculiar morbid state of the constitution exists, denominated by some Homoeopathists, a psoric tendency, a drop of the third potency of the Tincture of Sulphur in three dessert-spoonfuls of water, one daily, and the medicine then allowed to act from one to three weeks, according to circumstances, may be admin- istered. Diet. In a disease that presents so many varieties, it is difficult to give any rules upon this head applicable to all cases. When a marked inflammatory character is present, the same abstinence should be enjoined as already noted under Fevers; and in all cases, either during the progress of the disease or the period of convalescence, the greatest possible care should be taken to avoid taxing the digestive functions; the diet should be light and simple, and the patient never allowed to indulge the appetite to its full extent. PUTRID FEVER, or TYPHUS. Typhus Puiridus- We have already alluded to this form of the disease under Typhus, particularly in the indications given for the employ- *Vide note, p. 21. 36 putrid fever, mcnt of Arsenicum and Carbo vegetabilis ; but considor it of sufficient importance to be remarked ou separately, although of course, except in cases of decided emergency, no individual not properly qualified would think of treating so serious an affection. Diagnosis. The symptoms of Typhus already given, run- ning on to the colliquative state; extreme debility, pulse ex- ceedingly small and weak, so as to be scarcely perceptible; a peculiar sensation of burning pungent heat, communicating itself to the hand when placed upon the body of the patient, heavy cadaverous smell of the whole body, putrid odour of the breath, perspiration, and secretions in general; profuse oily and clammy sweats; involuntary evacuations; colliquative or sanguineous diarrhoea; dark and bloody urine; epistaxis, pe- techias, and other marked tendencies to organic dissolution. The patient is always found l)ing on his back, and continually shrinks down to the tout of the bed, a sign of utter helplessness aid prostration. Therapeutics. Arsenicum corresponds closely to the foregoing symptoms, and is, therefore, our principal remedy when the di-ease assumes this form, particularly when we find involuntary and sanguineous evacuations and tenesmus Carbo vegetabilis may also be with advantage alternated with it, when the symptoms already given under Typhus for the exhibition of that medicine are present; Mercurius is called for in case of great tenesmus, and when the discharge of blood is principally alvine, followed by Aciil. phos ph. K A-id. nitr., or Cantharides, should sanguineous diarrhoea continue. (See NERVOUS FEVER, p. 29.) Administration. When Arsenicum itself is found called for, we may add one drop of the third potency to an ounce of water, and administer a dessert-spoonful every six hours, or even every hour if the patient seems sinking, until an improve- ment takes place. If, however, from the symptoms given under that medicine, an alternation with Carbo vegetabilis seem desirable, they may be thus exhibited at intervals of OR TYPHIS. 37 from six to twelve hours, according to the urgency of the case ; in some instances, where Arsenicum does not produce all we could desire, this mode has been adopted with success.* Cinchona will be found useful when the more dangerous symptoms have been in a great measure subjugated, but at the same time great weakness remains from the loss of humours ; it is also useful when the little nutriment the patient may have partaken of passes off undigested. Administration. Six globules of the third potency in an ounce of water, a dessert-spoonful every four hours. In those cases where Arsenicum and Carbo vegetabilis seem to fail, the employment of the Mother Tincture of Rhus, one drop in a tea- spoonful of water every three hours, has, in a number of in- stances, been found most efficacious.! CONTAGIOUS FEVER, OR TYPHUS. Typhus Contagiosus. Diagnosis. The symptoms of typhus caused by infection or contagion. Therapeutics. The same as already given under Typhus. We may, however, here remark upon one remedy of especial value in this form of the disease, namely, Opium, indicated by drowsiness or coma.—Coma somnolentum, especially,—ster- torous breathing, mouth partly open, eyes open or partially closed, loss of speech, rigidity of the limbs, smallness or m- « It may here be remarked that Gross and others have recently recom- mended, and are in the habit of administering, Arsenicum at extremely high potencies (the 200th and even the 1600th) in typhus and other diseases, wh.n the vital energies seen, rapidly sinking. See also "Po- tencies of the medicaments" in the Introduction. t Many of the remedies, along with the indications for their employ- ment, which have been given in the preceding chapter, will also be found equally appropriate in particular cases or in certa.n stages of so-called putrid fever-the attention of the practitioner is therefore particularly called to them in such circumstances. 3S cONTUJIOU* kkver. tennission of the pulse, meteorismus, involuntary evacuations, or constipations. Administration. We may add six globules of the third potency to an ounce of water: give a dessert-spoonful every three or four hours until a favourable change is observed. When in addition to the above-named paralytic affection, we find jerkings in individual limbs, we should have recourse to Ht/osryamus or Stramonium administered in the same manner, choosing the remedy which most closely approximates to the symptoms we have given for their individual use, under Typhus (p. 30.) It may be remarked, that whenever the symptoms given under Opium, and the other medicines, present themselves in Typhus, from whatever cause arising, the remedies are of course indicated. A(< kssory Treatment—Prophylaxes, &c. We need hardly insist upon what every practitioner knows to be essentially adjuvant in the treatment of this affection, a con- stant supply of fresh and continually renewed air. Prophylaxes, during the prevalence of Typhus. Cool pure air, thorough ventilation, the avoidance of dark or dismal- looking apartments into which the genial daylight does not freely penetrate; and the removal of all causes generating the disease, such as stopped sewers, or collection of decaying vege- table and animal matter; a plain wholesome diet, with a mode- ration in the use of fermented liquors or wine, and total absti- nence from spirits; refraining from late hours, intense study, and excessive mental or corporeal exertion; exercise in open situations, with proper precautions against exposure to cold or damp; and finally, the preserving a healthy tone of mind and cheerful temper. The absurd practice of keeping the bowels constantly open by means of aperient medicines, and the use of sudorifics, can- not be too strongly reprobated; both these practices weaken the system, and predispose to the disease. intermittent fevers. 39 Standing between a fire or open window and the bed of the patient is to be avoided, as unnecessarily increasing the risk of taking the infection. The safest plan for the physician to pursue in epidemic or endemic typhus, is to form an aggregate of the symptoms by carefully collating those of individual sufferers, so as to present a perfect image of the existent malady, and to choose his remedies accordingly, which should be adminis- tered directly on the premonitory symptoms declaring them- selves, without waiting for the further development of the disease. It may be remarked, that Bryonia and Rhus cover a great number of the symptoms of typhus, as met with in this coun- try ; when, therefore, this point has been ascertained, they may be given alternately, Bryonia ^ and Rhus ^ each in one dose, at intervals of twenty-four hours, which will often either check the malady at its outset, or materially modify its virulence—in some cases one of these remedies is of itself sufficient, according to the leading symptoms of the reigning epidemic; in a great variety of instances, Arsenicum may prove a valuable prophylaxis ; but at the same time, the indi- cations we have already given of the several medicaments should be carefully consulted, as the same rule holds good for them all. INTERMITTENT FEVERS—AGUE. Febres Intermitlentes. We have now to enter upon a class of fevers differing essentially from those already considered, in possessing a marked character of their own, in the simplicity of their form, the periodicity of the different stages, and the uncertainty of their duration. Diagnosis. A chill or cold fit, followed by heat, and terminating by perspiration, more or less profuse ; these three stages constitute a paroxysm ; after which for a certain period, 40 intermittent fever*. called the Apyreria, the patient is generally free from suffering. These periods are generally of definite duration ;—if the paroxysms return at regular intervals of twenty four hours, the fever is termed a Quotidian; of forty-eigh', a Tertian; of seventy-two, a Quartan; even longer intervals have been ob- served between the attacks; hence the < >etanao of some writers,—if two paroxysms take place within each period, the ague is said to be doubled, as a double Quotidian or Tertian. These fevers are sometimes found existing in the simple form above noted and at others complicated with other forms of dis- ease, as in intermittent catarrhal or gastric fevers. They are exceedingly indefinite in duration, and frequently assume a chronic form. An individual once attacked with ague is frequently liable to a return in after-life, if the disease has not been radically cured at the commencement; nay more, any attacks of disease he may be hereafter subjected to, are peculi- arly apt to assume the intermittent form. Nervous or inflammatory fever may change into an intermit- tent, or the latter take upon itself, if it continue, the character of either of the two former, or become remittent; this frequently happens in hot climates. Ague is rarely daugerous in this country, except when of long continuance, by the weakness it occasions and the in- jury it inflicts upon the constitution; it may, however, lead to obstructions and indurations of the more important viscera, particularly of the liver and spleen, or induce dropsical affec- tions. But in hot climates or in low marshy countries, this disease is exceedingly fatal; and on dissection, the brain and its tissues, the mucous coat of the stomach and bowels, the lungs and peritoneum, have been found affected; in such instances, when the disease gains ground, the patient loses strength and becomes emaciated, every fresh paroxysm entails an increase of suflering, and the perspiration fails to relieve; he complains of a sense of weight in the hypochondria, particularly the right, with griping pain in the bowels, flatulent distention of the intermittent fevers. 41 abdomen, diarrhgea, or constipation, and constant thirst; or of headache, cough, and dyspnoea: the tongue is furred, and dry at the tip; the skin hot, harsh, and dry; the urine scanty, the abdomen tumid, the extremities become dropsical, and sleep is restless or broken. Death may ensue from collapse in the cold stage, the absence of perspiration, and the disease passing into continued or remit- tent fever, or from disorganization of some important function, such as the brain, lungs, spleen, or liver. We shall now proceed to a general consideration of the three stages of the disease, premising that the various modi- fications of the symptoms will be found more in detail under the medicaments when we enter into the therapeutic treatment. Premonitory symptoms. Sense of languor, or general un- easiness ; yawning, headache, stupor, pains in the limbs or dorsal region, the toes and fingers becoming numb, and the nails blue. Cold Stage. Coldness of the extremities, with a feeling as of a stream of cold water running down the back, and ex- tending itself to the chest and abdomen; general prostration of strength, insupportable coldness, external and internal tre- mors, chattering of the teeth, respiration laboured and hurried, with inability to draw a full inspiration, and oppression at the chest. The head is variously affected, sometimes with head- ache, at others with coma, stupor, or delirium; the pain no- ticed in the premonitory symptoms are generally present, and in some instances the patient complains of pain all over; the tongue is moist, the eyes are heavy and sunken, the features pinched, and the lips and cheeks livid; the rigors sometimes run on to convulsions. The pulse is weak and oppressed, sometimes slow, at others quick, and frequently intermitting, and often, from the severity of the rigors, scarcely perceptible. The heat of the body, except at the extremities, is gene- rally above the natural standard, while the patient complains of cold. Sometimes the patient feels only a slight degree of cold, without tremors, but accompanied with symptoms of functional 42 INTERMITTENT fevers. derangement, and in a few hours the hot fit declares itself. The duration of the cold stage is from an hour to four hours; and it runs into the hot without any marked interval. The Hot Stage presents all the characteristics of a modi- fied inflammatory attack, with hot, dry skin, and thirst, op- pression at the chest, hurried and anxious breathing, and acute pain in the head, region of the spleen, liver, &c.; there is also occasionally a degree of cerebral disturbance, or even delirium. The general duration of the hot fit is from four to twelve hours, when it terminates in the sweating stage; when this does not take place, it is apt to run on to continuous fever, or take the form of a remittent,—a not uncommon issue of this disease in warm climates. Sweating Stage. After the hot fit has continued a longer or shorter period, profuse perspiration sets in, commencing in the forehead and extremities, and quickly diffusing itself over the whole body; as soon as it makes its appearance, the un- easiness and other symptoms begin to disappear, and the patient, in simple ague, continues free from suffering until the next paroxysm. Causes. Marshy districts are noted as being the hot-beds of this malady ; a continuance of fish or farinaceous diet is also apt to produce it; it may, moreover, arise from taking cold, indigestion, internal obstructions, peculiar constitutional tendency, or local irritation. The medicines should generally be administered in the apy- rexia or interval between the paroxysms. Therapeutics. The following remedies have been found most appropriate in ordinary cases of this affection : Cinchona, Arsenicum, Ipecacuanha, Nux vomica, Pulsatilla, Antimonium crudum, Bryonia, Veratrum album, Cocculus, Sa- badilla, Ignatia, and Carbo vegetabilis. Cinchona. This well-known but too frequently abused remedy, is undoubtedly of the greatest efficacy in those fevers which owe their origin to the influence of marsh miasm, and are peculiarly prevalent at particular seasons of the year. It intermittent fevers. 43 may be given as soon as the precursory symptoms manifest themselves, when we find a degree of fever, with anxiety, palpi- tation of the heart, headache, sneezing, great thirst, bulimy, or nausea, and pain in the bowels. It is also indicated when the fever has set in by adypsia during the cold stage—but thirst after the heat and during the sweating. It is contra-indi- cated when thirst exists during the hot stage. Administration. When properly selected, a single dose of this medicine (three or four globules of the third potency) will generally remove the fever; but in other cases frequent repetitions and still lower potencies will sometimes be found necessary.* Arsenicum is indicated when the different stages are not definitely marked, but the fever, and heat, and shivering, appear simultaneously—or we find cold shuddering alternately with heat, or a sensation of cold internally, with heat, or an imperfect development of the paroxysms ; or burning heat, as if molten lead were coursing through the veins, communicating an unpleasant sensation of heat {color mordax) to the hand when placed upon the body of the patient—great restlessness ; and excessive, almost insatiable thirst, obliging the sufferer to drink constantly, although but little at a time; depression, marked prostration of strength and anxiety; nausea, desire to vomit, retching, and even vomiting; severe and burning pains in the stomach, and insupportable pains all over the body, espe- cially in the limbs. A marked characteristic of Arsenicum is, that all the suffer- ings of the patient, pains in the limbs, &c, increase in intensity during the paroxysm, and others develop themselves ; another is, its^marked periodicity, generally either Tertian or Quartan, and the rigors generally setting in towards evening. It is therefore called for in these cases where we meet with a well-marked periodicity of imperfectly developed paroxysms, with some or any of the symptoms above mentioned. Administration. Of this medicament saa given during the apyrexia, will be generally found a sufficient dose; how- ever, in some cases, when the vital energies of the patient * Vide note, p. 21. 44 intermittent fevers. seem insufficient to rally, and the cold fit continues, tiro drops of the tincture of the third potency may be added to an ounce of water, and a dessert-spoonful given every four or two hours, or every twenty minut. s. according to the exigency of the case. Such cases are happily rare in this country, but I have thought it advisable to touch upon the means to be employed when they do occur; in such instances also Veratrum (which see) is occa- sionally useful.* Ipecacuanha. This remedy will be found useful in most cases of this affection, for although it may not always prove competent to the entire removal of the complaint, yet when administered at the commencement it rarely fails to prove of considerable benefit, and in many instances, when judiciously selected, it of itself perforins a cure,—the most marked results have been derived from its Administration with rSur vomica in the following mode: exhibit Ipecacua.mia *§° in a little water, and repeat the dose, in three hours; Nix vomica fi|a twelve hours after, and if possible, in the evening. Should, however, the apyrexia take place towards evening, lengthen the intervals, giving the loecacuanha every five hours, • allowing twelve hours to intervene, and administering the Nu.r vomica in the evening, and if the attack be quotidian, repeating the latter medicine in the apyrexia preceding it. Either of these remedies is of itself sometimes found sufficient to shorten the duration of the disease; the indications for ln:- t acuamia are as follows: much shivering, with but little heat, or vice versa; increase of 'he shinring by e.t'ernai' u-arm'h ; oppression at the precordial region; adi/psia, or at least, little thirst; dryness of the mouth, nausea, vomiting, and other symptoms of deranged digestion. For Nux vomica. Giddiness, with feeling in the head as if from intoxication, desire to lie down, with trembling of the limbs, or a feeling of a paralytic weakness and prostration, with cramps in the different extremities, particularly the calves of the legs and feet, difficulty of breathing, anxiety, irascibility, fear of death, and even slight delirium ; gastric derangements, such as anorexia; dislike to bread; bitter and • Vide note, p. 37. intermittent fever?. 45 sour eructations, tension of the abdomen, or spasms of the abd uninal muscles, and constipation. During the fever: Coldness and blueness of the skin, desire to be constantly cov- ered, even during the access of heat and perspiration; oc- casionally stitches in the side, shooting pains in the abdomen, acldng in back and limbs, and dragging pain in abdomen dur- ing the rigors. During the hot fit particularly, headache, buzzing in the ears, heat in head, face, with redness of the checks, and thirst. Administration. In most cases the dose before mentioned will be found sufficient; but when the disease is violent, a few globules or a drop at the third potency may be added to an ounce of water, and a dessert-spoonful taken every night to the day a return is expected. Pulsatilla, like the two remedies last mentioned and Anlimonium crudum, Bryonia and Ignatia, is an excellent remedy in Agues complicated with gastric or bilious symptoms, whenever the slightest dyspeptic attack brings on a relapse; its more peculiar indications are : adypsia all through the fever, or thirst only during the hot fit; simultaneous heat and shivering—aggravated in the afternoon or towards evening; shivering when uncovered; anxiety and oppression of the chest during the shivering. During the hoi. slige, redness and swelling of the face, or redness of the cheeks only, and perspiration on the face. The presence of diarrhoea, and the patient being of a mild disposition, are corroborative indica- tions for its employment. Administration. In ordinary cases ^ may be given iu a dessertspoonful of water during the apyrexia; in very se- vere attacks, a few globules, or a drop or so of the third poten- cy, may be added to an ounce of water, and a dessert-spoonful given every six or twelve hours during the same period; in some instances, it will be sufficient to give a do3e about three hours before the expected attack. Vntimonium crudum. The indications for this remedy closely resemble those of Pulsatilla, but it is particularly called for when the perspiration breaks out simultaneously with the accesses of heat, and then suddenly disappears, leaving the skin 4K I n r e r M i tt k n t r k v k un. drt/ and ho'. It may be exhibited at the same potency and the same manner as Pulsatilla. Bryonia is indicated by headache and vertigo, with dry heat preceding the attacks of shivering; by the predominance of cold or shivering, with redness of the cheeks, heat in the head, and headache; or marked heat followed In shivering; by stitches in the side, excessive thirst, thickly coated tongue, bitter taste in the mouth, disgust at the sight of food, nausea or vomiting, and constipation. Administration. Bryonia maybe exhibited at the same potency and in the same manner as Xux vomica, (which see,) with the distinction of administering it when practicable in the morning, instead of at night. Veratrum album is indicated by the predominance of external coldness, with heat internally, cold clammy perspiration, especially on the forehead, or general coldness of the whole body ; or by shivering followed by heat and perspiration, and then relapsing into shivering; coldness, great thirst, deep- coloured urine, diarrhoea with griping, or constipation; some- times nausea or vomiting and vertigo, and pains in the dorsal and lumbar regions. Admimsph v i ion. This medicament may be exhibited in the same manner as Arsenicum, if the cold fit continues be- yond the usual time ; or may be had recourse to either singly or in alternation with that medicine, as circumstances may point out. Cocculus A^fi in a little water, at the customary period, when, in addition to the usual symptoms of Ague, we find during the apyrexia, symptoms of spasmodic affections, par- ticularly of th« stomach and abdomen, such as cramp-like pains at the epigastrium, or constrictive pinching, or tearing, burning, colic-like pains in the hypogastrium. Sabadilla has been found useful in cases where the attacks return always at the same hour, with chills of short duration, then thirst followed by heat; also where thirst is present just at the close of the cold stage, and in such affec- tions as consist entirely of chills. Administration *£ji a8 given under Arsmici.m. INTERMITTENT FEVERS. 47 Ignatia is indicated when with heat of some parts of the body there is coldness, chill, and shuddering of others, also where the heat is only external. Its best characteristic is, when the chills are easily relieved by external warmth, and at- tended with thirst. Administration, -£°- at the same potency and in the same manner as Pulsatilla. Carbo vegetabilis, in constitutions with a peculiar morbid tendency, will be found a most useful remedy. It is particu- larly indicated when thirst is present only during the shivering ; and there are rheumatic pains in the teeth or limbs before or during the attack, nausea, giddiness, redness of the face during the hot fit. Administration. °f^e may be dissolved in a little water, and given morning and evening during the apyrexia. • When the hot-fit continues long without perspiration super- vening, and the intermittent threatens to change into a remit- tent or inflammatory fever, we must have immediate recourse to Aconite, of which we may give -6°, and if no relief follows in three or four hours, add six globules of the third potency to an ounce of water, and administer a dessert-spoonful every hour until perspiration sets in, or the pulse is reduced Arsenicum, Carbo vegetabilis, and Lachesis, are three of the most important remedies against intermittent fevers which return every year. The preceding are the medicines that have been found use- ful in ordinary cases of this affection ; but as the disease is frequently found complicated with other complaints, it has only been found practicable to give a general statement of the course to be pursued when met with in its more simple forms, and merely to allude to the others—there being scarcely a disease known that may not assume the intermittent type, as there is scarcely a proved medicine that does not also partake of the same character. All the author has endeavoured to do, in the preceding pages, is to give a clear idea of the treatment of ague, commonly so called, as frequently met with; as he feels it would be vain to attempt to enter upon the many various forms and appearances which this malady presents. 48 eruptive fevers. EIUTT1VK FFAKKS. Under this head, I intend to treat of those diseases possess- ing the common property of febrile symptoms, preceding an eruption which is present during a part of their course, that eruption varying in character according to the nature of the affection. In this class are comprised scarlet fever, purples, measles, small-pox, chicken-pox, miliary fever, and nettle-rash. SCARLET FEVER. This disease, in its simple generic character, consists of a coutagious lever, with swelling of the face and a scarlet appear* ance of the skin—(hence its name)—which is of a bright rasp- berry colour, or of a hue resembling a boiled lobster, smooth and glossy, upon which the finger being pressed leaves a white imprint, which almost immediately disappears. However, in the present day, we seldom meet with it in this simple form, but more frequently complicated with severe or ulcerated sore throat, delirium, congestive or violent inflammatory symptoms, and often with more or less deviation from the characteristic efflorescence above described. Diagnosis. Fever with extreme quickness of pulse; a feeling of soreness or pain in the throat; and in one or more days, the appearance of an eruption of the colour above men- tioned, in large indefinitely marked patches, gradually growing paler towards their margins, and often extending over entire limbs with an uniform scarlet colour; the efflorescence disap- pears in five or six days, when the skin desquamates, and conies off in large pieces. We .sometimes find scarlet fever with scarce any, or even no external redness, but at the same time marked angina and bright redness of the tongue; in such cases the disease, in- stead of showing itself on the skin, has fixed upon the mucous SCARLET FEVER. 49 membrane ; end even the angina and redness of the tongue pre- sent in most cases of this disease may be considered as an in- ternal scarlatina. Scarlatina was formerly confounded with measles, from the resemblance which the two eruptions bear to each other at their commencement; but they are easily distinguishable, even without taking into consideration the peculiar appearance of the skin above mentioned—characteristic of the disease,—by the eruption in scarlet fever generally developing itself in from twenty-four to forty-eight hours from the commencement of the fever, whereas that of measles rarely sets in before the third or fifth day ; and moreover by the absence of catarrhal symptoms, such as cough, sneezing, lachrymation, the usual precursors of measles. The greatly accelerated pulse, which denotes the ap- proach of scarlatina, is also never met with to the same extent in any other disease. Therapeutics. In those cases in which it appears in its simple form, Belladonna is a specific remedy. We may dis- solve four globules of the sixth potency in four teaspoonfuls of water, and administer one every six or even three hours, if the fever run high, lengthening the intervals as it decreases in intensity, only repeating when a cessation of the amelioration takes place. We ought to watch carefully after each adminis- tration, for if the fever increases soon after, we may conclude it is a medicinal action, and avoid aggravating it by a repetition of the dose.* The next form which we shall treat of is, when the scarlatina becomes a severe and dangerous disease, when the throat is considerably affected ([Scarlatina anginosa), and high fever or congestive symptoms set in, which, if not properly treated, may assume the malignant type (Scarlatina maligna), attended with ulcerated sore throat, extension of the inflammation to the air- passages, delirium, spasm, &c. (Vide Ulcerated sore throat.) The fever and sore throat increase with the eruption in mild cases, and cease with its decline; but in the more severe, con- * Vide note, page 21. 3 50 eruptive fevers. tinue; it is when tho disease appears principally to attack the head, throat, thoracic or abdominal viscera, that it becomes dangerous.* The eruption frequently docs not appear before the third day, and then only in isolated patches : Belladonna should therefore bo administered as soon as the throat and tongue become affected with dryness and burn- ing; and there is desire, but complete inability, to swallow even drinks or saliva, with sense of suffocation ; further, when the throat presents a bright-red appearance, sometimes oxco- riated, with white specks, or stringy mucus, or appearance like thrush; tonsils swollen, and the tongue of a bright fiery red, sometimes interspersed with dark red patches, but generally appearing later in the disease, if at all; also when delirium is present. Administration. We should dissolve six globules of the third in six teaspoonfuls of water, and exhibit a teaspoonful every four hours; to a child under twelve years of age, £ in a teaspoonful of water repeated as above, which will generally be sufficient to bring about a speedy amelioration. If the disease have taken a favourable turn, we may allow the Belladonna to continue its action ;t but if we clearly per- ceive an appearance of ulceration commencing, with increase of mucus, and swelling of the throat and tongue, we must have immediate recourse to Mercurius. Administration. One grain of the third trituration in six dessert-spoonfuls of water, one dessert-spoonful every four hours; but when the ulcers present a livid appearance about the edges, and emit an offensive odour; or when there is ex- cessive thirst, with great dryness of the mouth, and extreme prostration of strength, we must exhibit Arsenicum a*a in a little water, every four or six hours, according to the effect pro- duced, and follow it with Svx vomica ^f4, in the /ame man- ner, if the former prove inadequate to complete the cure. (Vide Ulcerated sore throat.) * When scarlatina anginosa occurs in complication with pneumonia, phrenitiB, or enteritis, the remedies mentioned under these different heads must be had recourse to. t See the article on the "Adminittration of the remedy" in the In. troduction. scarlet fever. 51 When the fever assumes a clearly inflammatory type, and the pulse runs high, we may administer Aconite,* at the same potency and in the same manner as already given under In- flammatory Fever, which see. When the quickness of pulse and other inflammatory febrile symptoms are subdued, and the affection of the throat again appears prominent, we may return to Belladonna, especially if the skin retain the peculiar scarlatina hue. Opium may follow the administration of Belladonna when there is burning heat of the skin, drowsiness, stupor, sterto- rous breathing, open mouth, eyes half closed, restlessness with vomiting, or convulsions. Administration. Six globules of the tincture of the third potency, added to an ounce of water, a dessert-spoonful every four hours; if, however, a marked improvement follow the first dose, we may allow the remedy to continue its action. We may here notice a remedy which has been found par- ticularly efficacious in a peculiar affection of the brain, that frequently declares itself in cases of repercussed exanthemata, and which if not speedily checked, may terminate in paralysis of that organ. We shall therefore treat of this remedy here, and refer to this place, when we may hereafter have occasion to allude to it. The discovery of its value in such cases is * Antimonium tartaricum. The indications for Tartar emetic, ac- cording to Dr. Gray, are: a soporose condition from which the patient does not of itself fully arouse, and when awakened by the attendant, an- swers correctly without confusion or delirium ; intense heat with nausea or spasmodic jerks or general convulsions, and varying colour of the skin from pallor to deop redness, with imperfect patchy development of the eruption. The occurrence of sweat around the mouth, with pallor of the perspiring parts, increases the balance in favour of the Antimony. The Doctor gi. es it when Aconite proves unavailing, the indications for the latter being present. Our own views and results fully corroborate those of Dr. Gray. Dr. George W. Cook strongly commends the Antimony in his essay on Scarlet fever (Homoeopathic Examiner, new Series, p. 133, voi. I.). He presents the following indications for its use: convulsions which often precede the cutaneous efflorescence, colliquative diarrhoea, cold clammy skin, hurried respiration, hippocratic countenance, hoarse voice, retchings and vomiting of glairy-.atacus.—Ed. 52 ERUPTIVE FEVERS. due to Dr. Schmid of Vienna, whose formula for its exhibition we shall give herewith. Cuprum aceticum. When the eruption during efflores- cence is suddenly repereussed, the result of which is frequent- ly fatal, this medicament may be almost considered specific; or at least the substance with which the greate-t degree of certainty can save the patient; if in this condition death should happen, it is in consequence of paralysis of the brain. Symptoms indicating its employment : Quick, small, weak irregular pulse; temperature of the skin considerably reduced, in more severe cases chilly, and covered with perspiration. A tactions of the nervous system are never absent; to this be- long convulsive movements of various parts of the body, dis- tortion of the eyes, face, mouth, head, &rc, spasmodic affec- tion of the chest, sometimes even eclampsia; as well as great restlessness, frequent change of position, sopor, delirium, &e. It displays its efficacy in reproducing the eruption, when the cerebral affection disappears, and the disease runs its usual course. Formula. One grain of the Cuprum aceticum triturated with one hundred, one hundred and fifty, or two hundred grains of sugar of milk previously triturated so as to feel as fine as flour; the process should occupy from twenty to thirty minutes. Of this preparation take from three to four grains, dissolve in a tumbler of pure water, and administer in table- spoonfuls, every quarter, half, one, or two hours, according tr the violence of the disease.* Pulsatilla, when derangement of the stomach and digest- ive organs is a prominent symptom, the face pale, red, or bloated; also constipation—or looseness, especially at night,— occasionally with pains in the bowels, and shivering; dispo- sition fretful and sensitive, or melancholy. Administration. We may exhibit to an adult 4^A, and * The remarks made on this medicine are taken from the translation of Dr. Schmid's paper on the subject, in that excellent and useful med- ical periodical, the British Journal of Homoeopathy, No. III., page "233, to which the reader desirous of further information is referred. SCARLET FEVER. 53 repeat in six hours if no improvement takes place; to a child, one globule of the same potency. We frequently find this affection in a complicated form, distinguishable from pure scarlet fever by the absence of the peculiar hue of the skin, of which we have spoken at the commencement, and by the pressure of the finger leaving no white imprint. This so widely different type of the disorder will be found treated of in the succeeding chapter, under the denomination of Purpura miliaris or Scarlatina miliaris. In strumous habits, or in instances when the disease has been allopathically treated from the commencement, many troublesome sequelae are frequently left. And we may remark, that even after the desquamatory process is completed, the whole of the danger is not altogether passed, any exposure to cold or infringement of dietetic rules being likely to entail unpleasant and even dangerous consequences. Chamomilla may be employed with advantage, either alone or alternately with Belladonna against rawness of the face, &c. Administration. Six globules of the sixth or third poten- cy in six dessert-spoonfuls of water, one twice a day. Aurum. Against the offensive and purulent discharge from the nose with soreness and swelling of the interior. Administration. **** in half an ounce of water, a tea- spoonful taken morning and evening. Mercurius vivus against soreness of the nose and face with swelling of the submaxillary glands; followed by Hepar sulphuris, Silicea, Sulphur, and Calcarea if necessary. Administration. Half a grain of the third trituration in six dessert-spoonfuls of water, one three times a day. Against the following, Belladonna is extremely efficacious: Puffiness of the face, swelling of the hands and feet, lingering fever in the evening, glandular enlargements, chaps about the mouth, severe headaches, stammering, &c.; and may frequently be advantageously alternated with the medicines just men- tioned. t Dropsical swellings of the whole body is not an unfrequent 5* 54 ERUPTIVE FEVERS. sequela, sometimes requiring a most careful and discriminating treatment. The following remedies will generally bo found the best adapted to the successful treatment of the same: Helleborus, Arsenicum, Belladonna, and, in obstinate cases: Arnica, Bryonia, Phosphoric acid. Digitalis Baryta m., Sulph., Lycopod. Against Otitis, or Otorrhoea: Belladonna, Hepar sulphuris or Pulsatilla :—and in the case of Boils, Arnica followed by Bryonia and Sulphur when necessary :—Deaf- ness, Belladonna, Pulsatilla, Dulcamara, Sulphur, chiefly. Scarlet fever is chiefly dangerous when a latent constitu- tional virus is called into activity, and associates itself with the disease; in such cases, the allopathist finds himself baf- fled by an evil against which he possesses no specific remedy, and the utmost skill of the homoeopathic practitioner is called into play. Such, it is evident, are far beyond the sphere of a work of this nature : We may, however, remark, that Ammonium carbonicum, Arsenicum, Secale cornutum, and Acidum phosphoricum, have been found very useful in scarlatina when it assumes the ty- phoid form ; and Arsenicum in frequently repeated doses,—or Acidum nitricum, Aconitum, Lycopodium and Belladonna alternately, a dose of each remedy being given every hour, or oftener if necessary, to rouse the vital force to new efforts, for several successive hours,—in the severe and dangerous sore-throat which accompanies malignant scarlatina; the amygdalae being swollen into bard tumours, often as large as apples, with difficult, snorting, breathing, enlargement of the neighbouring glands, remitting pulse, and sopor. Belladonna is valuable as a preservative against pure scar- latina when epidemic, and moreover greatly assists in modi- fying the character of the disease, in such individuals as do not wholly escape its attacks; with children £*, in a teaspoonful of water, and with adults, or robust children above ten years of age, °-6°- every three or four days, for from two to three weeks at farthest, which will generally be found suf- ficient to obviate any risk; should the disease continue to rage, the treatment may in some instances be renewed : if the ruling epidemic be scarlatina in a complicated form, that is, scarlet rash. 55 not possessing the clear scarlatina hue, we should alternate this medicine with Aconite, one or two globules of the 6th potency, according to the age, allowing the Aconite an action of about twelve hours, and afterwards proceeding with the Bella- donna as before. While taking these medicaments, the patient must adhere strictly to the homoeopathic diet, particularly avoiding wine and acids. We must, in administering prophy- laxes, carefully watch their effects, and if a medicinal action set in, discontinue immediately. Diet. During the course of this malady, the greatest possi- ble attention must be paid to this point. In the more severe ac- cesses of fever, no other nourishment must be given than toast- water or weak barley-water; and after the fever has abated, every care must be taken, and a return be gradually made to a more nourishing diet, as negligence in this respect may be productive of the most serious consequences. In mild attacks the patient may be allowed gruel or weak broths. PURPURA RUBRA s. MILIARIS HAHNEMANN! Scarlatina miliaris. Miliaria purpurea. scarlet-rash. This affection is sometimes met with in complication with smallpox, measles, and scarlet fever, more particularly the latter, of which disease, indeed, it is regarded by many as a mere modification. It is easily distinguishable from pure scarlet fever, by the dark redness of the efflorescence, by the slight pressure of the finger leaving no white imprint, and by the small granular elevations, the cause of the dark red hue, which are felt on passing the hand over the affected cutaneous surface. This eruptive fever does not run a defined and regular course, like other exanthematic fevers. The efflorescence often disappears suddenly, and is then productive of extreme danger, frequently terminating in a fatal result. The extent 66 ERUPTIVE 1 KVEH3. of the efflorescence does necessarily add to the danger, as the latter is often greatest when the efflorescence is scarcely per- ceptible. Sweat is only met with on the surfaces affected with the eruption, and it is consequently only when the eruption covers the whole body that the sweat is general. Those who have been affected with the disorder are by no means exempt from future attacks. Soreness of the throat is chiefly encountered when the eruption is altogether wanting, but it is also frequently met with before tho outbreak of the rash, becomes trivial during the full bloom, and again very severe on the disappearance of the same. This disease, dissimilar though it be to the true scarlatina, has yet been frequently confounded with it by careless ob- servers. It requires a totally different treatment, and Bella- donna, the specific in scarlatina simplex, will in this case neither be found to be a preventive nor an indispensable curative remedy, but simply an auxiliary in some complicated cases. Auonitum. When the disorder occurs in an idiopathic form, there are few exceptions in which any other remedy but Aconite is required for the entire removal of the disorder. In administering it, we may dissolve three globules of the sixth potency in as many teaspoonfuls of water, and give a teaspoonful every three or four hours. Sometimes it is found necessary to administer a dose of Coffea (-3") a few hours after the first or second dose of Aconite, when the patient complains of severe pain in the head, trunk, or extremities, and is extremely restless, fretful, agitated, and disposed to shed tears; and then again to return to Aconite, after a similar in- terval ; and so on, alternately, until the cure is completed; which, under favourable circumstances, is speedily accomplished by means of these remedies. When, however, this eruptive fever occurs in complication with scarlatina, smallpox, or measles; or when it breaks out in unfavourable seasons, during the prevalence of one or more of the said exanthemata, it generally becomes a much more serious disorder, and requires the aid of other remedies in PURPLES. 57 addition to the above mentioned Amongst these : Ipecacuan- ha, Pulsatilla, Bryonia, Dulcamara, Belladonna, Arsenicum, Phosphorus, and Rhus, are the most important, preceded by Aconite, when symptoms of inflammatory fever, or the follow- ing, present thems-dves : Slight, general fever chills, with rapid- ly alternating redness and paleness of the face; quick, full pulse; slight confusion of ideas, increasing to a mild degree of delirium at night, combined with dryness of the mouth and lips, and thirst; eyes somewhat inflamed; oppression at the chest, short cough, sometimes attended with reddish sputa, and followed by a shooting pain under the ribs; occasional vomit- ing ; angina pharyngea. In such cases, then, a dose or two of Aconite, at intervals of four hours, will be found of considera- ble service, if not sufficient to put a check to the further pro- gress of the affection. Ipecacuanha 4£^4-&. In many instances, either at the commencement of the attack, before the appearance of the erup- tion, or during its full development, but particularly the former, this is a most efficient remedy. It is indicated when there is a sensation of distressing tightness of the chest, with laborious breathing, and heightening of the febrile action towards even- ing ; with symptoms of nausea, or even vomiting; extreme restlessness and agitation ; deep sighing, or moaning; dispo- sition to tearfulness or whining in children ; diarrhoea, colic. When the oppression at the chest and excessive restlessness have been removed by Ipecacuanha, but considerable nausea or frequent fits of vomiting remain, Pulsatilla will generally put an early termination to the latter. Bryonia °-fl£P-fi°-, is frequently more efficacious than either Coffea or Ipecacuanha in relieving the extreme anxiety, rest- lessness, deep sighing and moaning, which so generally attend this affection; it should therefore be had recourse to in all cases in which these remedies fail to afford speedy relief. In some rare cases even Bryonia is not sufficient, and it is then found necessary to administer ('inchona, followed by Phospho- rus. Bryonia is further indicated when the accompanying fever partakes of a nervous character, attended with delirium and other symptoms mentioned under Bryonia in the article on 3* 58 ERUPTIVE fevers. Ncrnws /nrr—whioh see. The excessive and continual urging to urinate, which sometimes sets in, in the course of the disease, is often very readily subdued by Bryonia or by Co- nium. Belladonna442/44- When the disorder is met with during the prevalence of Scarlatina, (as also when symptoms more or less characteristic of the latter affection make their appearance in the course of purpura miliaris.) this remedy is a most efficient auxiliary; it is, moreover, a most important remedy when symptoms of cerebral disturbance exhibit themselves ; or when the patient complains of the throat, which, on being examined, is found to be in a state of phlegmonous inflammation. Mer- curius may follow Belladonna when the tonsils become much inflamed and tumefied, or ulceration supervenes; in this lat- ter instance, however, Arsenicum or Acid, nitricum maybe- come necessary under particular circumstances. (Vide Scar- latina, p. 47; Soke throat, p. 84; and Scarlatina ma- liona, p. 50.) Phosphorus afto^&o. This remedy is very useful in cases in which there are symptoms of congestion in the chest, with extreme anxiety and oppression, and also when there is con- siderable cerebral irritability, characterized by over-excitabil- ity of the senses; further, when the patient appears extreme- ly listless and apathetic, and complains of burning sensations in isolated parts, causing a frequent change of posture neces- sary. Phosphorus is often of great utility after Bryonia or Belladonna. Dulcamara °-Q.o^o&. When severe aching or gnawing (rheu- matic) pains are complained of in the back or extremities, either in the course of the disease or at its termination, and when, in addition, there is an apparent complication of Scarla- tina with this affection, Dulcamara should be administered. Arsenicum £°-°^itt0, maybe had recourse to in any advanced stage of the complaint if the vital power seems rapidly sink- ing, and the organs which perform the act of deglutition are as it were paralyzed, so that the patient is incapacitated from swallowing; or when, from a metastasis to the throat, the latter MEASLES. 59 has become so rapidly and seriously affected, as to have assumed a gangrenous aspect. (See Ulcerated sore throat.) When the disease, in cases of a bad type, takes on a nervous or even a putrid character, with extreme often si veness of all the excretions, and hemorrhage from the nose, mouth, &c. The medicines mentioned under fevers of the said description, (which see, p. 32,) must here also be employed. Cuprum ace- ticum and Kreosote have been found useful in some of these almost hopeless but fortunately somewhat rare cases; the former particularly, when the efflorescence appears and disap- pears suddenly in the course of the disease.* Administration. Six globules of the remedy indicated, at the potency mentioned, may be dissolved in about an ounce of water, and one dessert-spoonful administered every three, four, or six hours, according to the urgency of the,case. The remedies required for the occasional sequelae, are the same as those enumerated at the conclusion of the chapter on Scarlatina. MEASLES. Rubeola. This disease generally reigns as an infectious epidemic, and for the most part confines its attack to children, in which cases it is seldom, when properly treated, either severe or dangerous; when it occurs in adults it generally assumes a more critical character. It rarely attacks an individual a second time. Measles is not to be so much dreaded for itself, as for the deleterious consequences it, under an improper mode of treat- ment, frequently entails, or to use the technical term, the dregs it leaves after it, in many constitutions developing an inherent disposition to consumption. * Rhus and Sulphur may also be mentioned as having been found use- ful in this disorder ; the former when the exanthema degenerated into a species of vesicular erysipelas, attended with lethargy, great thirst, and strangury; and the latter in cases where Belladonna had failed to effect all that could be expected. In the event of repercussion of the eruption, Bryonia, Phosphorus, Sulphur, and Cuprum aceticum, have been recom- mended as the most useful. 60 eruptive fevers. Diagnosis. Catarrhal symptoms, such as shor' dry cough, lachrymation, with redness of the c^c^, and a degree of fiver, more or less marked, preceding the eruption from three to five days, and generally continuing as long after, or all through the disease. Eruption of a number of small red spots (frequently papu- lar), the skin in the intervals between them gone-rally preserv- ing its natural colour, and sometimes exhibiting a faint reddish hue. We often find them in the shape of small irregular arcs. They for the most part make their first appearance on the face and neck, become confluent, and extend themselves gradually downwards over the rest of the frame. About the sixth or seventh day from the time of sickening, the eruption begins to turn pale on the face, and afterwards on the rest of the body, and generally entirely disappears about the ninth day, with a bran-I ike desquamation of the epidermis, a distinguishing sign of this disease. Aconiti: has been regarded, in some instances, as almost specific against measles, and in its mild form will frequently be found sufficient, in a few doses, to conquer the disease, or at least materially to shorten its duration ; it is particularly indicated when the fever assumes an inflammatory form, at- tended with dry heat of the skin, heat in the head, with confusion and giddiness, redness of the eyes, intolerance of light, general weakness or prostration; and is more or less useful throughout the course of the disease, either alone or in alternation with Pulsatilla, or any of the other remedies which may be better indicated, whenever marked febrile or inflammatory action becomes prominent. ([Coffea or Hepar are frequently useful after Aconite, when there is a distressing, dry cough.) Administration. °gft, or to very young children #, in a teaspoonful of water, every twelve hours; or in severe cases, exhibit it as under Inflammatory Fever, (which see,) and continue the treatment till we find an amelioration, should none of the symptoms hereafter mentioned, indicate the necessity of hiving recourse to another remedy. Pulsatilla is also very efficacious, and even specific, in MEA8LES. 61 this disease, and is frequently indicated in the commencement, from the strong resemblance which some of its pathogenetic* properties bear to the catarrh attendant upon measles, together with the characteristic exacerbation of the symptoms towards evening, &c. t This remedy is moreover of great utility in bringing out the eruption when it is longer than usual in making its appearance ; but whilst the fever is high, Aconitum must be administered; and if the febrile irritation does not diminish after a dose or two of Aconitum, Sulphur may be given; after which, if the fever return with increased force, Aconitum will rarely fail to answer our expectations. When there is great oppression at the chest, before the eruption is evolved, a dose or two of 1) ecacuanha is very useful. Administration. Of Pulsatilla flfft in an ounce of water, giving a dessert-spoonful every four hours while the same indications continue, until amelioration sets in. Pulsatilla is also valuable when any gastric derangement is present, or when the cough which so generally accompanies the disease, is worse towards evening or in the night, and is attended with considerable mucous ronchus, or copious, thick, yellowish .or whitish expectoration, sometimes followed by vomiting, or symptoms of threatening suffocation; further when there is coryza with a thick yellowish or greenish nasal discharge. (Sulphur is frequently of considerable service after Pulsatilla, particularly in strumous subjects.) Belladonna. When the inflammation attacks the throat, presenting many of the throat symptoms, we have given for this medicine under Scarlet Fever, attended with great thirst, which the patient is often prevented from indulging by the acute shooting or pricking yain in the throat produced by swallowing; and further, when there is a hoarse, dry, bark- ing, and somewhat spasmodic cough, worse at night, with mucous ronchus, great restlessness and high nervous excite- • Pathogenetic symptoms. Those caused by the action of a medicine upon a healthy individual. t Pulsatilla and Bryonia are two of the most important remedies when there is prominent bronchitic complication. (See also Bronchitis.) 62 EKl PTIVE FEVERS. ment; also in those cases of measles where no eruption de- clare itself, but simply headache and catarrh, with inflamma- tion of the eyes, which present a glassy appearance, are bloodshot, or streaked, and watery ; filially, when evident signs of cerebral irritation, kc. set in. Administration as under Scarlet Fever, (which see.) Bryonia is an excellent remedy when the eruption is faint, or imperfectly developed, and the respiration much oppressed and laborious; achings in the limbs, also when there is dry cough, and the patient complains of shooting pains in the chest, increased by a full inspiration. (Vide Pleuritis.) Administration. In mild cases °#° in a teaspoonful of water, given when practicable in the morning, and repeated in twenty-four hours; but in severe attacks, we may find it requisite to add six globules, or in some cases a drop or so of the third potency, to an ounce of water, and administer a dessert-spoonful every six hours until improvement set in. This disease has frequently terminated fatally, from the eruption being driven in by sudden exposure to cold or change of temperature; in such cases, Bryonia, administered as above, is generally found efficacious in re-evolving the erup- tion, and preventing this disaster; if diarrhoea, with mucous discharge, follow the suppression, Pulsatilla is indicated; if the vomiting with great oppression at the chest be the more prominent symptom, Ipecacuanha should be substituted, and followed in turn by Arsenicum if symptoms of improvement do not speedily show themselves.—In the case of children, Chamomilla is to be preferred to Ipecacuanha when there is dyspnoea and diarrhoea with colic and vomiting: When symp- toms of cerebral disturbance supervene, Cuprum aceticum, * Belladonna, and Stramonium, or Hellctborus niger, Arsenicum, and Sulphur, have proved of the greatest utility :—And in the case of pulmonic inflammation, Phosphorus, Bryonia, or Sulphur. In those comparatively rare cases in which typhoid symptoms manifest themselves, either during the course of the disease, or at its termination, Bryonia, Arsenicum, and Phos- * Vide Scarlatina, p. 52. smallpox. 63 phorus will be found useful, where any chance of recovery re- mains. (Vide Typhus.) For the treatment of coughs which measles sometimes leave after them, Sulphur, Sepia, Carbo v., Conium, Chamomilla, Drosera, Dulcamara, Hyoscyamus, Ignatia, Nux-v., Bella- donna, &c, are very serviceable. (See Coughs.) For the diarrhoea remaining under similar circumstances, Cinchona, Pulsatilla, Mercurius, and Sulphur, are in general the most appropriate : For their indications, see Diarrhoea. Otitis or Otorrhcea : Pulsatilla, Carbo v., Sulph., Merc, and Hepar sulphuris, chiefly. Parotitis : Arnica, and Phos. Ten- derness of the skin : Mercurius. Miliaria alba: chiefly Nux v. Burning, itching, rash, which bleeds after scratching: Arseni- cum and Sulphur. As a precautionary measure against the attacks of this dis- ease, when epidemic, we may administer Pulsatilla °^, in a little water, followed by Aconite 46a, three days after; allow the latter medicine to act for twenty-four hours, and continue the alternation for a fortnight, renewing it when necessary at the termination of a week or ten days. This treatment will frequently be found sufficient in warding off this disease, or, if taken, it will generally be in an extremely mild form. Diet. In this respect we may follow the rules given under Scarlet fever. SMALLPOX. Variola. This disease is, by pathologists of the present day, divided into two varieties—the distinct, when the pustules on the face are clearly defined, and do not run into one another; the con- fluent, when they coalesce and form one continuous whole. When the symptoms are less severe than those properly characteristic of the disease, and the eruption on the face slight, it is called the modified smallpox. We generally find this description in such persons as have been properly vacci- nated, which precaution, although not always a preservative 64 eruptive fevers. from the attacks of variola, greatly lessens its virulence, and gives a milder character to the complaint when taken. Diagnosis. This disease is frequently very sudden in its attacks, commencing with chilliness and shivering, followed by febrile symptoms, with headache, severe pains in the small of the back and loins, languor, weariness and faintness; the patient also complains of headache, oppression of the chest, and acute pain in the pit of the stomach, increased by pressure. The eruption makes its appearance at the close of the third day, first on the face and hairy scalp, then on the neck, and afti r- wards spreads over the whole body. Catarrhal symptoms, as Bneezing, coughing, wheezing, and frequently difficulty of breath- ing, often accompany this disease. The eruption first appears in the shape of small hard-pointed red elevations, which become depressed in the centre as they enlarge, and contain a semi-transparent fluid, with inflamed circular margin; about the sixth or eighth day, the lymph in the pustule becomes converted into pus, and the depression in the centre disappears. When the pustules are very numerous on the face, it gene- rally becomes much swollen, and the eyelids are frequently closed up. On the first day, a small lump like a millet-seed may be felt in each of the elevations above noticed, distin- guishing this eruption from all other exanthemata. The pocks continue coming on the first three eruptive days, and each pock runs its regular course; thus, those which first appeared are dying off, while the others are suppurating; and as the first dry and form into scab on the eleventh day from the com- mencement of the disease, the seventh from the appearance of the eruption, the general desiccation happens on the fourteenth day. When the pustules have attained their full development, they generally burst, in mild cases emitting an opaque l\mph, which dries into a crust and falls off; in severe ones, we find a discharge of puriform matter, forming scabs and sores, which leave, on their healing, permanent marks or pits. Red stains, caused by increased vascular action, always remain for SMALLPOX. 65 a while after the eruption ; but if no ulceration has taken place, they disappear in process of time. In Confluent Smallpox, all the precursory symptoms are wiore severe, the fever runs high, and frequently continues so thi oughout the course; the pain in the pit of the stomach, and difficulty of breathing, are more complained of, and in children the eruption is frequently preceded by convulsions and delirium ; the latter symptom is frequently present with adults during the suppurative or secondary fever, which frequently assumes a typhoid character, and sometimes carries off the pa- tient on the eleventh day; and all cases in which we have a deeply-rooted morbid constitutional taint to contend against, require the utmost skill of the experienced practitioner to ward off a fatal result. Salivation, with soreness of the throat and aphtha3, or pus- tules on the tongue and pharynx, frequently declares itself in both forms of this disease, but more particularly the confluent. Before we come to the medicines to be administered in the different stages of the disease, we may say a few words upon the treatment of the patient. Cool and fresh air are our best auxiliaries, the variolous virus is one which rests upon the organism, and warmth is calculated to increase its activity. So beneficial is cool air found in this malady, that taking a child to an open window when attacked with the convulsions, frequently present, will generally be found to afford immediate relief. Great cleauliness must also be ob- served, and the linen frequently changed. When the vesicles declare themselves, and begin to form into pustules, the room ought to be kept as dark as possible, to aid in preventing the risk of disfigurement, a precaution deducible from common experience, since we find that the parts of the frame exposed to the action of light are always those most strongly marked by the ravages of the disease. To avoid the cicatrices and consequent disfigurement left by this disease, many physicians have adopted a mask or plas- ter for the face, of different substances, such as gum, mucilage, calamine, &c. We have, however, in general course of prac- tice, found the specific action of the medicines, and the precau- 66 ERUPTIVE FEVERS. tion above mentioned, sufficient materially to obviate all evil consequences of this nature. Therapeutics. In the first or febrile .stage of the disorder, Coffea is valuable in allaying the nervous excitability general- ly present. Administration. ^ in a dessert-spoonful of water, re- peated in four hours, if necessary.* Aconite may either follow or precede this medicine when the fever runs high, and visceral congestion threatens. Ad- ministration as in Inflammatory Fever, page 23, (which see.) Chamomilla is often of great service at this period, or during the course of the disease, in children, when there is dyspnoea and diarrhoea, with colic and vomiting; or when starl- ings or convulsions set in prior to the appearance of the erup- tion ; and again during the maturative stage, when the nights of the little patient are much disturbed by a troublesomo cough. Should Chamomilla afford but slight relief, Belladonna may be administered. When considerable tightness and oppression at the chest, sometimes attended with nausea and vomiting, are experienced before the appearance of the eruption, the alternate use of Ipecacuanha and Anfimonium tartaric urn affords speedy relief; the latter remedy is, moreover, well indicated in this disease from the close analogy which the eruption it is capable of producing, bears to that of smallpox, and may therefore be also administered with advantage during the eruptive and ma- turative stages, unless some other remedies should be more urgently called for by the nature of the symptoms; the exist- ence of a hollow-sounding cough, with loud mucous ronchus, is an additional index for the employment of Antimonium tartaricum. Administration. Three globules of the sixth potency of each remedy, in a dessert-spoonful of water, alternately every one, two, or three hours, according to the severity of the » Vide note, p. 21. SMALLPOX. 67 symptoms, until symptoms of improvement set in. When Anti- monium tartaricum is given alone, it will be sufficient to repeat the dose every three to six or even twelve hours, according to circumstances. Bryonia is sometimes useful in assisting the natural course of the eruption; it is also indicated when considerable symp- toms of gastric derangement are present, such as bitter taste in the mouth, foulness of the tongue, headache, rheumatic pain in the limbs, increased by motion, constipation and irritability of disposition; also when there are occasional shooting pains in the chest, especially during inspiration. Rhus is equally serviceable at this stage of the disease, and particularly when the acute pains in the head, back, and loins, are aggravated when in a state of rest, and temporarily relieved by movement. Administration. In slight cases, °-6° in a teaspoonful of water, given every twelve hours, as the eruption continues de- veloping itself; in severe cases, six globules at the third po- tency to an ounce of water, a dessert-spoonful every six hours ; it may be preceded or followed by Aconite, should there be considerable fever, with dry heat of the skin, the medicine be- ing administered as above ordered until these symptoms are abated. Belladonna. This remedy may follow Aconite, when the latter has been indicated, should symptoms of cerebral disturb- ance have set in, characterized by flushed countenance, intol- erance of the eyes to light, headache and delirium; great thirst, nausea and vomiting; or when there is redness of the tongue at the tip and margins; abdomen tumid and painful, particu- larly at the epigastrium, with sensibility on pressure; prostra- tion of strength, stupor, &c. For further indication for the employment of this remedy, and the mode of exhibition, see Inflammation of the Brain AND ITS TISSUES. Opium is useful when there are symptoms of stupor or strong inclination to somnolence. ft|°. Should vomiting set in attended with diarrhoea, we may ad- minister Ipecacuanha e34, followed by Pulsatilla ^, if the 6<* ERUPTIVE FEVERS. symptoms become aggravated towards evening and the patient be of a mild and phlegmatic temperament. If Antimonium tartaricum and Ipecacuanha do not succeed in allaying the nausea and vomiting, and the patient complains of ex-essive thirst and dryness of the mouth, the tongue being at the same time very foul and dark, and the prostration of s'rength excessive, we may administer Arsenicum y in a teaspoonful of water, and repeat the dose every two or three hours, if required; but the remedy must be discontinued as soon as decided benefit has resulted from its action. The last syinp. torn generally occurs after the maturation of the eruption and secondary fever.* Pulsatilla is occasionally of considerable utility in con- fluent smallpox, when an efflorescence similar to that of measles precedes or accompanies the eruption, with nausea or vomiting, and aggravation of all the symptoms towards evening. An occasional dose of Stramonium ?£ is sometimes useful, when some pustules are already formed, in forwarding the erup- tion and shortening its duration. During the filling up of the pocks, a secondary or suppura- tive fever frequently sets in, particularly when the pustules are thick, and evince a disposition to run into the confluent form ; when, moreover, there is swelling of the head, inflammation of the eyes, throat, and nose, with salivation, hoarseness, and impeded deglutition; tenderness of the stomach; diarrhoea, with tenesmus, and sometimes sanguineous stools; having, if called for, first attacked the more prominent febrile symptoms with Aconite, exhibited as above prescribed, we should ad- minister on the same day, Mercurius, a grain of the third trituration in half an ounce of water, a dessert-spoonful eve/y six hours, until amelioration declares itself. When the fever runs high in confluent smallpox aud threatens to continue so, * In some cases, and especially those of a bad type, livid spots or dif- fused ecchyinoses are observed on the skin prior to the evolution of the eruption (variola nigra.) Arsenicum is here also of considerable service, the more so when great weakness and languor, thirst, nausea, or vomiting, with pain in the epigastrium, are present. SMALLPOX. 69 as it often does throughout this form of the disease, Aconite must repeatedly be had recourse to, and given in alternation with Sidphur, when not sufficient of itself to mitigate the ex- cessive febrile action. While the disease is running its course, particularly during the distention of the pustules, should no other remedies be imperatively called for, and also towards the period of their bursting, we may safely administer an occasional dose of Mer- curius as above, in the latter case, followed by a dose or two of Sulphur to assist in the desiccation. When rheumatic pains in the back and extremities, which become worse at night, and are somewhat relieved by move- ment, are complained of at this period, Rhus may be advan- tageously alternated with Sulphur. Rhus is moreover ex- tremely serviceable in confluent smallpox when the fever assumes a typhoid type, attended with the signs denominated putrescent; Mercurius and Arsenicum are equally useful, however, in the latter case, when indicated by the character of the symptoms. (Vide Typhus).* During the period of desiccation, continual laving with tepid water and bran, and gently drying it afterwards, will be sufficient; cleanliness being then the great requisite, with a careful attention to diet. Repercussion of the Eruption. When this has taken place, and the symptoms of cerebral disturbance, given under the head of the medicine about to be mentioned, (see Scar- let Fever, page 42,) set/ in, we must have immediate re- course to Cuprum aceticum, and employ it as there directed. Some physicians in their treatment of the affection divide it into two distinct stages; we have, however, contented our- selves, when necessary, with slightly referring to them. To the practitioner they are sufficiently well kuown: and the » When Pleuritis or Pneumonia intervene during the progress of the disorder, the remedies mentioned under these different heads must be called to our aid. The invasion and progress of the latter disorder is sometimes so insidious, that, unless the aggregate signs of pneumonia be narrowly looked for, disorganization of the lung may take place before the existence of such a complication is detected. 70 eruptive fevers. non-medical administrator must be guided by the symptoms that present themselves from time to time, in the selection of the remedy, by which mode he is less likely to fall into error than he might be were he to act by mere routine. Against the oough which sometimes results from an attack of smallpox, Bella- donna, Mercurius, and Arsenicum, are three of the most appro- priate remedies in most cases, (the particular indications for which will be found in the article on Coughs, which see ;) ami against asthmatic symptoms attended with mucous rattling in the chest, Tartarus emeticus, followed by Senega, should the former not effect a cure. Cinchona and Phosphorus have repeatedly been found spe- cific against the diarrhoea which occasionally results. And against the Ophthalmia, Conium, Belladonna, Hepar sulphur is, Euphrasia, Sulphur, Calcarea, Arsenicum, Pulsatilla, Mer- curius, Nu.r vomica, and Rhus toxicodendrum, have been found the most useful. Modified Smallpox is merely a mild description of the above, and as we have before said, is the form the disease gene- rally assumes when it attacks those who have been properly vaccinated. We must regulate our treatment according to the symptoms, being guided in the selection of the remedies by the indications before given.* Diet should be regulated by the virulence of the attack; but in all instances the beverages should be cold, as a warm regimen and neglect of the precautions before mentioned, may convert the mild into the malignant form ; and after recovery it is necessary that the patient abstain for a considerable time from animal food. It may be remarked, that after recovery from an attack of malignant smallpox, the patient's constitution frequently re- ft I have given in detail the treatment which has been generally adopt- ed by Homceopathists, aud with great success. Rut it may here be added, that Vaccinine, given internally, has obtained much repute as an impor- tant and eminently successful remedy, in the treatment of variola ; the most virulent cases having been reported to have yielded to it with a promptness and certainty that afford another great proof, if such were needed, of the truth of the homoeopathic law. chicken-pox. 71 quires a thorough renovation, and that he should be put under a course of medicine best calculated to attain that result. CHICKEN-POX. Variola spuria, Varicella. Diagnosis. A disease bearing a considerable resemblance in its external character to smallpox, but differing in its dura- tion, and symptomatically, being considerably milder, gene- rally requiring no medical assistance, but merely attention to diet, and but rarely becoming dangerous, except when it ex- tends itself to the lungs or brain. The fever, however, occa- sionally runs high. When this affection attacks an individual, and smallpox is epidemic, which is not unfrequently the case, it is often mis- taken for that disorder, but it soon discovers its real character by the rapidity with which the eruption declares itself; the pustules (in many instances closely resembling those of the smallpox) being generally fully matured by the third day, and the whole eruption disappearing at the end of the fourth or fifth, without leaving any mark. Therapeutics. When much fever is present, we should check it by the administration of Aconite \°, repeater! from time to time as required, or Coffea, y>, also occasionally re- peated if there be simply extreme restlessness and anxiety. When cerebral symptoms threaten, Belladonna ; for the em- ployment of this medicine, see Inflammation of the Brain. When attended with convulsions in children, particularly during dentition, see Convulsions. Antimonium tartaricum may be given to accelerate the eruption. Mercurius %° may be given when the lymph of the pustules becomes converted into pus, as in the smallpox, and is also beneficial if strangury be present. When the eruption has been driven in, see Repercussion of the eruption in Smallpox. In anomalous cases, where other symptoms su- pervene, more closely resembling Smallpox, we may consult the remedies mentioned under that disease. eruptive fevers. MILIARY FEVER. Miliaria, miliaria alba. M harts sudatoria. Sudor miliaris. Diagnosis. A great number of exceedingly small round, transparent vesicles, afterwards becoming opaque, and ending in scurf, irregularly scattered, of the size of millet-seeds, (hence its name,) which, when the hand is passed over the surface, feel as if they were small grains of sand beneath the cuticle. This affection is sometimes idiopathic, but more frequently associated with fever, and even occasionally present in various chronic diseases, in which latter instance it may generally bo considered as an evidence of some internal constitutional taint; it is also not uncommon with women at the period of confine- ment, arising from the room being kept at too high a tempera- ture—a frequent cause of this malady. This, like other cu- taneous affections of the same nature, is generally preceded by febrile symptoms; the eruption appearson the fifth or sixth day; from the commencement of the fever wo frequently find profuse perspiration, with a putrid sour odour; previous to the vesicles evolving themselves, there is a tingling or itching of the skin, occasionally attended with a sensation of burning, together with a numbness of the extremities ; the patient complains of a sense^f oppression at the chest, sometimes with short dry cough, and stitches in the side, and not unfrequently of severe or fugi- tive rheumatic pains in tlie limbs and teeth. Low spirits are a frequent accompaniment of this affection Therapeutics. In consequence of the numerous diseases with which it is complicated, it requires a variety of medica- ments. When it appears in a simple and apparently idiopathic firm, and is attended with anxiety and restlessness, which seem to depend upon an accelerated circulation of the blood, with great internal and external heat, Aconite is a specific remedy; and when the above seems more particularly to arise from high nervous excitability, Coffea is indicated. Belladonna \°, when the accelerated circulation is at- tended with considerable determination of blood to the head, and delirium. Arsenicum y, when the eruption is accompa- nied with excessive aiuictij. miliary fever. 73 When the disease is found conjoined with puerperal or other fevers, and is preceded by oppression, lassitude, anxiety and a sense of weight about the chest, restlessness, sighing, &c, it is generally speedily subdued by Ipecacuanha Q&, or should the symptoms which precede the eruption be accompanied by constipation, or shooting pains in the chest, Bryonia ^ should be selected. When this disease comes on in children, brought about by the same cause, viz., excessive warmth, or even errors in diet, attended with a greenish or watery yellowish diarrhoea, we may administer Chamomilla -6£, followed, if no alteration takes place, by Tincture of Sulphur -6°. Administration of the Medicines. When this disease appears in an idiopathic form, it is rarely so severe as to require a very frequent repetition of the medicines, if the accessory treatment about to be pointed out be carefully attended to—in most cases a globule or two at the potency above given, repeat- ed in from four to twelve hours, according to the intensity of the disease, will be found sufficient. And in many instances, a single dose will dissipate all the symptoms, or at least so modify them that we may safely trust to nature to perfect the cure. Remarks. When it exhibits itself in complication with other affections, Miliaria may be either symptomatic or critical, and the physician should always bear in mind that an improper treatment of other affections may develop it. Wrhen sympto- matic, it may be recognised by appearing either very early or late in the original affection, which so far from being relieved by the eruption, is frequently exacerbated by the excitement of the nervous system consequent on its appearance. Even when critical, in which case, after the eruption has been fully developed, amelioration takes place, it is still dangerous from its liability to retrocede. When a proper attention is paid to keeping the patient cool by light covering and the removal of feather beds, and allowing a free supply of pure air, this trou- blesome concomitant will rarely show itself. When, however, it appears critical, we must be most careful not to check it, and a moderately warm temperature must be kept up. Repercussion of the eruption. When this has taken 4 74 ERUrTIYK FEVERS place, we must carefully watch the result: sometimes Nature herself provides for it by an increase of some other secretion; but when symptoms of cerebral disturbance. &o, present them- selves, (see Cupr. acel., articlo Scarlet Fever, p. 4S.) Diet. Same as already given for Fever, modifying it ac- cording to the violence of the symptoms; when repercussion threatens to take place, the patient's beverages should be given moderately warm. NETTLE-RASH. Urticaria. Diagnosis. Spots or wheals, flat or prominent, and of a dull white colour like the sting of a nettle, or redder than the surrounding skin, generally encircled with a rosy areola, dis- appearing in warmth, and reappearing when exposed to cold, evolved suddenly and continually changing their situation. This eruption is brought to the surface by various causes, not nnfrequently arising from indigestion, caused by the use of im- proper articles of food. Before the eruption discloses itself, the patient is affected with restlessness, languor, oppression, and want of appetite, derangement of the digestive functions, and fever. When the eruption breaks out, the above symptoms become relieved, but considerable suffering arises from heat and itching; sometimes swelling of the parts affected; this disease, in almost all cases arising from a constitutional cause, requires for its total eradication a regular course of treatment. Therapeutics. In acute cases, the remedies found most useful are Dulcamara, Aconite, Nux vomica, Pulsatilla, Anti- mon. crud., Belladonna, Hepar sulph., Rhus tor., and Bryonia. Dulcamara when the exciting cause has been cold or damp, when the affection occurs in wet weather, or when we find con. siderable fever with bitter taste in the mouth, foul tongue, diarrhoea, pains in the limbs, and extreme itching, with a burn- ing sensation after scratching. Aconite when the febrile symptoms are more intense, the pulse high, the skin hot and dry, restlessness and anxiety present Nux vomica when there is considerable gn>tiic derangement, with constipation, more especially when arising from wine, stimu- lants, or indigestible substances; it may, if necessary, follow NETTLE-RASH. 75 Aconite in eight or twelve hours after the febrile symptoms are Bomewhat m< dined. I'ulsatillv deserves a preference under similar circumstan- ces, whe% the bowels are relaxed, and the patient of a quiet disposition and lymphatic temperament, and the attack has ap- parently been excited by indigestible food. Antimoniiim crudum may follow Pulsatilla, should the latter have failed to relieve the affection. Belladonna is indicated when the affection is attended with a severe throbbing headache, with redness of the face. Hepar sulphuris, when cold in the head, and particularly if affecting only one nostril. Rhus toxicodendron is one of the most useful remedies in a great majority of cases of this eruption, and especially when the affection has apparently arisen from some idiosyncrasy of consti- tution, in which the eruption has been thrown out by the use of some particular article of food. See article on Diet in In- troduction. AdministhaT' in of the Medicines. In ordinary cases we may dissolve four globules of the sixth potencies in six dessert- spoonfuls of water, and administer one morning and evening, ex- cept in the case or Aconite, which may be more frequently re- peated when the lobrile symptoms seem to demand it. (Vide note, p. "21.) In this, as in every other cutaneous eruption, great care ought to be taken against driving in the eruption, by external applica- tions or lotions; their sudden suppression, as before noted under Scarlatina and Smallpox, being frequently attended with fa- tal consequences. When, however, from improper treatment we have reason to dread this having taken place, we should adminis- ter Bryuma^, repeated every four hours until the eruption re- appears, which will generally be found sufficient to bring back the rash, and prevent further dangerous consequences. Should, however, marked cerebral symptoms declare themselves, see Scarlet Fever, Repercussion of the eruption. LIktica urens has been found useful in some cases. In those of a chronic or extremely obstirate character, Calc, Lyco- pod., Suti'L, Carb. v., Caustic, Acid, nitric, Conium, Natr.m., &:c : the latter two, particularly when the eruption is liable to re- 76 OASTRIC FEVER. — RIL1UU8 FEVRn. appear after violent exercise or exertion of any kind ; Calc, when exposed to cold fresh air; and Acid, nitric on going into the open air. after having kept within doors for a day or two. GASTRIC FEVER.—Symptoms: sensation of ftjness and weight in the epigastrium ; flatulent distention of the epigastric region, with inclination to vomit; eructations of offensive Hat us, and sometimes vomiting of ingesta and tenacious mucus mixed with bile; thickly furred, dirty yellow tongue; abdomen soft; bowels costive; but in the advanced stage of the disease the evacuations are often very offensive, and contain a portion of undi- gested food; frontal headache; languor; sickly and distressed expression of countenance, with yellow discoloration of the albu- ginea; more or less chilliness, succeeded by heat and dryness of skin; urine thick, cloudy, and dark coloured. BILIOTS FEVER.—Symptoms: more heat of the skin; restlessness and thirst excessive ; constant desire for acid drinks; the epigastrium is distended with flatus; the tongue is coloured at first with a pale yellow fur, which assumes a deeper or brown- ish colour; the taste and eructations are bitter, and the substance vomited consists of a greenish, bilious matter; the bowels are either confined or relaxed, in the latter case a yellow, preen, or brown colour; the face exhibits an earthy, somewhat jaundiced aspect; sometimes there is also a greater or less degree of sen- sibility, hardness, tension, burning in the hepatic region; the urine is dark brown, bilious. Therapeutics. In Gastric Fever: Puis., Nux-v., Ipec, An'im. c, Bryon., Cham, China, (,'occ., Tarl-c., Rhus-t., Sulph., Arsen., Verat., Co'oc, Acid. phos. (See Dyspepsia, p. 95.) When mental emotions have given rise to the disorder: Cham., Bryon., Color., Acid. phos.—Chum, and Bryon. in con- sequence of a fit of passion ; Color, from indignation or mortifi- cation. Staphys. when vexation is combined with indignation. Acid. phos. if grief, care, anxiety, have been the causes. (See Mental emotions.) In Bilious Fever: Acon., Cham., Puis., Nux-v., China, Cocc, Digit., Bell., Arsen., Coloc, Merc, Staph , C »lch., Tarax., Ignat., Asar (See dyspepsia hepatitis, mental emotions, nervous and putrid fevers.) DISEASES OF ORGANS connected with THE DIGESTIVE SYSTEM. TOOTHACHE. Odontalgia. When we find a constant disposition to this distressing malady, on the slightest exposure to cold, without any pre- sumable cause, or what is generally called rheumatic toothache, we are warranted in concluding that some taint lurks in the constitution; and until means are taken for its eradication, even the remedies most clearly indicated under other circum- stances fail for its relief, or at most but temporarily alleviate its pangs. Another obstacle to the selection of the proper remedy is the difficulty we find in obtaining from the patient a perfectly clear description of his sensations. We shall, nevertheless, mention a few of the remedies which have proved most efficacious in the relief of toothache, and when the symp- toms of the sufferer approximate closely to the indications given for the medicine, they will, in very many cases, afford a prompt relief. Therapeutics. Amrng these, Belladonna, Chamomilla, Mercurius, Nm vomica, Pulsatilla, Sulphur, Carbo vegetabilis, Hepar sulphuris, and Arsenicum, hold a high rank. Administration. The medicine selected may be taken dry, or dissolved in a teaspoonful of water; and if an aggra- vation of pain is experienced soon after taking the medicine, it must 'not be repeated, as this is generally succeeded by con- 78 digestive system. siderable relief; but when the pain threatens to get worse agnin, the same remedy may be repeated, provided the symptoms are of a similar description to what they were before taking the remedy; if they have altered, select another medicine. Belladonna 3-^, is particularly indicated when the pains are very severe, of a drawing, tearing, or shooting nature, extending to the face and cars; becoming aggravated in the. evening, and especially at night, with gnawing or boring pain in the carious teeth, swelling of the gums and cheeks, dryness of the mouth with excessive thirst, with or without salivation ; renewal of the pains from intellectual labour, or after eating; aggravation of suffering when masticating; also in the open air; congestion to the head, with heat and redness of the face, also pulsation in the head and cheeks. Chamomilla ■*•,•*-, when there are severe drawing, jerking, pulsative or shooting pains; heat and redness, especially of one of the cheeks: the pain becomes almost insufferable, especially at night in the warmth of the bed: shooting and pulsative pains in the ear and side affected, the pains are aggravated by eating or drinking anything hot or cold, but especially the former; great agitation and loss of self-control from pain, or excessive weakness, sometimes amounting to fainting; great irascibility, and disposition to shed tears during the paroxysms. Chamomilla is useful in cases of toothache which have arisen from abuse of Coffee,* in which aff. < ti,u Sux vomica and Pulsatilla are also valuable when indicated >y the symptoms. Rhus and Dulcamara frequently answer best fter Chamomilla in toothache from cold, where the former remedy has not re- moved the attack. And when the toothache returns after every exposure to cold, Sulphur is generally the best remedy; in some cases Cinchona. * Those who are subject to toothache, ought to abstain from coffee al- together; as also from very hot or cold drinks, stimulants of every descrip- tion, sweetmeats and acids ; they ought farther to refrain from using medicatpd tooth-powders, particularly if they wish to derive any benefit from homoeopathic treatment; the toothpick ought to be catiously used if required, and the mouth well rinsed with tepid water (or about the same temperature as that of the mouth) night and morning, and after each meal. TOOTHACHE. 79 Mercurius VV 1s particularly indicated when the pains affect carious teeth, or exist in the roots of the teeth, and con- sist of tearing, shooting pains, occupying the whole side of the head and face of the part affected, and extending to the ears; loosening of the teeth, and a feeling as if they were too long; the pain becomes almost insupportable towards evening, and especially at night in the warmth of the bed; aggravated when eating or drinking, particularly after anything cold, also by exposure to cold or damp air; swelling and inflammation of the gums; nocturnal perspiration, peevishness and inclination to tears; it is especially useful in persons who are subject to glandular swellings. Nux vomica -3-0- is useful for' persons who are habituated to wine, coffee, or other stimulants, or addicted to sedentary life or study ; of lively or irritable temperament, dark ox florid complexion; sufferings increased by intellectual labour. The pains generally occur in carious teeth, and are of a drawing and jerking or gnawing description, occasionally diffusing themselves to the head and ears, sometimes attended with painful enlargement of the submaxillary glands ; gums swollen and painful, accompanied with throbbing and pulsation. The toothache is more liable to come at night or on awaking in the morning, sometimes also after dinner or in the open air. Pulsatilla -,-^° is peculiarly adapted to persons of a mild or phlegmatic disposition. The pains are digging and gnaw- ing, attended with pricking in the gums, extending to the face, head, eye and ear of the side affected; this remedy is particularly efficacious in toothache, attended with earache, with paleness of the face, and when the toothache has been excited by taking cold, or where we find shortness and difficulty of breathing ; the pains are sometimes of a drawing, tearing, shooting, or jerking description, and occasionally produce a sensation as if the nerve were drawn tight, and then suddenly relaxed ; the pain is much aggravated in the evening or after midnight, generally increased by warmth and when at rest, and mitigated by cold air or cold applications to the mouth. Tincture of Sulphur -3a. This remedy is particularly valuable in strumous habits, with a tendency to constipation; ?0 DK.ESTIV E SYtil r>l. pain, sometimes attended with swelling of the cheek and shoot- ing pains in the ears, congestion of blcoel to the head, and pul- sative headache; the pain is of a tearing, jerking, pulsathe description, affecting both carious and sound teeth; aggra- vated in th*e evening and at nijit, or by exposure to the open air, also by the application of cold water, or by mastication; loosening, sensation of elongation, and setting on edge of the teeth; the gums are suo'len, affected with pulsat ire pains, and bleed easily. , Bryonia *y is also a useful remedy in this affection, par- ticularly with persons of lively, choleric, and obstinate dis- position. Its indications are loosening and sensation of elon- ga ion of the teeth, especially during or after eating; shooting in the ears, with inclination to lie down, pains aggravated hy taking anything hot in the mouth, mitigated by lying on the affected side or exacerbated by the contrary position. Carbo vegetabilis *3y is indicated by toothadhe, with dragging-tearing, or constrictive and throbbing pains excited by anything hot, co"d, or salt; chronic looseness of the teeth ; receding, ulcerated and suppurating gums, (particularly after the abuse of mercurial preparations, such as calomel, etc.,) bleeding from the teeth and gums, with tendency of the teeth to decay rapidly. Hepar sulphuris £ gr. of the third trituration, is indicated by dragging jerking toothache, increased by approximating"the teeth (clenching), by masticating, or from sitting in a warm room; swelling of the gums, with tenderness on pressure, ab- scess in the gums; (especially useful in cases where hurtful doses of Mercury have previously been taken under allopathic treatment.) Arsenicum-°3y by nocturnal pain, which extends into the ear, cheek, bones of the lace, and temple; aggravation of the pain by lying on the affected side; amelioration from the warmth of the fire; aching in the teeth so excessive as almost to drive to madness or distraction ; sensation of elongation and looseness of the teeth; grinding of teeth; and bleeding of the gums. Aconite, Belladonna, Chcmomilla, CJ/eu, and Ignatia, are the most useful in affections of this nature with children. SORE THROAT, or quinsey. 81 Aconite *2y. When the pains are difficult of description, attended with great agitation, feverish sensation, blood to the head, heat and redness of the face, and when the pains are de- scribed as of a pulsative, throbbing nature. Coffea *y. Against violent pains with great. excitability and almost distraction in adults ; also when the patient is con- scious that the excitement is disproportionate to the pain suf- fered. For Chamomilla we have already given indications ; if it prove insufficient, has been caused by a chill, and is attended with diarrhoea, we may substitute Dulcamara h. Iunatia fi-y is suitable to those cases presenting similar in- dications to those of Nux vomica or Pulsatilla, but more par- ticularly applicable to mild or sensitive dispositions with alter- nation of high and low spirits. Tartarus emeticus. 1 gr. of the third trituration in about an ounce of water, a dessert-spoonful three times a day;—in toothache occurring during cold, wet weather,—particularly in women, with nocturnal exacerbations, or aggravation of the pain when drinking any cold liquid.* SORE THROAT, or QUINSEY. APHTHOUS SORE THROAT. Angina faucium, Tonsillitis phlegmonoides, Cynanche tonsillaris,—Angina aphthosa,—etc. Quinsey.—Diagnosis. Inflammation of the throat, denoted by swelling and red colour of the back part of the throat, accom- panied with difficulty of swallowing, impeded respiration, alter- ation of the voice, and fever. In the incipient stage of this affection, there is a sense of * In rheumatic or arthritic toothache with nocturnal aggravations, or in- crease of pain on partaking of cold or warm drinks, but temporary relief on the external application of heat; also in toothache which returns every spring or autumn, during the prevalence of easterly winds, (and then con- tinues sometimes for several weeks,) the pain being occasionally confined to one tooth, which is extremely sensitive to the slightest touch, and often accompanied with acute shooiings into the ear, Rhododendron chrysan- thum is a useful remedy, in repeated doses. 4* DIGESTIVE SVSTIM. constriction about the threat, with a feeling of «orpness, n' <1 sometimes of obstruction in the act ef swnlli wing tlie Hitliva; if it runs its course, the difficulty of swallowig and breathing increases, the tongue swells and becomes foul, the tonsils as- sume a redder hue, occasionally a number of small \ellow emi- nences appear at the back of the throat, and particularly on the tonsils : the patiei t c< mplains of thirst, and the pulse is high, strong, and frequent ; sometimes the cheeks swell and be- come florid, and the eyes inflamed, and in severe cases deliri- um is not an unfeijuent occurrence. As the local affection progresses, the majority of the foregoing symptoms become ag- gravated, the tonsils tumefied, and suppuration ensues if resolu- tion be not speedily effected. When suppuration takes place, the pain is instantly relieved on the bursting of the abscess; it sometimes happens, how- ever, that scarcely has the patient been relieved from suffering by the latter event, before the state of the other tonsil gives in- dications that a similar train of symptoms are about to be en. countered there. This affection, occasionall;, if not properly treated, dangerous in its simple form, becomes particularly crit- ical when it puts on the putrid type. In such instances, the attendant fever generally assumes a t\phoid character; when this takes phu-e, we may always inter a peculiar coi stitutional tendency. Therapeutics. The following are the piincipal remedies used in the treatment of this affection :—Aconitum, li.lladonna, M-rcurius, Carbo v., Acidum nitricum, Lachesis—Pulsa'illa, Ntir v., Arsenicum, Chamomilla, Ignatia, Dulcamara, //. ptr sulphuris, Silicea, Sulphur. When tl is affection i« at the commencement attended with considerable fever, thiist, and dry heat, deep redness of the parts affected, paiiful and difficult deglutition, pricking sensation in the throat, with aggravation of the symptoms when speaking, we should i.ave recourse to Aconite. Administration. This must be regulated by the intensity of the inflammation ; in many casts a dose of y, repeated in six hours, if necessary, will be found sufficient; but if the in- flammatory symptoms are very violent, we may add six glo- SORB THROAT, OR UUIN8EY. 83 bules of the third potency to six dessert-spoonfuls of water, and administer one every hour or half hour, according to the urgency of the case. Should, however, deglutition of liquids prove extremely distressing, or almost impracticable, we may give "J4 dry upon the patient's tongue, at similar intervals. This rule will hold good for the other remedies about to be mentioned in this complaint.* The next medicament we shall mention, Belladonna, as may have been observed in the treatment of Scarlatina, Measles, &c, is one of the best remedies we possess against phlegmo- nous inflammation of the throat. When the above symptoms have been subdued by Aconite, or should the following symp- toms have existed from the commencement, we should have im- mediate recourse to its administration. Pain in the throat as if from excoriation, attended with scraping, and a sensation of enlargement, and burning or shooting pains, principally experienced during the act of swal- lowing ; these pains sometimes extend to the ears. Other characteristic indications for this remedy are—sense of spas- modic constriction or contraction of the throat, with constant desire to swallow saliva; occasionally there is violent thirst, with dryness of the throat, but a dread of drink from the suffering it occasions. Sometimes a complete inability to drink exists, and the liquid returns by the nostrils. On examination, the throat presents a bright- red colour, with swelling of the palate, uvula and tonsils; also accumulation of slimy whitish mucus in the throat and on the tongue, obliging the patient to syit frequently; swelling of the muscles and glands of the neck, severe headache, chiefly confined to the forehead, some- times determination of blood to the head, and delirium. (After Belladonna, Mercurius, Ladies is, or Pulsatilla, are often suitable.) Administration. The same as Aconite, but allowing a longer interval between the doses, say from four to twelve hours, according to the violence of the affection. This remedy frequently succeeds in speedily removing the » Vide note, p. 21. 84 DIGESTIVE SYSTEM. whole of the above group of symptoms, or, at least, so far sub- dues them as to enable Mercurius to complete the cure. Mercurius, frequently valuable at the commencement of the disease when so indicated, or in alternation with Bella- donna in troublesome cases, is one of the most valuable remedial agents; following that medicine, when necessary, to c.....plete the cure. Its indications are violent shooting in the throat and tonsils, especially when swallowing ; these pains extend to the ears, and glands before the ears, and under the jaw; inflam- matory redness and swelling of the affected parts of the throat, burning in the throat, desire to swallow, attended with a sensa- tion of an obstruction existing in the passage ; accumulation of thick and tenacious mucus in the throat, difficult deglutition, especially of liquids, which sometimes escape through the nostrils; swelling of the glands, and muscles of the neck, and of the posterior part of the tongu?; occasional swelling of the gums; unpleasant taste in the mouth, which is filled with salira more or less insyissa'ed; throbbing of, and matter forming in the tonsils; (confluent, or small, isolated, round, white specks or vesicles on the tonsils; indolent ulcers in the throat';) (Angina aphthosa ;) offensive odour from the mouth, aggravation of symptoms at night, when speaking, and in the evening; chills, and shivering, sometimes alternated with heat. (Lachesis, 'Hejiar sulphuris, Carb. v. or Ac nit. are often suitable after Mac.) Administration. Six globules of the sixth potency, or in severe cases with small ulcerations,—a grain of the third trituration dissolved in an ounce of water, and a dessert-spoon- ful given every six to twelve hours, according to the results; if an alternation with Belladonna seem advisable, we may allow a similar interval to elapse between the exhibition of the two medicines. Lachesis. One of the characteristic indications for this remedy is, aggravation of the pain in tlie throat from the slight- est external pressure,—it is moreover an excellent remedy in all cases of tonsillitis in which B-lladonna or Mercurius have afforded relief, but seem incapable of effecting resolution ; and also in aphthous sore throat with considerable ulceration, when Mercurius has afforded only partial relief. SORE THROAT, OR QUINSEY. 85 Administration. Six globules of the sixth potency to an ounce of water, a dose every twelve hours in ordinary cases ; in the more virulent, at intervals of three to six hours, according to the effect produced. Carbo vegetabilis This remedy may either follow, or be selected in preference to Mercurius, after a previous dose or two of Aconite when necessary, in Aphthous sore throat characterized by the appearance of small white specks or pimples, on the enlarged and protuberant tonsils, (which if not checked become confluent and spread beyond the throat,) when the patient complains of severe burning and pricking pain, with great thirst. Administration. Six globules of the sixth to be dissolved in about an ounce of water, a dessert-spoonful to be adminis- tered twice a day. A dose or two-of Sulphur is sometimes re- quired after Carbo v. or Mercurius in very obstinate cases. Acidum nitricum. After Aconite and Mercurius in Aph- thous sore throat, characterized by superficial ulcerations in the throat, should the small white or gray ulcers not put on a heal- ing appearance a few hours after the use of M'-rcurius. 'administration. Six globules of the third potency in an ounce of water, a dessert-spoonful every six, then every twelve or twenty-four hours uutil the cure is complete. Nux vomica. This remedy is especially useful when the sore throat appears to arise from or to be accompanied by symptoms of deranged digestion, and when a sense of scraping or excoriation exists in the throat; also when a feeling of con- traction is experienced in the upper part of the throat during empty deglutition ; swelling and elongation of the uvula, pro- ducinir a constant desire to swallow; at times only a sensation of swelling, with pressure and pains; or when cold has been the exciting cause, and the affection is attended with dry cough and headache, chiefly in the morning, and pains under the lower ribs during the cough. This remedy is also indi- cated likewise when there are small offensive ulcers of the throat, or considerable debility is present. (Vide Ulcerated Sore Throat, page 89.) Sulphur is frequently usetul after Nux vomica. 86 DIGESTIVE SYSTEM. Administration. */ in a little water exhibited in the evening when practicable; in severe cases repeated every six hours, until improvement results. Pulsatilla is frequently serviceable after Belladonna, when there is an increased secretion of viscid mucus in the fauces: but it is more particularly when the following symp- toms are met with that this remedy is called for: gaetric do- rangement, with dark livid redness of the throat and tonsils ; a sensation as if the parts affected were much swollen, or a feeling of an enlargement of the upper part of the throat, as also, of excoriation and scraping, with dryness of the throat wifhou' thirst, shooting pains in the throat when not swallowing, aggravation of the symptoms towards evening, attended with shivering ; also accumulation of adhesive mucus in the throat. This remedy is more particularly suitable for females, or for in- dividuals of a mild and phlegmatic temperament. Administration. £6a in a little water, repeated in twelve hours, if no amelioration takes place within that interval.* Chamomilla is a remedy particularly useful in the sore throat occurring in children, and especially when the disease has been brought about by checked perspiration, when there are shooting or burning pains, with sensation of a s'idling of the ihroi', deep redness of the parts affected, inability to swal- low solid food, especially when lying down; thirst, with dry. ness of the mouth and throat, swelling of the tonsils and glands before the ear and under the jaw; cough excited by constant tickling of the throat, attended with fioarseness ; fever towards evening, with alternate heat and shivering, redness of one cheek, great excitability and tossing about. Administration. £6£ administered every twelve hours, until amelioration takes place. Ignatia is indicated when there is a sensation as of a plug in the throat, with red and inflammatory swelling of the tonsils, or palate ; burning pains in deglutition, as if a sub- stance were passing over an excoriated surface, or partially obstructed by some foreign body in the throat. Liquids are ■ Vide note, p. 21. SORE THROAT, OR ftUINSEY. 87 more difficult to swallow than solids : there are also shooting pains in the cheeks, thence extending to the ears, when not performing the act of deglutition; induration of the tonsils, or evolution of small pustules upon them. Administration. The same as Pulsatilla. Dui.c vm \ra. An almost specific remedy when sore throat, particularly in the form of tonsillitis, has arisen from ex- l-osrin: to wet. It may be followed by BeVadonna or Mercurius, should it not wholly remove the affection, and should any of the symptoms given under these medicines present themselves. Administration. *■*■ repeated in twelve hours, and if no symptoms of increased pain or swelling present themselves, allowed an action of thirty-six hours from the last exhibition, during which period a marked amelioration, if not a perfect cure, sometimes preceded by a temporary aggravation, fre- quently develops itself. This medicine, it' taken immediately after a severe wetting, often succeeds in preventing any un- pleasant consequences. Coffea cruda. Sometimes useful as an intermediate rem- edy ; when many of the symptoms enumerated under Bella- donna, with the exception of the external swelling of the throat, are present; and also by a sensation as if the uvula were elongated or loaded with mucus, causing a constant in- clination to swallow. One of the best indications for its empleyncnt in this, as in other diseases, is an extreme over- excitabiliiy of the nervous system, characterized by sleepless- ness, great restlessness, sensitiveness, disposition to weep, and peculiar impressibility to external agents. Administration. A few globules of the sixth or thirtieth potency. Arsenicum. The indications for the employment of this remedy in sore throat have been already given under Scarlet Fever, p. 48, and under Malignant Sore Throat, p. 89. Hepar sulpuuris is valuable in bringing the matter to a head, when resolution cannot be effected, and the quinsey has attained to such a height that its bursting is desirable from 8* digestive system. the painful sensation of suffocation which arises in conse- quence of the tumefied condition of the tonsils. Administration. One grain of the trituration, third po- tency, added to an ounce of water. Ono dessert-spoonful every two hours until the quinscv bursts. Silicea. This remedy is in some instances more efficacious than Hepar in rapidly forwarding the suppurative process, and causing the ripened abscess to burst. Administration. Six globules of the sixth in an ounce of water, a dessert-spoonful every two hours. Mehcuuius may follow the above medicine after an interval of a few hours, to facilitate the healing. In obstinate cases, such as are occasionally met with in bad constitutions, the healing of the cavity after the matter has been discharged goes on very unfavourably, and even fresh absccsscB form in sue- cession : Sulphur, lit pur s. and I'soricum, repeated every eight or twelve hours, have chiefly been recommended in these fortunately rare cases. Sulphur in ordinary cases ; He/ ar s. when the patient has been previously subjected to an abuse of Mercury under allopathic treatment, and P.-,oricum when Sulphur has been taken in excess. * Half a grain of the tri- turation to an ounce of water, a tablespoonful every twelve hours. Tue diet of the patient must be regulated according to the degree of inflammation present. If required, the throat may be gargled with a little warm water, and when much pain is present, inhalation of the vapour from boiling water will often afford considerable relief; but at the same time, it may be observed, that all medicinal gargles, blisters, leeches, or other topical applications, are rendered unnecessary by proper homoeopathic treatment. While we thus free the patient from a considerable degree of annoyance and needless suffering, we, at the same time, by a careful attention to the symptoms, and the exhibition of the proper remedy, effect a speedy cure. • Brit. Journ. of Homeopathy, No. vii. ULCERATED sore turoat. 89 ULCERATED SORE THROAT. Malignant Quinsey, Malignant, putrid or gangrenous Sore Throat.—Angina Mdigna, Tonsilitis Maligna, Cynanche Maligna. Diagnosis. This serious disease is also known by the name of Scarlatina Maligna, from the eruption with which it is frequently attended. It is usually epidemic, of a highly contagious nature, and generally occurs in damp and sultry autumnal seasons. It sets in with cold and shivering, succeeded by heat, and accompanied with great languor and oppression at the chest; nausea or vomiting and sometimes purging; eyes in- flamed and watery; deep red colour of the cheeks; the nos- trils are also more or less inflamed and secrete a thin acrid discharge, frequently causing soreness or excoriation of the nose and lips; pulse indistinct, or very weak, small, and ir- regular ; tongue white and moist. The deglutition is painful and difficult, and on examining the throat early in the disease, it is observed to be of a bright red, and much tumefied; but this state is very soon altered, and numerous ulcers of various sizes will then be observed to be interspersed over the parts, which become covered with a white, grayish brown, or livid coat. In some cases these ulcerations spread so as to extend over the whole fauces into the nostrils, or downwards even to the glottis and gullet, &c, and assume a sloughing appearance as they increase in size : The prostration of strength, considerable from the first, is now excessive; the tongue, lips and teeth are covered with brown or blackish incrustations, and there is more or less delirium; the breath is extremely fetid, and the patient himself complains of a disagreeable odour. The neck appears swollen and of a livid colour, and an efflorescence of a faint scarlet hue, or blotches of a dark or livid red sometimes intermixed with petechias, break out on various parts of the 90 digestive system. body, and usually, though not necessarily, add to tho danger,— as many are carried "ff, particularly children or persons of an advanced age, without any eruption,—when the l"eal symp- toms are severe and the lever high: Hit tho appearance of livid spots or petechia, and other indications of so called putrc.-cency, with frequent shivering, weak fluttering or inter- mittent pulse, sunken countenance, sen re purging, extreme pi-'strati >n, and bleedings from the no>c, m >uth, &■•., must decidedly be regarded as symptoms of imminent danger. When the local symptoms are mild, the danger is rarely great ; and even in the severe forms of the disease, when a gentle sweat breaks out about tho third or fifth das, when tho sloughs throw off in a favourable manner, leaving a clean florid healthy-looking bottom, and the 1 ojiiratinn becomes more trentlo and free, the expression of the face more lively, and the pulse stronger and more equal, a salutarj result may be held in expectation. Therapeutics. The remedies to be employed are nearly the same as those which are commonly used in scarlet fever of a bad t\pe, or in typhus. The following will generally be found adequate to subdue the various forms which the malady assumes, where any prospect of a cure may reasonably be entertained from the commencement: Aconitum, Belladonna, Mi rcurias, Acidum nitricum, Pulsatilla, Arsenicum, Lach sis, Nux v., Carbo vtgdabilis, Sulphur, dfc. The accompanying fever being generally of a low typhoid character, Aconite is rarely necessary in this complaint; how- ever, there are cases, and particularly when the fever runs high from the commencement, in which advantage is found to result from a dose or two of this remedy, followed by Belladonna as soon as the patieut complains of dryness, with impeded deglutition and a sense of constriction or choking in the throat, which latter, on examination, is observed to be swollen and to present a florid red appearance. Be'lad uinu is also indicated when the fever continues to run high; when the face is bloated and the e\ea much in- ulcerated bore throat. 91 flamed; when the patient is affected with considerable deli- rium, and is occasionally only with difficulty to be restrained from leaving the bed or commiting acts of violence; or far- ther, when the rash, which sometimes breaks out in this dis- order about the third day, presents a scarlet hue. In cases in which the symptoms are mild, or in which the above-mentioned symptoms have been reduced by means of the remedies quoted, and an increased secretion of mucus sup- plies the place of the previous dryness, while the patient is at the same time afflieted with nausea and bilious vomiting, a dose or two of Pulsatilla may be administered with effect; the progress of matters in the throat must however be, carefully watched, and as soon as the presence of small ulcers, or still better, their incipient formation, tan be detected, a dose of Mercurius should be prescribed, followed by Acidum nitricum, when from the increasing size and painfulness of the ulcers, Mercurius does not promise to arrest their progress or cause them to take on a healthy aspect. In the milder forms of this disease, the two last-named remedies will frequently be found sufficient to conduct it to a speedy and successful termination. But in those much more dangerous forms which the com- plaint so readily assumes when it rages as an epidemic, and where the patient at the commencement is seized with vom- iting and purging, attended with such prostration of strength as to render it Impossible for him to leave the recumbent posture without feeling faint, and compelled to fall back ex- hausted by his efforts:—Where, moreover, the ulcerations spread with alarming rapidity, and early take on a sloughing character:-in such cases, the conducting of the disease to a happy i*sue becomes obviously a much more serious and dif- ficult task. Here the symptoms must generally at once be attacked by administering Arsenicum .— Sometimes, however, a little benefit will be found to result from a dose of Pulsatilla at the commencement, when there is an excessive degree of bilious vomiting; but Arsenicum must unhesitatingly be had recourse to when there is that marked -prostration of strength" so characteristic of this disease, ac- 92 DICKSTIVH SYSTEM eompanied with nausea or vomiting: or when tho ulcers pre- sent a lieid hue. This important remedy is nlso indicated in a more advanced stage of the disease, when the ulcerations aro covered with dark sloughs, surrounded by a livid margin ; the teeth and lips encrusted withsordes; the pulse small and ir- regular; and there is delirium or constnnt muttering, with fre- • quent hanging of the lower jaw; laborious respiration; acrid discharge from the nostrils, causing excoriations; the e\cs dull and glassy; the skin hit and dry, and the thirst excessive; yet the patient drinks but little at a time, and appears to per- form the act of deglutition with great pain and difficulty; finally, when the prostration of strength is so extreme that the patient seems rapidly sinking, and a rash of a livid colour breaks out in blotches, here and there intermingled with petechia. Lachesis will frequently be found very useful after, and in some eases alternately with \rscnicum, should the pa- tient complain of great pain in the throat, which is aggravated by the slightest external pressure; or should the sloughs not B-'i-m disposed to cast off in a kindly maimer; and the neck become much swollen and discoloured. When the tendency to gangrene continues, and tho patient is still affected with considerable prostration accompanied with debilitating sweats, (iwhona will often be found of service?. Nm- vomica i-> frequently serviceable alter Arsenicum when tho diarrhoea has been checked, but numerous small, foul, offensive ulcers aro seen in the mouth and throat —succeeded by Carb. v., should a copious fetid ichor be discharged from tho ulcers ; with extreme exhaustion, and small, indistinct, or scarcely per- ceptible pulse. Serale cornulum may sometimes be admin- istered with advantage in alternation with Carb. when the lat- ter appears to afford but temporary benefit. Rhus is also occasionally u.-eful in extreme cases, particularly if there bo great muscular weakness, with trembling of the extremities, especially on movement; sopor and other swnptoms described under this remedy in the Chapter on Typhus. When from the beneficial effects, of Arsenicum, or any of the other remedies above mentioned, the strength of the patient MUMPS. 93 becomes invigorated, the countenance more animated, and the sloughs are thrown off in a kindly manner, yet the ulcers threaten to become indolent ; they will generally very speedily acquire a clean and florid bottom, and begin to cicatrize, on the administration of Acid, nitricum. For further particulars in the treatment of malignant sore- throat, the reader is referred to page 54 of this work.* It re- • mains but to be added, that in conducting the cure, the utmost cleanliness, combined with free ventilation, ought to be strictly observed,—for the double purpose of removing all malignant excretions and effluvia, and thereby putting a check to the ready extension of the contagion, as well as for the comfort and well-being of the patient. The diet should consist of semolina, sago, gruel, and Buch like. * MUMPS. Parotitis, Angina, Parotidea. Dmc.nosis. Inflammation with swelling of the parotid and submaxillary glands, sometimes running high, and extending to the throahjand tonsils, with danger of suffocation. This affection generally affects individuals under the age ot puberty, and frequently declares itself as an epidemic during the prevalence of cold damp weather. When properly treated it is rarely dangerous, but particularly apt, if not carefully at- tended to. to attack some more important organs by metastasis; for example, suddenly disappearing in the glands mentioned, and painfully affecting those of the breast, etc.: these metas t. J.may occur cither from fresh exposure to cold, or by the application of saturnine, camphorated, or other repellent lotions. ,. , ,. This affection is generally ushered in by the ordinary symp- tom, of mild catarrhal fever, after which the swelhng declares itself, sometimes interfering with the motion of the jaw, and by the extension of inflammation to the tonsils, affecting the hearing and impeding inspiration. • See also Sore Throat, page 81. 94 P If. rsriTB SYSTP.M Thbripfutks. Mercurius may ahn>sf bo termed the specific remedy in the idiopathic form of this disc isc. Administk \tion. In many cases a single dpathic remedies for the treatment of this affection are, .Vmj- vomica, Sulphur, Pul- gatilla, Bryonia, Chamomilla, Ipecacuanha, 1'iia'ia. Carbo vegetabilis, Cinchona, and II par sulphuris. Of these, A«.r vomica and I'ul^i'i/la are tho chief.* Admim-tk \tio\. In dyspeptic cases we may dissolve seven globules of the third or sixth potency of each medicine, with the exception of A/.w mmica, in fourteen teaspoonfuls of water, taking one morning and evening for a week, and cease its ad- ministration as l>ng as we find manifest improvement ; or if a medicinal aggravation come on, await the result. Of A;/r romica, we may dissolve three globules in seven teaspoonfuls of water, and take one each evening cm going to bod ; or when people are in the habit of taking supper, from half an hour to an hour be- fore that meal. It will be found useful in many cases to vary the potency of the medicines chosen, the high acting better upon some constitutions, and the low upon others; but tho principal point is the correct selection of the remedy,t An abuse of coffee and tea is a frequent cause of many de- scriptions of sick and nervous headache, attended with excite- ment and dyspeptic symptoms, which will frequently disap- * Calcarea carbonica is, in our estimation, one of the net valuable m< (I ciimenU for iKtsppfmiu. It is indicated for the principal plienomeun contained under Mux vomica, although, in regard to temperament, m-x, &c , it accord* more ucnerally with Pulsatilla. It '» peculiarly availubla aa a transient or long-working remedy, after the UHe of either of th»-»e two medicine*, especially when ti.'-ir imprewiionH become by repetition i-v.id- eecnt— Ki>. t V.da note, p. 21. INDIUKSTION, OR DYSPEPSIA. 97 pear of themselves on the disuse of these beverages; however, should not this speedily be the case, for the effects of coffee we may have recourse to Nux vomr.ro, PulsaliVa, Chamomi'la, < r Isnalia, under which the sufferer will find his symptoms indi- cated. Against,the effects of tea, Cnrhe.na will generally be found an antidote, followed by Fen um if necessary ; in other cases, Ipicacuan/rr, Tluji or Selenium will he found useful. Nix vomica covers the following symptoms, cither when they have arisen in consequence of sedentary habits, excessive mental exertion, long watching, or the abuse of wine or ardent spirits : the head confused, with < ccasionally a feeling as if from in'oxicalion, and giddiness, with sensation of turning and wavering of the biain; headache, unfitting for, and increased by, mental exeition ; tearing, drawing, or jerking pains in the head or cheeks, and pulsative pains, and a sensation as if a nail were drireii into the brain ; congestion of bloed to the head, with humming in the cars. The headaches are often deeply seated in the brain, or in the back part of the head, frequently confined to one side, or over the eyes, and at the root of the m se, coming on diicfly in the morning, after a meal, or in the open air. l]vi:s, yellowness of the lower part of the whites, with a mist before them ; a sensation as if one were about to fall; sparks, or small gray or black spots before the eyes ; short-sightedness Face pale or yellouish, especially about the mouth and nose, frequent headache, and redness of the face, impaired powers of digestion, with insi- pidity of food. Toxcite foul, dry, while, or yellowish; thirst with water-brash, particularly after acids or rich food, accu- mulation of slimy mucus, or of water in the mouth; metallic, salt, sulphurous, herbaceous, mucous, biter, putrid, sour, sweetish, or pa'rid taste, chiefly in the morning, or after meals; bitter eructations, or continued nausea, especially after meals, or even after drinking cold water or milk,—or on going into the open air after a meal; also from acids. Hkarthikn, Miccoioh, Acidity, Flati lknck—frequent and violent vomiting of focd, mucus, or bile, or ineffectual efforts to vomit. Distention and fulness in the epigastrium, with excessive ten- derness to the touch; a feeling of tightness of the clothes 5 9^ Diorsrivi: system. round the upper part of the waist ; crami-s in tiik -tom m ii ; co\stii'\ i ion ; reddish urine, with brick-dust coloured sedi- ment ; sleep unrefresiling, restless, either from suffering or otherwise, with disagreeable dreams, and drowsiness in the morning. See Administration, pago '."'>. One of the most di-tinctivc indications for the employment of this remedy in preference to the next mentioned, is the temperament, which is restless, irritable, lively, and choleric. A disposition to Hemorrhoids is also a good indication. For l'ul. Ion vti v may sometimes follow Pulsatil'a to complete a cure, or even supersede it, when there is a tendency to constipation, and particularly in temperaments alternating from high to low spirits, or vice versa ; it is especially indicated when grief has been the inducing cause of dyspepsia, hysteria, and hypochon- driasis. **§***. 100 DIGESTIVE system. In chronic cases, these remedies, as indicated, are chiefly V.d nable in the Commencement >t treatment, and may be re- quired tn be followed by other remedies t" complete the cure. Sulphur sj- or **, or Ti\< it iik or Si i.riii'ii, especially useful a'ter I't-isa'i'la and \u.i vomica, in removing any sympt >ma that may rem tin. IIkp vr si eiiitkis *J°, is a valuable remedy in s me cases of d\-p'p>ia, but particularly in those in which the patient I as previously been taking blue-pill or any other mercurial preparation for a considerable time. \i idi m ^i i.i'iiiKK i m, ijy. llyspcpsia arising from execs- sivc sti d., drinking, or other excesses, with the following symp- toms: gnat weakness of digestion; acrid, foul, putrid taste in the iiinuth, dry tongue, burning and smarting sensation in the tin. at, sometimes attended with pricking, especially at night, and so troublesome as to prevent sleep ( l'i/io\is) ; offensive breath, especially in the morning (apht/ue); renewal or aggra- vati m of the symptoms from drinking co'd water; all cold drinks appear t«. disagree, unless a little brandy or some . ther ardent spirits is added to them; accumulation of water; saliva in the mouth ; flatulence; bitter risings; voini ing of a limpid final, or of food, it may hero be remarked, that, in canes where .\ux rouuca scents indicated, but the disposition is of a nioiose or hypochondriacal turn, Cocci 1.1 - *■** may be substi- tuted with effect; when the indications for temperament are not sufficiently distinctive, Cocculus, .\m vomica and Pu's inila may be advantageously alternated, i inally, ('aiiim vi.i.i ia- bims **,* will frequently remove any symptoms that may re- main after A»/j vomica. t 'i.\ciio\ \ -£■ is a valuable auxiliary in the treatment of this derangement, when there is impaired appetite with gieut weak- ness of digestion, which is more liable to be experienced on partaking of supper; flatulence; bitter taste; languor; hypo- chondriacal disposition; and particularly when we can trace it to debilitating L.—es of fluids, such as to abstraction or loss of blood, too great a drain upon the resources during lactation, prolonged use «.f aperient medicines, m'sia and (\ih>i vl- r.iA : namely, \ux vomica, ('hauuani la, I'ulsatd'a, Cinchona, I pi cairuanha, Antimonium crudum, Bryonia, arnica, Hi par sulphuris, Lachesis, Sulphur, and ('alcana- WANT 0» APPETITE. 103 Administration, the same as in Dyspepsia, (page 96,) which Sec. Ni x vomica is the principal remedy when the want of appetite can be traced to la;e hours, the habitual use of wino ami coffee, sedentary and studious habits,—also when the following symptoms are present : dryness of mouth, tongue coated white with cracks or slimy mucus in the mouth, agustia, pyrosis, or inspidity of aliments, particularly meat, accumulation of water in the mouth, aversion to food, costive- ness or constipation, confusion in the head or giddiness, as if the results of intoxication, amnesia, and difficulty of fixing the mind to a train of application, weight in the occiput, tinnitus aurium, heaviness and aching in the limbs, uneasiness, and a feeling of winking or dragging of the tendons in the lower extremities, or cramps, restlessness, and general irritability of disposition,—symptoms aggravated in the morning, (p. 96.) Chamomilla is frequently found useful after Nux vomica, when, although considerable benefit has been derived, the whole train of symptoms are not removed. The following are its particular indication: restless sleep, sensation of fulness and aching in the head, heat and redness of the face, a degree of fever, and tongue thickly coated, yellowish, rough and cracked, (anorexia and greenish diarrhoea,) general sensibility of the nervous system. This remedy is especially called for when a bitter taste in the mouth (or vomiting of bile, or of greenish mucus) ensues after eating. (Administ. p. 96.) Pulsatilla. This remedy is specific in the affections arising from partaking of over-rich or greasy food, or pork, or pastry, or of aliments causing flatulence, such as vegetables, or of food in the preparation of which rancid butter or lard has been used. The more immediate indications are: whitish tongue with cracks, bitter, salt, or foul taste in the mouth, Blindness of the mouth, scraping roughness or acidity at the pharynx, hitter eructations, aversion to warm food or to meat, butter, and all rich food; loss of taste ; distention of the ab- domen, and particularly a feeling of tension under the false ribs, borborygmus, retarded or difficult defecation or diarrhoea, drawing in the limbs resembling that presentment in ague, 104 DiorsTivR kystem. exacerbation of symptoms in the cveiing, in co-i'i.uli-i-m-ti >n to .V / I( ,,n' a, which is generall, in the in iming. litis te- medy is well adapted to the mild lymphatic temperament, and also when there is a peculiar sensibility, with a dislike to conversation, and valuable when imperfect mastii atiuii is tho cause of the affection. Ki.ially, in cases when- there is a marked aversion to tobacco. e\en when act ustoni' 1 to its use M. re ivcr, rhis r-im-dy will be frequently found of benefit in some cases where ("lanomifla has only temporal ily relieved; bit should a considerable degree of nervousness, i r even irritability, remain after Pulsild'a, Nui vomica may be had r course to. (Sec \dmimst. p. 116.) Cinchona in anocii occurring during foggy weather when the air is charge 1 with unwholcs me vapours, or in the vicinity ot marshy lauds The following are its indications : a Sensation of constant satiety, with general indiflcrrnee to ftod, and alypsia; toigue cracked or loaded with yellow *r white ccathg; sensation of sinking and fluttciing in tho epigastrium (particularly when this symptom can be traced to the effects of tea); eructation after eating; desire for*/./ h ' y- sen\o'ird foul, acids, j epper, ami other ennd incuts ; general wcakui■«.<*, with inclination to assume the recumbent p< stare, and inability to remain l>ii£r in oik- position; unc inf rtablo feeling of dry heat, or shivering and sensitiveness in the open air; retarded or interrupted sleep; general feeling of uneasi- ness, with moroHciicss and peevishness. (Adm. p. 96.) Ipecacuanha is indicated by the following p\tnptc i.'i. with indigestion from the slightest cause, even with the most careful observance of diet. It is indicated by de- sire for high-seasmed dishes, acids, and wine; nausea, even inclination to vomit, particularly in the morning; and consti- pation, frequently with colic. This remedy is one of our • (Tartarus emet., Sulphur, Valerian, Srpia, Stannum, also cover the latter symptoms): tlie practitioner will therefore do well to bear the said remedies in mind when this particular symptom is a promiueut oue, aud does not yield to Arnica. 5* 10G DIGESTIVE st.«tem. chief antidotes t> 1/ rcuriu^, and consequently one best adapted to those affc> tions arising from loiigeoniinucd um of Calomel. Administration. One grain of the third trituration in six dessert-spoonfuls of water, one daily, fatting. In other eases, it will be found more beneficial to give a glibule or two of tin- sixth in a little water, and not to repeat tho dose until five or ten days." Luiiksis is a valuable remedy to follow II par su'phuris in obstinate eases particularly when long -continued constipa- tion is complaim-d of, and the symptoms have always been aggravated by acid th inks, \e. ; in the hitter ease Ars, no um is also useful, and may sometimes precede I.aclasis with ady antagc. Administration. •$• in the samo manner as Hepar sulphuris. In addition to the two last ■mentioned remedies wo may observe, that in tho same elass of cases, II lladonna, Mercu- rius, Su'phur and ('alcana may be used with considerable ady at it age, when the former remedies have only afforded partial relief. At'iniw si i.i'iu met m is a useful remedy in cases of im- paired appetite, with weakness y'a c, Ai-nl. nitr., Kali c, \atr. m. and c-, Cia^hi'is, Hy>. vrge'abilis, which see. Nix vomica °J°, offensive eructations, constipation, and con'used headache, particularly it aiding from previous intoxi- cation, or even .slight over-indulgence in wine or other stimu- lants ; when possible, it should be taken tho same night ; as, ta'ien in the morning, although eventually relieving, it frequent- ly causes an aggravation for a few hours. Arnica *f*. Eructations resembling rotten eggs.* I'i i.satilla °°°, next to Antimonium crudum, the inrgt imp .rtant remedy ii recent cases of d-ranged digestion, with eructations of ingesta, tongue foul and covircd with mucus: chilliness and lowncss o/ spirits ; and also when a rash has been thrown out in consequence of the derangenient. This remedy is, moreover, almost specific when the disturbance has aiisi-n from the effects of rich fo< d, such as jork ir pastry, or ev-u tainted meat, or from the effects of ires, raid fruits, or crude vere'ible , a< il wiiv, ice. (Arseni um may follow Pulsatilla, if the latter do not effectually relieve.) A' onitk •}•. When the affection owes its origin to par- * s. e al*o note, p. 105. derangement of the sTOM\CH, ETC. 109 faking o'" sour beer, vinegar, or other acids, particularly when wo find oppressive pain in the stomach, great heat in the head, nausea, or actual vomiting of mucus, or even of blood. IIei'ak svmmuhiis £*£. When the digestion is naturally weak, and sour vomiting, attended with burning in the throat, colic and diarrhoea, is liable to ensue from the s ightest error of diet, and particularly when anything of an acid quality has been partaken of. {Lachesis is often of great service here in alter- nation with II< par su'phuris, at intervals of a week or so.) C vnno vegetabilis £,V, although last nienti >ned, is not one of the least valuable remedies in this affection, and is often found particularly useful after Pul.sati.Ua, Arsenicum, or A//.i vomica, in removing any symptoms that may remain ; it is, more- over, particularly useful where great susceptibility to the influ- ence of the atmosphere, particularly to cold, exists at the sumo time; or in sufferings arising from abuse of wine, ices, salt; further, in derangenient of the stomach arising from having par- taken of game, or lish which has been too long kept, or meat which has been recooked while in a state of fermentation, as is liable to occur in warm weather ;—in the latter instances, Carbo v. is to be preferred to any other medicine, and will rarely fail to afford relief; if any disagreeable symptoms remain, Cinchona §, may he administered in a little water, and followed, if required, by Pulsatilla jj in the same manner; —finally, this remedy is pe- culiarly valuable in obstinate and chronic cases of deranged di- gestion, when annoyance or inconvenience is felt after every meal, even amounting to nausea and vomiting attended with excessive flatulency, and where the pit of the stomach is tender on pressure.* Administration of the medicines. A single dose, as above noted, is ordinarily all required; when, however, vomiting and other severe symptoms declare themselves, it may be better to diss-olvc four or five globules in eight or ten teaspooniuls of • A small quantity of finely powdered charcoal in a little good French brandy will be found an equally efficacious mode of administer ng this remedy »s u corrective against any unpleasant effect ur.siug itjiij hav- ing partaken of tainted meat or fish. 110 Dll.K«T|\ K IYITKM. water, and give ono from time to time, according to tho i-xi- geuoy of the case ri.ATri.r.NCV. I'at'is. Tympanitis tntcstinalis. This affection, ami tin- sufferings it entails, are generally found in individuals of weak digestion, and many also suffer from it immediately on taking cold in the abdomen or feet ; it is also, as well known, a common result of errors in diet, and the too fre. quent indulgence in vegetables ami fruits : In corpulent indivi- duals the sufferings arising from this complaint, such as difficulty of breathing, palpitation of the heart, trembling of the limbs, confusion of the head, and swelling of the face, especially in hy- pochondriacal subjects, are most distressing. However, with proper attention to regimen, ami suitable medical treatment, it is rarely very difficult to remove. As an accompaniment of deranged digestion, it has also been noticed under I>y sn i-sia. Against this complaint tho most caroful preservatives are: avoiding •■<■l«i. exposure in cold damp we.itIter, very cold drink*, or distending the stomach with a large (piantity of warm fluid, particularly strong tea or coffee; each patient should also study his own digestion, and carefully refrain fn in partaking of any species of aliut tit which experience has found liable to produce flatulency. Sedentary habits also sliould.be avoided, ami a pro- per porti »n of the day devoted to exercise in the <.j,cn air. Tiierapetth'S. In the treatment of this affection, tho fol- lowing medicines have been found most frequently ealh-d for : Cinchona. Arsenicum, \in vomica, Pulsatilla, Carbo vegeta- bilis, Co1' hicum, Belladonna, Colocynth, and Tincture of Sul- phur. Of these, \ui vomica and Pidsiidla are most fre- quently required. Administration. In recent cases, six globules of the third p'.tem-v may be given, dissoKt d in an ounce of water, a dessert- spoonful every half hour till relief ensues; after which a 'lose of a couple of globules every four or five days or so, to counteract the tendency to this affection. * • Vide note, p. 21. 6403 FLATULENCY. Ill Cinchona *$■*. When the affection can be traced to tea or warm drinks, an hour or two after a hearty meal, by which the process of indigestion has been interrupted ; or to debility, loss of humours from venesection, or the continued u«e of purgatives; or to deranged digestion arising from flatulent food, with pain- ful tension and dis'enlion of the abdomen ; or when, on the oc- casional expulsion of flatus, a sensation of tension is felt in the umbilical region; another indication for this remedy is where coldness or shuddering is experienced after drinking. Arsenicum ^ where the last-mentioned symptom has not been relieved by the foregoing medicine. NrxvoM. 1|". In cases where the flatulence is attended with sensation of pressure at the pit of the stomach, causing dyspnoea and a feeling as if the clothing were too tight, or a sen- sation of pressure as from a stone, particularly when the affection arises from an habitual use of coffee, or sedentary habits. Pulsatilla i^fl6^^5, when the affection has arisen from having eaten of rich or greasy food, after which a copious draught of water has been partaken of, and the abdomen is swollen with a pain as from a bruise, with borborygmus. Carbo vegetabilis is one of the most important remedies after the foregoing in chronic cases, and particularly when the inconvenience arises after partaking of the smallest morsel of food. tJoLciiu i m ifii^na^ when from a considerable accumulation of wind the abdomen is extremely distended, or as it might be expressed, inflated, amounting almost to tympanites, and sounds like a drum on striking it. will the hand—without any marked pain, but with heat and difficulty of respiration. (This remedy is often peculiarly efficacious when the derangement is attri- butable to vegetable food.) Belladonna a|a. In eases of flatulent obstruction, iu which the transverse section of the colon is the particular seat of the accumulated flatus, and becomes protruded like a pad, this remedy should be administered ; it may be followed by Co- locynth, when the relief obtained is only temporary, or when, fmrn the manner in which the patient traces the course of his uuccuifortable feelings, there is every reason to conclude that 112 DIOKSTIVE IYSTRM. tho flatulent tliitenti-n and obstruction occupy tho entire cxt'-rt ot the colon. When the flatulence recurs very frequently, in fnet, where a maiki tl prcdisn*s tion to it exists, we must have recourse to Tim it hi or Si i.i-iii it "/J, or one dn p of the ollth potoncy. Although I have pointed out the remedies best suited to the eases of this allc :toi most oidi uirily occurring, ami hn\e also tread d of the same subject under Pvspepsiv and C< i.ic, to which the reader is referred, I still t1 ink it advisable to add a few medicines which bear particularly upon this ilisi rder, and deserve a careful study. They are: l.ijan odium, Cocculus, \atrum, A i'rum muriali um,'/. icum foliatum, M ignetis fo'us arcius, Agnus castas, l\ rrum, Cr phitis. SI'AS MS OF TIIH STOMACH. Cisliod.ni, Ci.rdiu g>-i, (la •tr.dgia. Ihin yvitb Pu'sait'la and Sn'tdnr; the in -istrual flux, it tiejiienlly removes the ca.dial- gta ami hvsteiia consequent upon this deiangi inenf, or at lu in such a position that it i* easily eun d by some other medicine, elo-cly correspo ibng to the remaining synq t mis. Ii.naiia amah\ Y3° is indicated under nearly similar cir- cunt-tances as /'//'.v., with the exeepti m of the s'ate of tho bowels the Iguatia being in >re appropriate to easts attended with eostivi ncss, and where tin- inclinuti'n to \omil is ab-cnt, or when the affe tio;t has b en caused I-, gt i ;f, anxiety, etc., or occurs in hvst'-rical or hypi e'londi iaeal indu uluals. Cinchona °"° is of grat service in m st eases of »| nMnti of the stomach with general weakness, arising fr in loss of humvir-j, the result of bla idlcttui'j, or repeated hemorrhages, abuse of emetics or apericn's, loo !iih for the empl-iym ot of this in di inc. (Nux v. and Carb » v. muy b.llow Cinchona, sh uld the latter not remove all these symptoms.) SrAPiiy iaukia •$•. 1 ois is useful in some cases of this BTASMS of the stomach. 117 complaint, and is particularly applicable when there is acute pressive tension aid squeezing ubmt the pit of the sumach, which si nictimcs obstruct the breathing, but which is reliivcd by bend in:' the l.ody forwaid. When the pain partakes of a marked tensive character, and eilends to the region <>J the nan', with sensibility of the region of the stomach on ex- ternal pressure, shortness of breath, anxiety, and nausea, iSrvNNiM «:; will be found more appropriate. Bryonia QT0.,0. This medicine is more particularly adapted to the milder cases of caidialgia, with puinful pressure, or a feeling of disagreeable, fulness in the stomach after a meal, which occasionally becomes converted into a feeling of con- striction, cutting or pinching, and is reliered by eructation and external pressure. This remedy is nion over still more clearly indicated when the symptoms arc generally accom- panied with severe headache or painful compression in various parts of the head, and particularly at the temples, which are liable to be excited whenever any article of diet disagrees in the slightest degree; increase of the sufferings by movement; habitual costiveness. Platina *£. Spasms of the stomach in females, occurring particularly at the monthly period, (Chamomilla, Pirsa'd'a, Nu.r v., and C. cad us, are equally efficacious at such perl ds when the symptoms are as indicated under these remedies) and especially when the catamenia at the same time are gen- erally very copious, and of too lung duration. Si:nkha ot>° will be found efficacious in cases with painful pressure and burning in the stomach, especially at night. Rvrwniv °£°. Spasms of the st. niach, or painful con- strictive pai:-. relieved by eructation, with loss of appetite, hie cough, distention of the abdomen, cestiveness, and frequent micturition. ■\kmc\ Montana oooooo^ ;„ Spasms or pains in the stomach which have originated in the effects of a strain, or from a blow, -vc, wili be found specific. It is, however, also an excellent remedy when there is a sense of pressure as from a stone, or of fulness in the stomach and scrobiculus, constrictive in the stmach and in the pra::ordial region, shooting 3 33 11* DIGESTIVE 'V opi n air, after a meal <>r in the morning. Caidialgia in lymphatic fe- males, with t>o copious eatamenia. I.aiiiksis ff. Spasms of the stomach, particularly in persons addicted to excessive indulgence in wine or anient spirits, relieved by partaking of food; flatulence, constipation, numbness, and paralytic weakness of the extremities. Si li-ihr Y- Frequently an indispensable remedy in chronic cases, attended with heartburn; aggravation of tho pains after a meal; constipation, hemorrhoids Calcarea r|. In obstinate eases, occurring in individuals who are habitually addicted to the abuse of wine or ardent spit it.-. Cat,-, will generally be found of great service, especially afLer the previous employment of .\m »•., Lach. and Sulph. It is further a valuable remedy in the eases of plethoric females subject to nasal hemorrhage, or to excessi\|.|y eopfous menstru- ation; and is generally indicated when the paroxysms of pain come on usually at night, or after a meat; in which latter instance vomiting sometimes results, or nausea and acidity, with painful sensibility or pressure at the epigastric region ; constipation, hemorrhoids, or chronic looseness of tho bowels. Administration. In mot eases these medicines may be exhibited in the same manner as already noted under Carfto vegetubUu and Sulphur. (Sn also remarks upon Xuj vomica.) 7 3673 vomiting of blood. 119 In severe cases, six globules of the potency named may be dis- solved in eight dessert-spoonfuls of water, and one given every two, four, or six hours, according to the results obtained; for example, in individuals of delicate organization it may sometimes be needful to give a less number of globules, and to select a higher potency, the thirtieth.* These are the principal remedies to be employed against the ordinary cases of ('ardialgia; t but in some cases may be called for : Sanguin., Graph., Gratiot-, Mign., .^/tr.sp., Sil., Sfann., Slront., Am.c.,(-upr., Daph., Kali c, Euphorb., Kreos-, Aa/r., Nutr. m., Asaf. In hysterical or hypochondriacal subjects: Ign., Xux v., Calc, Gral., Cocc, Slann., Bism., Digit, &c. IIKARTBURN. Black-water. Water-brash. Pyrosis. This is not an affection of the organ, which its name would imply, but a painful or uneasy sensation of heat or acrimony about the pit of tho stomach, sometimes extending upwards. It is frequently accompanied with anxiety, nausea, and vnmit- ing; or a violent gnawing spasmodic pain in the region of the stomach, from which the patient experiences no relief until he succeeds in ejecting a quantity of limpid fluid. The remedies required for the treatment of the disorder are the same as those mentioned under Dyspepsia, Flatulence, Spasm of the Stomach, according to symptoms: of which, Nux v., Puis., Sulphur, Arid, sulphuricum, Carbo v.. Cinchona, or Calcarea will be found the most appropriate in ordinary cases. (See the afore- said derangements for particular indications.) VOMITING OF BLOOD. ILrmatemesis. Diagnosis. Blood evacuated by vomiting, sometimes pure, (generally venous,) of a dark colour, but sometimes of a bright red; it is occasionally mixed with bile, food, \*e ; the quantity varies; blood is occasionally discharged in coagula by stool. Premonitory symptoms. Weight, pressure, fulness or tensive •Vide note, p. 21. + Vide Dyspepsia, p. 95. ]20 DIOIITIYR ninir.a. pain or spasm in the hyp gastric or hypochondriacal n-u'i-ns; grijing and e-lic; burning heat in the region of «h«' stomach; anxi.tv. | articiil.ii U mi partaking of find it diink. or on pressure on the stomach : saltish taste in the mouth; impaired ■pp. tite aid nausea; giddiness, symojio, cold perspiration; sometiim s also an intermittent pulsation is perceptible it the scr.bieulus. S -me only if the preceding symptoms may be present previous to the attack, and others dining its curse when very severe, or frequently renew, d. We often find wild do- liriuin or wandering, accompanied with spasms and a gradually increasing weakness, and remission of pulse with frequent syncope. The m st frequent causes of this affection arc the sudden suppression of anv sanguineous discbarge, and the consequent determination of blood to the stomach ; it is consequently apt to declare itself after a stoppage ot the h.einorrheidal flux, and is a very common affection in females, from the .suppression or cessation of the eatamenia; in which case, as before remarked under that affection, it is frequently preceded by (\\i:i>i ii.i.ia. Other causes are: scinhus of the stomach, internal lesions tr injury of thut organ from swallowing sharp substances, or In in worms; poisons, diastie purgatives, or emetic dings, external Contusion, obstruction of importa t viscera, or a change in the coiistituei t principles of the blond itself; the direct cause is the bursting of B<•me of tho vessels of the st. mach. The dangers arising from the use of pouerful astringents are, inflammation or subsequent induration of the stomach, or potrid gastric fever. Tiikuapeitics. Although it is unlikely that any ono, not properly qualified, would think of treating a severe case of this affection, unless compelled to do so from the diHiculty of obtain* ing n edical advice, yet it may be advisable to pilot out such remedies as experience has proved to be most serviceable in it as ordinarily met with, — premising, h >\m ver, that when it arises fr«>m any organic disease, of the existence of which tho experienced practitioner can alone determine, a different course may be necessary. vomiti.no of blood. 121 When it occurs in females from the non-appearance or sup- pression of the monthly discharge, or from its final cessation, Bee articles Chlorosis, Amknorriio>;a, Cessatio Mensium; from worms, see Helminthiasis; poisonous substances, see Poisons ; disease of the spleen, consult Splenitis. We may now proceed to the consideration of the remedies above alluded to. Aconitum. When the premonitory symptoms above given declare themselves, and particularly when a considerable de- gree of fever precedes the attack. Administration, oojhioo jn an ounce 0f water, giving a dessert-spoonful, repeating in half an hour, and then every hour till the fever abates; in this mode, if taken in time, we may often, by calming the circulation, prevent an attack. Nux vomica. In a decidedly plethoric constitution with a marked (venous) stomachic or abdominal congestion, and tendency to constipation; particularly when arising from sup- pression of hemorrhoids, or of the menstrual flux, or from in- dulgence in vinous, spirituous, or fermented liquors, and still further indicated by irritability of temper. Administration. "^ in a teaspoonful of water, repeated in from three to twelve hours, according to the exigencies of the case. Pulsatilla. The value of this remedy is noticed in the diseases of females above mentioned; it is also in many cases found more suitable than Nux vomica for males when of lym- phatic temperament and mild disposition. Some of the best indications for this medicine will be found under Dyspepsia, Cahdialgia, and Derangkment of the Stomach. Admi- nistration the same as Nux vomica. Cinchona. When a quantity of blood has been already vomited, this remedy, from its power of restoring the energy of the system after debilitating losses, is clearly indicated ; it should also be chosen when the patient has had a severe at- tack of hwmatemesis, which has ceased of itself, but still left great weakness. Administration. *§4 in about a teaspoonful of water, after which, if a slight aggravation ensue, we must wait quietly 6 122 DlCKSTIVK SYSTFM. uttil it passes off; and whilo improvement continues progrr«*. ing. refrain from repeating; and after forty-eight to seventy- two hours, we may give a second dose; but if no mark..! alteration of any kind declare its, If. or if the disease advance, we may repeat it from four to six hours, the same d so. Arnic*. One of our most important remedies in severe cases, and especially when occurring in individuals of a robust eomti- tution, of a sanguine temperament and choleric disposition. It is further indicated when the patient complains of pains, resem- bling the results of a contusion, in all the extremities. Administration. Six globules of the thittl potency in an ounce of water, a dessert-spoonful every three hours, desist- ing if a medicinal action declare itself, and lengthening the intervals according to the amelioration that takes place. In mild aita ks, °,P in a little water, repeated every six or even every twelve hours, have been found sufficient. TiNt rniu: nr Sili'iiuk is useful in strumous habits, or when the affection has arisen from suppressed lurtimrrhoids; its value, also, in cases of abnormal menstruation, will be pointed out in the proper place. Ahmimstii \tio.n. *V°» 'n four dessert spoonfuls of water, one morning ami evening for two days, aud if no severe symp- toms direct our attention to another remedy, it should bo al- lowed to continue its action for a week or fortnight, as long as a grailual improvement is going on ; in fact, in such constitutions we should take every opportunity bit ween the intervals of the attacks, of giving a dose or two of this medicine, should no other better calculated to combat this tendency appear to merit a preference. The following remedies also deserve a careful study: I'lm-.- phorus. B' 'lail'iiiu.a, Arsenicum, Lycopodium, (may be ranked next to .V«r r. in cases arising from abdominal congestion,) and Hic>scyamus, (which, with li-dadonna, is particularly useful in case3 with Spasmodic action,) L-;eN. Oh tructio Alvi. We have now to treat of an affection which so frequently baffles the skill of the practitioners of the old school; their leading cause of failure is their ignorance of the great curative principle, and consequent proceeding upon a system opposed to the operations of nature. This affection is generally sym- pathetic with some other derangenient of the organism, and, consequently, in our treatment of different diseases, we have had frequent occasion to allude to it. One of the leading causes of aggravation and excessive obstinacy in the Constipa- tion, most closely approaching to an idiopathic form, is the practice of flying to aperient medicines on the slightest ap- pearance of costiveness, under the absurd idea that keeping the bowels open is a species of panacea against disease of every description. Many mothers are so possessed with this idea, that they are continually administering physic to their chil- dren, without the slightest apparent call for it, and thus lay the foundation of dyspepsia and other visceral derangements in after-life. Many a slight case of costiveness which, if left 124 DIOKSTTVB STsTril t<> nsfnre. Would have dis«p|>earrd of itsrlf. leaving no ill e..n- p< queues, ha», by an ill judged administration of nperitnt-*, bet50 converted into obstinate Cm^fiftalioii, embittering ex- istence aid predisposing the constitution to a variety of dis- eases in after-life. To prevent misconception upon this point, we may remark that we by no means undervalue a regular ■tau- of the bowels: but when costiveness shows itself, we happily possess remedies calculated to restore the balance of the system; and in obstinate cases do not content ourselves with simply alleviating the symptoms, but mainly direct our attention to the permanent removal of tho ailed ion. Mauy of the principal causes of this disorder, besides that mentioned, arc tho same with those particularized under Indiuks iion or Dysi-kp-i v Thrhai-i:i riti. In trivial cases it will be found sufficient to |*y proper attention to diet, to avoid too dry or indigestible food, niaMicate properly, to partake of meat only once a day, ami to take sufficient exercise in the open air.* Should this curse not have tho desired effect, we must choose ono or more of the following remedies : namely, Opium, Mamma, Br i mia, Xm vrnnica, Pulsatilla, P/atina, Nairnm muriaticum, Plumbum mrlallicum, or ("arbanicum, Sulphur, I.aclasis, Ve- ratrum, l.icopodium, Sepia, Veratrum, Silo-, a. (>pii;m is chiefly to be selected in recent caws when Con- stipation is not habitual, but is also, like Xux v., and other remedies, serviceable in cases of a more <-hp,iiic character when arising from sedentary habits. In old people, it u gener- al!. more useful than B ii>mia and Lach, sis, although these and the other remedies must be borne in mind and admini-tered when called for by the nature of the symptoms. The more in,me.bate indications for Opium are: want of power to relievo the bowels, with a feeling of constriction in a no; pulsation and sense of weight in the abdomen, dull, heavy pain in the stomach, parched mouth, ami want of appetite, determinutum of blood to the had, with redness of the face and headache. • Km afao the concluding remarks of thia Chapter constipation. 125 AnMiNisTBATioN. y, in a little water, repeated in twelve hours if no benefit result. (Vide note, p. 21.) Alumina. Constipation from an apparent absence of peris- taltic motion; faeces hard, dry, broken, evacuated with consider- able exertion of the abdominal muscles and forcing, and some- times streaked with blood ; constipation from travelling. Administration. Same as Nux v. Bryonia is especially useful in constipation occurring in warm weather, and in persons of dark complexion and an irri- table or obstinate disposition, with a tendency to be easily chilled and subject to rheumatism ; it is further indicated when constipation arises from disordered stomach, and is attended with determination of blood to the head, and headache. Administuation. jfg, in a little water, repeated in twenty- four hours, even if partial relief ensue. In chronic cases, two globules be taken daily for a week or so until benefit result, or a change ensue which may render tho selection of another re- medy, appropriate to the modified symptoms, necessary. Nux vomica. This remedy is particularly useful when con- stipation results from too heavy a meal, indigestible food, and stimulating liquids; or in chronic cases arising from long- oontinued indulgence in vinous, fermented, or spirituous drinks, or coffee, or from sedentary habits or excessive study. It is peculiarly adapted to persons of irascible and Hvely temper, with determination of blood to the head, and headache, unfit- ness for exercise, disturbed sleep, and a feeling of general op- pression or heaviness; frequent and ineffectual efforts to relieve the bowels, attended with sensation of stricture and sometimes frequent, painful and difficult emission of urine. It is, as re- marked under Dyspepsia, particularly indicated for individuaia subject to hemorrhoids. Administration. 5£a, taken in a little water towards evening. In chronic cases 00°§00, in six teaspoonfuls of wa- ter, one each night at bed time; or ^ repeated every four to eight days. (Vide note, p. 21.) Pulsatilla has nearly the same indications as Nux vomica, with the characteristic distinction of temperament before noted 126 DHJFSTIVK SVBTSM under Dyspepsia. In nc it esses, it is , xi-ularly indicated when the obstruction has arisen fr- in indigestion brought about by rich or greasy food, and when it is accompanied with mo- r-senesss and pbivoring. Admin.ikmion. °l° or °°?f°° in the Fame manner as A1..1 r. Platina is a useful remedy when constipation has been brought abut by travelling, when Opium has failed, or especially when the constriction is attended with straining. Ai>minis,1!aTion. •$•, ttl**11, m the same manner as Pulsatilla. IYimhim MKTu.i.iiiM or C mi m «n it 1 >i. < )bstinato con- stipation, with ineffectual efforts; painful retraction and constric- tion of the anus; or evacuation of tenacious, hard, bullot-»hapcd fsjecs. Administration. Same as Xur vomica. Natiu.m muriatk im. «" or Jg. This remedy will some tiun- be found efficacious when many others have tailed to re- lieve, particularly in chronic and extremely obstinate cases. Anministration. Sameas \//i vomica, or, in chronic cases, four globules of tho .'50th in a teaspoonful of water every four or five da\ s until relief is obtained, or aim! her remedy called for by an alteration in the symptoms. Sulph 11 is one of the best remedies in the relief of habitual constipation, and particularly when hemorrboids aro present, or a disposition to them exists; frequent inclination to go to stool, but without the desired result. Administration. ***J£' in six dessert-spoonfuls of water. One to be taken morning and evening until finished ; or in the same manner as described under Xati am muriaticum. Veratrum. Constipation, chiefly from inactivity of the rec- tum, with heat and dryness of skin, determination of blood to the bead and lateral headache. Administration. Sameas SiJphur. La«iik-I". Obstinate constipation, aft r Ami r., io those who habitually take wine rather freely, attended with flatulent distention after meal- aud ineffectual efforts to eructate. CONSTIPATION. 127 Administration. Same as Nux vomica. Skpia : May frequently be taken with advantage in chronic constipation after At/.i and Sulphur; this remedy is, moreover, particularly well adapted for females in whom there is an irre- gularity or obstruction of the menstrual flux; constipation in in- dividuals subject to rheumatism; hard conglomerate bullet-shaped fieces. (Administration. See Sulphur.) Silicea. When constipation is accompanied with colic, im- paired appetite, and thirst; and the stools aro hard, knotty and passed with great difficulty; tenesmus. (Conium is occasionally useful in completing the cure after Silicea. Administration. See Sulphur. liYroi'oDir.M. Chronic constipation with ebullition and de- termination to the head; flatulence, sense of weight in the lower part of the bowels. Administration. Same as Sulphur. In Constipation with indurated faeces, formed into hard balls (scyba!a>), Plumb-, M ign. m., Sep., Hutu, Verb., also Nux v., Op., Veratr., Sulph., &rc ; and several other remedies in obsti- nate cases, the treatment of which, however, requires expe- rience and a good knowledge of disease, and of the Materia Medica. In all cases of an obstinate or chronic nature, re- course may occasionally be had to an enema or lavement of tepid water, as a temporary mode of relief, until the medicine has effected the desired result. The drinking of a tumblerful of cold water* night and morning, and the partaking of a due proportion of fruit, bread, and vegetables along with meat at dinner, combined with early rising and daily exercise, (not vio- lent so as to cause suffering,) will be found useful auxiliaries in promoting a regular action of the bowels. Constipation in al- ternation with diarrhtea, Aim c, Lach., Rhus, Anlim.c, Ruta, Bryonia, Opium and Phosphorus. Constipation in aged per- • Wo would suggest as an important adjuvant in many cases, the pouring of a stream of cold water, or the fall of a shower bath, on the lower third of the abdomen, or sitting in a cold hip bath for five minutes, every morning ou rising, until the natural habit is re- stored, when it should be omitted, aud ouly resumed on a repetiUon of the U-ouble. 12S Mi.rSTIVB STSTKM. sons: Op., Aur. m., A • m., or Ycrat., Bry^ I*ich. Baryt. c, Rut a. &c PILKS. HEMORRHOIDS. Pn,;Mi-ii-i. Varices, or effusion of blood in the cellular tissue of the rectum, either within or without the anus, (in- ternal or external piles;) or protrusion and filling of one or more of tho inner foldings of the same intestine, and with or without bleeding, (open or blind pilos,) preceded or accom- panied by paiiiB in the back, sacrum, and abdomen; sensation of itching, pricking, ti. kling, burning, or pressing at tho rectum, sometimes extending to tho adjacent parts, with, in general, constipation and ii>t unfrequcntly derangements of the urinary functions. The predisposing cause is attributable t<> a constitutional tai t; among the exciting causes are habitual costiveness, se- ven,- exertion <>u horseback, prolapsus, use of drastic medicines, stimulating diet, the uso of vinous, alcoholic, and fermented drinks, and coffee, and suppression of long continued discharges, sedentary habits, ice. During the treatment of this affection it is of the utmost importance to attend strictly to the homeopathic rules for diet. Strong or healing drinks, such as wines, coffie, tea, and stimulating or highly-scasonul food of all kinds are par- ticularly to be avoided. Sedentary habits ami the use of soft cushions or chairs materially tend to aggravate the affection. The painful practice amongst surgeons of removing the he- morrhoidal excrescences by means of the knife or ligature, is much to be deprecated; for, independent of the danger not unfrequently attending the operation, it may occasion serious consequences by metastasis of the congestion, to some of the noble viscera; and besides that in a great number of ca^n it wholly fails, and the disease returns, and sometimes in an aggra- vated form. Thkrapkitu s. The medicines inoBt used in this affection are Aconitum, Nux vomica, Sulphur, Lycopodium, A> lenicum HEMORRHOIDS. 129 Belladonna, Hepar sulphuris, Pulsatilla, Platina, Ignatia, Antimonium crudum, and Cinchona. Administration, as follows, except where particularly speci- fied to the contrary : Six globuleB of the potency marked after each medicine, in six dessert-spoonfuls of water, giving one morning and evening until finished, and in ordinary cases allow- ing this exhibition to continue its action for a week or ten days. (Vide note, p. 21.) AroNiri:, although not specific in its curative action, is use- ful in allaying pain when considerable and distressing inflamma- tion exists, and may in such cases precede the administration of each of the following medicines, which arc among the principal remedial agents in this disease. Administration. fij-° in six teaspoonfuls of water, one every six hours, until the inflammation abates; twenty-four to forty-eight hours after which we may have recourse to one of the other remedies mentioned. Nrx vomica Voa» as we have before had occasion to remark, is a most valuable remedy in this affection ; it is equally effi- cacious against both descriptions ; it is particularly indicated for individuals who lead a sedentary life, or who indulge in the use of coffee or stimulating liquids, and for females during pregnancy. When hemorrhoids are present, attended with shooting, burning, or itching pains, colic, shooting and jerking pain, as if from bruises in the loins, rendering it difficult to rise or walk in an erect position, and when they are accompanied by constipation and sometimes painful and difficult urination, and the other symptoms described under Indioi -tion or Dvsl'KI'SIA. Sut i'iu'R iJ'1°, may follow the administration of Nux v., and an alternation at intervals of from a week to ten days of these remedies, frequently effects a cure in cases of long standing. Ahsknhtm \%. Hemorrhoids accompanied by burning and shooting pains, heat and agitation, and sometimes pros- tration of strength. Belladonna $«. Moist hemorrhoids, with an insufferable pain in the sacral region, as if the back would break or be rent asunder; difficulty in voiding urine. 6* 130 PIUESTITI STBTSM. Hn ak iiii'iirRis may f How Blladonna should that mod- icine fail to, or only partially relieve these symptoms. Ai.minihtration. Hilf s grain .f the third trituration in six dessert-s|K).'iifuls of water, one every six hours until finished. Rius roin oukndron *ii- When the violent pain men- tioned under Belladonna still continues severe, and particularly if relieved by motion. ( \r»n i m *,',*. When a burning sensation exists, attended witb considerable itching and diarrhcea. 1'iisiTiLi.A °*M*. l>ischftrge of blood and mucus during ■tool, ami at other times with painful smarting ami sensation of excoriation in the hemorrhoids, pains in tho buck, pallid countenance and disposition to fainting. 1'i.viinv |J, when there is frequent inclination to go to stool, followed by a very scanty aud difficult evacuation, succeeded by general shuddering and a ft cling of wiul.nrss in the ab. domrn ; frequent creeping, itching and piercing at tho anus, particularly in the evening; violent dull pinching in tho lower intestine, discharge of blood during stool, and at other times. I.vcopoohm |f. An important remedy in chronic hemor- rhoidal affections, particularly when then-is congestion to the head, with giddiness and headache, flatulent distention of the abdomen, constipation, severe burning, itching, and pricking pains in ano, with painful protrusion of the hemorrhoids, and sometimes prolapsus ani utter amotion; acrid discharge from the hemorrhoids; prurieut eruption arumd the anus. Iunativ ^ff. Itching and creeping, also sensation of con- striction and excoriation in the anus, aud prickings extending deep into the lower intestine ; discbarge of blood or of bloody mui-us, and rumbling noise in the abdomen, and protrusion of tl.e lower intestine, accompanied with acute pain. AvriMo.MtM rrhira mtcstim recti), M-nin«s Hvlleborus „,,,., ( olchicum, and Si n,Ua. PROTRUSION «>F THK INTKSTINKS ProLipsus Am. By this term is understood the protrusion of a portion of the raucous membrane -f the 1 »wer intestine : it is of much more frequent ooeunvnco in children than adults, and takes place during straining when at st.ol, or when urinating. The reduction of the protruded portion of intestine is easily effect- ed by gentle pressure with the thumbs, or thumb and fore- finger, which have previously been dipped in oil. TiiRHArF.rTirs. The principal remedies for removing tho tendency to this affection aro: l::na'n, .\m vomica, Mercu- rius, and Sn:i bur. Aiimini«»tration. The same as in hemorrhoids; in chil- dren under ten years of age, one to two globules, in the qiinn- tity of water -fated. Ii.nativ /',, in particularly efficacious in mild or sons five temperament-^ attended with constipation. Ni x vomica .,,,, is indicated for persons of irritable or lively disposition, and addicted to high and stimulating diet, with a tendency to hemorrhoids and constipation. Mkhithiii f, is particulaily suited for children, in win in the disease is attended with hardness and swelling of tho abdomen, and where the straining is excessive. Sulphur is one of the be-t remedies for the permanent removal of the disease. Administration. $•*, repeated in five or six days. Calcarea, Lycopodium, and S< pin may be found necessary in some "l»stinate cases, alter Sulph., administered in a simi- lar manner as described for that remedy. In other cases, Plumbum, Ars, ni'-uiit, M'z< reum, A'/i/ru;/i m., ("Ichicum, Rata, Tlurniiun, and Magnet Artijicialis have been found effica- cious. 133 COLIC. Enteralgia. Diagnosis. Griping, tearing, gnawing, or shooting pain in the bowels, chiefly confined to the region of the navel, gener- ally attended with a painful distention of the abdomen, with spasmodic contraction, and sometimes accompanied with vomit- ing and costiveness, or diarrhoea. Tho general exciting causes of this complaint are : acid fruits and indigestible substances; cold from wet feet, drinking cold beverages when heated, constipation, worms. Ace. It is frequently also a concomitant symptom of some other derange- ment, but occurs equally often as the primary disease. We shall here content ourselves with giving the symptoms under the medicines, without entering upon the different varieties of this affection. One of the distinctive characteristics be- tween this malady and internal inflammation, is the pain being somewhat relieved by pressure. Tiii:uai'kttics. The principal remedies in its treatment are: .\ux vomica, Pulsatilla, Chamomilla, Belladonna, Coc- culus, and Coffea. Administration. Four globules at the potency named, dissolved in six dessert-spoonfuls of water, one to be taken every hour, or half hour, until relief is obtained, and after- wards a dose given every four or five days, to combat the disposition to this affection when such exists. Nix vomica-o06ft0 is a valuable remedy in either flatulent or hemorrhoidal* colic, or colic arising from a chill, and is par- ticularly indicated when there is a sensation of fulness and tightness at the upper part of the waist; deep-seated or cut- ting pains in the abdomen, with acute and hard, pn.ssivc, and forcing-down sensation, compelling the sufferer to bend double; violent cutting pains in the hypogastrium; confused head- ache, with occasional loss of consciousness; respiration short and difficult; flatulence, aggravation of the pains on the slight- • See Hemorrhoids. 134 I>I«.K*T|VB 1YBTKM ea motion, generally dL«ap|>caring when st rest; violent pain in the loins, and sensation of internal heat snd obstruction; constipation, coldm-ss and numbness in the hands sod !< et during the par-xysm; at the monthly peri- d in females, whin we find weight or violent deep-seated aching pain in the abdo- men, and aching in the sacral region; dragging pains extend- ing to the thigb ; aching snd creeping sensation in the same part when sitting; painful pressure towards the rectum. I*i l»\tiii.\ *yu is more useful in the affection occurring in females, oither during the cntauienia or at other tunes, when coming on periodically in tin- evening during c<>ld, damp weather; also when there are present a disagreeable tight- ness and distention of the abdomen and the upper part of the waist; pulsation in the pit of the stomach, aggravation of the suffering whin at rest or in the ret mug, attended with shivering, which increase* with the pains, and is mitigated by motion ; severe bruising pains in the loins, especially when rising up; when it has arisen from overloading tho stomach, or from rich greasy food, with inclination to vomit, fl ilulcncc, diarr'nea, |iab-m-ss of the face, livid circle round the eyes, and headache ; also in hemorrhoidal colic, with fulm-ss of the veins of tho bands ami forehead, restlessness, anxiety, and sleeplessness. Ciiamomill\ °-*,*". Hilious colic ; colic in tcm.ilcs during the menstrual flux. The following are the principal indications: sensation as if the intestines were gathered into a ball, and us if the abdomen were empty, with tearing and drawing pains, attnded with excessive anxiety and restlessness; distention under the lower ribs and in the pit of the stomach; incarce- rated flatulency, sometimes nausea, bitter vaunting, followed by desire to relieve the bowels, and bdiom diarrhaa ; livid cir- cles round the eyes, alternate paleness and redness of the tae; the pains come on patticularly at night, at other times early in the morning, or after a meal. This remedy, as before Btated, is particularly adapted for children of irritable tem- perament s, and is extremely serviceable in all cases in which a fit of passion has been tho exciting cause of the sufferings. It is also useful when colic has arisen from cold in tie feet, or checked perspiration. Although in most instances COLIC. 135 Chamomilla is of itself sufficient, it has been sometimes found useful to precede it by a dose of Aconite. (Colocynth is often useful after Chamomdla, when the latter has only produced partial relief.) Hklladonna a°600. Flatulent colic when there is protru- sion of the transvise. section of the great intestine, which be- comes distended like a pad, attended with colic-like pain, doub- ling up of the body, which is relieved by pressure on the part; also severe bearing-down pains, aggravated by motion; at other times theie is a sensation as if the above swelling had been removed downwards, deep into the abdomen, with feeling of bearing-down of tho whole intestines; also in menstrual colic, with spasmodic constrictions in the abdomen, with burn- ing pain lower down or in the small of the back ; or pain under the ribs, as if a number of nails were holding the in- testines. The symptoms are also attended with a liquid or puriform species of diarrlm-a, and swelling of the veins of the head; the pains are sometimes so violent as almost to deprive the patient of reason. Co< (tlus 2J>^a is indicated (menstrual or flatulent colic) when there are severe constrictive or spasmodic pains in the lower part of the abdomen ; great flatulence, fulness, and dis- tention of the entire abdomen, with nausea and difficulty of breathing; also when there is a sensation of emptiness, tearing and burning pains in the intestines, sometimes with squeezing, tearing and pulling pains, excessive anguish and nervous ex- citement, and constipation. Colocvntii Jtajui. ]„ the majority of violent and obstinate cases, we find this a valuable remedy; it is indicated when the pains are excessively violent, and of a constrictive or spasmodic character, or resembles stabbing and cutting, as if from knives; sometimes a sensation of clawing and pinching, tenderness of the abdomen, with a pain as from a blow; or distention of the abdomen; at other times a sense of emptiness is experienced, cramps and shivering, or tearing pains in the legs ; during the coutinuanee of the attack, excessive restlessness, agitation, and tossing about from the violence of the pain: when the pains come on, they continue without any apparent intermission; 134 DH-km iv r. uniM. after their disappearance, a er-nsati m of bruising remains, >nd the sufferer feels as tin ugh the intestines were held together by tbin threads, likely t . break from tin- slightest motion. R .th this remedy snd (ha mom ilia an- particularly efficacious in the so-called bilious colic, being indicated by the di arrhu-a ami bilious vomiting attending it, snd in cases where passion has been the exciting causes. Color nth is more particularly useful in the case of adults, or where th. fit of anger is at- tended with indignation. •sfLPniR 5»«* may full"W either Chamomilla < miting; diarrlnea, with green or yellow evacua- ti >n, vielent gripiiigs, headache, paleness of tho face, and blue mark-* round the eyt-s; accession of the pains particularly dur- ing tlie night, or after eating or drinking. t'oin\ **** is valuable when wo have to deal with colic with excessive pains, attended with great agitation, anxiety, and tossing about, grinding of the teeth, convulsions, suffocative, oppressive despair, acidity, coldness of the t» dy and extremi- st-- If is also useful in some kinds of menstrual rolie, with a •••ns.-ition as if the abdomen were being rent asunder; or with fulness and pressure in the abd mien and violent spasm which extend t • me e|m-t Cutting pains in the intestines as if di- vidi d by a knife. The pains present so violent, as almost to drive f'n- patient to distraction, and cause him to bend double and draw up his limbs ; violent spasms in all his members. Rryonm, colic with constipation, tension in the abdomen, si d flow of saliva like salivation. In cases of coRc arising suddenly from indigestible food, a eup of black <• flee, with< ut milk or sugar, will frequently af- f-T'l relief, by causing the stomach to free it-elf from tl.....-ause of annoyance; in instances where that article has not been mada one of ordinary beverage. When from Constipation, Siilicbi is an excellent remedy, and sometimes Conium. See Cu.N-TirATiox. For colic arising from worms, see Worms. 137 LOOSENESS OF THE BOWELS. Diarrhcea. Diagnosis. Fluid discharge from the intestines in increased quantity. This affection is simply an increase of the peristaltic action of the intestinal canal, and is so well known under its different forms, that I shall simply allude to the principal exciting causes, and then proceed to the treatment. The exciting causes are acid, indigestible food, a check of perspiration, sudden changes of temperature, the prolonged use of powerful purgatives, which, although still more frequently the cause of constipation, nevertheless, by producing irritation of the intestinal canal, also predispose to attacks of this derange- ment, worms, etc. Sometimes diarrhoea is a salutary crisis, as remarked under fevers ; here again the homoeopathic treatment assists nature, and while it abridges the duration of the affection, and thereby obviates future debility, does not rashly check its course. Therapeutics. The principal remedies in this affection are Dulcamara, Bryonia, Cinchona, Ferrum aceticum, Chamomilla, Rlii um, Mercurius, Pulsatilla, Nux vomica, Arsenicum, Anti- monium crudum, Rhus toxicodendron, Opium, Sulphur, Calca- rea, Acidum phosphoricum, and Phosphorus. Administration. In recent cases, six globules of the sixth potency may be dissolved in about an ounce of water, and a dessert-spoonful after each motion until benefit results;—in the case of children, half the quant it}', administered in tea- spoonfuls. In chronic cases it Will generally be sufficient to administer the dose night and morning, or only once a day, and even only once in four or five days or longer, according to the effects produced.* Dulcamara G00^00-, should be administered in diarrhoea oc- curring in summer from cold, probably from wet feet or ex- posure to rain. Particular indications for its exhibitions are * Vide note, p. 21. loS DM IsTlVl SVBTKM. when the diarrhoea is attended with colic, or cultine- pain, chiefly in the n-gion of the naval; when the evacuations aro liquid, slimy and yellow, generally coming on at night, ami attenJed with nausea or Vomiting; want ■■« appetite and gnat thirst; palenost- ld exposed situation, or in draughts—or from biting, easterly winds. When this affection has been produced by passion, particularly in individuals of what physiologists tie- nominate a bilious temperament, it is imst useful—if any symptoms remain after Cluimomilla, which in such cases de- serve a preference. It may also be remarked, that tin- dianhua arising from drinking impure water when heatid has frequently found relief in this medicine. When tin; water is strongly im- pregnated with vegetable substances, it may be advantageously followed by Cm, hum. This is a ease which seldom occurs, but knowing that it does occasionally, particularly with sports- men on moors, and in marshy ground, it has been judged advisa- ble to add these remarks. ( Anlimoniiim is sometimes requited to complete the cure, titter the previous exhibition of B, nonia.) See \dministration, p. T>7. Cinchona. Looseness, in consequence of indigestion, par- ticularly if in consequence of partaking of fruit or flatulent food, such as vegetables; evacuations an- very profuse, and sometimes attended with but litth- pain, and when the dis- charge comes on immediately after partaking of foot I, or at night, evacuations liquid and brownish, sometimes containing portions of undigested food; it is, in some instances, also in- LOOSENESS OF TME BOWTI.s. 139 dieated, when consitlerable spasmodic or colic-like pain is pre- sent, with flatulence, want of appetite, thirst, and great weak- ness; it is also valuable after improper treatment of this affec- tion, when considerable debility remains. Sec Administration, p. 137. Jehrim \t ivriciM may be advantageously given in alterna- tion with Cinchona at intervals of twelve hours, when the eva- cuations are partly composed of undigested food* and pass without pain; or this remedy may be administered alone, when the diarrhoea is unattended with pain, and then- is paleness of tho face, weakness of the eyes, pains in the back and anus; with great wcaknes8*of digestion. See Administration, p. lo7. Chamomilla *, is a remedy, as already stated elsewhere, particularly useful in children, either at the time of teething, or at a more advanced period, when tho affection has been excited by cheeked perspiration ; it is further particularly indicated, when the evacuations arc watery, bilious,^ green, yellow, or slimy, or of a fetor resembling rotten eggs; when there are ful- ness at the. pit of the stomach, severe colic or spasm, pain in the abdomen, distention and hardness of the abdomen, bitter taste in the mouth, foul tongue, thirst, want of appetite, bilious vomit- ing and flatulency in infants, attended with restlessness and screaming, and drawing up of the limbs towards the stomach; in cases of adults, °3n. Sulphur is frequently useful in com- pleting the euro when the pains or colic has been removed by Chamomilla. See Administration, p. l'>7. Riiecm fi§ft, when the symptoms, in a great measure, resem- ble Chamomilla, but the pain is not so violent, and the evacu- ations have a sour smell; paleness of the face is also an indica- tion for this medicine. (See Diurrhwa in children.') i MKiuntn.s attiMKLft. When the diarrluea arises from* chill, and tho motions are copious, watery, slimy, frothy, bilious, or greenish, or streaked with blood, and cause a smarting or burn- ing sensation on being evacuated; also when there is painful straining before, during, and after evacuation; severe cutting pains ; moreover, nausea and eructation, cold perspiration, • Sec also Ai-<-«., Merc, Bryonia, Phospk., Lachesis. t Dittrrha-a bilioso. 140 DIOKHTIYB STBTBM. trembling or shivering, snd shuddering, great lassitude, and dis- position to syncope ; disrrhora with ingesta Pun - vtili. v One of the best remedies in simple looseness or diarrhcra arising from frron of dirt, su-h as indulgence in acid*, fruits, or rich indigestible food, attended with foul tongue and other dysprptir Symptoms. (See I ni.i.kstion.) Another remarksble indication f. r this remedy is one evacuation differing from another in colour. See Administration, p. 137. Iphm.uaniiv *Yf- '.....seness arising from indigestion, particularly if caused by imperfect mastication, attended with nausea and vomiting; paleness of the lace, (see also 4 sen.,) vraMnrss, snd desire to retain tho recumbent posture (in the esse of ohildren). When // < cucnunha does imt appear to afford much relief, Pulsatilla ought to bo had recourse to in tin- space of from 1"J to 'J I hours, after the last dose of Ipecacuanha : when, in the case of ohildren, tho motions have a very sour smell, Rheum is to be preferred to Pulsatilla, from whatever Osumj the attack may have arisen. Nix yomu \. .Si until evacuations or motions, consisting of siimo ami blood, attended with straining und great weakness, flatulency, and violent cutting pains in the region of the navel; for some of the accompanying symptoms the reader is requested to study the indications given under this remedy, in Inuiok.s- TIon See Administration, p. l->7. Ahskniclm. Autumnal diarrhoea, or looseness arising from errors in diet, ac'uls, fruits, cold drinks, ices, or from a chill, &c., the eliaraetitri-tie symptoms for its employment an- watery, slimy, greenish, or brownish rorro.siiv, burning evacuations, with violent co'ic, excessive thirst, emac'uition, and great weak- ness ; and when more liable to come on at night or after eating or drinking.—( Vol. the further indications for this important remedy in Part III., under Bowel Complaints in Chil- dren.)* See Administration, p. l'J7. Antimonium chudi m. Also in cases arising from disor- der,d stomach, with white tongue, loss of appetite, eructations * Whrn Arsenicum doe* not answer our eij»-ct.viona, Veratrum should be substituted ; the latter remedy is, moreover, for id* moat pert to be pre- ferred wbeo the disease at■ ;>• a.-» to have arisen from aiuicwphenc causes. DYSENTERY. 141 and nausea; diarrhoea alternating with constipation. (See article upon this affection.) See Administration, p. l.°,7. Ituus toxicodendron. Lumpy or pap-like diarrhoea, com- ing on only at night, preceded by colic, which disappears after each evacuation. See Administration, p. 137. Opium fln3',(). Diarrhoea arising from fright or from cold, followed, if required, by Dulcamara in tho latter case. For other indications, vide Mental Kmotions. Lachesis. Diarrhoea from acid drinks, or sour unripe fruits, with severe griping; diarrhoea with ingesta. Sulphur °|°. Is a moat valuable remedy in diarrhoea, par. ticularly during the night, occurring in strumous habits, or in very obstinate cases. In adults predisposed to hemorrhoids, or in ohildren, when the diarrhoea is attended with excoriation and papular eruptions, it is particularly efficacious ; also in eases where the slightest cold brings on a relapse or an attack; or when milk disagrees and causes a looseness. Calcarea flft^ft. May be had recourse to after Sulphur. Acidum phosphoricum. In obstinate cases, with portions of undigested food in the evacuations; or occasional involun- tary evacuations. Phosphorus 4J6fta. In chronic, painless diarrhaa, with gradual prostration of strength ; diarrhoea with ingesta. Diet. Acids or acidulous wines, beer, coffee, strong tea, and fruits, whether raw or cooked, should be carefully avoided. Solid food proscribed as tending to keep up the intestinal irrita- tion ; and gruel, fresh milk in moderation, broths, and light mucilaginous food substituted. DYSE XTER Y. Dysenteria. Diagnosis. Constant urgency to evacuate the bowels, tenesmus, violent pains in the abdomen, a greater or less degree of fever, and stools of mucus or blood, or both. It may appear suddenly, but is frequently preceded some time by loss of appetite, costiveness, flatulency, nausea or slight vomiting, with chills followed by heat of skin and accelerated pulse, then dull abdominal pains and increased 142 DIGESTIVK S\«Ti:M. rra^nstions; sfter s time n« trees an- discharged, but white mucus, wl ich may afterwards change to hl.« ,| (hh*>< , H>,r); ►tools, ,*rtieulsrly when fever is pr.-«.iit. urv frequent and felid; if not checked in time, the disease may terminate in ulceration or gangrene, -r the patient msy sink from ex- haustion. Phis affection is very frequently complicated with rheumatic pains, which will be noticed umh-r the different remedies, as an additional indication for their employment. Tin- rxeiiing esuscs are. cheeked perspiration, particularly in warm weather; low or marshy situations, local ii litatinns, such as worms, sey- bala, \ •;., and suppression of hemorrhoids, metastases, and sometimes, in infants, difficult dentition. Tin rai-iui i< s. The principal remedies found useful in treatment are \conilum, ('hamomilla, Pulsatilla, Ipecacu- anha, Colocynlh, V, rcirrius virus, Arsenicum album, Carbo \, :etabilis, \m tomua, Cinthona, and Sulphur, Staphys., Sepia, ete. Viomtim This remedy is |.....uliarly adapted to tin- fever frequently present, and in young and plethoric patients is gene- rally required in tin- commencement or in tho course of the disease. It is indicated by full and html pulse ; severe pains, generally in one spot ; abdomen tense ami painful when touch- ed denoting the commencement of inflammation; also valuable when we find pains resembling rheum .it ism in different parts of the btnly, with shivering, or excessive heat ami thirst. AoMIMsTR \T|on. As in I nklammatohv I'kvkh, which -ce. ( ii vmomii.i.v If a'ter tin- administration of Aconite, w« still find violent heat and thirst, rheumatic pains in the head, ami constant aXati'i, and tossing. This remedy is also use- ful when this di»casc seems to take for it- pi.,miniate cause ga>tric impurities formed in the prima- \i.i-; or when it has arisen from exposure to a cod atmosphere when in a state of perspiration. When we find foul tongue with clammy, bitter tante in the mouth, bilious stools, and before tene-mus declare itself, this evidently points out the remedy as more useful in the first or diarrheal btage ; it may be followed by Put a:, la. when the symptoms given under that remed. pi- sent themselves. DYSENTERY. 14:3 Administration *Ya. i» a little water, repeated everv six hours, until improvement takes place, or indications for another remedy present themselves.* Pulsatilla, when the gastric, symptoms noted under Cha- momilla are present, but the stools consist entirely of mucus striated with blood. (Dyscnlcia pituitosa.) Administration, same as Chamomilla, but at the sixth po- tency. Tho three remedies, above mentioned, are also valuable in dysentery arising from cold, or what is commonly denominated rheumatic catarrhal dysentery, Rheumati.smus Intestinorum. Ipiicaci'aniia. This remedy is serviceable when the dysen- teric affection seems fairly established ; when the stool consists of slimy matter containing white flocks, followed by evacuations of sanguiuolont mucus. Administration, same as Chamomilla. Colocynth. In cases attended with violent colic and exces- sive distention of the abdomen, shivering with chills, apparently extending from the abdomen over tin- whole body, excessive agi- tation and restlessness, tongue coated white ; slimy, and some- times bloody evacuations ; it is sometimes found useful to fol- low Ipecacuanha or Mcrrurius.f Administration, ii^ii, in six ten.spoonsful of water, one every hour until improyeiucnt declares itself, when the intervals between the doses may be lengthened.! MkiuTiuus vivus in the red dysentery or ijloody fltx, • Vide note, p. 21. t A successful procedure in our practice has been the alternate admin- istration of Colmi/nth and Mercury for very many forms of dysentery. The general indications permitting, we have given the first trituration of the Colocynth apple (rubbed dry with Sugar of Milk) every two, three, four or more hours during the day, and Mercury at evening or during the night. In some cases, however, where the griping pains and tenes- mus were intense, we have alternated the Colocynth and Mercury during Uie night, at such intervals as the urgency of symptoms demanded. After a favourable impression from these drugs, the disease sometimes re- maining stationary, especially during the autumn or prevalence of febrile miaMiis, we have found a dose or two of Volchicum to awaken anew the susceptibility of the system to the above or other indicated remedies.—Ed. X Vide note, page 21. 144 DIOBSTIVl 8Y8TSM. when we find severe tenesmus or train ine, with evacuation, merely of a little nuieos, sometimes sm-eeed» d by or accompa- nied with protrusion of a poitimi t the intestine aud increased discharge of pure blood, or of pu'i id, corrosm, gncnish, yel- lowish, or fnthv mucus, intermixed with blood, snd sometimes followed by the evacuation .f small hard substances (scybala) after much straining; burning in sno ; severe griping and lan- cinating psin before, during, and even after the inotions ; in- creased urgency to stool after each evacuation. * In cases with the above symptoms, Mercurius may almost be considered a specific, or will at all events prove so ellieacioui s rvm«»dy. that any remaining symptoms will, in general, bo re- moved with facility, either by means of Colocynth, Acidum phos. pharicum, A idum nitricum, (tho two latter especially in the event of a continuance "f tho sangui.....ius stools,) or any of tho other remedies which may seem more appropriate according to the indications for their employment, as given in this chapter. Administration. A grain of the third trituration in an ounce of water, a des-ert-spoonful every three hours until tho symptoms are mitigated, when the intervals may be lengthened. Bryonia is frequently called for in those eases in which it has been found necessary to administer Aconite at tho com- mencement of tho disease; but is more particularly indicated when the attack hss occurred during the heat of summer from the effects of a chill, and is attended with typhoid fe\cr of the inflammatory form; with loose evacuations of s brownish colour and putrid odour, occasionally containing lumps of coagulated mucus resembling undigested substances, or also smull bard lumps or ballh, (scybalous fax-al matter) with griping during, snd burning in ano after tin- act of evacuating, aching pains in t'.e limbs, aggravated by movement. When the disease has attained an advanced stage, and tin- accompanying fever is of a low typhoid tv pe, the patient much exhausted and distressed with severe rhcumatie or aching pains in the loins and extrem- ities when reclining or sitting still, ami tin- stools of a slimy, ' V'/ -urius sublimatus eorrositus m sometime* more speedily effioa- eiom thta M> i r,UULt tsicus or Mere, solubulis agaiuat the above «yuip- tom*. DTSENTERY. 145 frothy, white, gelatinous, or sanguineous nature, passed invol- untarily at night in bed : Rms not unfrcpnntly gives a favour- able turn to the disorder. Administration of Bryonia and Rhus. Six globules of the third potency in about half an ounce of water, a teaspoonful every two hours until an alteration is effected. Ahskmum. Dysentery of epidemic or contagious origin with fever of a typhoid or putrid type:* dysentery arising from exposure to .noxious exhalations in marshy situations, &c. This remedy may, however, be selected in all cases, from whatever cause arising, when great weakness and even pros- tra ion exists from the commencement, with burning pain in evacuating the bowels, thirst and aggravations of the sufferings after drinking; or, on the contrary, adipsia :—also when the disease threatens to assume the ulcerative or gangrenous cha- racter—characterized by previous severe pains, particularly burning, which suddenly cease ; hypocratic expression of counte- nance ; rapid sinking of the vital energies; pulse small and in- termittent ; coldness of the extremities; highly offensive, putrid, and cadaverous smelling evacuations, both of faeces and urine; unconscious passing of stools ; offensive breath and petechia in different parts of the body. Administration. Six globules of the third potency in an ounce of water, a dessert spoonful every two, three, or six hours, according to the urgency of the case, carefully watch- ing the effects, and shortening or lengthening the intervals accordingly. Carbo vkgktaiiilis is a most useful remedy in these des- perate cases, when the breath is cold, the pulse almost imper- ceptible, and the patient complains of severe burning pains : its indications closely resemble those of Arsenicum, with the exception of the thirst, and the aggravation caused by drinking. It may be given with benefit when that remedy has failed, or only partially relieved, and in this, as in other affections, many instances might be cited where a judicious alternation of these T • Dyeenteria putrida. 140 rT-rSTiTr st«tfm. tw,. n medic* hn« effete 1 benefit —where ne'ther of thrm might have !. e i sjoj. adcipn'e to the exigency o'" tho pas". At'MIMsTRATI • *. Six globules if the sixth or twel th po- tency exhibited in the same main or as 1- rnitun:. Vx vnviitt. When 1 v nirwn bns diminished th.....s'.mp- t .ins and waidul off the danger, but we find that the ln-cM Mill retain a hijrldv | ntiid odour; also at any prri >d during tho course or the disease, when the following sympt in* arc present — Vretpiot t srtnty eraruolmns of mum* or saiuruineons mu- eu- ami occasionally sinnll, eonipsct, hard fzvi es (sev Imln) nt- t.nded wriX violent cutting or griping pains in the region of t! . navel: b ib rvgmns, pain* in t! e 1 ins, to esmtis In ruing or senxri >o of excoriation in the a-m*, anil sometimes protrusion of t'ie intestine; great heat and exclusive tl irsf. Administration. Same as Pu'sa'ifh.'. t'lMlliNA. Ill I'ift « wlele the lli-cine llOS all crtleintc crtsrS'-t'T. oei urriug in inar*by count i its, and in many ci-i s when n »tnte of pettiditv remains in the fa-ce* alter the atliuin- U*' .itioil ol tin rented e« nbi.Ve lie ntiolicd \ ii»iini» riiAtion. S.mi" ns Cham > ilia. Cantii mides SanguLenus ^t \n mixed with wrii' i-li mu- cus or solid substances like fal-e m mbiiincs; strangury.* Administration. Six globul « of tl.c third in an ounce of wal^r, a d< ».* i t-spoonftd every f< in or eix In in a. X Lfiicr.. When tin- more marked a\uipti m* are nmelio. rsttd by the upc time b« en subdued, srd a'ti-rwards returned with greater or h •«* vir»b'e lo Canthiindr* wton the » mp- toma are us described, aud ;:<* dwoider ragr* epidemically d r c, lbs a .- !-:..„... season. DYsF.NTBRT. 147 In the instance first noted by its removal, the affection is ter- minated ; i„ the scco.,1, the predisposition to a return of the attack ,s „bvi«t.-d; and in the thi.d, the constitutional taint alluded to being cent.oiled, the organism becomes susceptible to the speeifie action of the other medicaments. Admin;im ration, m in a little water, repeated at li,-t every twelve hours until an effect is produced, then discontinued for a time and allowed to act. In conclusion it must not be omitted to add, that when tho disease is of long standing, and has become, so to speak, habitual, a cure is often effected by means of Phosphorus. Adminivtuation. Two globules of the third potency in a little water daily, unti! a favourable change sets in.* Rules of Conduct aid Die'. In this affection it is of great importance to keep up a moderate degree of warmth around flic abdomen, which is best obtained by flannel worn outside tho linen. During the course of treatment cold drinks are to be avoided, barely sufficient nutriment to keep up the strength of the pa- tient allowed ; and tl e more severe the inflammatory symp. toins. the more strict must bo the abstinence. No solids should on any account be given; but the diet should consist piincipally of mucilaginous or demulcent fluids, such as thin barley-water and gruel ; in comparatively mild cases, weak chicken-broth or beef-tea, at the discretion of the physician, may be allowed. Evi n after convalescence this course of diet should be for a short time observed, especially when the dis. ease is raging in an epidemic form, and a return to the usual _dict gradually brought about. Wine and alcohol are absolute poisons in this affection. Having thus given the best mode of treatment for this dis- ease, ordinarily so fatal, we may remark that in a great maj iity of eases, the hoimeopathi • method checks it at its commence- ment, without allowing it to assume the more frightful forms portrayed in the instructions of its treatment; aud it passes • Vidt> note, psge 21. 14*5 DIOtSTIVR SfSTVM off lesving the patient in sound health; in the most violent cases where it La* already made bead, snd seem* approaching s fatal tciminalion, it may slui'it be said to be the only sys- tem which offers a chancr of salvation to the stiff.-icr ; and in strum u* constitutions, where, under the old mode of procedure, t>-.» results ore commonly so unfortunate, it gently mitigate* the violence of tbe symptoms, snd safely conducts the patient thmugh his |*riU. Suppressed Djsm'rry. When the dysenteric evacuations hi.ve been suddenly cheeked by a'lopatliic means, and a viob nt inflammatory or spasmodic action declare itself, such as severe pains, anxiety, dyspnoea, nausea, and empty retchings, or dis- tention ami tenderness of the abdomen ; suppression both of f.eceB and mine; coldness of the face, tongue, and extremities; breath also cold; with spasms of various kinds in different patt> of the body, which are renewed by any exertion, cither of Kpcech or movement—the following remedies will be found usefnl : A- oniti m. Against any iuflammat< rv symptoms that may pr. -cut themselves to be repeated according to the rulealnady given until relief fnlliw.* (i i-ri m AiRiit i m. When spasms or cold sweats predom- inate A i ministration. '*, in a little water, repeati d in three to •ix hours, sccording to the effe t produced. Bm.lao >nna, sgainst inflammatory colic, or if symptoms of abdominal inflammation set in, see article Knikritis, and also Colic, and administer accordingly. Colocynth. Violent colic and distention of the abdomen, see Colic \ krathi m albi >i Coldness of the body and extremities, snd retching. A i ministration. Six globules of the sixth p> tency in an ounce of water, a dc*«ert-»poonful every two to eix hours. (vhbo \ k<;i:tahilis in extreme cases, with scarcely |«r- oeptible pulse, and cold breath. • Vide not*, p. SI CHOLEKA. 149 Administration, as already given in the foregoing article. The use of clysters of warm water has in many instances been found serviceable in promoting an evacuation of the bowels, and bringing back the suppressed discharge. W hen the patient has escaped the serious consequences above noticed, chronic complaints frequently are the result of Suppressed Dysentery; the most frequent arc Dropsy, Paraly- Bis, and Rheumatism. CHOLERA. By the term Cliolera Morbus was formerly understood a disease attended with nausea, griping, purging, and vomiting, generally prevalent towards our summer months, and at the season when fruit was plentiful. Hut it has now become a generic teim, under which are included two varieties—the Cliolera Morbus, properly so called, and the Asiatic Cholera. I)i\«;nos|s. The first named, sometimes called the Spora- dic Cholera, generally commences with a sudden feeling of nausea and giiping, followed by purging and vomiting; in severe cases accoinpanied with coldness of the body, particularly the extremities, and anxious and hurried breathings, excessive thirst, a feeling of cramping in the legs, sometimes in the arms, with spasmodic contractions of the abdominal muscles, shrinking of the features, and a hollow expression about the eyes; pulse weak, sometimes scarcely perceptible; thin, watery, and fetid, or bilious evacuations, sometimes with dark bilious vomiting, anxity, and tenesmus. 1'um:s. The most frequent are worms, gall-stones, indi- gestible substances, fruits, or crude vegetables, alterations in temperature, moist or marshy situations, or damp weather, dentition, or parturition. Tiikrvi-ii tk s. In the treatment of Cholera in its sporadic form, (i. e, when the disease arises from occasional causes, such as eld, fatigue, <.Vc.,) the following remedies will be found to be the most efficacious: Cham., Ipecac, Mux v., Veratrum album, Ar.seni.um album, Cinchona, and Pulsatilla. Chamomilla is almost specific when the attack has been ]50 DIOKsTITE itstrm , x.ited by a chill or a fit of passion, or great dread of Wing sttscked during the prevalence of the disease The following arc the svmntom* whi.-i pa t. ularly indicate its employment scut- coli.-like pains, or hcsvy pressure m the region of the nsvel. sometime* extending to the hesrt, with excessive sngui*h ; biliou* dinrrhcrs, cramps in tie calves of the leg-; tongue coated yellow, and s in times vomiting of scid matter. Vi.MiNisiHvrioN A few globufe* of the third p-tencs to half an oun......f water, a teaspoonful ev -ry two X six hour*, according to eircumstsnees. (Vide note, p -1 ) Ii-ki v. hmm may be administered s tor the above, should the a'tacksof vomi'inq become more |......linetit ; or it may Imj «m lectcd fnin the nimmni-rm-Bt, should -onilinif predumma'c, or at leant sssume a* marked a character in tho complaint as the diarrli.ca. Other imbeati ms an- son ati .lis of weakness, or Softness, (flaecidilv ) coldness in the face aid limb*, sen*e of shivering in the abdomen; sliirbt crampi in toe calves of the leg*, and in the finger.* and toe*. (Nix v after Ipec, when siixict., pain in tbo abdominal parts, frequent small evacuations ■nd tenesmus, frontal hoada Ins, horripilation with internal chill*.) A mil nutrition. Same as ('11 \Mo>;:i i. \. \i.h*trim alhi'm. Shmld tin- disease increase, notwith- standing the administration of the pieceding remedy, ami imuiih' the following charactorDtics, i,,'ent vomiting vt'h \, rrrr diarrhcei, rxctssire weakness, anil cramps m the ca'reu of the bgs ; eye* ln.ll -w or sunken, cout tenance pale, and ex- pressive of acufr suffering and tntiiisr anguish ; coldness of the breath anil tongue, excruciating jutin in the regiitn of the navel, tejderne*s of the abd mien when touched; dragging piii- ami cramps in the fingers, shrivelled appears ice of tin- skin on tin- palms of the hands. This is also one of the best remedies in b .th vsrieties of this disease. Administration. Six globules of the third potency in a teasp -onfi.l of water, repeated in half an hour or even less, should there lie no change of any kind t r tho better; or one or two drops of the third tincture may be added to an ounce of cholera. 151 water, a dessert spomiful every hul', one, or two heirs, ace rd- i .g to tin- sev rity of the .* nipt ids ; vv ion am linati n las taken p'ac ■, leigtlu-i.il- t'.e intciv.ds. \km:ni. rM is useful vvl.e i this ina'ady ass mes a severe character In m the begin: in , but it is imne particularly indi- cated when the dis.as,! is attended witii rap d pmstra ion of s •en :'h. ins ili -Id ihirs , ex-cssive a ixi ty, loss of articulation, with fear of uppn a hing d atli, hieuna sensa'ion in the region ot the stomach, almost constant discharge i'mm the bowels, or renewal of the discharge on every occasion that the desire for d.-iuk is gratified; suppression of urine or scanty mieturil in, I. lloivetl by a burning sensation; vio'en' and pain fid rami ing, ten uc and lips dry, cracked and b'ue.'sh, or btack ; hollow cheeks, pointed nose, pulse aim st imperceptible, or sm >!l, weak, inermit ant, and trembling; severe s: asms in the fingcis and toes; clammy / er.sp'r-al.or the remedies sire d. mentioned under Sporadic Cholera, p. 1 :><•, administer- ing, however, in »re frequently, say every hour at first 1> it when Cholera sets in in all it* frightful forms, we should have imm dia'e recourse to \ krathim Administration A few globules of the third in a tea- spoonful of water every quarter of an hour: should no im- provement set in after several doses, and the cramps chance to spasms and convulsion*, with spasm, die conatiictioti of tho chest, which obstructs respiration, (iprim must be hud te- course to in tbc same manner as described for \trutrum. \rsknktm should be alternated with \ • xp liciiccd in the st. mach aid bowels, with i xtr> un prostration of strength, great thirst, etc (Vid. Indications, page 160.j Carbo vjeoxtabilis may often be given with advantage CHOLERA. 158 when the patient is reduced to a state of almost complete as- phyxia, with scarcely perrep'ible puis, ; or when, on the cessa- tion of vomiting, diarrhoea, and cramps or convulsions, con- gestion to the head and chest ensues, with oppressed breath- ing, coldness of the breath, and redness or lividity of the face, (which is covered with clammy sweat,) and lethargy:—Should the pulse become stronger under the action of Curb, v., but the pain, vomiting, cramps, etc, return, Veratrum must again be had recourse to. I'liosi-noRus (followed by Acidtm piiosphorictm, should great clamminess of the tona'tie supervene) is particularly use- ful in cases of diarrheru, which are so liable to occur during the prevalence of cholera, and which, if neglected, are but too prone to pass on rapidly to confirmed cholera. AiUhinistiivtion. A few globules of the third potency every four or six hours.* Piiosi-iioKiis is further indicated in the course of con "estion " in the chest" during the course of the disease ,—finally, it is one of the most serviceable remedies against the obs'inate diar- rl.ee' which sometimes remains after an attack. In conclu- sion, it maybe added that a few doses of Canth \riiu>, 3, will be found useful when there is great irritation and pain in the bladder. Rhus, Bryonia, etc, when Typhis Fever re- sults (vide Tyjihus). Bdladonna, followed, if required, by Odum and Lach'-sis, when there is Congestion of tuk Brain. Aconite, Phosphorus, Bryonia, B lladonna, etc.. in the event of Congestion to tiik Ciikst ; and Aconite, followed by .\ux v., H '/onia, or Mercurius, etc., when the stomach and intes- tines become the seat of congestion (vide Congestion to the Abdomen ) Sm'vi.i: counttim is very useful in cases of colourless diarrha"r, with pains in the extremities remaining on the ces- sation of the vomiting, hut is also valuable after Vera'rum and Cuprum, when the cramps or convulsions do net yield to these remedies. Cinchona against the weakness,—and Sulphur and Phosphorus are two of the m >st important remedies against irritation or weakness in the alimentary canal, characterized * Vide note, p. 21. 7* 1M DIGESTIVE STSTTM b. freqi'tt attacks of or nearly c ntim al 'o»uttr*s occurring after cm lent The foregoing, thon, sn< tin- principal rune- dies empl.ved by hoimropatliisls in cholera, ami when the tint. moot is had recourse X frmii lie nuiini no-incut, it generally yields without difficulty; the disease rarely passing int.. tho second stage, and almost never into the t ii d The best preservatives agniust infecti n are Veratrum, Cu- prum, and Camphor; an occasional l»c of the preparation mentioned under the latter medicine, at page l>'_\ has fre- quentlv been found sufficient to ward <>t! an attack; it is more particularly during the first .stay, of the .is, use itself, however, under whatever form it sets in, that the greatest reliance is to be plated on this remedy. Vcra'rum and Cuprum are the prophylactics which have been employ I with the grcateit success. One drop of tin- tincture at the third dibit pes, or a few el bules of the same potencs of eh medicine, may be taken alternately every third day, in a little water, fasting; avoiding, m-rciiver, excesses of all kinds, late hours, exposure to night air, and melancholy thoughts, r fear, which an- all strongly predisposing causes to attacks of this malady. When the disease happens t<> break out, n >twi (islanding these pre- cautions, it is almost invariably in tho u ildr.st form. It may also be remarked, that dmi ig the prevalence of this affection 11 e clothing should be sufficient to preieive The b tly at an eipiablc teui|M-rature, ami tan- taken to ..void chills or check- ed pcr*p'nution, or eld and net fed; those who are affect.-d with considerable perspiration in trnir feet should change their stocking* at h-ast once daily ; a flannel bandage worn round the abd nun is also a useful pre. mtion, ami it should not be hastily laid aside when the dancer seem* to have pass. ed away; slso constant exercise should be taken during the dav in the r ]<■ u air. Adnerencc to the In m. patliic rules is a s ifii'i> nt dietetic guide; raw vegetable* aid cold fruits, for example, melons, should l>e carefully abstained from, ami even the m< re wholes »me varieties snd sil coiked vegetsbles, ex- cept po'at r individuals not at. tacked with the same limitation. It may appear almost super- CHOLERA. 155 military t-i observe that purity of air and thorough ventilation is highly necessary. Act i svonv Thi. vtmknt. The patient should be kept in a room of a warm temperature, the bed should be heated by ar- tificial mean*, and b.tiles of hot water applii d to the feet if necessary. The observance of this rule greatly fac litatcs tho action of the medicine employed; anything which might dis- till b the equanimity of the sufferer, such as noise ysi:ntkrv. CHOLERINE. This affection being merely diarrlaa, occurring during tho prevalence of cholera without any of the more sjvere symp- toms ot the disease, consult that article for its treatment. LIVER COMPLAINT. This diseaso is divided into the Acute and Chronic ; the lat- ter generally goe* by the name of Liver C mpluiut, although a care.ul diagnosis will genera.ly discover that the real disiase is in tho stomach and intcsti.es. however, in many cases the liver itsel;' becomes much affected from this cause, aud in its.k' deserves considerable attention. 166 PtoMTIVB sTsTTM When the disesse has been for a long time unchecked, ard the iuflaminatioii bee im* deeply seated in thr sulmtai iv of I n liver, an abscess frequently forms, bursting either externally or internal!.. ; in the latter esse not unseldoiu proving critical, or bringiug on hectic fever. ACUTE INFLAMMATION OF THE LIVKR Ihiafitis. Tnis disease is much more common in tropical clinic* than with us. There, s high mode of living, exp«*uro t" heavy dews or damp* in the evening, stid the powerful rsys qf the *un by day, are among its principal exciting causes; but it may al.so arise fnm vii lent mental emotions, the use of stimulating or alcoholic drinks, suddenly suppressed evacuation*, strong emetics or purgative*, the use of iid-p hi v. gall-stones, external lesions, or injury of the btaiu. Din.xosi*. This differs according to the seat of tin- in- flammation, when on the outer surface or convex side the symptoms closely resemble those of pleuritis; there i* gene- rally a violent pain in the right hypoehondrium, aoiuetiim-N re- sembling stitches, at others burning—shooting to the sternum, the right scapula, and point of the *h ulder, ad even affc ling the right d> t, with sensation of numbness or Uncling in the arm of tin- ssme side, the psin incn-ssed by inspiration ; a abort dry cough, and the symptoms of inflammatory tuvci , bowel* inegu- lar, generally constipated, and evacuation* in most instances of an unnatural colour. In Xi- form the patient can only lie on the left side. When the seat of inflammation is on th-- inner or concave ride of the liver, the pain is much less, and the patient com- plains rather of a sensation of pressure than actual pain, but the whole biliary system is much more afT.-t'd The eyes and countenance become \ellow, snd sometimes complete jaundice declares itself; the urine is orange <-< loured, the e\ac- uati his mostly hard and generally of a whitish i.r gray co- lour. We also find lit r taste in the mouth, vomiting, and considerable distrcs,—the patient can only lie on the right Bide. Inflammatory fever is also present in thii form, snd in acttr inflammation of thf. livkr. 157 both, the right hypnchnndrium, on examination, will usually be found hot, tumefied, and painful on pressure. Inflammation of the liver, unless well treated, is apt to assume the chronic form ; it may also end in suppuration ex- ternally, or internally by a communication either with the lungs or intestinal canal, or by a vomica in the substance of the organ itself: in indurations or other alterations of structure, in gan- grene, or in the formation of adhesions. The disease may terminate by resolution, critical metastases, hemorrhoids, diarrhoea, epistaxes, or cutaneous, particularly erv sipelatous eruptions. Tiii:k \er.int s. The following remedies are those most required in its treatment: Aconitum, Belladonna, Mercurius, Lachesis, Bryonia alba, Chamomilla, Xuv vomica, Pulsatilla, and Sulphur. V< omtk is especially indicated in the commencement of the attack', and may always precede the other remedies, when there is violent inflammatory fever, attended with insupportable shoot- ing pains in the region of tho liver, with tossing, restlessness, and great anxiety and anguish, Ad>ii\i*tr\tio\. &99JIS.9 m an ounce of water, a dessert- spoonful every three hours. (Vide note. p. '21.) Bki.lado.vw may be advantageously administered after Aconite has subdued tho preceding symptoms, or from the commencement, when the following indications present them- selves : oppressive pains in the region of* the liver, which ex- ten I to the chest and shoulders; distention of the pit of the stomach, sometimes extending across the epigastrium, produc- ing a sensation of tension, with difficult and anxious respiration; determination of blood to the head, with cloudiness and giddi- ness, sometimes causing faintness; great thirst, tossing about at night and sleeplessness. Administration Six globules of the third potency to an ounce of water, a dessert-spoonful every three or six hours, according to the violence of the attack ; being careful, if a marked medicinal action declare itself, to allow it to pass off before repeating the medicine, and also to lengthen the intervals according to the amelioration produced. 15* ni.itsTivr. *v«Tr.M. When Belladonna fail* to rem ive the wh do of theso symp- torn*, we frequently fi id that .Mi:mi iku« »UI have the- desired effect; this in di. anient i* to • well knoun a* an allopathic reme- dy in the cure of tiis discise, si:d the ronsnpirnc s pm-luettl by its abuse are f ^urnlly so gre.il, as lo render the dnrair a'mott inurable. I is rmcrally adminis'red, even uhrn not inliea'cd, until its m irked pathogenetic symj torn* dec'are them- se'rrji, and ronsr.pioir'y the patient, in addition lo the original nodaly, has frequently to con'rml with a medicinal disrate. Tho following are some of the principal indications for its employment : Painful sensations in the region of the liver, with shotting, burning, or of pressire pahs, not allowing the pal nut t -. lie lung on the right side, sometimes augmented by movement of the body or part affected ; bitter taste in the mouth, want of appe- tite, tliitst. and continual sniveling sometimes foil .we I b, sweat- ing. but without relief, with well marked veil iw colour <>r tho skin and eye* ; also when there are enlargement nnd induration of the liver, or where we have reason to suppose the formation of matter. (Abo. Irs., 11,-r. s., or Stiic. The alternate, em- ployment of Bell, and Bey.; when the liver remained tumid aud painful after tho n in val .,(' the fever: /'/,..«. aid Hi,.; when dull pain with dispupsia. Carb. v. a I ll.-y.; when eruc- talion, constipati .ii, jam.dice : Carb. r. and Nux v. in alter- nation.) Administration. A rraiu of tin- ?#d trituration to an ounce of water, a dessert.spoonful every three lo six hours, according to results, and with the precaution specified u d:r B 'ludomta. Lv< in: I". In subsc it- esses, or in thos*. in which Bella- dnnn i or Mercurius have merely afforded partial relief, Lacht is is o ten of great service. It may also be administered with ad- vantage alternately with the said remedied in obstinate cases occurring in drunkards (Admims'ra.'ion, sec /'«/«■., l.»'J.) Bkyiivm, when the pains in the region of the liver are mostly shooting, or consist of an obtuse pressure, with t .-nsion and burning, increased by touch, coughiag, or respirstion, and especially during inspiration; also much exacerbated by move meut; also when the .v. mptouis ar. attended with violent ACI-To inflammation OF thf. LIVER. 159 snnsm .die opprc*si >n of the chest ; rapid and a-ixims res*.ira- tion bitter taste in tie mouth, tongue coated yellow ; const'pa- tio i present. A dm i Ms i in i io\. Sameas Bellailo-ina. ('ir%MoMii.i. \. when there are pressive pains, pressure in the stomach, oppressi m of the chest, and a sensation of tightness under the rib* ; yello'r colour of the .s.'.in, pains no' aggravated by m it ion, a\:e ; tongue foul and yi How, bitter taste in the mouth; paron/sms of grea' amie'y. Chamomdla is also almost a specific when tho above symptoms have been brought on by a fit of passion. Advum s|-hation. Sameas Bryonia, Nix vioik \ is particularly indicated when the pains are shooting ami pulsative, and attended with excessive tenderness at the region of the liver to the touch, pressure in the epigas- trium and under the ribs, with shortness of breath; constipa- tion ; als i when enlargement and induration occur; and in the chronic form, when there are marked symptoms of gastric derangement. (Vide Nux vomica, art. Immoksi ion.) Adhims i ii ation. Same as Bryonia. IVi.s v i n,i. v. Sensation of tension in the region of the liver, and pn sstire or dull pain in the epigastric region; oppression at the chest, bitter taste, yellow tongue, nausea; loos., green- ish, ami slimy stools; excessive anxiety, especially towaids evening or during the night. Admimsi natiom. Six globules of the sixth in an ounce of water, a dessertspoonful every s x hours. Stli'iii a is valuablo to follow any of the preceding medi- cines, which, although apparently indicated, does not speedily declare a decided action, or when the disease continues, al- though in a diminished degree; it is particularly efficacious alter .\'itx ronica. to combat the seqmhe of the disease Vdministr vrtov. When to assist the action of the medi- cines, a single dusc y in a teaspooniul of water may be given, and followed by the remedy judged most appropriate to the case in the space of six or twelve haurs. ace mling X circum- stances ; when employed to combat the setpuhe of the disease, four globules at the same potency may be diss< lvod in four 32 180 DiattmvB «T«TrM. desecrt-spoonfulB of water, nnd one exhibited morning and evening, snd s> on until relief i* obtained, or another remedy is called t .r by an sllerstimi in the *ympt"in«. Di»t. The ssme ss under I'ivkr*. modified according to the v i lence of the disease. LIVKR COMPLAINT. OR fHKONIC IM'LAMMATK »N OF TIIK LI V Kit. Hepatitis ( hodca. In this form of the disease we fiml maiiy of the foregoing aympt in*, but in a modified degree; further, a continued pnin or uneasiness in tin- right side seldom leaves the patient, who gradually falls off in flesh ami lo*es alr.-ngth ; ami there is n t unfrctpicntly present an occasional cough with expectoration; sometimes considerable perceptible enlargement "t the liver, either continual or returning periodically, with a number of dyspeptic symptoms; high coloured or red urine, \ellow tinge of the skin and eves, occasional febrile symptoms; the pulse, except during these attacks, generally <|uick but regular. Ni\ viimrt 32 and S( i.i-in h fg arc two of the principal remedies in thi* affect ion, which, however, frequently repines a careful discriminative treatment, and all the acumen of the practis- d physician, to cm.duet it to a happy i*-ue. l-'nr the indications of these remedies, see \< in. Inflamma- tion ok thk Livkr Administration. As in Indication, which sec; under which slso will be found directions for the regulation of Dif.t. Carduos marianis This remedy i* indicated by most of the symptoms which have been des-ribed under Brir„ni and Nur v. in the preceding chapter, but it is more particularly called for when there is bitter taste, with dull pain cr occasions! sh tin:: or pricking in the right hypochondrium, increased by inspiration, yellow hue of the iki'i: short dry cough, or c .ugh with expect ratim of mucus strcak.il with blood; sli-Xt feverishness. Aurum, lh i ars., Lig npodium, Mmn. m., Si1 mm, Si'rr, Cinhona, Alumina, and Ca'rurea, bare also been found useful in particular esses. 161 JAUNDICE. Icterus. Diagnosis Yellow cnl >ur, varying ii shade from a pale saffron to a dark-brown yellow, first in the eyes, then extending over the surface of the whole body; hard whitish fmces ; orange. coloured urine; symptoms of deranged digestion, sometimes tensive pain or pressure in the retri >n of the liver. In severe cases even the perspiration will impart a yellow butt to the patient's linen. The disease freipiently declares itself without being plainly referable to nny exciting cause; the principal are affections of the liver, indigestion, poisonous substances, taking cold, powerful mental emotions, emetics, or drastic purgatives or internal obstructions, such as gall-stones, or even worms ob- structing the biliary duct. Among the predisposing causes may be enumerated a too sedentary or irregular mode of life, indulgence in spirituous liquors, or a frequent use of aperients. It may also be remarked that this disease frequently assumes the intermittent type. .Jaundice is not of itself to be considered as a dangerous dis- order, but rather as an indication of some internal derangement, which, if neglected, may entail serious consequences, for exam- ple, dropsy, hectic fever, or general atrophy. Mrrctrits ami Cinchona are two of the best remedies in the treatment of this disorder, particularly the former ; but in cases when the patient has suffered from the abuses of that mineral substance, we give a preference to Cinchona, especially when we can trace the disease to have arisen from partakiHg of indigestible substances, or where it appears in an intermittent 101 in. In cases which have been excited by a fit of passion, as we have before noted—no unfrequent cause—we should have re- course to Chamomilla, or Xux-vomica, should the bowels be confined, or alternately confined and relaxed. \u.i-vomica is also indicated when sedentary habits, over- study, or indulgence in spirituous liquors, appear to be the pre- disposing, or partly the exciting causes. lf»2 I I .R.STITS «T«TrM. I'ilsatill v. lassitude, great wesknesa and aniiety es- pecially towards evening, obtuse pressure, but soiucti ucs also pricking or s'nM.|iiiv' pain ii the region of 1 hi liver, ext inlng iHwasionally upnsids towards the light shoulder; wl.ituh •I.kU Licit m id. A im-st important remedy in many esses of this di-ease; the full >wing are the piiucipal iudicatioi a lor iticm- pl •um-i.t : nausea, retelling. <>r voiuitiug; tongue > Icin, • r coaled white; pnssurr at the pi' of the s.'o im h ami re:ion of t'ir liver; sluggish stale of the bowels, with white, gray, or eluy. ctlourrd r ,icu i ions, alternate heat and chill*. (Icterus Spas- mod. I- Sj n*t.) Ai in m is frequently an excellent remedy in • bsiinate cases after Pu x it la, when the dis. rdet occurs in young females. V dmi m-t k \ i n>\ * In general cases, l<>ui glubuh s at tho sixth potency, in four dessert--pooufuls of wa'er, one exhibited uinriii ig ami evening; m car- s of very young children wo ma, substitute one for I. ur gl-ilmlcs in the same quantity of water (S. e remarks upon this subject in Introduction X furl 111.) 5 i >uid .1 10 '.d.c • lie a-coinpaui d wit Ii symptoms of i,dim- inution, and pain and prei-Min- in tin- hepatic region, sev A'TTK Isn. vmviatiox or tiik l.ivnu; and that ace -rdingly in the maj iriiy of such cas.-s, 1 ;„i.-'/»■, followed if needful by It -'la Ion- na, M rear us. or ('humom la, a* best iudi.atid. will be found of i ssenlial service. In very obstinate icterus t u; alternation of Sulphur, Hepar su'phuns, I. chests, and l< J. nitricum, has In en found success- ful; but as these cases frequently arise fr in obstructions at.my, or a sjiasin d.-- or irritable state, they repair.- considerable skill and discrimination in their treat;n< ..t. INFLAMMATION OF THE HI'LKKN. • S/ilrnitis. Mi*t.\osM. Slurp pressing or shooting |*in* it the region of the spl.-en; in ui-st ia-.es a high degree of fever, with * V.denoU, y. 21. INFLAMMATION OF TIIK M'M:r\. 103 general derail'_"•mcit ; sometimes enlargement and tumefaction; and when very severe, hcmatcmcsis. It declares s un times in In t seasons, when it is not unfre- ipu-atly mistaken for other off-eti ms. It may, however, arise in individuals of delicate constitutions, or in children when ex- posed to the influence of marsh miasms, pattictilarly when to that cause has been added insullicicnt el thing, want of exercise, of proper nutriment, and loitg-c .ntiuued mental (lis piietude. The value ol Cinchona in this malady and the power it dis- plays of developing an affection closely similar, affords a beau- tiful excmpbli -atioti of the truth of the htmi.copathic law. From our very impelled knowledge ol' tin- physiology of this viscus and its relation to the other organs, this disease, except when it presents itself in tho tangible form above meii- ti uied, is extremely dilli ult to diagnose. Its bc-t character- isli.s are tenderness or sensibility on pressure in the splenic region, with general debility ; paleness of the complexion, bl.....IIcsh appearance of the conjunctiva, languid circulation, uml tendency of the extremities to become cold. Tiikkai'ki ri< s. The chief remedies in this affection aro Cinchona and 1-v mcem. which are moid not only in its treatment, but against the tend-ncy to dropsy, which not uu- freqiiently develops itself; this can but rarely oc ur, however, where the proceedings of the physician are guided by the ho- meopathic law, inasmuch as the very remedies employed to combat the disease it sol.', are the surest preventives against such a result. The other medicines most frequently required are Aconitum, Arnica nonlana, A Mr romi-'a, and Bryonia alba. VroM-ri'M. Against the fever generally present, if tho disease be severe. Vdministh vno\.* m***- to an ounce of water, administer- ing one dessert-spoonful every half hour, hour, or four hours, according to the exigency of the case. Cinchona. When the inflammatory sMiipti ins lave abat- ed, <>r if no lever of any m nieut existed from the comm.-nce- • Vale note, p. 31. K4 DICXSTIVl BVSTKW. m- nt, psrticulsrlv if the di«ea«c owes its origin to marsh miasm. or if t tie ace mpsnying f.v r pn «e ii an int- •nniti- nt type, in which ca« • it sh uld be mhniui-tcred dmiug tho Apurrria. M.-reover. i impaired nppeiito and general derangement b« pre«ert. -ec this m-dieine iimb-r Aim-h \bo, if the patent have been weakened by hrma'rmrsis, or diarrl.tr i, (see those articles. \i»Mi\i«rR\ rniv. In general cases we may di«-' lve *y in four dessert spoonluls of water, snd give a dose morning antl evening, snd m on until improvement results Absrmci'V, also useful where the disease assume* an inter- mittent charai t r. ..r is complicated with thai affection, '-cc ('inchnna, and this rem-dy, in Ivii iuniri;vi Vr.vr.u) And further, when th« pati-nt c tnphiins of a vi dent burning pain in the re^'i >n f the spleen, and a constant puliation at the srobiculus, a't,'tided with "rent nnxi- tv ; nlso watery or san- guineous dian hi-a, and b irni g at the nnu* ; rurssivc urak- »r>«, ami tttli tn:i of tie feet. Vhmimstr » rin\, same as Cinchona. In S'-me esses it hss been found advsiitsgeous to nlternate these two n ne dies, giv- ing s dose of the medicine se|i .led m .n.ing and eveniriL'. sllow- ing sn sciion of one, two, «.r three dsys, according to D a. indicated by pressing psin in tin- loft hv poehondri- nn, causing dvspttn-., and when the v. initing of bl ial exertion fins pro- duct d the disease. Ki.himstua i ion. *•. in a teaspoonful of water, rep ated in six hours, if necessary; but wln-n the vuiiiting of blood is present, exhibit as under // ma'rmeri*. \i x vi.xirt is chiefly indicated by the aympt'ins of de- ranged ili - t >>n, constipation, ic"., which remain a ter the more threatening symptoms sn- removed. Administration. **f in a little water, at night, repeated every twenty-four hours while Dec.ssary. Bit yon it is found useful in milder cases, where an aching, «hooting pain is in the splenetic region, which is much aggra- vate! by the slightest movement, or when the patient com- inflammation or the stomach. 1R5 plains of a constant atitch in the side, or the left hypochon- driac region, and general gastric derangement with constipa- tion exists. Administration, y, in a little water, repeated as the above until benefit results. The preceding are the remedies which have been found most useful in the treatment of the disease in the acute form. Chronic enlargement and indurations of the Bplecn require a long and judicious course of treatment for removal, or even amelioration. I shall, therefore, briefly direct the attention of the reader to those remedies which have proved nn st successful in these in- stances— namely, Sulphur, Calcarea carbonica, and Bary'a carltonica (particularly when the mesenteric glands have become affected), and further, Lycopodium, Carlto rcgi abilis, P.'uadmm, Ferrum, 1/. .1 rcum, Plat i no, Si annum. INFLAMMATION OF THE STOMACH. Gasjriti.s. As there is some difference among medical authors as to the application of this term, it may be as well to state clearly the disease intended to be treated of in this place. By gastritis is here meant inflammation of the mucous mem- brane of the stomach, which frequently involves the submucous tissue, and Sometimes the muscular coat. Diai.nosis. Burning,, pricking, or shooting pain in the gas- tric region, increased by pressure, inspiration or the passage of food. Swelling, considerable heat, and tension over the whole stomachic region, sometimes with pulsation; nausea, inclination to vi niit, retching, vomiting, great thirst, increased or brought on by the smallest quantity of food or drink ; some- times with hydrophobic symptoms (hydroj hob in symptomatica); soreness of the throat, with inflammation of the fauces; hic- cough, sobbing, gnat restlessness, anxiety, and prostration of Btien^th; coldness of the extremities; tongue generally red at the tip and round the edges, foul, rough at the centre and towards the root; frequently also syncope, violent spasms, convulsions, even tetanus; small, sometimes scarcely percep- tible, snd remittent pulse ; sunken features, with expressions ]Q0 DIOKSTIVR BVSTRM. of anxiety, constipation, but frequently diarrhira • r alternations r.' these two Stat- * Dnti may i■ .» ie fr. in Langrcne, in which ens.- the pains an-Menlv cease, the c. Id.u-t-s ... the extn milies increases, and tin- puis* »*c.-m.s -sr.-idy perceptible and nmitlcnt; or from paralysis of ilm nervous svstein during the altseks ..( tin- »pa«ms or syncope. When thii tiisease bss been impnjm rly treated, if the patient has the go. d fortune to oseape with hie, it msv pa*" into ebr..itie iuflamiustioii, scirrhus, or ulceration of the stomach. C\|-sk«. One of tin- most frequent is pnrlsking of cold drinks or ice-water, when heated or during hot weather, and also acid or jtoismous sub-lain es taken iut" the .stomach ; le- sion fmm any n.ugh-poinled hotly swallowed, external eontu- »i..n. ardent spirits, suddenlv cheeked secretions or evacua- tions, ill.us- of emetics, metastases. TttiHAi-M um The rctnetlies which have been found Ihe m< at useful in the homu-opsthic treatment «.t <. i-t i .t.is, are: A a'um na/Mi'lus, B, lia toima, I < ci, tnrdm. A/ vomica, I iimoiitum crudum, Pidsa'illa, Bryonia, Ranunculus bttllio- sik, l.n horbimtt. Can harulcs, Hj scyamus, A sent urn. Aionitk - !J * is r, quisite iii those eases in which synochal fever is developed,—and must be repealed until relief is < b- tsincd or an alterstiou in the symptoms calls for the selection r.f another remedy.* Ipki *« ivnii v Rieft is useful when the vomiting is exeos-ivo, the epigastric region con 'ierably distended, and the patient a fbet.d with great anxiety, restlessness und difficulty of breath- ing;. An'imoHium crulum 9£ may follow the former remedy, or be given in preference thereto, if the tongue be much loaded Bruonta nay be administered alter any of the foregoing reme- dies, sh-u.'l they have afforded only partial relief, ami particu- larly it the disorder has been excited by a chill from e,,'..| drinks when ovciheated. Nix Vomica *** is one of the most important remedies in Ga-ir tis mucosa of drunkards, and in the same affection when occurring as a m .-ta-ta.-is from supprei • d haemorrhoids; ' Vide note, p. 21. rNTLAMMATION OF THE STOMACH. 1C7 finally, Act vonicu has been found effu ru-i >us after the pre- vious otlininislrati n of A nnium. B-i/nnia. lp-caruanha, and Arsenicum °0°, when the disorder has been caused by a chill from driukim-: i.-ed water when overheated. Lachesis and t - scnirum may. in s- me instances, be advantage uisly administered in aiternnti-.il with .\uj v., in the idiopathic gastiitis mucosa of drunkards.* I'i i.satii.i.\ A^4 has been recomnionded in the snbaente form of gastritis arising fn in tie sudden suppression of some secretion, siic.h as the menstrual flux, ct<- ; and also in eases proceeding fn m a chill in the stomach fn in ice, particularly after tlie previous employment of / ,'uci niha or Ars- nicum. /,' iiuncidus liu'lious. Kupharhium, and Cantharides have been recommended in tho more violent forms of the disease, and especially when the burning pain, so commonly attendant on this disease, is well marked: When, however, in addition to tlie Bait! symptom, there is < vces.sire prostration of strength : thirst with vi.le if v. miting immediately a t.-r drinking; small, quick, and occasionally intermittent pulse: anxiety, resthssness. and apparent sinking of the vital energies.— Aim:mci'm must at onto be had recourse to, whether the disease may have arisen from a chill in the stomach or any ether cause, (excepting, of course, poisoning by that remedy, ill which case the treatment to be followed will be found under the head of 1'oisons). Tho alternate administration of A "on Hum with Arsenicum las been found usei'ul in some cases; in others, V, rat mm and Arseni- cum: The fonner. at an earlier stage of the disorder, with aoc mpanving inflammatory fever, and th* latter where the ex- tremities hare become cold, the pulse small, features sunk and expressive of great anxiety : hiccough, thirst, vomiting on par- taking of the smallest morsel of food, solid or liquid : extreme debility, and other symptoms mentioned in the diagnosis. In certain cases the attention of the practitioner may bedirecttd t,. the followi..-: Bkllidonna *y*,—Inflammation of the ranees with redness of the tongue at the tip and margins; hy- drophobia sympt. matica. IIvosovamis y,-Stiq or. or confu- • Opium also may bf> included with advantage here- 1ft? DIORST1VB sT'TrM. sion of ideas with inoohen>ot speech ; convulsions, sympt mstw hxdmphobia. I.trhrsi*. S oan»«i»as and ('authorities may likewise prove useful in < •.-"• in which I lie latler sympt m is present (see II vdroihomi s\ Finally, CoWuntk, H nunus r»rsi> ^nlphmr, and ( Jt imnmtlla may bo mentioned as likely to prove serviceable auxiUary remedies in s..me instances |r/*/r,i ab»nl I be bnrne in mind, if the attack can be traced t lesion of the at-.msch from any rough or jminl.-d aubsloTiccs having been awsllowed. or als.. if from external contusion. When the disease baa pass, d iit- the chronic form, \ itmm mi., I^irh. ami Vmx r.. may be admini-tcn-d in alternation with great advantage: followed, if required, by Lump.. Co'ch, >,:i.h„ Piosph., also the :.!t<-rna»» employment of Sulphur snd t'arA. r., ice. .V. p^ Pat., I'umb., Kalic, Magn. c, Rims. Vide rutmm.it (which chronic gastritis nearly prjemblea) and Pysi-ki-sia. INFLAMMATION OF THK 1IOWKI.S Fn'mtu. I>iaonosis. This disease is comparatively of rare occur- rence in th- idiopathic form, and ap|H-ais much more frequently sa a symptomatic affection, particularly in the course of mm.1 fevers—such ss low \errous I'■'. errs, Scarlet Ft »vr, Measles, bi.c; ako in all di-easc* attended with hectic fever It much more tn-'juenlly occurs in the Bubsoute or chronic t :>■ in the acute form In the acute form of the dir< ase, involving the submucous tissue and peritoneal coat, ss well aa fie mucous membrane, the symptoms nte usually ss follows: Intense burning or pungent pain, generally in one sp t <>t the abdomen, eBpecially in the n-gioti of the navel, increased by the slightest pressure and by movement, with tightness, heat, snd distention of the abdomen; sobbing, anxiety, ami violent thirst, with aggravation of suffering fr< m cold drinks; obstinate consti; ation; violent vomiting, first of Bliioe and bile, and aomctim- s even of excrements (Ileus miserere); small and contracted pulse, inflammatory fevor, flatulence, and frciuenily obstr . tion of urine. In the subacute form of the disease, or in simple enter,,,» IlfVLAMMATION 07 TnB BOWKI.s 169 mucosa, the pain is often very slightly felt, in comparison with that which accompanies inflammation of the peritoneal coat, and generally consists of a diffused soreness ever the abdomen, which is ei mmoi lv, though not always, increased on pressure; but cold drinks or indigestible food almost invariably causes an aggravation of pain. The tongue is often red and smooth, though not invariably so; generally speaking, however, there is more or less redness at the tip at tl margins, however foul the centre may be. Loss of appetite, indigestion with nausea ami vomiting, more or less pn mincnt. according to the portion of the intestinal tube affected ; being greater the nearer tie s. at of the inflammation is to the stomach. When the inferior parts are implhatcd (as is indicated by pain or soreness in tho iliac regions and in the course of the colon), there is usually diarrhea, the stools being frequently slimy and mixed with blood, in severe cases consisting of pure blood, particularly when the rectum is involved, in which rase there is, more- over, considerable straining. The pulse is quick, the thirst Bometinn s excessive, with a greater or loss degree of fever and cvtrrir.e languor. I'nless resolution tukc place, it may terminate in induration of the intistines—laving the foundation of chronic constipa- tion, suppuration, or gangrene. Tho signs of approaching gangrene, or of its having set in, are the same as in gastritis, with the difference of situation. Among its exciting causes arc cold in the foot and abdomen, suppressed discharges, cathartics, worms, metastases, partu- rition, indigestible or highly stimulating food, prolonged use of acids, sour wine or beer, &e. The state of the atmosphere appears to have some share in producing it, from the circum- stance that tho disorder sometimes prevails almost as an epidemic. Tiibuat-imitk «. A< nicum, and where required, Veratrum, are the principal remedies in the first described variety of this disease, us well as in the severest forms of gastritis, to which latter, indeed, it bears a strong resemblance; but the treatment must necessarily be commenced with Aconite when the accom- 8 170 ptr.rtTivB btsttm psnying fever "is intense, and the skin h-1 and parched. F r the v Iction and administration of those t«. n medic-., see (;»-r«-ins. <»,-f/wsnd Pumhim sre the principal remedies against I rus M ^rrn . as noticed in the I bignosis. ( See II, rma.) In tho Bubscute fonn of the complaint, a few doses of \//., .-r Coat-d white, or yellowish brown in the centre with ut'cinc rtdnrss of the tip ami mirgins, snd inflammatory redness of the papdhr; skin hot snd dry, niien.se thirst, with occasional delirium, (specially at night; sensation <-f \orrnrsi or n of the arch or tnius- verse section of the colon. Nt;x vomh a. Redness of th margins of the tongue, with yellow or whitish coating in the centre; sensation «.f sort m is, with burning li«at in the abdomen loss of appetite; indiges- tion, with v.miting alter pint iking of food, ami aggravation of the abdominal pain after drinking; flatulence, cmistii ation, or constipation and loosen ;ong, cannot bt loo stroiigty urgr,l in Una dsagf-rnua disease, rsprci- a!ly wkica Um symptom* are fearfully prominent.—Ed. 6 IKFLA' MATIOJf OF TTIF. BOWELS. 171 very foul, coated uhi -. or dark brown ; it is soniotim<»s dry, but more frequently cov red with thick mucus; excess.re thirst; abdomen hard, tense, distended, and vtry tender to the touch; copious watery, biliovs, ami highly offensive stools; but more frequently there is constant urging to stool, followed, after severe straining, by the evacuation of a small quantity of mucus tinged with bl >od ; at other times of pure blood in con- siderable quantity ; ■ ztrcme prostration of strength, chilliness and shivering, with tendency to sweating at night, which, how- ever, brings littlo or no relief. Audi-vi nitku-im . The indications for this nmedy are much the same as t ose described under the foregoing; it is therefore of great service in completing the cure when Mercu- rius has only produ id partial relief. It is an invaluable medicine in chronic eases, attended with abdominal tenderness ami tenesmus, and es ceially when the disorder occurs in indi- viduals who have been previously subjected to an abuse of Mercury under allopathic treatment. Hiiyom v. After the previous employment of Aconite, Bry- onia is occasionally a useful remedy here, when tho patient complains of severe headache, with constipation, and pain in the abdomen after n eals ; it is also indicated, however, when, after Aconite, there remains dark redness of the tongue, or whitish or yellow c .atoil tongue, with parched mouth and considerable thirst ; loose offensive evacuations, particularly after partaking of / >od or drink; nausea and vomiting after eating. Piri.sATH.rv. When the acute inflammatory symptoms of enteritis, arising from the sudden suppression of s mo habitual discharge, such as t ■• catamenia. or the hemorrhoidal flux, or occurring as a so-, th In esses where the Inrge intestines sre the scat of the uiflammsti->n. attend-.I with tympanitic dulrm'ion of the rto.i<.*jrs). s remss and M-nsibil iv to the touch; tormimi snd disrrh«ra. wiih increase of pain followed b> urgent desire t . go to stool ufl.r r.i'i'sjg - r drinking; nauacs, or v. milu.g of bilious mat tor ; frequenl discharge of flatus. I ii««ouii.i.4. I- peculiarly well adapted I the trtalmenl of the disonler ss it i* likely to occur in children, or in highly nervous and excitable females, who are extremely sensitive to pain, and «•• mplaiu baulk fn in trivial suffering; it i* indi- cated, moreover, by s sen-slion of soreness in the aid' men, as i: ari«ing fr-.m internal excoriation >t ulci tatii.ti, ace in panic d with painful tenderness on slight pressure, and slimy, v hit b, trsitery, or grerntth or v-liowish diarilnca of an offensive odour. I'im hosa. Is frequently useful after \e,on'e or anv of the foreg.i ig remedirs, when there is a tympanitic distention of tho abd im-n ; diarrluea. aggray at. I after a im-al, with undigested I k1 in tin- evacuations ; Ihir-t, extreme weakness of digestion, ami grea' ,lt,!ention ••! the ablomrn, diarrhoea, the stools consisting of u f,r, or transparent gelatinous um.-ui, or of blood mix. d with si.b-taueo* resembling falv- membrane. Kilt's. When eruptions break out about the mouth, and th.-re is redness of the t >nguo, with pain as if from soreness <>r ulcerati m in the abdomen, and tenderness on pressure; watery, slimy, :r thy, or sanguineous stools; low fe'rr, with iceturnal d lirium. Rhus is chiefly un d in sympt- malic enteritis, -mh as frequently occurs in low .V r,.,us l',rrr, which see. The chronic stsge of the complaint, which is chiefly chnr- a u-.u ] by fixed pain, fulness, or uneasiness and oppression INFLAMMATION OF TIIK BOWEI.s. 173 in the lower part of the abdomen, increased after meals or after ro'il drinks; appetite impaired or capricious; thirst, particu- larly a ler diiner or at night; bowels constantly relaxed, or there is constipation alternately with diarrhoea; fetid aid dis- coloured evacuations; skin h >t, harsh, and of an unhealthy hue; pulse rather quick; tongue loaded, but red at the tip and margins,—or redness of the entire tongue, with large and chvatd papillae, especially at the mot ; emaciation, weakness, and languor. Here the foregoing remetlies described for the acute ami subacute variety, but more particularly Bel'adonna, Am r , Bryonia, ami Rhus, together with Aealum nitricum, P/iasfliortis, Sn!i,huv. Sihct, and Arsenicum, will in most in- Btanees bo found uniting the most serviceable. .Venn m NiTKici m. Is particularly indicated when there is thirst, attended with pains i i the bowels or other uneasiness after drinking; impaired appetite, /c;n/c;-nc*s "f the abdomen, fetid diarrhoea and tenesmus ; greenish stools, with ingesta ; skin dry and harsh during the day, sometimes with nocturnal sweats. I'iiosi-iioiu-s. Soreness in the abdomen, with tenderness on pressure, and distressing distention after meals; obstinate diarrha-a, or constipation and diarrhoea alternately ; stools con- taining ingesta ; pulse rather quick and hard; weakness and emaciation. Sn.riu-R. This remedy is one of the most useful in elite- ritis, arising from the suppression of s..me accustomed dis- charge, such as the hemorrhoidal, &e.; as also in cases arising from the driving inward of a tetter, or sudden healing up of an ulcer: tongue Veil, or loaded; thirst; pain, as from excori- ation, in tlie abdomen, with tenderness on pressure ; or fulness and uneasiness in the abdomen, increased by cold drinks or alter meals; diminished or fastidious appetite, with aveision to meat; fetid diarrh.ca. frequently containing ingesta; coiisti- pai.n. or consti.atin alternately with diarrhosa; flatulence; skiu v'ellow or otherwise unhealthy looking, or dry and peal- ing li„t often covered with perspirati n at night, or towards morning ; pulse quick ami bard ; emaciation, with considerable debility. 174 diobstivs bvsti*. Silicea When tbs disorder has be* excited by the aud- dan snppre.sii.il of the prspir.ti.ii of the bet. or tl* rapid swabs* up f « chnmic ulcvr. Sdtoa is v e -f the m-st im|-r- t.nt remedies. The f,4l..wmg aympioms n- some of the more ■nmedtate iodicslions f.-r iU section: .Irvnos..! the m .ulb, had* I t ssgue, grcst thirst, with dimmish, d np|H-lito, sud some. tunes disgust at meat, or co- k< d and hot food, with dwdre for asJd f-s-1 and drinks ; sbd.-m.-n hard, h«t nd tmsr. and painful to the fc.oeh; constipation, or cUnim-l fetid watery stools; borb-rygmua. c*|>ecially on movement ; -kin dry and |*rchfd during the day. and covered with swn -l towards morniiig; pulse quick and liard. A'-.semiccw. lias already l»ecn noti-ed as th.- principal remedy in acute cases of a violent character; it is, moreover, a rem.-dv of considerable sen ice in some ol th. chronic varieties of enteritis, wilh a sensation as fn-m excoriation, or of burning heat in the abd men, attended with nau--s, want t apjM-tite, snd •'rent th,*t; increase of pain after . old drink ; h.rboryg- niim; disrrb es, sometimes with ingesta; fetid, discoloured Btools; skin parched, hsrd, snd of a i-llowish, unhealthy- looking hue; emaciation, with extreme d. bility. Lachesis, la/ ■'' odium, Galium muriali um, Se, ale cor nut um, Hrpor sulphuris, S,put, ( alciiea, ■»' «s —the two last named have occasionally hen usX with adv mtsgc after \n. Y\ repeated every si\ to twelve hours, ace .rding to the at vor t, of tic -yuiptoiin. M :an Mil's is m..... particularly ami d to the advanced stages .1 tho dtsea.e. nitu weak, quick pulso, nocturnal ureals. ati 1 gn >t weakness. When the inflammation extends I > the pirn:a. and the breathing becomes a'Tct.- 1 with acuto sh ...ling psin, we should have roe.-ui.-e t-> Uhyoxia 'J*, as describe I l..r \-oiiite. (Sec also Pi.r.tMi i.- i When the iK-riiim-sl coat, or upper |>o:ti m* of the alimen- tary tul>- or <•! the stoma.-h i'M-1'. lie-"im-i affi-cted, evidenced by an increas • in the intensity of the duo um-, the pain extend- ing higher—voraiii .g. generally a rare symptom, h.-c. ming severe and continual -co. lap Ml of the featun s, Miiall pul-M :.t..| s rapid sinking of the vital enorgics, closely rcemblii g gastritis —wc should lisve recourse to t enjrumi Admimatsatio*. y, in a little water every four to six hours, until relief is obtain, d In esses where there are evidences of the brain being affect.-d, Belladonna may be had recourse to. (S.| In other instances Canthnrides, Ch-imom>"a, Bryonia, It',,,-, L,,. enpnlium, Colocyn'h, «t , may be found necessary. As this is a disease whose can- st of the n-im-dies which have been described applicable ti the treatment of that disease will generally be found equally useful here.* INFLAMMATION OF THE KIDNKYS Nephritis. Diagnosis. Pressing, pungent pain in the renal region, shooting along the urethra X the bladder, dystiria, strangury, ami ischuria (when both kidneys are affected;, hot and liigh- colouretl .....un- of this painful dis .nh-r. is another of l he many beautiful evnnpliiieati-ns «.f th-- truth ->f ll»c hoimsmpathie law; and it* p.w.-r of causing diseases of the urinary organs, even when applied in the f rm t a Idistrr. it »o well known, that in all avdi-al works it has been n. td us an exciting cause of this affection. Nt\ \om«-%. When the affection cim be tr.e ed to a sup. nrmston of a hemorrhoidal y. ',», nf the last-im iti.ncd n-im-dies, re i«ati*d every twelve hours, while nei-essaiy.t MsLLAbo^MA. Wli.-n shooting pains i the kidne\M are pre- sent, ei'emling t.. th. blsdder, -this m> liciuc is further imlt- csted when nephritis 19 sec mpanied with colic and e.udialgia, beat ami distention in the region of the k d icys, senety mietu- ritiuti of an orange yellow, or » uuetimca o! a bright ml, dcp.,sit- ins? red or whitish thick s-dime it ; auxi. ty, «< -th- sness, and peri< do al aggravation—constipation. AnuiMsTkATiosj. Same ns (,'anthar '< < IIkpas ft l imiisi* is useful when we ' sve n-ss ni t . spprc- heud the formation of on ahseess or the a toiuem-.-ineiit of „up- |>nrslioii ; ht-e the diagnosis is difli ult. and the pr .saional s'udt it must b.j canful not t . mistake t. .- app.m- t alleviation of suffering for the subjugation of the d -ease Tl ■ fallowing symptoms may serve as a irtiidc in these . .*•■* : 091 - itb n of t .e s.-ote pain ; a sensation of throbbing nt.d a sente of weigfit in the ngion .f the kidneys; alternate chills am> slight flushes of best a;4l c p.ous pen-piratioii Vms note, p. 21. t IU1 INFLAMMATION OF THE KIDS1YS. 17» Admimstbatiosj. A grain of the third trituration to an ounce ..f water, a dessert-spoonful every three or four hours, lengthening the intervals aconling to results. Mi in tHius is also valuable in this stage, but more particu- larly when diarrhoea and tene-mus are present. Aomim-iuvtion. Sameas llepar sulphuris, at intervals of from six to twelve hours. C y\.\Aiiis. When a dragging pain or sensation as if from excoriation is experienced, extending from the region of the kidneys down towanls the groin, with painful urination. \n\iiM-TUATio\. Same as Cantharides, but at somewhat longer intervals. • (01. iu« rvi. When in addition to the usual symptoms of this disease there is eiccs.sive nausea with tympanitic disten- thn of the abdomen, and painful and scanty emission of bright red urine. \i»mi\|sth\tion. Same as Can'handcs. When the disease hns assumed a chronic form, and indura- tion of the kidneys has taken place, .Vrrruri'iM **\ in a tea" spoonful of water, will often be found useful, a dose once a week for three or four weeks, followed by Aurum *|«, a dose mice a week, unless s ..no marked indication call for the em- ploy inent of another medicine. in Nephritis arising fr...,. contusions or violent coiicussi-ns of the bodv. Arnica is the principal remedy Ai.mimhthation. V- repeated in twelve hours, and a lo- tion applied externally. (See Kxtkknal lviriuKs.) In 'asos arising from the abuse of Cantharides in blistering, an occa-ional drop or so of the saturated solution of Camphor in a little water, and the inside of the thighs to be rubbed with the same preparation, twice a day, until relief is attained. On-KKvvnoN. This disease sometimes arises from the pnscee of calculi in the kidneys; in which ease the svn.p. Lnts of fever do not occur until a considerable tune after se- vere pain has been experienced; further, a numbness of the Si and a retraction of the testicle of the affected side, are considered as distinguishing marks of the existence ot aca. cuius in the kidney or ureter :-Uere the use of Rattan 1*0 ninRsnvr m«tih m.r, j hss repestedly been found sn useful psllisti e. sdmin- ist-red st s l»w p tc i.y «•» every halt hour In conclusion, the following n-medies, whose utility in tsrioin fi-rnn of ne- phritis or nephralgia, clinical i bsorvati u. has culiruu-d. may be pointed out as meriting the atienlion of t*»e professions! Student: (tic. r. Lump., Capsicum. Ph... . Srp,a. I r.i ursi, S trsap. Kali c, ami r. apht. In the .vent of suppuration : Hep s., tr» Sulph., > / . Ra'.- n . Sarsap. Patients suffering frtmi N.-phniis should strictly av id wine, malt liquor, snd spirils. INFLAMMATION Ol' TllR IUst\I>I>KK. CysUtis. ]\ irning pain in the region of tlie vesica, with tension, In-nt, pain when touched, and external tumefaction; frequent nnd psinful discharge of urine, or suppression, ami ei-nenilly tenesmus; fev. r, snd sometimes vomiting, ss in Nephritis. The rauses c| sely r ■ ■*<-mble those of Nephritis, but it slso occurs mure frequently in psrluriti m than the burner n'lection. Tiir.KAri i 11< s We ahould have n-<- m>i- t.> \i.miim, as in N.phritis, when a oonsideialde degree of inflainmat ry fever 1-. pre»ei,t, followed by — » ANTiiARim:s, which b<-re, ss in the above-mentioned dis- ease, is the lesding n nu d , Nc« vomica When atxbutablo to an indulgence in wine or spirituous liquors, this remedy, tiui'-usly admiuisteie I, will in many instances check its fuit'er pn gress ; also, when it results from suppressed hemurrb id-. • r dvipcptic d<> rs-igcments :— \-i e. may bo followed, if required, by .v.'y l,ur aisd ('alcana The two la t named aro well adapt, d t. the treatment of t> <• chronic form of the complaii t Pclba: t:.i.A. Valuable in checking the devel -pineM of the affection when aricing fr m suppressed mens trust ion.* * Pulsatilla i«. morooT^r, •Tv.rn.tbie in all eas»a, from whole* rr rnti«a ar«ng, when occurring in individuals of phirywalic l"iiijwrsiii«>nl, w.tli H.- following symptom*: trr.j ,rul dr.irr lo iir.nntr, painful oik) son lit? •utimou of kIiiuj ist Mnguiuoout unite, which drpor i. a pnt-l'>ok- iog w,i. u-at ; baru.ngand rmtui^ uaiui> .11 th«- bypogaotnum, with ex- UraoJ boot *.<- tomofa.n ..a; supprcu uu of ur.no. WORMS. 181 Hvoscyamiib. When difficult urination is present, but the disease is n< t far advanced, particularly when we have reason to suspect that this symptom arises from spasmodic constriction of the neck of the bladder, or when in fact it is more of a spasmodic than inflammatory character. Digitalis is also valuable, when in addition to the ischuria a. constrictive pain is felt in the bladder. Am n cum and Carb. v. have been found very serviceable in al- laying the burning in the urethra during urination. When .SW- phur, ('alcana, or any of the foregoing remedies have not suc- ceeded ifi arresting it Aomimsi hation of the first-named remedies, the same as in Nkimihitis; IL/oscyamu-s, Digitalis, Sulphur, Calcarea, Arse- nicum and ( 'urlio r. in the same manner as \nr r. and Pu'salilla. When this disease has arisen from the application of Cantha-uleg as a blister in allopathic practice, Camphor must be administered as ascribed umlcr Nki-iikitis. When the disease arises from the presence of STONE or GKAVEI,, the same remedies as these mentioned at the termi- nation of the preceding chapter are the most useful. IN VERMIN ATI ON. WORMS. Ilc'min'hiasis. The existence of worms in the intestinal canal, in the majority of cases, evidently arises from a peculiar constitutional taint, in- ducing a certain diseased stato of the mucous or lining membrane and theteby giving rise to the formation of these parasites; and although nil period of life is wholly exempt from their presence. yet infants and children appear to be much more subject to this affection than adults, on account of the predominance of nutri- tion at that age. Weakness of the digestive function, accumula- tion of mucus in the intestines, an ill-regulated diet, and a degree of moisture in the atmosphere, also favour their generation. The three species most generally met with in the human subject are, the ascaris, lumhrieus, ami tamia or tanc-'rorm : of the lat- ter then' are two varieties —tic sali'ary taor-irorm, comp.se d of lone and slender articulations, which has been known to ex- ceed the length of thirty feet; and the common tap, -icorm, which varies from three to" ten feet, seldom comes away entire, 1**2 ninssrirn irsrrs but in joints, which sre e«m«derably bn-sder ami thirker than lh«-oe ol the variety hrst meoliooed The pn s-nce of worms, unbs* when passed, is not always easy of dele- umi. since subacute inflammation of the mue>>u* raesnbrana fri-m ether causes will frequently present marly the same rnngct of sympt rass; but here. ias in the treatment of many of the un-st sen-ms s. t Isob Iruacharacter <-f the complaint, and seloet a me.beam.-ut X'/u 'lly ooitct'r I hi the um'ed si/mp'oms, it will bo found applicable to the affection, from whatever cause it arises ; and a can-lul observ- ance of the known pathogenetic powers of the remedies selected, will materially assist us in tracing the disease ii its proper source. |)u..mi.iv Worms, and especially utcariln, frequently exist in the iute-tities without occssiouing any disturbance, and their pre«« n-e is only k i\wn by their being observed in the evacuated firccs; but when tlm alimentary tub.- become-, irri'at d by them, a number ..I svmpt >maare developed, of which the following an the prin ipal: Pallor and sickly appearance of the countenance, and s •in.--iiii.s flushing; livid circles round the eyes, dilsted pupil*, heads'-' c or vertigo, irregul irity of appett-, I .tidily of breath, acrid eructations, occasional nausea and Vomiting, foul t ii.ote, n-HKire fulness of ab.l.meu, with a sensation of gnawing and hurtl- ing at i .articular |«rts of the int< -tin.-, hard and tumid belly; great thirst; dis-harge of mucit» tioin the miutn, bladtl-r, (at d vagina;; heat and itching at the anus; slight lebrile symptoms, and nocturnal wakefnbo-ss, with low spirts or irritability of tern. per. si d gradual emaciation; we also generally to tt.e an inflam- matory n-dnca of fin- m strils, with great disposition to picking or boring st the nose, es|iecislly in children, with sudden M-reain- iig. when wakine, ami grinding of teeth. In addition to the aUive general symptoms of this afff.-tion, we frequently moat with severe colic-like pains, with slimy and bloody evscualions; involni.tary discharge of saliva, especially when asleep; convul- sions in children, and epileptic attaeka, combined with cerebral affections in adults; inflammation of the bowels. 60 WOSMS. ]J»3 In (tenia, in addition to tin- above, we find a sensation as of something rising into the left side of th- throat, and then fall- ing buck; or a feeling of a lump on either side, with an un. dulatory motion; feeling of sugillation in the abdomen, creeping torpor and numbness in the fingers and toes. I iii.KAi'i.i i iuh. Aeon., hunt., Sulph., Calc. r, China, rerr. m., Alarum vr., t.'inu, .\ui v., Mere., Valeriana, SjiigeL, Bellad., Sabnd., Sdic, Ctcuta v., and IHie mis. Of these, Aeon., I'crr., I nil., Alt re., .\u., v., Yaler., Marum v., Cina and Snlph. tinct. are l he most appropriate against As-arides. (Una, \/m v., China, Bellad., M re, Spia., etc., against Lum- briei. And (irap/i., Calc., Sabad.. I'tia. risen, or >n,'phn Merc, Calc., also Curb, an., Carl, vrg., h'-tli e, Mign.m., \tttr., Pimsph., Pc'roh, Pla'., 'I'ereb., /•'//. mus., Punica gran., St-mnum, against tape-worm. At oniti vi Wlicn considerable febrile irritation exists with restlessness at night, fever, and irritability of temper, contin- ual itching and burning at the anus, and at times a sense of crawling in the throat AnuiviaTK vtiov.* y, to an infant ,°j, in a little water, repeated in six hours if necessary ; when it has lowered the fever we must have recourse X seme other remedy. Ii.\ viia avi vha, in most cases, which is also particularly in- dicated by Bpasniodic twitchings in one of the extremities or in individual muscles. Vomimsi u \ i ion. ••• in fur tless.it -sp .onfuls of water, one twice a day ; for an infant T<^ in four ti asp .onfuls, one night and morning. >Si'i.riiri<, in case the annoyance siill continues after the lapse .I two or three days. Vom i \isrn vtion. styt± \n an ounce of water, a teaspoon- ful morning ami evening until finished; for infants11 in the same manner. (hnuKit cvKHOMii-.i and Siluiv may be administered in like manner, should no marked amelioration ensue; allowing au interval of about a week or ten days to elspse between the dif- ferent remedies. • Vide note, p. 91. 1*4 ni ;r«Tiva «T«Trw |„„M VrTUt.Hi * when th. n- is (return! vnmting and ar nuMilsti n of watery fluid in ri <• m ' th iDsivKTitTi.v A grain of the ihtr I trituratt o to an osju<*e -»f water, a t*aap. onful once a day; for infants "," '" t'c ssim- manner. This es.urse of treatment, persevered in fir a short tune, haa t/t. n pn>ved successful i„ nm-l obstinate cases, by purifying the constitution aid re«t 'ring the mucins membrane t . a bealtS »tste When nreftirr intitton is present and d es n t appear to diminish padily under the aeii-m «if the precede.g iM-tm-dy, we miv give a dr>.p >.f the liiictim <-i IWttra tirrns, in a little water, or on a piece of leaf sugar, pvery night or morning f.>r several successive days; and should this not relieve the an- aoya sre, we may administer an enema of a dessert--poonful of Ball t > a pint <.f water, of which from two to six fluid ounces, arc >rding to age. may l»« inje ted ; i; this act as a laxative, a th itun- of vinegar ami water in the prop .rtion of one-fourth pail of the former may tie us. d * A'ti-r this palliative course of treatment, th<- c uirs. above mentioned may again lie resumed should it appear necessary I'in v This is an .initio 11 v us ful medicine in the ease of «orm«, ami is gem rslly it.di. ate.l where the following sympt uin art met with: Krcpii it b .ring st tlienose.gn.it penorsonesa df temp-r heal and irritation, const.it nuj li.tud. ami rosthas- neas, with, in children, a desire for things which are rejected wh« i offered; fits ..f crviig when li.iicbed, paletcs of face, w t livid circle round the eves; emistai I craving f.t four days if called for. Mkiuti n s. When we find diarrhoea, distention of the ab- domen, and hardness in the umbilical region, with increased se- cretion of saliva. Administration. As Ignatia China is appropriate when the symptoms are generally ex- acerbated at night, particularly the abdominal sufferings; or, when prt-ssive aching puins are experienced below the umbilical region after every meal, and are attended with distention of the abdomen, pyrosis, pains in the epigastrium, and retching; also, when in addition to the foregoing, there is an over-excitability of the nervous system, with spasmodic t .\ it.-l inns of the mus- cles in various parts, tremiilousncss and debility. (Valeriana ami Vira'.un aro also deserving of attention lure.) SrniKLiA in extrune cases, with ct lie, voia.ity, diarrba-a, and chilliness ; ulphur, each */, a snijrbi doss*, alternated st inlenrals ot fr in six to eight dav*. When any improvement takes place alter the administration of any ooe -f th.** remedies in particular, it will 1st well t> rcpi-at that m- ii< ne at tin- slated intervals, as long ss it sp|x-srs t > n * M'HTr«»»er. in tins course of treatment, Calcarea carlxmtra y, mat advantsL'ei.iuly follow Sulphur, iu scrofulous habits, at an interval -f ten days. \afrum muriaticum, L .ro/mnltuw, Cra. pkitn. H trt/a. «>r Pkaipluirus, have been f.uud necessary to eomplele the cure in particular oases. Hsuimbn. The f.MM| ought to be wholesome snd nulrilious ; meat, such as roast or boiled Ix-ef or mutt .n, om-i- a day, iu m-sferate iptaniity, and occasionally a light pudding; urrrn fruits or vegetables must bo strictly prohibiiod, ami tin utmost rare should lx- Isken t > prevent, children from eating raw hcihs, r- I-, vtc., which tliey sn- *.. pn.ne t.. pick up in their rambles "Iksj not looked a: tor. ri.-nty of t xi-rci»- in the open sir ta of essential service, snd must on no secotiiit be neglect. J. • Vi.L- note, p. 21. DISK ASKS OK THK ORGANS toNNKOTKI) WITH Till: R INSPIRATORY SYSTEM. CATARRH, or COMMON COLD,—CATARRHAL FKVEIl. This term is given to an affection which consists of a mild degree ol inflammation of the lining membrane of the nostrils, windpipe, and occasionally ;:lso of the ramifications of the lat- ter ; induced by exposure to sudden changes of temperature, or to a damp or chilly atmosphere with i.nsi ii it ikvt < lotiii.m:, TARTU TI.AKI.V AS RKCAHU9 I llll.DKKN. This Colliplaii t is characterized by slight fever, impaired appetite, obstruction of the nose, sneezing, unusual languor, pains in the head or in the back and extremities, and subsequently hoarseness or cough, generally preceded by transit..r\ chills or shiverings; there is also a slight degree of wheezing and difficulty of breathing. When the disease is confined to the nose and sinuses it is termed \ roi.n in tiik head; of which latter affection, and moreover, Hoaksexkss and Coi uu, I shall treat separately. TiiKRAFErTirs. Iii many instances catarrh is carried off, or runs to a salutary termination, in a day or two; and this desirable result is frequently obtained by having timely re- course to the simple proceeding of remaining a little longer in bed, and encouraging a gentle sweat by drinking a icarm de- mulcent fluid, such as gruel; bathing the feet and legs in warm water, at the temperature of about 98 to 100 degrees of l i umara, \nica. Mac., A< i-lum iVntA, Sulph^ Calc, I■•rac, \ sent., SiHcta, (amphora, aid (oiim \i'Uisi.Ti. vti-im K.i-h m< dieit.e in s little wster, st the. d ■••• specified ; re|M-sled t.i twelve hours, if n k It is also iu- rls- sted by external pain* in th. bead fr-m tin- same cause. 'I ickling rat lung i the larynx, dry cough in the in .ruing, ■ is > lining tin- dav. iai.lv during tl c nip hi Iu est in thai fever, with dis|M.sition to cbillim as. When convene t. it i» preferable t" adtninister t|u» remedy towards evening. Cil\W.>Mil.Lv bc" In the tieatim nt >.f cltillr-u tni* medii ine is generally preferable to \«j vomica in arresting the attack. It is 'like Bell,t,I,,una, B yoma, China, Dulcamara, Sulphur, and Stltcra) cxtn-ui'dy valuable in restoring the suppressed perspiration, ami removing the follow ing symptoms: colic nit'. | an-.s in the head, ears, and teeth, thirst, ill humour, and ini| ati.nee. X.trEA « in t • -'. This n-medv is indicated when- there is exce-si.e sensibility, fn-tfulne»s. and sleeplessness, with gene- ral pains, e.jre iallv in v »ung persons. • \'4s N >i«. pw'ii 1409 COMMON COLD. 189 Hrt.LAnoNXA \*, when there is throbbing, bursting besd- sche, attended with determination of blood to tl c load, in- crease of the pain from movement . r exposure to cold air. Bryonia •••. Heathiche, particularly at the temples, with aching pains in the limbs, much increased by the slightest movement. Cim'iiom °^°. Aching pains in the shoulder-blades, and in the extremities, incrca-ed by the slight, st pressure on the affected puts with great restlessness and constant desire to change the position of the limbs. Dun an vn\ i^, when the pain is more of a passive or dull aching description, and felt only in particular parts of the head, with humming in the ours, nnd obtuseneBB of hearing; pains in tin- limbs, increased when at rest, and attended with a feeling of coldness, stiffness, and numbness ; or when an offensive perspiration breaks out after an attack of c Id; or when the affection has been brought on by suppressed perspira- tion, from exposure to cold and damp weather. A11 mca Montana 00°, when aching pains, or pains as if arising from a bruise, are felt in the limbs after exposure to cold, causing excessive restlessness ami constant disposition to change the position of the affected parts, ami increase of pain from the slightest touch or movement. Mi.KtiKius »j°> when the pains in the limbs and joints are accompanied with profuse sweating, which affords no reliei; followed by l)idcama-u should the sweat continue, and be of sn offensive odour. Acini vi riiosrHORicrvi «• Aching pains, relieved by movement. Sii.ick \ **. Pains in the limbs, colic and general derange- ment arising from suppressed perspiration, particularly in those who are subject to sirealing at the feet. Si i.i*m-it **, in cases of swelling of the knee, or of the joints of the hand and fingers, from taking cold. It may, in many such cases, be followed by Calcarea carbonica in a week or ten dav s Iin urvNMA ••. Nausea and inclination to vomit, or Dyamtei, almost amounting to suffocatiou, arising from haviug taken cold, followed by— 100 l*BF!»ATOBT svrri w V.•s^irrw y, should no smelt-ration declsre itself in six ■ r . njni l»ours IN i > triLLi Ivful in cold in the head with loss of taste snd -in ij nssulling from s .hill, followed t pr.-ccd«d b« Hrl- ImJ < no. should there be an uncomfortable serration of heat in »h. . ,-m and bead, and heat and smarting iu the n .se < »r by \.ut, should there be comp!e:r stuffing or dryness ..f the *>«• (See (i.Kllv p. l'«3 ) Itiiti roitti.ticvintiiy, geuersl indi-p< siti<>n from exposure to a thorough wetting when in a state <>f inspiration; followed by Rri/ania in a few hours, if no improvement is experienced. ( \wriioM\.* when there is unusual Weariness, heaviness, ami general uneasiness, attended with shirrrinr, snd dryness or coldness of the skin, will generally succeed in preventing tha development of sn attack either of common cold or of iliflueliXS \i»wtM»rs »Tiov. A dn>p of weak spirits of Camphor rverv tw<> or tir< <> hours, nntil relief is obtained \<<>KlTtM is u-ually ealh d for in febrilu attacks, pn>\<.k•» ,m Ike throat. It x-f-iiw also to predapoar the ..*em to srrrpt nv.rf readily Um iraprewoa of other rented** that may l»r • iiarqijraUjr required. Our rats has been to adm.ii.trr a UrsWpnoiiful of weak Camphor. w»i« Ivf. oe thnre. at latvrrafe of three four, «r . i hours — Ed. HOAnsrsjEss. 191 out every day, provided there is no inherent predisposition to pulmonary consumption; all extremes, either of hat or eld. should at the same time be avoided, and can- taken, when the btly is heated, t. let it cool gradually:—When these means are not sufficient to remove the tendency to suffer from the slightest exposure to cold, the practitioner will And Silica, Curb, v., ami Calcarea, administered at intervals of from two to three weeks, to have considerable power in removing this constitutional delicacy. In other cases, one or more of the following remetlies must be had recourse to:- Bijonia, Bel- ladonna, Dulcamara, .Wi- r., C/iinu, Mercurius, Rhus, Chamo- milla, Arsenicum, Lachesis, Rho-lielctu'nm, according to the character of the sufferings which are experienced after each exposure X the influence of tin- atmoBphcre IIHARSKNESS. Raucitas. The scat of this affe'tion is in the mucous membrane of the throat, (larynx,) which is extremely liable to be affected by the common causes of Catarrh; hence it is a fretpient accom- paniment of this disorder. The remedies mentioned under Catariui ami Co an are those which are generally found most useful in this'coinplaint. Amongst these, in eases of recent origin, the following deserve particular notice : namely, Pulsatilla, Mrrcurius, \ux v., Cap- sicum, R'rustox., Sambucu-s nigra, Chamomilla, Carbo vegeta- bilis, Drosera, Su'phuv, and Hepar sulphuris. The indications for the employment of these medicines are as follow : Pn.svriLLA 1V1- Almost complete aphonia, particularly when accompanied with loose cough, or thick yellow eorv/a. Mi:iu riiitta "V"- This remedy will be found useful in re- m 'vinir anv sympt. ins remaining after the above, but is to be preferred should the hoarseness, from the commencement, be attended with thin coryza. And when a sensation of burning or tickling is complained of in the larynx, with the character- istic indication of .WrrMrins namely, a disposition to profuse sweating, especially at uight. 102 BEsrtSATOBV SVSTSM. \i xvt.mick *|*. 11 arsrncss, accompanied with a dry. fatiguing cough, worse in the early In urs of tlie no ruing, with dry obstruction >.f tie none. CarBirt M «|«. H arsemss, at d dry «.b»lrucli-in in the ii-se, a tended with an unpleasant sensation t crawling and tickling in the ins.; with a severe cough, worse t mards evening; with j a-ns in other parts I the body, such as the head and abdomen. It ia also better suited than A u tomtcm for individuals of s lymphatic temperament. lliirs To\irot>i:M>M..N 1V*- Hosrseness, aceimpanud with sensation ..fexo. ri.ition iu tho chest ; ..ppn ssed bn . n ing, with frequr; 1. and vi< but snt-tsinr, unseeoinpsnied by ror\xs, but ooessionslly by a gn.it discharge ..f mucus from the nose during the attacks of sternutation. SvNiiril'* mi.ii* •§•. Hoarseness, with deep, hollow oough; oppression at the chest ; frequent yawning; restless- ness, and t!ur-t. t'u «mom 11 t v *)'. Hoarseness, with accumulation of mucus in the throat ; cough worse at night, cut inning even during sl.-ep. ami frequently with a degree of fever towards eveiling. and great irritability .1 temper. This remedy is fie.jueiitly found s|t i.i-ihr 55- Hoarseness, attended with roughness snd scraping in the tbr .at; and of gre-.t value in obstinate eases, where the voice is low, ami nearly extinct; particularly in oold damp weather. (Sulphur is especially useful after /'///» ) Hi.i'ak si i ciiiHis •*,•*• -'^" sdroirable remedy in ohroiiic hoars n.-ss, particularly iu individuals who hsve taken large quantities of mercurial preparations ; otherwise Caibtkimis equally useful.* * Sulph. calcarea and Silicea are most useful remedies u> obstinate hoarseooaa attended with eoryza. uoAr.srs rss 10* Apmintstr vTins op thk Fti mi inr■ * Dissolve the glo- bules, at the potencies mentioned, in four dessert.spoonfuls of water, and exhibit one, morning and evening, for two days; or, in s. in.- cases, continue for throe; being guided by the re- sult. Of Hepar »., half a grain, 3d trit., in the same manner. When wo find individuals in whom this affection occurs fre- quently at different seasons, <>r on the slighteM exposure t<> cold or damp, we may naturally infer that there is a constitutional predisposition to chronic laryngitis, a malady requiring a judi- cious treatment by an experienced practitioner, as, if neglected, it may eventually end in CHRONIC LARYNGITIS PHTHISIS LARYNGEA. Chronic Inflammation of the Larynx. This is a comparatively rare disease, and, when present, there is generally a degree of ulceration. The following are its prin- cipal contents : pain in the larynx, and round the glottis; pain and difficulty in swallowing; hoarseness, and difficulty of respi- ration; frequent attacks of severe cough, with scanty and occa- sionally sanious expectoration; it sometimes ends in hectic fever, which carries the patient off. The medicines to which we would particularly direct the attention of the practitioner in the treatment of this malady, are, Hepar s-, Lachesis, Phosph., Carbo reg., Causticum, Acidum nitricum, Calcarea carb., Arsenicum, and SjHnigi". Aconite with Spongia, and IL par sulph., and frequently also Lach., aro the most useful remedies in this disease in the acute form. (Sec also Croup.) AJ.-iimstruiion, see hoarseness. The patient should, in both forms of this affection, adhere rigidly to dietetic rules, avoid unnecessary exposure, and enter as little as possible into conversation. COLD IN THE HEAD. Coryza. Diagnosis. This affection is a very general attendant upon Catarrh Tuerapeutu-s. When it is the leading symptom, or ex- • See note, p. 21. 0 194 RBsriRATOtT BTsTrM ists independently of th.«e already mentioned, the best medi- cmeaforei,^. ...g if rrn..».l an \,s n mica. F.uphi >« PululiUm, (hamomJIo. M-rrurm,. Hepar sulphur,; IM- ludaona. Ammonium, N.xsas, snd Arsenicum, L.„ hests, .St a. Si-> V, MiMsrsAiiox Three globules of the potencies named. t > be dissolved in fur t^poonfuls of water, one to fc taken men ing and evening, unless otherwise s|>coiflod.* Ni \ vomii * Dry obstruction, es|n-cislly. during the night only, with prrssive heaviness in tho forcbesd, and confusion in th- head ; heat in the face, increasing t iwanli evening. If in combination with other catarrhal symptoms, see the indications already given for its exhibition under the several h« ads of Catarrh. IIoak«i:m-.ss. and Cotuii. This direction equally applies to the other medicaments here quoted. Ai.mimstratiosi. 'IVi globules of the sixth potency, to be dissolved in a tesBpoonful of wster, snd taken towards Wd- time; t. r - repested the second day following; but should an alteration in t' ■• symptoms have taken place without any cor- resjM,tiding improvement, another remedy must be selected. Lvioroiurw °,00, will often l»e found efficacious after \m r , in obsdoate cases of stuffing of tho nose, particularly at night, rendering it nt-oesssry to sleep with the mouth open, winch c a uses s disagreeable drvm-.s without much thirst, confusion in th. bead, and burning pain in the forehead. Ibis mind;, is frequently more or less useful in colds in the head of all kinds. Khministratiom, sarin: as A ux v. Pilsatilla ft2*. The discharge thick, fetid, greenish yel- low, or mixed with clots of blood ; loss of taste and smell, head- anhea, sneezing, chill, es|M-r-ially towards evening; disposition to weep, lowness of spiriti. heaviness or confusion of tho bead iu a warm ro-.ni. Chamomilla *|ft. The affection having risen from checked perspiration, acrid discharge fr.im the no»e, causing redness of the nontrila, snd excoriation or s-.n-m-M under the nose; chap- ped lips; shivering, with thirst. Mcrciricb "I1. Dryness of the nose, with obstruction; • Vsis note, p 91 COLO 1.1 THE HEAO. 195 profuse discharge, producing excoriation, swelling or redness of the nose, pains in the head and face. This is a valuable reme- dy in the generality of ordinary ruses of cold in the head, and particularly when the complaint is. as it were, epidemic.* Mkpar siM-iirids '*ft. Chiefly when only one nostril is affected, or when headache is experienced, or the complaint re- newed on each exposure to cold air; further, in most cases in which M, rem-ius, though apparently iudicatcd, has produced little or no improvement. lti:i.t.Aim\NA ***, may follow the above, if required, but especially when the sense of smelling becomes variously affected, being at one time too acute, ami another too dull. Ammonitm ",•. Stuffed nose, especially at night; swelling and painful sensibility of the nostrils; dryness of the nose. Natri'm y. Cold in the head, renewed by the slightest chill, or exposure to a current of air; obstruction of the noso every second day. Lvtiitsis f§. S,celling and soreness of the nose and nos- trils, with copious watery secretion. Aksi-nm i m Y- distinction of the nose, with, at the same- time, discharge of thin, acrid, excoriating mucus, and burning heat in the nostrils, «?ce. Suffering rcliend by heat ; pain in the back, feeling of general debility, or prostration of strength. Dulcamara is useful when fresh obstructions arise from every trivial exposure to the air. Ipecacuanha may be had recourse to after Arsenicum, if the latter has only partially relieved. Graphites and also Sii.kka arc useful in all cases which aro of frequent recurrence, and always of a most obstinate character. Camphor. In the premonitory stage of the complaint, with shivering and headache, the attack may frequently be check, d by a drop or two of spirits of weak camphor. Sulphur, Calcarc; Craphilis, Silicea, Natrum, and Pulsa- tilla, are the best remedies for removing extreme susceptibility • When the secretion from the nose is excessive, and there in at the same time, confusion in the head with redness and wrcueas of the eyes and eyelids, aud copioua acrid or scalding lachrymaUon, Euphrmsimshould be prescribed. 19© as*eta*ToBV «Tmg an the m<>«< important remedies: A +t!c again* headache, f..||..wrd by Paho'tU*. and then t iM-kemm, it the secretion *«/- phmr ; against h<«»rs.-n««i««, rough, or disease in the resptraliry organs, ariaiaf from a similar cause, see the remedies menlioned uodor these different heads. run; n 7't/tti». Diaomosii. Force*! and audible r. spiralion with nit fever ; or a symptom in acute diseases, such ss fever, pneumonia, or phtM. s ; either drj <>r ace inpaute I with expectoration (' jgh, although not dangerous of it*. I'. may become so, or form an important feature of other dn> a«> s As a precursor <>f phthisis, it is too often neglected It Bsay arise from an irritation of the sir-passages or lungs ; from -Id or other rausss, or from disease of (he same organs, or be rnen-lv sympathetic or the consequence, of derangements or other important timers. TutSArst tics. The following are the medicines most u»«- fnl in this affection : Aconitum, Dulcamara, Bellad., llt/os, , Aw > . Pmlsati'lft, Amm-mtum carboiiinim, \mmomum muri- aticum, Chamomdla, llrpar sulphuris, I •nalta. Ipecacuanha, AhrcurtHS, Carlx, tr.rlabdts, liipsicum, B oontu, Rhus tori- ndendron, \rienirum album, Dritsera, Sill, ra, Lachesis, Causticum. Sulphur, Calcarea carbonica, l.nphra'ia. Septa, S annum, » Tbascum, Arnica montana, and Sauillu, Stc. \eo\iTtw •*•. Violent sh->rt cough, with quick hard pulse and feverish heat; pricking in the ehi «t whan coughing, or during inspiration. S-* Bronchitis, p 2*25. • In <4her cssm this desirable r«*ult may be stunted by the sdmina. Irissaol M'rrurots, Hepar S. and /I'm nM.ntsrt Hi-rNNna sllark wheat the •vrnptocn* rniaaall llw^S whirh have Urn dmrnbrd under thr«s> rrnMstkM}—«»d faiftntg Iheea, Siltres Sulphur, aud I'alearea; m«J Um- other remrdW mcutioord ahos« aa uaotui 10 mooting Ihw •uacopti- BsUjr muet he had racours* Is. C0CUH. 197 Dulcamara °g». The following are indications for the selection of this remedy : moist cough, a'ier exposure to wet, or cough with expectoration of bright-coloured blood; aggra- vation of the cough on movement or when out of doors; alle- viation in tin- recumbent posture or when within doors. IJki.lauos.va °g°. Short, dry, barking, (spasmodic catar. rhal, or nervous,) cough at n'rdit in bed, and also during sleep, renewed by the slightest movement ; dry cough day and night, with irritation or tickling iu tho pit of the throat, or sensation as if a foreign body were in the larynx, or as if dust had been inhaled; spasmodic cough, which scarcely allows time for respiration. Finally, this medicine is sometimes useful in congh with rattling of mucus in the chest, prioking in the sternum or in the hypochondria, and expectoration of thick white mucus, coming on especially after meals ; pains in the abdomen ; hoarse- rn-ss, r.dncss of tho face, headache, sneezing after coughing, and pain in the nape of the neck.* Nt x vomica °J}°. This is a valuable remedy in many cases either of catarrhal or nervous character, ami is particu- larly efficacious where there is a dry, hoarse, fatiguing, and sometimes spasmodic cough, which occurs in an aggravated form in the morninu, and occasionally also towards evening, ami attacks more or less during the day, but relaxes agaiu at night. When, however, it is occasionally supplanted by op- pression at tho chest, on lying down or on awaking during the night, accompanied with a feeling of heat, and dryness in the mouth, if there be any expectoration it consists merely of a li'dc mucus trhich is detached irith great dijiculty. The cough is generally excited by a disagreable tickling or scraping, with a feeling of roundness or rawness in the throat, sometimes attended with uoarsknkss and feeling of roughness in the chest, but more frequently with severe headache, or pain as if from a b'oic or bruis, in the rpigas'rium and hypochondria ; it is frequently aggravated after meals, or by movement, not un- • Hyoseyamus frequently answers when Belladonna has only afforded part...! relief, and may be preferred to ihe latter, when the nocturnal cough is initialled for the time by silling- up in bed ; also when there is mucus rattling- in tho throat Conium ui dry spasmodic cough, increased at n.ght 19* BRtriBATORT BTtTIW. fWqTMKitly also by reading r meditation, and is ocra*. nally followed by semiring rit.siTii.Lt •••. Severe shaking, catarrhal or nervi.ua spasm, she cough, worse loecards evening mod at night, fn- quentlv followed br vomiting; sensstion <.f sufocaiion. as if fnas the laponr of sulphur; increase . f sough when in the rtvusabent p*ture; cough which is at fits! .In. ihcii followed by co/mo** esperlonstton of yellowish or whitish mucus. s..me- thnes of a salt or hitler taste; ..r ex|ieclorstioii of mm us streaked with blood; wheeling ..r rattling of mucus in the chest; the |.an»xysiiis «.f ooughing are. frequently accompanied «ith sssreness in the abdomen, as if friB m bruise <-r blow, or painful shocks in the arms, shouldcis, or back, and some- times followed by a sensation as if the si .mach became in- verted from the violonee of the cough; involuntary emission of urirsB when coughing, l'»ose cough, with aching in the cb«st. I., arseneas, eld in the head ; ex< ited by a sensation of scraping <>r of < n>si>n iu the thr at; shivering. \va<.Mis t ihro.mi in •■,. Dy, tickling, stiff** atinf, etmgk, in tlie morning, sometimes with fi vcr, occurring during th* prevalence ..fa e».|.|, stormy, bleak, state of the atmosphero, and attended with a sensation of hrat in- In nun ' behind the ster- num, resembling that which is occasioned by drinking spirits; rotjjrbncftfl iif the Voic«-; cold in the head Amm<>xkm sjcbiatictm •••. This remedy is s m.times serviceable a'1- r the former when tho cough sounds looser, Vet is unattended with cxjicctorstion Chamomilla. !>ry cough, excited bt continual tickling or irritation in the larynx and cheat, and increased by talking; the congh is ne-t troubles .me during the night, but also occurs daring the day, particularly iu the morning and towards even. ing; scruinulstion of tenacious mucus in the throat ; whet-s- ing in ih> cheat; cough during sleep, f>m. times accompanied with paroxysms, as of threatening -ufl ication ; cough with scanty expectoration of tcuacious bitter mucus This tnedi- cine is well adapted t... the treatment of boughs in children ae- c rnpa- c.| with more or less of the ByBO| tomfl above de*. rtl*rd, or mitb h-^ixMssa, cold in the head, Orvuess iu the tbroati COCOH. 199 and thirst; great frctfulness; fever towards evening; parox- ysms of coughing after orbing, or after a fit of passi.n. Hbpar sii.imhris n;;n. Obstinate cases of violent dry hoarse cmigh, sometimes attended with a dread of suffocation, and ending in lachrymation. Th<- attacks are frequently ex- cited or aggravated on any part of the body being e,posed or becoming cold from tho brd-clathcs slipping off, and are gene. rally worst- at night; also dry deep cough excited by a feeling of tightness in tho chest, or by talking, stooping, or ascending stairs; hoarseness. Iunatia 2j«. Shaking spasmodic cough, or short hacking couth, as if arising from the presence of dust or feather-down iu tho throat, which becomes aggravated the longer tho parox- ysms of coughing continues; dry cough with coryta, occurring both day and nLdit. This remedy is further particularly effi- cacious when the attacks of coughing become aggravated after ea'ini', or on lying doien at nii-lit, or on rising in the morning, and when the sufferer is of a mild and placid temper, or subject to alternations of high and low spirits. IrecAt tanii v 4J2. Catarrhal, nervous, or spasmodic cough, particularly at night, attended with painful shocks in the head and stomach, and followed by nausea, retching, and vomiting ; or try cough, arising from tickling in the throat; or severe, sh iking, spasnio'lic cough, with oppressed breathing, almost amounting to suffocation. In the case of children, this remedy is frequently valuable when they appear to bo threatened with su faction from the accumulation of mucus, or where the parox- ysm is so severe as scarcely to afford time for respiration, caus- ing the face to assume a livid hue, and the frame to become quite rigid. (Calc. is often useful after //wv.) Mkrctjrii'8 *J*. Catarrhal cough, with hoarseness, watery coryza, or with diarrhcea ; or dry cou^h. excited by irritation in the throat, or the upper part of the chest, which becomes particularly troublesome towards evening, and at night; some- times with slight prickings in the chest when coughing or sneexing; excited or increased by talking ; cough in children with diBoharge of blood from the nose, which coagulates as it 200 naar.RAT «r .rsrasi flnws. r-saituritiAO. and headache; dry ap-sm^ie eongh. with retching a-ier the pan.i»»in«. sn I eipectorsti n of Li-d t Ann, vM.rru.iiis ', H'Jn.w o.agh incited by irri- tatn*u. or a tr ubles.me sensation of cradling in the thn at, a I attended with burning pain, and sensation ss if from cx-o. risnm in the chest: catarrhal or nervous Mp.ismo.lte t,.,.h, fretaentlv followed by inebnati n X vomit -r v miling. .«•< ur- nngin ,*n.x.vsms throughout the day; ".ugh with h» tr «.-.. *s, eBpes-ially towards ..vening. --r mornutg ami evening, im reas- •d by s|HMiking. Ohmnie cough with expectoration of green- ish mucus, >f tin- Ivm, ha'ir >r nrrr.tuten'. It is particularly indicated when the pamxvsiua an tnrf »cvere towards evening and at m^ht, frequently at- tended uitu uns tiled pains in various parts >.f tho iMidy, and bursting headache; also painful fnsstir- and arhnir iu the rAnxr and nn ; cough with offensive bresth, sml disagreeubla las'.- in the mouth. Khvoma ***. Catarrhal cough oocurring in winter during the prevsleno- of fn at snd cold easterly winds, with agi-ra- valion of the fits ■•( .. u/hing on coming Ir .111 the open air into a warm rssn. Ttie f.II .wing are th.- general indications '.,r its employment : dry much netted by constant irri'a't,,n in the tkroa', a as if caus-d by vs|x>ur in tin larynx and wind- pipe with greatly accelerated respiration, as if it wen- impos- sible to obtain sufficient air; spasmodic, suffocating cough, af'er partaking >>/ food or drinks, and also slter midnight; cough with prickings m the chest, snd violent bursting head- ache, especially at th- tem Its. slso with prickings iu th.. pit of the stomach, or in the «idc : further, in loom- eough with ,.e''otrish ejprrtnra'mn or slight spitting of blood, this remedy will frequently be found of great service ; dry uervous cough. Kims roxit.iDK.sii>«osj r*R. Shor', dry cough, worse to- wards ecKntmg and before midnight, ex. ited by tickling m the coron. 201 rhcyt, attended with anxiety and shortness of breath; cough on waking in the morning, or shirt cough with bitter tas'e in the mouth, on lying down at night and on waking in the morn- ing. Cough with expectoration of bright blood, with sensation of insipidity »■«.«», the dnmss or irrilsli-.n in the U n-ai ; »h.iel, dru. suf. footi.ng cough, ss if caused by th. pi.-aei cc of a crumb of bread staking iu ihe th^at, with ineffectual ■ ff -rts to expect..rait. Cough on rising fr-.m ths iwcumtwiit p. store, or sttacksof cough BlwsvaWvr sleeping. <>t on lying down to sleep; eough also during ihe dsiy. or sUo at night during ah p. so that ihe patient is unconscious of it; eonlinusl hoarsen, s, with s sensoti .11 as if something wen- in th- throat which could not be detached Vk\ sricL'M *4*. Dry. hollow roug/i, which even awakes one In-iri sleep ; ah'-rt cmgh cxcit- -I by tickling, crswling, «r a feeling as if the thr at were excoriated, ■ r by talking and cold, attended at times with burning or a sensation of soreness m thr ches*. snd rattling of mucus; psin in tho hip, and occasionally involuntary du--barge of urine when coughing. Si-lmh a •|'. 1" "oine cases of chro'iie coughs, snd par- lieularlv in dry cough, which disturbs th. patient at night aa well as during the day, the cough is frequently ex< it< d after partaking <>f fi*"l, . r during a deep inspir iti-.n, and ia generally attemlid with a sensation of spasm, die en stinte n iu the chest, soaietums f.|l >wed by inclinstioii to von it, or involuntary es. cape of urine, or psin as if fn in exc rmtir 1, or pricking pains in tne ehest; headache, pans in the chest, t ,.• abdomen, loins and hips; slso, cough, with ex|ssotorstion of thick, whitish, or yel- lowish mucus, or ol s greenish yellow, fetid mucus, or pus, of a salt or sweetish taste ; feverish cough wit 1 spitting of blood. Calcarea carbosica *f ♦. I'ry eoug ., aggrarat. d towards evening, or at night, excited by tickling in the throat, or by a sensation as if then- were a froth, r dim* in the thtxit ; also, loose cough, with rattling > f mucus in the ehest, and cxpectora. lion of offensive thick, yellow mu> m .- snsiety. KcriiRvBlA •••. O'.ugh, w.th coryx.i snd Inchryn ation ; diurnal cough, with difficult expectorati-m « f mucus ; or matutinal cough, with copious rX|»e« t >ratioii, and oppressed bnatbiug. SsriA syy Cugh with copious expe<-tcration of mucus of a sottish tat'c, of u yellow or greenish colour; also dry COCOH. 203 spasmolie cough, particularly at night, or on first lying down, attended, in children, with crying, fits of choking, nausea, retching, and bilious vomiting. This remedy is especially adapted to individuals having a constituti .nal taint, such as the scrofulous, scorbutic/dec.; in chronic coughs, with thick, yel- lowish, greenish, or even puriform expectoration, with a putrid taste, it is a valuable remedy. Stannum *$*. Cough, with copious expectoration of a greenish yellow, of a sweetish <>r saltish taste, attended with great weaknoss and disposition X sweats; or dry shaking cugh, worse at night or towards morning, excited or aggra- vated by speaking or laughing, and occasionally followed by vomiting of ingesta. Cim iiona °£°. Paroxysms of cough as if excited by the vapour of sulphur, with whistling or rattling in the throat from mucus; expectoration difficult, consisting of clear tenacious mucus, sometimes streaked with blood ; pains in the shoulders, or prickings in the chest and windpipe; cough, sometimes with bilious vomitings; cough after hemoptysis. Ykrhascim °$°. This remedy is frequently of great ser- vice in children, though less frequently bo than Chamomdla. Indications : dry, hoarse cough, worse towards evening and at night: occurring during sleep. Iodium ***. Cough in plethoric children, with copious ac- cumulation of mucus iu tho bronchi, and ineffectual efforts to expectorate. I'nosi-iioRCS °l9. Dry cough, excited by tickling irritation in the throat or chest, or by laughing, talking, or drinking, or by cold air, and accompanied with pricking in the larynx ; hoarse- ness, or pains in the chest as if from r.rciwia/ion ; cough with hoarseness, from fever and depression of spirits, sometimes with apprehensions of death; dry sounding cough, followed by expectoration of viscous or sanguineous mucus. Arnica *}* is of great value in coughs, with bleeding from the nose snd mouth; headache, pricking in the chest (pleurodynia), rheumatic pains in tho loins and extremities, and soreness or pain, as from a bruise, in the chest and abdomen. 104 ■•iriBAToav ti'trs Sm hi « »|» In abort dry ensign, netted by a full inspi. raUoo, .sr chronic <- -ugh. or catarrh with c.pt us Msrrelmn of whitish viscous mums, whrh is aliernately ei|«rctorsled with case and diffiruliv this r« medy ia u.olul, VnsiM.ra iti..y of the remedies. The d-se nfnti n> r. repeated in from twenty-four t> forty-eight hours, as requited ; in setrrs eases, »u >v eight glr four hours " These are tlie princi|>al remedies to l>e had recourse to in this disorder; but in complicated case* we may hare to fall in the aid .1 other medicaments In some obstinate, nmous eougha, occurring in highly irritable, nervous, ami hyalerieal habits which an< generally dry, <>r attend, d with scanty and difficult expect ration, consisting . f a little clear ii.m us, change of sir will frequently readily effect a cure For cough arisn.g from Worms, sre the remedies m-iitimd under that heading ; or from teething, see l>K:sririo\ S roM». it coughs, at coughs eecurring in women during the Isj-t months of preg- nancy, sn- t - be relieved by the remedies mentioned under IlyirrrsiA I'nmedieat'd jujubes, <>r sugar randy, may be all wed orra»ionally. to moisten the throat or mouth, in cases of dry irritsting eough*. nOOPINCCC MI Tussis Convulsira. Pertussis This is almost peculiarly a discsse of chil«>d, and one which few individuals sn--a|-« during that peri-xl; it generally apiiears aa an epidemic ; and is, by th* in ijorilv of physiologists, a< knowledged to be communicable by contagion, we seldom find an instance of a |»erson suffering s n > ond time In.m its attack b Over many the affection passes lightly, but in the majority of case* it prove* a distressing, and in B'ime a fatal ina!ady baffling all the ill-directed efforts < f the alhq«thic pbysi an to omduet .t to a favourable termination. Under the old ; -actios, not ooly was a great deal of valuable * Vast assv*. ... UI 20-5 me 1st in endeavouring 'o subdue inflammation bv antiphlo- i-t,io measures, but the pati.-ut's vital cncrjics were weakened, ml rendered less capable of contending with the disease, when , assumes the spasmodic t .pn. On the contrary, we have it in our power, by the ndminXra- ion of remetlies s/« cijic to the affection, to check the inflamina- i«>n at its outset, subdue the other distressing attendant symp- ouis, ami shorten the duration of the complaint, without allow- ng it to leave after it any of those evil consequence, such as cbility and emaciation, which oblige the patient to endure a cdious and protracted period of convalescence. Diaunosis. I'aroxysiiis of violent anil convulsive expira- i.uis, in rapid succession, interrupted by long whistling in- pirations, and in young subjects a loud shrill win.op, termi- ni ted by the expectoration of a quantity of mucus, 0r a fit of -omiting, after which the attack ceases for somo time. If ho case is severe, tlie features swell uml become livid; blood scapes from the nose, nmuth, and even from the ears. A oinplete cessation of respiration anil almost suffocation takes ilace as if from spasm of the lungs, which lasts for minutes. rhe attacks return every three or four hours, more frequently n severe cases; the hast excitement brings them on ; they are nore frequent ami violent at night. Respiration is free during he intervals, and the patient in every respect healthy, except jcing weak. Pathologists generally consider this disease under three .tages : the distinction bet ween the second and third is, how- iver, not often very clearly marked. Tho first or febrile stage commences with the symptoms of in ordinary catarrh, attended with Blight fever, which gradually neroasea, the breathing becomes mom difficult, and is accent- janied with irritative cough and pains in the chest. In the second or convulsive stage* the febrile activity disap- pears, and the ehai act eristic cough snd other symptoms of the disease develop themselves. In the third or nervous stage there are longer intermissions • Th* congestive and uervuus of some authors. uoopisio-eonoiT. Vet RRsriRAToRT »V • I fM between the paroxysms, but increased wrakness from the dura- li-A of the cough TtiERAnrTirs. In the incipient, febrile, irritative, - r oatar rhal stage of the cough, the most appropriate remedies sre lo be found amongst those we have already jx-inu-d out in tile treatment of Common Cough, and must be selected according to the indications there given, and sdministcitHl iu the same manner unless otherwise s|*cciticd. lly a careful selection of these remodies it is frequently possible X check the disorder in the first stsge. Accrilingiy, the ui<*t suitable medicaments for this purpose are Dulcamara, Pulsatilla, \1 rcurius, Brlladonnm, lie par sulphur i < Chamomilla, V i van.*, a. Arnica, l^cacu- anha. Aconite, Bryonia, and Phosphorus. VOMIMSIHA I l'l\. See (""Ol «.ll, p. l'l>l. Dihamarv ")'" When tho attack has apparently b<-«n excited by ex|Kisure to wet, (a thorough wetting.) tha c ugh loose, with copious and easy i t]>ectitration. I'i'lsatilla 9SB. Cough loose, and accompanied with laehrymati'rn, weakness of tho eye*, sneezing, thick, disco- loured ronia and slight hoarseness, and inclination to vomit after coughing; occasional diarrhcua, eBjiecially at night. Meri iHirs *J». II larsoness, watery coryxa, with soreness of the nostrils ; dry fatiguing cough, generally occurring in two successive fits. Bei-'adokxa '**, is one of the most important remedies in t; ' catarrhal stage of hooping-cough, when there ia dry, hollow, or harsh and barking cough occasionally nt night, or which becomes materially aggravated at that period This medicine is also particularly well adapted to the angina or B->n- throat, which is not unfrequently oonet mitant at tbe commencement of the affection. IIkpab siieiitjns. Cough worse at night, but looser than t11* indicating Belladonna. This medicine is also useful in forwarding the secretory process. Aumimstratiosi. Half a grain of the trituration, at tbe th.rd potency, to half an ounce of wster, a dcaaert-Bpooijiul twice s day. HOoristO-COUCH. 207 Chamomilla ■**. Dry hoarse cough, or cough with dif- ficult expectoration of tenacious mucus, followed by a feeling of soreness at the part from which the mucus seems to have been detached. Tbe paroxysms of coughing are excited by an almost incessant irritation of the larynx, and in th. upper part of tbe chest. Nrx vomii-v ogt, is of greater service when the cough ap- proaches tin- second stage. It is indicated by tbe following Bvinptoms: Dry. fatiguing cough, attended with vomiting,and occurring particularly from about midnight until morning, the paroxysms so protracted ami violent as to produce appa- rent danger of suffocation, with blueness of the face, and occasionally bleeding from the mouth and nose. (Ainu \ is bettor adapted to this latter symptom when it occurs with a copious discharge of blood.) b'H 01 (mia »|» is, like tho former, of great value when the cough is attended with danger of suffocation, and each inspiration appears to excite a fresh fit of coughing. It is further indicated when the fits are attended with spasmodic stilnuisa of the body, and blueness of the face, great anxiety, and accumulation of mucus in tho chest hnviri: *§* may be had recourse to from time to time, when marked febrile or inflammatory sympt.hub are present, bearing in mind, that its action is of short duration, snd may bo followed in a few hours by any other of the remedies which appear more particularly indicated. The last mentioned remedy, Bryonia and Phosphorus, are ohiefly called for when tho cough threatens to become associ- ated with inflammatory action in the lungs, \o Si . o\i> or Cow ii.sive St m;r.—Thkrapkitii s. Drosera, I ratrum album, Cuprum aceticum, Arn>r i. Ferrum meta'li- cum, and Conium macula turn* . IXoskka is one of the principal remedies in the treatment of the disease when it has rescbed this stage; snd in cases * Acipcm iivoaocTAMCi m. In some cases we have had satisfactory reeulta from the use of thw arid. It m m«t indicated when lite couch m violent, ronriMiive, attended by rattling of mucus, suffocating rsapi- muoa and ejection of blood from tho mouth and nose.—Ed. r* brs»ibatsbv ""ni where the constituti »n has n t be«n enfeebled by the transmit- si -n of hereditary wesknesa . r other causes, il will spseddy de- clare ils beneficial effects, and materially ahorien this trying and painful peri d c-f the dis-.nler The [.articular indications fiar Ihe uae < f this medicine are. violent paroxysm* of <*.uirh, oc- rurring in such rapid succeasion ss t ■> thn-aten snff station, and attended with the characteristic shrill sound during in- spiration, and sometimes fever; after esch fit of coughing; vo- miting of food, or of stringy mucus ; relief on moving about. sUMiMsru «i ion. ■ */*• m *'* lesspoonfuls of water, a teaspoonful sftcr esch s< v.-n< paroxysm of coughing.* N khatri m vim >i is indicated when the child has become reduced in strength nnd emaciated; or when il suffers from cold sw-ra'i, particularly on the forehead, with excessue thirst, in. rsdunlary emission of urine, vomit inn, arid other sympt. ins com- mon to this stage; also pain iu chest and inguinal region; tlow fever, t VnwiM-tTRATio*. The asms a* D, ,s,ra. Perm„ s, ,.,.,, ,.„ This has been found most useful in the nervous stage, particularly when convulsions vilh loss of con- sciousnrsn ensue after each paroxysm. Also when we find vo- miting sfter the attacks, snd rsttling of mucus in the ehest, and wheeling at sil tinn-a. In slmo-t all cases a marked benefit has followed the employment of this remedy; sometimes it has been found sufficient of itself to cut short ihe disease, and in thcrs, has so fsr modified it that other n medic which had be- f n- seemed to fail, have sfter its exhibition at. .1 with the most marked effect, snd completed the cure \ Aomish-tbatiosj According to the formula already given in Si ablii Fkvkr, a dessert-spoonful n't. r each paroiytsu • V.-«V not*, p. 21. ♦ ( trko tegetakitts m freo, imtly useful in bnofiof Ihsi stag* of tho aflVciion lo an *»Hy sod mirmaful termination after tin- pres-toos oao of Veratrum ot Drosera. or both of th~» important nmesium ; parti- eahrir sties, notoritrM.iand.rir ihe de*-re*»- of cough, the tendency U »onrt Mill rriuain*. >'#■• alto ferrum., ■ < •- also the rewedioa for coujjus of a bad character under the head of Covaa. 210 RESPIRATORY SYSTEM. CROUP. Angina Mcmbranacca. Angina perniciosa. Cynanchc laryngea. Cynanche tracheitis. s. trachealis, SfC, Sfc. Diagnosis. Short, difficult, and hoarse respiration, accom- panied by a shrill, whistling, squeaking, harsh, rattling, or metallic sound, with cough of the same character; tho patient throws the head back; fever, and sometimes comatose state of the brain. This well known disease is one that requires the promptest treatment to avert the danger. From the moment we are as- sured of the nature of the complaint, recourse must be had to the remedy most clearly indicated by the assemblage of the symptoms, so that not an instant be lost in arresting its further progress, since, if not .skilfully kept in check, it sometimes runs to a fatal termination within twenty-four hours; although in the generality of cases, when such an event does take place, it happens about the fourth or fifth day. Croup consists of a peculiar inflammation of the lining mem- brane of the windpipe, causing the secretion of a thick, viscid substance, generally opake, of about the consistency of the boiled white of an egg, which adheres to the interior of the windpipe, and takes the form of the parts it covers; when this, generally denominated the false membrane, has been allowed to form, the case becomes extremely critical. That croup arises from inherent constitutional taint, is evi- dent from the fact of some families having a peculiar tenden- cy to this disorder. It particularly affects early childhood. The principal exciting causes seem to be, exposure to cold or damp, and derangement of the digestive functions, from a too nutritious or heating diet, too much animal food, or stimulants, such as wine or coffee. It seldom attacks adults, though we occasionally see exceptions to this rule, and is not unfrequently found in complication with other affections both of the lungs and windpipe. The attack generally commences with the symptoms of a CROUP. 211 common catarrh, such as cough, sneezing and hoarseness, with a greater or less degree of fever; in a day or two the cough changes its character, and becomes shrill and squeaking, or deep, hoarse, or sonorous, attended with a ringing sound during speaking and respiration, as if the air were passing through a metallic tube; as the disease progresses, the cough becomes more shrill, and when long continued, resembles the crowing of a young cock. There is seldom much expectoration, and when any matter comes up in coughing, it has a stringy appearance, resembling portions of a membrane. After inflammation has set in, considerable fever and restlessness continue, occasionally varying in intensity, but never wholly remitting; the counte- nance expresses great anxiety, and alternates from a red to a livid hue ; the paroxysms are followed by a profuse and clammy perspiration of the whole body, more particularly of the head and face. When danger threatens, the pulse is hard, frequent, and occasionally intermittent; the breathing, particularly during inspiration, difficult and audible; the features become livid, and almost purple from the sense of suffocation; tbe head is thrown back; the cough assumes a veiled and husky tone; the voice sinks to a whisper; the eye has a dull, glassy, or dilated appearance, and the whole system seems in a state of utter prostration. Therapeutics. The medicines upon which the greatest re- liance is to be placed in the treatment of this affection, are Aco- nite, Cham., Bryon., Spongia, Hepar sulphuris, and Lachesis. Aconite is called for during the inflammatory period of this dangerous disease with great febrile disturbance, burning heat, thirst, short dry cough, and hurried, laborious breathing. It may be exhibited as below specified, until these symptoms begin to abate. -~, in six teaspoonfuls of water, one every half-hour to six hours, according to the violence of the fever. After Aconite, recourse must be had to— Spongia, when there is a hoarse, ringing, hollow, and squeak- ing cough, with slow wheezing respiration, or Jits of choking, with inability to breathe but with the head thrown back. Administration. °|°, in six teaspoonfuls of water, one every half, or every one, two, or three hours, according to the 212 RESPIRATORY SYSTEM. intensity of the symptoms, and the effects produced by each do.se. Hepvr sulpuvris. EitTier when the symptoms are partially subdued by Spongia, or when from the commencement the cough is moist or loose, with accumulation of mucus in the re- spiratory organs ; or when, after Aconite, there remains a dry, deep, hollow cough with weak, hoarse voice, and more or less distressing oppression of breathing.* Aumi:\isiration. One grain of the trituration, third po- tency, to an ounce of water, a dessert-spoonful every two hours, or oftener if required. It may also be advantageously alternated with Spongia at intervals of half an hour to an hour or more according to the severity of the case, and the effects produced ; the administrator carefully noticing the effects of each medicine.f Phosphorrs is preferable to Spongia when the inflammation threatens to extend to the air-passages and lungs, (Pneumomc f roup,) or when the latter are implicated from the commence- ment, and may also be given in alternation with that medicine, or follow it; and may further, in some instances, be advan- tageously alternated with Lachesis. Lachksis ||, in very serious and difficult cases, in which there is short dry cough with hoarseness : great sensitiveness to the (ouch, the slightest, pressure ajfic'ing almost to suffo- cation ; voice very low and hollow, with a sound like that of a person speaking thr< ugh the nose; fainting; nausea; swooning ; loss of sense ; rigidity of frame ; great prostration of strength, especially towards evening. Admimstration. Six globules of the sixth in about an ounce of water, a teaspoonful every half-hour, hour, or two hours, according to the intensity of the symptoms, and their abatement. « After having subdued these threatening symptoms by the * Th s remedy is of itae'f seffiiient, in many instances, to arrest the progress of the dia^aae, if administered as soon as the incipient symptoms of the attack are observed ; but Aconite, Hepar sulphuris and Spongia, generally alternately, become necessary when ihe affection is more deve- loped. tVide note, p. 21. CROUP. 213 administration of the last-mentioned remedy, we may, if the dis- ease is not wholly vanquished, again fall back upon Sj ongin or Hepar sulphuris, according to the indications given for those remedies. There are other remedies which afford valuable assistance in the treatment of complicated attacks ; but in truth it may be said, that in the majority of eases, under any circumstances. Aconitum, Hepar sulphuris, and Spongia, administered alter- nately, are almost always sufficient to effect a cure in a few hours. It may, however, be mentioned, that Tartarus emeticus has been found valuable in some apparently hopeless cases arising from paralysis of the lungs; Arsenicum, Sambucvs, and Mo - chus, in complications with Asthma Millari; and Iodium either alone in repeated doses, or alternately with Aconite, has been much recommended in obstinate cases, particularly when oc- curring in plethoric subjects. Hepar sulphuris, Phosphorus, and Lycopodium, have been recommended as useful against a predisposition to this affection. [We are rejoiced to find that the subject of Croup has elici- ted so much attention from the profession during the few past years, and that some expedients have been proposed with a prospect of success in those fearful cases of true membranous croup, that have bid defiance, in the practice of every expe- rienced Homoeopathist, to th» most renowned remedies of the school. These medicines are Ammonium causticum* (Caustic am- monia), Brominium (Bromine,) and Kali biciiromatum (Bi- chromate of po'ash.~) They have been urged principally in consequence of the correspondence of their pathogenetic effects with the- pathological development of genuine croup, especially in regard to the transuded membrane. The Vapour of chlo- rine, on the testimony of Albers, has produced true croup symp- toms, even to the formation of the membrane; but to what ex- tent this gas may be made safely available, must be determined by subsequent careful experimentation. » See note, p. 218. 214 RESPIRATORY system. According to the " Pressburgh physicians," the following aro the characteristic expressions of " CAUSTIC ammonia croup. Deep, weak voice; fatiguing, interrupted speech. Increased secretion of mucus in the bronchia. Violent cough, with co- pious expectoration of mucus, especially after drinking. Difficult, rattling, laboured breathing; stertorous breathing. Suffocative fits. Spasms of the chest." " BROMINE CROUP. Formation of pseudo membrane in the larynx and trachea. Spasms in the larynx occasioning suffocation. Cough with croup-sound, hoarse, wheezing, fatiguing, not permitting one to utter a word; accompanied with sneezing; with violent suffocative fits. Respiration characterized by mucous rattling; wheezing; alternately slow and suffocative, and hurried and superficial; laboured ; painful; oppressed ; gasping for air. Heat in the face. Increased secretion of urine. Pulse rather hard ; slow at first, afterwards accelerated." BICHROMATE OF POTASH-CROUP. Dr. "W. E. Payne, of Bath, Maine,* was induced to make trial of the Bichromate of Potash in croup, after reading Dr. Drysdale's " Summary of Pathological Appearances," pro- duced by this drug, and contained in the British Journal of Homoeopathy. These appearances were :—" Respiratory apparatus. " The air passages were constantly lined with a thick ropy muco-purulent fluid, when death was delayed beyond several days. In some instances the trachea was lined with a complete false membrane. The" epiglottis, rima glottidis, trachea and bronchia, were, at different times, deeply injected. The lungs were generally healthy, and presented a remarkable contrast to the highly inflamed bronchia." Als i elsewhere in the same summary : " Elastic plugs of mucus in the nostrils." • See note, p. 218. CROUP. 215 Dr. Payne, relying on these croup-like developments, pre- scribed the Bichromate of Potash in two cases of croup suc- cessfully. The first case presented the following phenomena, (those of an analogous case of croup that proved fatal under the usual remedies,) with this exception, "that the difficulty of breathing increased rather more rapidly, and the cough was rather more frequent." " Case 1. Boy of two years ; had enjoyed good health up to the time of this attack. A slight difficulty of breathing, when the mouth was closed, owing to one nostril being ob- structed with a plug of mucus, was observable. Pulse irreg- ular and intermittent. There was a slight elevation of the temperature of the skin. Otherwise the child appeared well. He was lively and playful. This state continued for three or four days without any perceptible change, except the appear- ance of a few small sores below the nostrils, which were somewhat moist. On the evening of the third or fourth day there was, evidently, a change or increase of the disease. The respiration, though not hard, could be heard distinctly in any part of the room when the child made a deep inspiration. This did not seem to proceed, as before, from the obstructed nostril, though this remained the same, but from some difficulty about the larynx. The child would frequently carry his hand to his throat and put his fingers into his mouth. On the following day the difficulty of breathing had evidently increased. On applying the ear to the neck, a whistling sound was apparent, like that which may be produced by the passage of air through a metallic tube. Voice hoarse. Cough not frequent, but hoarse, dry and barking or crowing. The child was restless, sleepless, and refused to drink, apparently because deglutition was painful. The tonsils and upper part of the larynx were red and swollen, and about the fauces was a small quantity of tenacious mucus. After the first day of invasion the child could swallow his drinks without difficulty, and was thirsty. As the disease progressed, the difficulty of breathing gradually increased, causing a strong action of the abdominal muscles, the muscles of the neck and shoulder-blades. The head was 216 RESPIRATORY STSTKkt. inclined backwards. The shrill whistling respiratory s.nnd increased, together with a tearing sound like that produced by a saw running though a dry board. The cough was mostly dry, but occasionally sounded loose and rattling. It, however, grew less and less distinct, until towards the close of the dis- ease it amounted to little more than a grunt. The child would be carried to and fro continually—not one moment would he allow his parents to sit with him. The breath became very offensive, and this offensivencss increased to an intolerant de- gree as the disease advanced. The plug of mucus remained in the nostril, but the herpetic sores gradually died away. The temperature of the skin was rather below than above the natural standard. During the last day or two of the disease the child was inclined to stupor. Though these symptoms gradually increased, yet there were occasional remissions;— the breathing became less difficult, and the whole general ap- pearance of the child was much better; but this apparent giv- ing way of the disease lasted only for a short time. The breathing could be heard often in the street." Administration. One drop of the sixth dilution was mix. ed with half a tumblerful of rain water, and a tablespoonful of the liquid was given every Jive hours. In this instance the Bichromate was not administered until eighteen hours after the commencement of the attack. Dur- ing the use of this remedy, cold, wet linen was applied exter- nally to the throat. After the difficult respiration became na- tural, hoarseness and a barking cough remained, which were subdued in three or four days by morning and evening doses of Hepar sulphuris. Case 2. The second case, similar to the one detailed, was treated early in the course of the disease, without a consen- sual application of cold, wet linen to the throat, and recovered under the use of the Bichromate of Potash. IODINE. # Dr. Koch, of Germany, commends Iodine as a most effi- cient agent against croup. As Aconite was employed alter- nately with this remedy in his thirteen successful cases, its specific power in his instances has been questioned. Dr. Tietze, who followed the experience of Dr. Koch, offers tea- CROUP. 217 timony in favour of Iodine in croup, and asserts that "it is only suitable in the treatment of croup as long as there is inflam- mation and exudation. When this ratter process has stopped, Iodine probably ceases to have any good effect. Hepar sul- phuris then appears to be in its place." Iodine, according to its pathogenesis, applies rather to a catarrhal than a membra- nous croup, but may hold a preventive place to true croup, as Aconite, Spongia, and Hepar have undoubtedly done in many instances, although Prefessor Ware deems the conversion of one form of croup into another impossible. Dr. Tietze states with apparent justice: " Although the symptoms which I have here described may not constitute real croup, yet everybody knows that they occurred under circumstances where croup must have been the inevitable consequence of this first attack, unless met in the outset by proper treatment." Future observations of intelligent physicians will probably define these points, and especially the true position of Iodine. We add the following summary of the effects of Iodine by the " Pressburgh physicians." " * The larynx is painful. (Vogel.) * Pain in the larynx and expectoration of indurated mucus. (Hartlaub.) * Pressure in the region of the larynx, as far as the fauces, as if those parts were swollen. (Jorg.) * Aching and pricking pain in the region of the larynx and the sublingual glands, several attacks on one day. (Jbrg.) * Pressure in the throat inducing frequent hawking up of a quantity of tenacious mucus. (Hartlaub.) * Contraction and heat in the throat. (Hartl.) * Sore feeling in the throat and chest, while in bed, with wheezing in the throat and drawing pains in the lungs, which is felt regularly with the beats of the heart. (Hartl.) * Inflammation of the trachea. Roughness of the trachea the whole day. Hoarseness. (Comdet.) Hoarseness early in the morning. * The asterisk indicates that these symptoms have been removed as well as produced by this drug. 10 218 respiratory system. Hoarseness for more than two weeks. (Hartl.) The voice becomes deeper, and Anally quite deep. (S. IT.) Sensation as if something were lodged in the larynx which he can bring up by hawking, the whole day and evening. Intolerable titillation in the larynx, which can only be ar- rested by hawking and coughing, with aecuniuhition of water in the mouth, early in the morning when in bed. ((iff.) Expectoration of tenacious mucus, with pressure in the throat, as if something were lodged in it which he imagines he can swallow, early in tho morning. (Illb.) Violent titillation in the throat, inducing a desire to cough. (S.) Dry cough. (Matthey.) Violent oppression of breathing. (Gob's.) Asthma with pain during a deep inspiration ; stronger, quicker beating of the heart, and smaller, more frequent pulse. (Jorg.) * Asthma and arrest of breathing in the throat for a fort- night. (Illb.) Loss of breath. (Gardner.) Want of breath. (Neumann.) Suffocative catarrh. (Orfila.) " To the layman we cannot too strongly urge the necessity of promptly sending for a physician on the Jirst threateiiings of this frightful malady. The physician will give close attention to the laryngeal wheezing or whizzing, and make a careful examination of the throat. The peculiar crowing tone of the larynx, and specks of coagulable lymph on the tonsils and in the throat, are sure in- dications of impending danger from true croup.]—En. Note—1. Characteristics and Physiography of croup and its varie. ties. Arranged by a member of Homoeopathic physicians in Pressburgh. Translated by Ch. J. Hcmpel, M.D. (Horn. Exam., new series, vol. I., p. 43X 2.—Bichromate of Potash in .Membraneous Croup. By W. E. Payne, M.D., Bath, (Me.) (Same Ex., vol. I., p. 343.) 3.—On croup. By John Peters, M. D., (Same Exam., p. 187.) 4.—Ou the use of Iodine iu croup, (Same Ex., p. ?.">.) These interesting papers, which hair fur- nished the staple of our remarks on croup, deserve the careful perusal of physicians.—Ed. 219 INFLUENZA. Diagnosis. Catarrh appearing in an epidemic form, at- tended, in addition to the symptoms described at the com- mencement of the article, on common cold, with extreme op. pression and prostration of strength; sleepiness, followed by shuddering and general chilliness ; rheumatic pains in the head, back, and limbs; and slight redness of the eyes, painful pres- sure, and sensibility to light. Therapeutics. The principal medicine in the treatment of this affection is Arsenicum, and in most cases, if not adminis- tered too late, it will be found specific. The following are the characteristic indications for its em- ployment : heaviness and rheumatic pain in the bead; pro- fuse watery and corrosive discharge from the nose, causing a disagreeable burning sensation in the nostrils ; violent sneez- ing ; shiverings and shuddering, with severe pains in the limbs; oppression of the chest; difficulty of breathing ; thirst; anxiety; restlessness; great prostration of strength, with aggra- vation of suffering at night, or after a meal; inflammation of the eyes, with sensibility to light. These symptoms may be attended with deep dry, fatiguing cough, exacerbated in the evening, at night, or "after drinking, or sensations of dryness and burning, with mucus in tbe throat, which is difficult to detach. Administration. °g?, in a little water, repeated every six to twenty-four hours, according to the greater or less severity of the attack, until improvement sets in.* If this remedy be not sufficient to remove the disorder, we may have recourse to the following medicines: Aconitum, Nux vomica, Causticum, Mercurius, Phosphorus, Belladonna, Pul- satilla, Camphor. Aconitum. When the disorder assumes an inflammatory character, with quickness of pulse, dry hot skin, and short, harsh, shaking cough. * Vide note, page 21. 220 respiratory ryatkm. Administration. °T°, in a teaspoonful of water, repeated in from six to twelve hours as required. Nux vomica. Obstruction of the nose, hoarse hollow cough, excited by tickling in the throat, and attended with severe headache, confusion in the head, giddiness, want of appetite, or sickness, thirst, aching pain in the lower part of the back, con- stipation, pain in the chest as if from excoriation. Administration. y, in a dessert-spoonful of water, re- peated for two or three evenings successively. Causticum will generally be found of great value, where Nux vomica has not produced the desired benefit, especially where the patient is of a lymphatic temperament. It is, how- ever, more particularly indicated when there are aching pains in all the limbs increased by movement; facial pains; violent, dry cough, worse at night, with pain in the chesl as from exco- riation ; constipation, disinclination for food; vomiting. Administration. Same as Nux v. Mercurius. Dry or fluent eoryza ; pains in the head, face, and teeth ; acre throat; violent shaking cough, excited by irri- tation in the throat and chest; shivering or heat with profuse perspiration; aching in the bones and slimy bilious diarrhoea, attended with tenesmus. Administration. iJt84i, dissolved in four dessert-spoon- fuls of water, one to be taken night and morning. Piiospiiorus is frequently exceedingly useful after Mercu- rius ; it is particularly indicated when there is excessive irri- tation in the larynx and bronchia, with alteration of the voice, and pain during articulation. Administration. -56-°» the same as Ale re, but when the pulmonary symptoms give evidence of a greater degree of irrita- tion, a few globules of the third potency may be dissolved in six dessert-spoonfuls of water, one to be taken every four hours. Belladonna. Dry, spasmodic cough, aggravated towarde night; sore throat, excessive headache, increased by talking, moving, or bright light; fixed look ; confusion of ideas on clos- ing the eyes. Administration. ^ in a teaspoonful of water, to be re- peated in twenty-four hours, if necessary.1* • Vid* nata. p. Q] determination or blood to the chest. 221 Pulsatilla. Loose cough day and night, exacerbated by lying down, thick offensive coryza, tendency to relaxation in the bowels, hiss of appetite, foul tongue, disagreeable or insipid taste in the mouth. Administration. \°, in a dessert-spoonful of water, for three or four successive mornings, fasting.* Camphora. One or two drops of weak spirits of Camphor when taken at.the commencement of the attack, and repeated until the chilliness or shivering begins to subside, will frequent- ly check the further progress of the disease. In a more advanced stage of the affection, with (laborious) asthmatic breathing, accumulation of mucus in the bronchi, and cold, dry skin, Camphora is further of considerable service. Finally:—Arnica may be administered with advantage in some cases, particularly when pricking pains are experienced in the chest during inspiration (pseudo-pleurisy) with aching pains over the whole body, headache, and hemorrhage from the nose; Ipecacuanha after Arsenicum or any of the other remedies when there is vomiting or violent retching during or after each fit of coughing. Senega. Tickling irritation and continual burning in the larynx or throat, with loud mucous rale, and fear of suffocation on lying down: Stannum in neglected or protracted cases with easy but excessive expectoration of mucus, and great weak- ness :—Cinchona may advantageously follow the last remedy when the expectoration has been diminished. DETERMINATION OF BLOOD TO THE CHEST. Congestio ad Pectus. Diagnosis. Sensation of great fulness, throbbing, weight, or pressure in the chest; and palpitation of the heart, attended with anxiety, short sighing respiration, and dyspnoea. We find that the predisposition to affections of the chest and lunes is greater during the period preceding puberty, and for some years after, than at any other epoch of man's existence. * Vide note, p. 21. 222 respiratory system. As remarked in the Diseases of Childron in Infancy and during very early childhood, from the duproportion between the cerebral system and the other portions of the economy, tbe diseases which the physician has chiefly to combat aro those arising from over-excitements of the nervous organization. In maturer years the tendency to abdominal congestion generally develops itself. This is easily explained by entering into the physiology of these different periods of human life ; but as my object is rather the treatment of disease than the elucidation of these interesting points, I shall here content myself with briefly alluding to them. There is no doubt, as already remarked, that a particular period of human life is peculiarly liable to chest affections, and, among others, to this disorder, but too frequently the precursor of other more serious maladies. Some constitu- tions, however, particularly those in which a hereditary phthisical taint exists, exhibit a marked predisposition to pec- toral congestion. Amongst the most frequent causes of this predisposition being called into dangerous activity are, expo- • sure to extremes of heat or cold; stimulants, such as alcoholic vinous, or fermented beverages, or coffee; the abuse of narco- tic drugs; violent exercise, such as running, dancing, &c, or over-exertion even of the voice either in speaking or singing; sudden check of perspiration; cold or damp feet; sedentary habits; metastases; repercussed cutaneous eruption; or sup- pression of customary discharges, such as the catamenial and hemorrhoidal flux. Therapeutics. Aconitum, Nux vomica, Ipecacuanha, Bel- ladonna, Aurum foliatum, Mercurius, Pulsatilla, Spongia, Cin- chona, Sulphur, are the best remedies in general cases. Aconitum is especially indicated when there is violent oppression with great heat and thirst, palpitation of the heart gnat anxiety, and shaking cough. It will be found particu- larly valuable for plethoric females of sedentary habits, who suffer considerably from congestion before and during the catamenia. In such cases it may be advantageously fid- lowed by Mercurius, to prevent a relapse. (In others by Belladonna.) determination of blood to the chest. 223 Administration. fi$5, repeated in twenty-four hours, if necessary, and the same symptoms continue. When the con- gestion runs high, it must be administered as in Inflammatory Fever, which see. Nux vomica. When the affection has been developed by sedentary habits or by habitual indulgence in the stimulants already alluded to, or from hemorrhoidal metastasis or sup- pression, in such cases this remedy itself frequently effects a cure. Administration. %, in the same number of dessert-spoon- fuls of water, one each evening, at bedtime; adding thereto four or five drops of spirits of wine, to prevent its decomposition, and keeping the mixture protected from the air. Ipecacuanha will frequently complete the cure, when Nux Vomica has not removed the whole of the symptoms. Administration. -§-, in a little water, repeated every twenty-four hours until improvement results. Belladonna. Oppression and throbbing at the chest, with shortness of breath and strong palpitation of the heart, extend- ing into the head ; short cough, chiefly at night; internal heat, and considerable thirst. Administration. \°, in a teaspoonful of water, daily until perceptible melioration arises, or an alteration of symptoms takes place which may call for another remedy. Aurum. Extreme oppression of the chest, as if suffocation impended, sometimes with loss of consciousness and livid hue of countenance; palpitation of the heart; and excessive anguish. Dose. Half a grain of the third trituration, or a few globules of the sixth in half an ounce of water, a teaspoonful every four, six or twelve hours, according to circumstances. Mercurius, as already remarked, is valuable after Aconitum on certain occasions, (see that remedy;) and also when there is burning heat and oppression at the chest, and frequent desire to take a deep inspiration; or, cough with expectoration streak- ed with blood, and palpitation of the heart. Administration. -gfl, in a teaspoonful of water, repeated in twelve hours, after which we may lengthen the interval, 224 respiratory systfm. and only repeat again should a cessation of improvement take place; in many instances it may be exhibited in the same man- ner as Nux vomica. Pulsatilla. Ebullition of blood in the chest with external heat; constriction in the chest with impeded respiration ; pal- pitation of the heart; anxiety and aggravation of the symptoms towards evening, also when pectoral congestion has arisen in phlegmatic subjects from hemorrhoidal suppression, or in females from stoppage of the menstrual flux. Administration, f |, in a teaspoonful of water, repeated in twenty-four hours, if necessary, but in the majority of cases it may be administered in the same manner as given under Nux vomica, with a difference in time, taking a dose half an hour before breakfast. Spongia tosta. When the symptoms are provoked by tbe slightest exertion or even movement, and are attended with anguish, sensation of threatened suffocation, nausea, prostration and fainting. Administration. Same as Aurum. Bryonia. Burning heat in the chest with a sensation of tightness, dyspnoea, and anxiety; palpitation of the heart; occasional prickings in the chest during inspiration. Administration same as Pulsatilla. Cinchona. When we can trace the affection to debili- tating losses, with palpitation of the heart and oppressed breathing. Administration. The same as Pulsatilla. Sulphur. Ebullition of blood, weight, fulness, and pres- sure in the chest, aggravated by coughing, palpitation of the heart, dyspnoea, chiefly on lying down at night; it is also most serviceable in sujrpressed hemorrhoids, after Nux vomica or Pulsatilla, and after the latter remedy in checked catamenia. Administration. *-, repeated every five days until a marked alteration for tbe better take place, or the symptoms assume another form, calling for the employment of some other more appropriate remedy. Phosphorus. In some obstinate cases this remedy is fre- BRONCHITIS. 225 quently successful in affording speedy relief, particularly when in addition to the more usual symptoms, shooting or pricking pains are frequently experienced on laughing, speaking, or walk- ing quickly ; palpitation of the heart, anxiety, sensation of heat extending from the chest into the throat. Administration. A few globules of the third, night and morning, discontinuing as soon as decided relief is obtained. Some one or more of the preceding remedies, if judiciously se- lected, and timely administered, will 'generally check the dis- ease, and prevent it assuming a more dangerous form; for example, running into hemoptysis, phthisis, pneumonia, carditis, &c. The following, among others, have also been found useful in peculiar cases : Rhus toxicodendron, Sepia, Natrum muriati- cum, Phosphorus, Carbo vegetabilis, Acidum nitricum, Ammo- niacum carbonicum, and Ferrum metallicum. INFLAMMATION OF THE MUCOUS MEMBRANE OF THE BRONCHIAL TUBES. COLD ON THE CHEST. Bronchitis. Pulmonary catarrh. This disease consists of a greater or less degree of inflam- mation of the mucous membrane of the bronchi, and is divided intQ acute and chronic. Of the former it is intended more parti- cularly to treat. The disorder is of frequent occurrence, both as an idiopathic affection, and as a concomitant of measles, scarla- tina, smallpox, hooping-cough, &c. Diagnosis of Acute Bronchitis. Chillness, "succeeded by fever; hoarseness; difficulty of respiration; severe, frequent, and distressing cough, at first dry or with scanty expectoration of frothy or viscid mucus, which subsequently becomes copious and sometimes streaked with blood; constriction at the chest with a feeling of oppression; general weakness, foul tongue, and loss of appetite; rapid pulse, increase of the difficulty of res- piration, which sometimes approaches to a feeling of suffoca- tion ; paleness of the lips, cadaverous and anxious countenance, loud wheezing, and on applying the ear to the chest, a louder sound than the natural respiration, either rattling, whistling, or 10* 226 respiratory systfm droning, or harsh and broken, according to the advance of the disease.* In the cases which terminate favourably, the first symptom of improvement which sets in is a greater freedom of breathing, with remission of the fever, ami an alteration in the cxpoXra- tion, which becomes thicker, whiter, ami diminished in (piantity. But when the disease takes an unfavourable turn, the difficulty of breathing increases, a state of excessive debility and collapse BUpervenes; the face becomes livid, the body covered with a cold and clammy sweat; the mucus accumulates rapidly in the bron- chial'tubes, and the cough, which has become feeble through the exhausted and sinking energies of the patient, is insufficient for its ejection; aeration of the blood in tbe cells of the lungs is prevented; cerebral symptoms declare themselves from im- peded circulation, or the effect of unarterialized blood circula- ting in the brain, and the patient is carried off in a state of asphyxia. In many, and the most dangerous cases of acute bronchitis, although a degree of oppression at the ehest be present, no par. ticular pain, heat of skin, nor fever, may exist : this is the most insidious form of the disease, in which it is but too frequently neglected until beyond the power of the physician's art; this occurs most frequently in children who may apparently be only troubled with a slight wheezing, of which scarcely any notice is taken or any medical aid called in, until suddenly suffocation threatens, or some organic lesion is produced, so that an affec- tion which probably might have been easily subdued at the on- set, is now beyond control. The frequency of the disease in infancy and early life deserves a particular notice. It generally commences, as in adults, with the symptoms of a common catarrh; the breathing becomes quick and oppressed, and from the increased action of the diaphragm, the abdomen becomes prominent ; bt th the shuulders and nostrils are in continual motion, but the * Sibilant and sonorous rhouchi, in the early stage, and mucous or bub- bling rhonchus when the secretion becomes increased, indicate both the nature and extent of the disease. BRONCHITIS. 227 wheezing is often more marked than the difficulty of respira- tion, and on applying the ear to the chest, a mucous rattle is heard over almost every part; expectoration sometimes tempo- rarily relieves, and occasionally the mucus is expelled from the air-passages by vomiting; the countenance is pale and anxious, and somewhat livid :—these symptoms are interrupted and relieved by occasional remissions, during which the child gene- rally appears drowsy; but they return with additional severity, and, if not checked, an accession of extreme dyspnoea ensues, and death takes place from suffocation. When sore throat is also present, coughing produces considerable pain, and the child for that reason frequently endeavours to suppress it. There is also impaired appetite with thirst, although when the disease has advanced, it is found difficult to take a long draught, from its impeding respiration : this is very observable with children at the breast, who, after eagerly seizing the nip- ple, will bite it, and discontinue sucking, cry, and throw hack the head, and after vomiting up the phlegm, continue for some time in that position. In some cases, from the character of the voice and cough, bronchitis has been mistaken for croup. The tubes of one lobe, or of one lung only, may be affected, but sometimes those of both lungs participate. The exacerbation of suffering at night is a very remarkable symptom of this complaint. The causes are the same as those of common catarrh. Therapeutics. The remedies about to be pointed out as most appropriate in ordinary cases of this affection are : Aconi- tum, Spongia, Belladonna, Nux vomica, Bryonia alba, Lache- sis, Phosphorus, Pulsatilla, Mercurius, Cannabis, &c. Aconitum is the remedy upon which we must place our chief reliance in the inflammatory stage of the disease, and throughout its course, as long as a febrile character exists. Its more marked indications are hot, dry skin, with strong, hard, and accelerated pulse; hoarseness, with roughness of the voice; short, dry, and frequent cough, excited by tickling in the throat and chest; obstructed respiration, sibilant or sono- 228 RESPIRATORY SYSTEM. rous rhonchus, anxiety, restlessness, headache, and thirst, with occasionally scanty expectoration of viscid mucus. Administration. A few globules of the third potency, added to an ounce of water; a dessert-spoonful every three hours, until relief be obtained, after which wo may either lengthen the intervals, or select some other remedy more ap- propriate to the symptoms present. It will also be found occasionally necessary to return to this remedy, as above re- marked, ^during the course of the disease, particularly during the nocturnal febrile exacerbations. Spongia is often of the greatest service after the previous administration of Aconite, when there still remains a considera- ble degree of inflammation in the bronchial tubes, especially the larger, with sibilant or sonorous rhonchus; and also at a more advanced stage of the disease, when the mucous rhonchus is distinctly audible; with hollow, dry cough day and night, but worse towards evening; or cough with scanty, viscid, ropy ex- c pectoration; heat in the chest, burning, tickling irritation in the larynx, quick, anxious, laborious respiration; hoarseness. (Hepar s. is sometimes useful after Spongia when the mucous rhonchus is predominant, the skin hot and dry, and the efforts to .expectorate ineffectual.) Belladonna. This remedy is useful when there is severe cephalalgia, materially aggravated by coughing : oppression of the chest, and constriction as if bound, with rattling of mucus in the bronchi; short, anxious, and rapid respiration; dry, fatiguing cough, especially at nigh', and thirst. Soreness of the throat, (see Soke Throat.) Sulphur after Belladonna. Administration. The same as Aconite, only at intervals of four, six, or twelve, instead of three hours.* Nux vomica. Dyspnoea, with excessive tightness of the chest, particularly at night; hoarseness; dry cough, worse towards morning, attended with a sensation as from a blow, a bruise, in the epigastric or hypochondriac regions ; cough with difficult and scanty expectoration of viscid mucus; dryness of the mouth and lips, thirst, constipation, peevishness. Administration. The same as Belladonna. • Vide note, p. 31. BRONCHITIS. 229 Lachesis. Oppression at the chest, with short and hurried respiration, anxiety, and dejection ; mucous rale ; dry, fatiguing cough, sometimes followed by the expectoration of a little tenacious or frothy mucus, after much effort, occasionally streaked with blood ; hoarseness. Administration. Same as Belladonna. Bryonia. Difficult and anxious respiration, with constant inclination to make a deep inspiration ; hoarseness ; headache ; cough dry, attended with a sensation of burning, or cough with expectoration of viscid sputa; in some instances tinged with blood; dryness of the mouth and lips, excessive thirst. When, moreover, the respiration is impeded by shootings in the chest, and this infection threatens to become com- plicated with pleurisy, this remedy is still more particularly called for. Administration. The same as Aconite. Phosphorus. This important remedy is frequently of great utility in this affection when the more inflammatory symptoms have been subdued by Aconite, but the respiration continues much oppressed, accompanied with great anxiety, and heat in -the chest; dry cough, excited by tickling in the throat or chest, aggravated by talking or laughing, and follow- ed by expectoration of stringy mucus of a saltish taste: Fur- ther, when the disease has been neglected, or when, from the phenomena which present themselves at the commencement, we have reason to dread complication, or an extension of the inflammation to the substance of tbe lungs, which we gene- rally recognise by crepitation and rusty sputa,—there will be additional reason for administering Phosphorus. (See Pneumonia.) Pulsatilla. Respiration short, accelerated, and impeded, attended with rattling of mucus, heat in the chest, and anx- iety; hoarseness; shaking cough, worse towards evening, at night, or in the morning, accompanied with considerable ex- pectoration of tenacious, or thick, yellowish mucus, sometimes mixed with blood; coryza with copious discharge of thick, dis- coloured mucus. Administration. Same as Belladonna. 230 RESPIRATORY SYSTEM. Sepia may be selected in preference to Pulsatilla, when the expectoration is very copious, though somewhat difficult, and of a salt taste; exacerbation of cough in the morning and towards evening,—followed by Stann., if still profuse, but more easy, greenish, and less saline, or of a sweetish taste. Lycopodium. When the cough is materially worse at night, and attended with thirst, quickness of pulse, but moist skin or tendency to sweat ; expectoration yellowish gray, and of a saltish taste; oppression at the chest. .Mehcuuius. This remedy may occasionally be found use- ful when tho symptoms of bronchitis are found accompanied by excessive perspiration; when the cough is fatiguing, worse in the evening and at night, and excited by a tickling irritation, or sensation of dryness in the chest, with quick, short, oppressed breathing, and louder respiration than ordi- nary; hoarseness; coryzu with watery, acrid discharge; swell- ing of nose. Dulcamara is occasionally serviceable after Mercurius, when there is a continuance of night sweats of an offensive odour. Administration. J in an ounce of wate/; a dessert- spoonful every four or six hours, until relief ensues. Chamomilla may also be mentioned as a useful remedy in cases of children, after the previous exhibition of Aconite, when a slight degree of whistling or sonorous rhonchus still remains; dry cough worse at night, occurring even during sleep. For further indications, see this remedy under the head of Cough. Ipecacuanha. Also very valuable in the case of children, but generally at a more advanced stage of the disorder, with mucous rhonchus in the chest, and when on coughing they are almost suffocated by the excessive secretion of mucus, and be- come livid in the face; shortness of breath, and perspiration on the forehead after each fit of coughing.—Administration. One globule every two hours until improvement results. There are some other remedies which have been found of great value in the treatment of this affection, namely, Tartarus emeticus, Arsenicum, Sulphur, 6co. bronchitis. 231 Tartarus emeticus is chiefly found useful in those ex- treme cases where the .smaller tubes are clogged with mucus, and suffocation threatens; when the cough suddenly ceases, either from weakness or other causes. Administration. A grain of the trituration at the second or third potency in four dessert-spoonfuls of water, one every quarter, every half, or every hour, according to the severity of the symptoms or the effects produced. Arsenicum is occasionally of the utmost service in those un- favourable cases in which the pulse becomes very quick, feeble and intermitting, and the patient is reduced to a state of ex- treme debility and collapse. Administration, °^, in four teaspoonfuls of water, one to be given from time to time, as required.* Sulphur is used in winding up a cure, and preventing the disease running on to the chronic form, or when the expecto- ration has increased in quantity and become whitish and less viscid. (Administration : see Arsenicum.) For the benefit of the medical reader, I may add, that Hepar sulphuris, Ammonium carbonicum, Cannabis, Bromium, etc., may also be found useful in some particular cases. Opium, Belladonna, Tart, em., and Lachesis, may be found service- able against the symptoms of stupor which are so liable to set in in severe attacks of this disorder. Diet. In the severe forms of bronchitis the diet to be ob- served should be the same as that mentioned under fever; but when the febrile and inflammatory symptoms have been com- pletely removed, the patient should gradually return to a more nutritious diet, even though a considerable degree of cough and expectoration remain. In the slighter forms of the complaint, spare diet, confine- ment to the house, in short, the simple measures laid down for the treatment of common colds in another part of this work, will frequently check or at all events materially shorten the attack. See also article Cough, in which further indications will be found for the selection of the remedies required iu both varieties of bronchitis. • Vide note, p. 21. 232 RKSPIRATORY SYSTEM. Chronic Bronchitis: Bronchitis Chronica. This com- plaint may be the result of the acute affection, or it may arise as a gradual and insidious inflammation of tho muous mem- brane of the bronchial tubes, or proceed from the inhalation of dust or other minute particles carried into the lungs; it may also be coeval with diseases of the heart, or declare itself after eruptive fevers. It differs from acute bronchitis chiefly in the greater mildness and longer duration of its symptoms, the continuance of which varies from several weeks or months to many years. It affects elderly persons more frequently than the young, but is of course liable to occur at all ages as the result of an acute attack, (although such a circumstance is comparatively of rare occurrence under proper homoeopath- ic treatment,) the consecutive of measles, etc. A compara- tive exemption from cough, is frequently experienced during summer; but in winter, or in inclement springs, the patient is tormented with harassing cough, and copious viscid expec- toration, especially in the morning, which in the severe forms of the disorder is peculiarly distressing. The expectorated matter in the chronic affection is of a different nature from that in the acute, being of a thicker consistence, and of a greenish or yellowish white colour; it is not unfrequently muco-purulent, and sometimes decidedly purulent, and occa- sionally streaked with blood, particularly in obstinate, invet- erate cases. There is generally more or less dyspnoea, with acceleration of pulse after slight corporeal exertion; but in other respects the health may be good and continue so. In tbe more trying forms of the disorder, an aggravated state of all the symptoms enumerated is met with; moreover, where the sputa is of a purulent nature, hectic fever, extreme emaci- ation, nocturnal sweats, and occasional attacks of diarrhoea are frequent adjuncts; these latter are sometimes liable to cause the disease to be mistaken for tubercular consumption ; but in the majority of cases, auscultation, percussion, together with a careful attention to the symptoms and the history of the case enable us to form an accurate diagnosis between them. In chronic bronchitis, the resonance of the chest is on percussion, little if at all diminished. On applying the ear BRONCHITIS. 233 or stethoscope to the chest, the respiratory murmur is found to vary much in intensity, but is never permanently absent in any part of the chest, and is frequently even puerile. The mu- cous rhonchus in most of its varieties is heard in various parts of the chest at different times, and occasionally the whistling and sonorous rattles are discernible. When the dilatation of the bronchial tubes is considerable, as is not unfrequently the case in this affection, a loud bronchophony is heard which is with difficulty if at all to be distinguished from pectorilo- quy, and a rale closely resembling a cavernous rattle is appa- rent in the vicinity of the dilated tube. The sound on per- cussion will, however, generally enable us to form the required distinction, the dulness of tone being not so great over a dila- ted tube, as it is in the vicinity of a vomica; the situation of the cavity of tbe two cases is, moreover, usually different: di- lated bronchi being, as is well known, most frequently detected in the scapular, mammary, and lateral regions, and vomicae in the subclavian and axillary regions. However, as before said, we must combine the history of the attack, the constitu- tion of the patient, and the progress of emaciation, &c, with the symptoms to be heard by the ear after repeated examina- tions, in all doubtful cases, ere we come to a definite conclu- sion as to the exact nature of the case, where that is of material consequence; but as regards the prognosis, chronic bronchitis, with purulent expectoration, dilated tubes and hectic fever, has been truly considered to be nearly as formidable and serious a malady as phthisis itself, and hence ultimate recovery almost as doubtful. As this is a disease which requires a long and judicious treat- ment for its removal, I shall content myself with a brief enume- ration of the remedies hitherto found most useful in cases of this nature. These are Sulphur, Calcarea carbonica, Carbo vegetabilis, Pulsatilla, Hepar sulphuris, Phosphorus, Stannum, Sepia, Ly- copodium, Natrum carbonicum, Natrum muriaticum, Baryta c, Lachesis, Causticum, Arsenicum, Silicea, Staphysagria, Kali carbonicum, Acidum nitricum, and Conium maculatum. 284 RESPIRATORY SYSTEM. Sec, however, the article Cough, where indications for the selection of most of the above remedies will be met with. INFLAMMATION OF THE Ll'NvJS. Pneumonia, Peripneumonia, Pneumonitis. This disorder consists in an inflammation of the parenchyma of the lungs. Diagnosis. Shiverings and chills, followed by heat or fever; ' dyspmea ; respiration short and hurried; cough, short, dry, continuous, and distressing at the commencement, afterwards attended with scanty expectoration of viscid, lumpy, and ex- tremely tenacious mucus, generally intermixed with brick-dust sputa, (giving it a rusty colour,)* but occasionally of a bright red; cough at every deep inspiration, or on every attempt to speak ; interrupted speech, or a pause after every articulation ; abdominal respiration, sometimes a dull pain in tho chest, but more frequently rather a tightness than pain ; pulse variable, generally full and strong and quick ; but when the inflamma- tion has run high,—hard, wiry, and greatly accelerated ; tongue parched and dark coloured. The patient generally, in severe cases, lies upon his back. In the first stage of many cases, when not marked by com- plication with bronchitis, on application of the stethoscope or the ear to the chest, the crepitous rale may be heard ; but the sound on percussion only slightly impaired. As the inflam- mation gains ground, and the substance of the lung becomes altered in structure,! bronchial or tubular respiration is per- ceptible, with louder respiratory murmur than natural, in the sound parts of the lung, particularly in severe attacks; al- so bronchophony may be present; and the tone elicited by * This rusty or sanguinolent hue being intimately combined, not in streaks : It apppears usually about the second or third day, and is a char- acteristic indication of the presence of the disease in question ; at the same time, it must be borne in mind, that its absence is by no means a certain criterion of the non-existence of inflammation of the lungs. t Second stage, or that of hepatization. INFLAMMATION OP THE LUNGS. 235 percussion more or less dull according to the seat of the struc- tural derangement, but rarely so complete or extensive as in pleuritis with copious liquid effusion. In the latter stages of the complaint, the face frequently be- comes patched with red, and sometimes livid; and the prostra- tion of strength is excessive.* I have remarked that the pulse was variable, inasmuch as it has been frequently the fashion to lay too much stress upon that symptom; but the disease may run on to a fatal termina- tion without it being beyond the natural standard. Neither is a hot dry skin a sure criterion, inasmuch as in the congestive form of this disease from the determination of the blood to the lungs, the surface of the body is almost invariably cold. Such are the general symptoms of pure Pneumonia, but in severe cases it is often found combined with pleurisy, when the pains of the chest are intense, and mostly of an acute shooting character. Bronchitis is another and still more frequent com- plication. Therapeutics. Aconite, Bryonia alba, Phosphorus, Tar- tarus emeticus. Rhus toxicodendron, Belladonna. Aconite ^s-. In the stage of simple inflammatory conges- tion with severe inflammatory fever, whether or not accompa- nied or followed by severe shooting pains in the chest, this remedy is unquestionably of great service. Administration. The same as in Inflammatory Fever. Bryonia is generally the best remedy to follow Aconite, when the more severe febrile symptoms have been lowered by that medicine ; or from the commencement, when the following indications present themselves : cough, attended with expecto- ration of viscid or tenacious mucus, of a brick-dust colour, oppression at the thorax, and acute shooting pain in the chest and sides, or rheumatic pains in the pleura, and pectoral muscles, or in the extremities, with increase of pain on move- * In the third or suppurative stage of the disorder, the tubular respira- tion and vocal resonance commonly disappear, and a gurgling mucous rale is occasionally substituted. The expectoration becomes muco- purulent, or converted into a brown serous fluid; and the vital energies generally sink rapidly. 236 RESPIRATORY SYSTEM. ment ; foul tongue and constipation. A complication with pleurisy, pleuro-pneumonia, indicated by increased dullness on percussion, and in some instances a double-sounding voice, central bronchial respiration, and bronchophony, is often an additional reason for the selection of this remedy. (See also Pleuritis.) Administration. One drop of the tincture at the third potency, in about an ounce of water, a dessert-spoonful to be administered every four, six or eight hours, or a few globules of the third in a dessert-spoonful of water, repeated at similar intervals, according to the severity of the case.* Phosphorus. This remedy has been lately almost exclu- sively employed by Dr. Fleischmann.f of Vienna, in almost every stage of pneumonia under what form soever it presents itself, and with the most marked success, even when exten- sive hepatization has taken place. Although the homceopathio treatment hitherto adopted with Aconitum, Bryonia, &c, has proved eminently successful, yet this remedy, which seems to have such a specific influence over this serious disease, deserves a more extensive trial.$ Administration. A drop of the tincture at the third potency, added to four dessert-spoonfuls of water, one in four hours, lengthening the intervals according to the effects pro- duced. Tartarus emeticus is chiefly valuable in promoting reso- lution after hepatization has taken place, which is indicated by the greater or less degree of dulness on percussion, the bronchial or tubular respiration, and the peculiar pectoral sounds given by the voice, and may be had recourse to when * Vide note, p. 21. t Dr. Fleischmann's preparation is made with 10 drops to the 100, ad- ministered at the third to the sixth potency, from four to eight drops, in from two to four ounces of distilled water, a spoonful three to six times a day. Hygsea, vol. viii. X It sometimes happens that, notwithstanding the early f-mployment of this medicine, the physical signs of this disease appear to advance un- interruptedly, and it is only from unequivocal symptoms of improvement in other respects, that we feel encouraged to perwevere with the remedy, and thereby obtain the most satisfactory and triumphant results. INFLAMMATION op the lungs. 237 the preceding remedy has not completely effected this desirable object. Administration. One grain of the second potency in an ounce of water, a dessert-spoonful three times a day. Tincture sulphuris may deserve a preference to the last- mentioned remedy in similar cases, in strumous habits, also where hepatization has advanced to some extent, and where Phosphorus may have only relieved ; also where there is com- plication with pleurisy, and obstinate constipation. In obsti- nate or chrome cases, Lachesis and Lycopodium have been found very useful after, or in alternation with Sulphur. Administration. A few globules of the third or sixth potency in a teaspoonful of water repeated in from six to twelve hours, according to circumstances,—if an improvement ensue, allowing the medicine to continue its action. The preceding are the principal remedies used in the ma jority of cases of this disease; but the following also have been found excellent auxiliaries in some instances, and merit attention. Belladonna, where the fever has returned, after having been apparently subdued by Aconite, and the difficulty of breathing and pain continue, particularly when the pain seems more at the sternum; the sputa tinged with blood and difficult of expecto- ration, the cheeks flushed, lips and tongue dry and scorched, leaving heat of the skin and incessant thirst. Acidum nitricum has been of service in some cases, where, after Aconite, a cessation of pain has taken place with increase of fever. Squill a has been recommended as useful in forwarding the crisis : further, in pneumonia accompanied with gastric symp- toms, and where the expectoration is copious, or in cases which have previously been treated by venesection, and China has not proved sufficient to rouse the sinking energies. Mercurius, when the fever has been lowered by the em- ployment of Aconite, but pain and difficulty of breathing re- main, copious nocturnal sweats exhaust the patient's strength, and the pulse is small and quick ; also where there is promi- nent bronchitic complication:—In the latter instance Capsicum, 238 respiratory system. Nux v., Pulsatilla and Bryonia, have also proved efficacious : Capsicum particularly in the ease of phlegmatic subjects ; A»-t v., alternately with Phosphorus, especially in the case of drunk- ards; and Pulsati'la in chlorotic females. The indications for Bryonia have already been given. Cannabis has also been found useful in this frequent complication, und in one or two eases where there was disease of the heart and largo ves- sels, with greenish vomiting and delirium. Arnica ffifa. Against effusion into tho air-passages, with local congestions and hemoptysis. Rhus ton. in the congestive stage of pneumonia, with rest- lessness, palpitation of the heart and redness of the face. But with diarrhoea and clammy sweats, Arsenic When inflammatory symptoms have been subdued, but tho expectoration presents a niuco-purulent appearance, and there is great prostration with nocturnal sweats, Lycopodium ~ has been found very efficacious. Lachesis |$ has proved beneficial sometimes in alternation with Arsen. and China, in those almost hopeless cases which threaten to turn to gangrene of the lungs, (with fetid breath and sputa.) Phosph., Kali, and Lycop., §§, useful in pneumonia occur- ring in phthisical subjects. It may be useful to add a few words respecting the pectoral signs in this affection when pro- gressing to resolution: if no hepatization have taken place, the crepitous rale, at first audible, becomes gradually less per- ceptible, and the natural respiration is heard, till at last the former wholly disappears; if the lung have already partly solidified, but the disease is approaching a cure, the crepitous rale is first heard, then gradually yields to the natural respira- tion ; in fact, the disease, so to speak, runs its course back again. Diet. It is scarcely necessary to remark, that during the inflammatory period, an almost total abstinence must be ob- served; even during convalescence there is caution required, and care must be taken not to allow the patient to over-indulge his returning appetite, as any error in this respect may entail troublesome consequences. The drinks may consist of water, toast-water, and sometimes whey, rice or bailey-water, sweet- ened with a little sugar if desired. 239 PNEUMONIA NOTHA, OCCULTA. This affection, which is usually most insiduous in each ap- proach, is more frequently met with in old than in young or mid- dle-aged subjects, and is liable to terminate in paralysis of the lungs. Sometimes the attack is preceded by a feeling of general prostration; or comes on like an attack of common cold, with cough and alternate heats and chills. The cough is generally loose from the commencement; the sputa white, yellow, slimy, and generally blood-streaked. There is great weight or oppres- sion at the chest, with quick laborious breathing; pain only when taking a deep inspiration, and generally in a small circumscribed spot. All these symptoms are usually aggravated by any thing which calls for an increased play of the lungs, such as talking, or laughing loudly, ascending stairs, etc.; finally, particularly in the more severe attacks, lying upon either side becomes oppressive, so that the patient is generally found on his back. Pulse soft but quick, the cheeks slightly flushed, the skin moist and damp, and sometimes there is nocturnal sweating, which affords no relief; towards morning the febrile action subsides a little, and the patient feels generally somewhat easier. The voice is low and weak, sometimes dying away to a whisper. In the treatment of this affection, a dose or two of Aconite is occasionally required, when the fever runs rather high, but Mercurius is more frequently called for, even at the very commencement, and particularly when there is nocturnal sweating and moist or clammy skin during the day; after Mercurius has been administered with more or less benefit, Belladonna will generally be found useful, and especially when a short dry cough remains, attended with spasmodic constric- tion in the chest which impedes respiration, and causes an oppressive sensation of suffocation. If Belladonna does not complete the cure, and the cough is accompanied with sibilant or wheezing respiration, a dose of Aconite may be given, fob lowed by Chamomilla and Nux v., the latter especially when there is dry cough, or cough with difficult expectoration of a little slimy mucus, and excessive tension and oppression in 240 RESPIRATORY SYSTEM the chest. In those cases in which Mercurius affords little relief, and the breathing continues quick and laborious, and the countenance is expressive of great anxiety. Ipecacuanha in repeated doses is frequently followed by satisfactory results ; but should the extremities become cold, and the sensation of constrict i. hi in the chest, with extreme anxiety, increase, Veratrum may be administered : on the other hand, if the paroxysms of threatening suffocation become more and more distressing and the patient appears sinking from exhaustion— Arsenicum <*££■ must claim a preference, and will often succeed in restoring the expiring energies of the patient when the case has assumed a perfectly hopeless appearance. It may be added, that Arnica -§4 has been found useful in some instances in the early stage of the disorder, when a bruised or beaten pain was experienced in the chest, the cough not very troublesome, but attended with blood-streaked slimy sputa; followed by Pulsat. °$° when the expectoration became more considerable, with melioration of the pectoral symptoms. Some of the remedies mentioned under Pneumonia Vera, such as Bryonia, Tartarus, Sulphur, Lycopodium, &c. may also be found useful in this complaint under particular circumstances. TYPHOID OR CONGESTIVE PNEUMONIA. In this variety of pneumonia the local symptoms are usually very obscure, and the accompanying fever is of the typhoid kind; the pulse quick and very weak, the skin harsh, dry, or clammy, tongue brown and parched, and the urine of greatly diminished quantity and high coloured. In some cases the following physical signs can be detected : dulness on percussion, and absence of respiratory murmur in the lower and back parts of the chest, and occasionally bron- chophony and bronchial respiration when the central or middle portion of the lung is the part affected.* The remedies which have been used with the most advantage * Phosphorus deserves attention in such cases, particularly when there is bronchial respiration. pneumonia notha. 241 in typhoid pneumonia, are Opium, Arnica, Veratrum, Ar- senicum. Opium °ja. This remedy is generally the most appropriate as soon as the disease becomes clearly defined, and may be repeated once or twice, after which, if no change be effected, Arnica ^2 should be administered. Should no improvement result from the foregoing remedies, Yeratrum --- may be administered, particularly when there is clammy sweat on the forehead, with coldness of the extremities and creat weakness, and the respiration unequal, laborious and rattling. Arsenicum --- may follow Veratrum if the prostration and rattling respiration increase, the pulse become irregular, and the tongue dark brown or black: the alternate administration of these two remedies every half hour, to every hour or two hours, according to the urgency of the symptoms, is frequently attended with the best results; in other cases, Veratrum, Ipe- cacuanha and Arsenicum answer better:—But when only temporary improvement results, a few globules of Sulphur may be administered; and then again Veratrum and Arseni- cum, or Veratrum, Ipecacuanha, and Arsenicum alternately, or any one of these remedies alone from which any marked degree of improvement may previously have been observed to arise. Bryonia, Rhus, and Senega will be found useful in some cases. Some of the leading indications for the employ- ment of the two former will be found under the head of Nervous Fever, (which see.) Senega is chiefly serviceable when the lungs are loaded with mucus. Belladonna will be found serviceable when temporary blindness is complained of and Natrum m. when the prostration of strength increases, notwithstanding the administration of Arsenicum, which is generally so valuable in such cases. When galling or exco- riation (decubitus) has ensued from lying in bed, Cinchona and Arsenicum must be administered alternately; in milder eases Arnica in the form of lotion (one part in ten) will fre- auenUy remove this evil. When symptoms of INCIPIENT PHTHISIS PULMONALIS supervene on pneumonia, Sul- phur is one of the most important remedies; but will in most 11 242 respiratory system. cases require to be followed by Lycop., Lachesis, Plio.sjth., Amnion, c. ; in others by Kuli c, Acid, nitr., Natrum m-, Calcarea, Hepar sulph., Stannum, Pulsat., Carbo v., Silica, Sipia ; and Ferrum and Cinchona as intermediate remedies. A proper knowledge of the Materia Medica is indispensable to facilitate the selection of these remedies. INFLAMMATION OF THE PLEURA. Pleurisy, Pleuritis. Diagnosis. Severe pain in the side, like a stitch, or as from a stab, remaining in one circumscribed spot, interfering with breathing, and increased by inspiration; difficult and anxious respiration, but not so oppressed as in pneumonia and bronchitis; quick hard pulse; hot skin, particularly over the chest, or the seat of the disease; dry tongue ; scanty and high-coloured urine ; and occasionally cerebral symptoms. Position in bed, usually dorsal; and if the effusion be free and partial, a change to the sound side creates great un- easiness. Pleurisy seems to consist in a peculiar inflammation in the pleura, with a disposition to effusion or to tho secretion of plastic lymph; and the disease may run its whole course without any of the symptoms above given declaring them- selves. At the commencement of the disease there is diminution of motion and respiratory murmur from pain (subsequently these abnormal signs arise from effusion) and a rubbing sound is not unfrequently heard, generally about the centre of the chest accompanying the pectoral movements. Soon after the outset of the inflammation, in the great number of cases, exudation ensues, and if not encysted, accumulates at the lowest part of the chest. When, in such instances, the quantity exuded is considerable, and the lung is not restrained by adhesions, that organ will be floated upwards to some extent, and a dull stroke- sound elicited from the parts beneath it, whilst the upper will be found unusually resonant. inflammation of the pleura. 243 As the fluid accumulates and ascends in the chest, the antecedent clearness of stroke-sound becomes impaired, as is more especially obvious on gentle percussion,—the breath- sound diminished, and respiration more impeded. When these latter abnormal symptoms are met with as high as the middle regions of the thorax, the vocal resonance there, and particu- larly anteriorly, becomes preternaturally distinct, and is changed to a small, sharp and tremulous note resembling the bleating of a goat, and hence termed cegophony; posteriorly the resonance partakes somewhat more of the character of bronchophony, from the greater caliber of the tubes at the root of the lung. (Egophony and all sound of the voice ceases at the affected side of the chest, as the liquid effusion increases, with exception of those portions where the lung may have been adherent, or at the space within an inch or two of the spine ; percussion now gives an extremely dull sound from the lung being deprived of and rendered impermeable to air by compression, and the respiratory murmur is abolished or only heard in the interscapular and subclavicular region, particularly the former. In those cases in which the effusion is very considerable, enlargement of the affected side takes place. This enlarge- ment is generally discernible only during expiration at first, but as the exudation increases, the difference can readily be detected, during the entire performance of respiration. In attenuated subjects, the intercostal spaces will also be observed to have become prominent instead of presenting their natural depression. But should absorption be effected after such an enlargement, the state of matters is reversed, and the side which was previously enlarged becomes abnormally contracted __the result of atmospheric pressure, and unantagonized mus- cular action. Displacement of organs adjoining the effusion, such as the heart, liver and mediastinum, is also an occasional result of ex- tensive effusion On examining the sound side of the chest, in addition to the negative proofs of the absence of disease, an excess of the usual normal signs will also be perceived, indicated by an ac- 244 respiratory system. eelerated and deeper action, together with a greatly increased degree of respiratory murmur, resembling that of children, and hence denominated put rile. The signs of improvement and approaching recovery are marked by a dimiiiuti<>n of pain, fever, dyspmea and enlargement of the side; a return of the respiratory murmur, together with an increasing clearness of sound on percussion. When tho result is fatal, death occa- sionally supervenes very rapidly from the compression of both lungs; but in most eases this event is more gradual and arises from atrophy of the lungs, as also affections of the heart, and consequent dropsy, caused by the efforts required to propel the blood through the compressed lung. In all cases of pleurisy the whole of the above detailed symptoms are not to be deemed constant, or even certain diag- nostic signs : The absence of marked dulness on percussion, is not a con- clusive test that effusion has not taken place. The greater or less degree of clearness of tone appears to depend upon the condition of the lung under the effusion,'and the elasticity of the parietes that cover the latter. If the quantity of the effusion be very considerable, and the lung deprived of its air by compression, the sound on percussion is necessarily almost uniformly dull; but when the exudation is inconsiderable and the compression is not sufficient to deprive the lung of its air, the stroke-sound will be found to consist more of a tympanitic and frequently even a louder tone than the normal expanded lung. Subsequently, however, if the pressure be unrestrained the lung will be deprived of its air, and the part formerly so resonant will then yield a dull sound. The auscultatory pheno- mena are in like manner naturally liable to be materially modi- fied by circumstances. Much depends on the extent of the ex- udation, and upon the state of the lung on which it rests. If the lung still contain air, both voice and respiratory sound will be found indistinct or inaudible. If, from the extent of the effusion, or from the long continuance of the disorder, the portion of lung be entirely emptied of air, weak bronchophony and bronchial respiration will be discernible; but when the amount of effusion is very great, possibly filling the whole INFLAMMATION OF THE PLEURA. 245 cavity of the pleura, no sound whatever will be audible.* On the other hand, when the quantity effused is inconsiderable, the normal sounds frequently remain unchanged. Again, the phy- sical signs are liable to be further modified by«old and close ad- hesions, arising from previous disease, which render the lung adherent to the walls of the chest. And upper lobes are the most subject to these adhesions; and in such cases the free portion of lung is pressed upwards by the subjacent effusion, against the superior part of the thorax. And although the lung may yet admit air, still, from the degree of compression to which its vesicular structure is subjected, both breath and stroke- sound will be bronchial, and loud bronchophony pervade the upper part of the affected side. The lower part of the chest from whence the lung has been separated or raised upwards by the effusion will necessarily give decided dullness on per- cussion. Finally, it may be added that azgophony, although a frequent phenomenon in pleuritis, has no necessary connection with the presence of liquid in the pleural sac, and is consequently not to be held as an essential link in the chain of evidence in deter- mining the existence of the disease. The same may in a great measure be said of the intercepted vibration of the voice, usually felt by the hand when placed against the chest, for this, although a very useful and early corroborative indication of the accumulation of fluid in the cav- ity of the pleura, is yet liable to some exceptions both positive and negative. The rubbing sound already referred to is an important sign; it is not so audible at the commencement of the attack as it is at a later period ; when the effusion becomes more consistent, then it is rarely absent. From what has been stated, it will be seen that some of the preconceived characteristics cannot, individually considered, be taken as conclusive indications of the existence of pleu- risy. The collective physical signs, however, in the majority of cases, are far from equivocal, and are mainly to be depended on * Brit. Jour, of Homceopathy, vol. 1, p. 42. 246 RESPIRATORY SYSTEM. in forming the diagnosis Pain is, with few exceptions, an invariable concomitant on pleurisy, and its preseneo and intensity has been found of great use, in combination with other signs, in estimating the amount as well as tho quality of the effusion; for it has been found that the greater the quantity of plastic lymph it contains, proportionally great- er will be the pain.* Grent rapidity of effusion is also a frequent, though not an infallible source of extreme pain. The greater or miuor degree of dyspnoea depends on the (piantity and rapidity of the effusion, as well as the condition of the lungs; when both sides of the ehest are the seat of effusion, the oppression is usually excessive. Tho fever is in like manner modified by the nature and extent of the exudation being generally slight or altogether absent when the quan- tity is trivial, slow, and not unfrequently intermittent when more extensive but of a serous character, and highly in- flammatory when much plastic lymph is contained in the effu- aion.t Cough is not an accompaniment of simple pleurisy; when present, there is either bronchitic or pneumonic complication, or the case may be one of hemorrhagic-pleuritis. Therapeutics. The chief remedies are Aconitum napel- lus, Bryonia alba, Sulplmr, Belladonna, (atropa), Mercurius, Arsenicum, Arnica montana, Hepar sulphuris, Calcarea, Phos. phorus, Lycojiodium claratum, Carbo vegetabilis el animalis, Cinchona officinalis, Digitalis purpurea, Kali carbonicum, Ipecacuanha (cephaaelis), Helleborus nigcr, Sabadilla, Scilla tnaritima. Aconitum. Is an indispensable remedy in allaying inflam- matory fever when attendant on pleurisy ; and is in many cases, indeed, when timely administered, alone sufficient to cure the disease. It rarely fails to effect the desired results, in from six to eight hours; should it not do so in th%t space of time, another remedy must be selected. In most instances Bryonia will be the most appropriate, but we must not hesitate to select Sulphur in preference if called for, or indeed any other reme- dy that may seem more strikingly indicated. * Brit. Homotop. Journ., vol. 1, p. 44. t Ibid. INFLAMMATION OF THE PLEURA. 247 Administration. A few globules of the third potency every two hours; or one drop of the tincture at the third potency to an ounce of water, a dessert-spoonful every two to three hours.* Bryonia alba should in general cases follow Aconitum when the fever has been somewhat allayed by that remedy. It is more particularly indicated, either in simple or compli- cated pleurisy, when the following symptoms are encountered at an early stage of the disease; aching, burning, but more especially acute shooting pains in the chest, much increased during inspiration or on movement; dry cough, or dry sound- ing cough, followed by expectoration of dirty yellow-coloured mucus streaked or tinged with blood, and attended with aggra- vation of pain ; oppressed and anxious respiration; palpitation of the heart; dry, cracked, brown, or yellow-coated tongue; bitter taste, nausea, and occasionally vomiting of mucus, or of a bitter, bilious-looking fluid; aching or painful pressure at the scrobiculus and hypochondria; intense thirst, especially at night; constipation; head confused and heavy; giddiness on sitting up in bed; aching and shooting pains in the head, or pain as if the head would burst, particularly at the temples, with exacerbation on coughing, or moving ; fiery, or bluish red- ness, and puffiness of the face; restless, disturbed sleep, fre- quent startings ; nocturnal delirium, with alternations of coma- tose sleep; burning heat of the skin; occasionally, partial, clammy perspiration; pulse generally frequent, hard and small, but sometimes full, unequal, intermittent and weak; aching in the limbs. Lastly, when in connection with many of the above, the following symptoms are met with : dullness on percussion, particularly at the right mammary and scapular regions, with puerile respiration ; cough on lying on the right side, or impos- sibility of lying otherwise than on the back,—Bryonia will rarely fail to render undeniable service, and can indeed with difficulty be dispensed with. (Vide Sulphur.) Administration. The same as Aconite, but at intervals of from three to four hours. ■ * Vide note, p. 21. 248 RESPIRATORY SYAIEM. Sulphur may with advantage follow Bryonia when tho pain mentioned has been removed by that medicine, and often completes the cure. It is also of value when the fever con- tinues after the administration of Aconite, and may bo ad- ministered without the previous employment of Act mil um, when the fever is not violent, yet we have reason to suspect recent effusion of plastic lymph. Again, when the affection has already been of some daysi duration and is complicated with pneumonia, it is our chief stay in preventing solidification, or effecting resolution where that has already commenced, and may therefore generally be selected in preference to Bryonia, in Buch cases, unless the latter be otherwise strongly indicated, in which event a dose or two of that medicine previous to the em- ployment of Sulphur may be found serviceable. Administration. A globule or two of the third potency in a teaspoonful of water every two to three hours; or two drops of the tincture in three ounces of water, a tablespoonful every three hours; or in very severe cases every hour. These three are the most important remedies in the greater number of cases of pleuritis, and are frequently found suffi- fient to effect a speedy cure. There aro often occasions, how- ever, in which it will be found necessary to select one or more of the under-mentioned remedies.* Mercurius °£°. Has been found very useful in cases where the fever has been subdued, but pain and dyspnoea have not been relieved by Aconite, and the patient's strength is becoming exhausted by copious nocturnal sweats. Arnica Montana. Principally when pleuritis is caused by external injury ; but also in other cases when the more inflam- matory symptoms have been subdued by Aconite, etc.; and pain in the chest, with oppressed respiration, only remain; also to promote absorption when considerable effusion has taken place. Administration. One drop of the tincture of the third potency to an ounce of water, a dessert-spoonful every three * Belladonna has been recommended in cases where the fever return- ed, and pain aud dyspnoea continued notwithstanding the employment of Aconite.—Brit. Homceop. Jour., vol. i, p. 51. inflammation of the pleura. 249 or four hours ; or two or three globules of the third, in a tea- spoonful of water, at the same intervals, until the pain begins to yield and the breathing becomes freer, when the intervals between the doses must be lengthened or the medicine dis- continued, and only resumed should the improvement proceed tardily; but if pain return, Aconitum must again be had re- course to, after which Belladonna, in repeated doses, is often extremely useful, if not sufficient to effect the desired end. In other cases, Bryonia or Sulphur will be seen to be more appropriate, and must be selected accordingly, Arsenicum °|° is our main dependence in those serious cases where serous effusion to a very great ex'ent has taken place, and where the respiration is painfully impeded and asth- matic, with extreme prostration of strength. Hepar Sulphuris °|° has been particularly recommended when the effusion is plastic, aud the disease has been of some duration, (chronic plastic pleurisy,) or where, even at the commencement, there appears, from the pain, fever and dyspnoea, continuing with but slightly diminished severity after Aconite, every probability that the case will prove ex. tremely obstinate and tenacious. Complication with pericar- ditis or bronchitis is an additional indication for the employ. ment of Hepar under the above circumstances. Phosphorus. From what has been said of this remedy in Pneumonia, it will readily be suggested that it may be useful in cases of complication of pleuritis therewith, and such it has repeatedly proved to be. In complications with bronchi- tis, and in that form of pleuritjs which so frequently shows itself in phthisis pulmonalis, it has further been found of es- sential service. Vide Pneumonia and Bronchitis. Administration. A few globules of the third, or a drop of the sixth, in a little water every three or four hours, or oft- ener if necessary, until the respiration becomes easier. Carbo vegetabilis is a good remedy when pleuritis is com- plicated with chronic bronchitis; or at an advanced stage of the disorder, when the patient is much emaciated and hectic at night, presenting in short the usual symptoms of threaten- ing purulent degeneration. It is also peculiarly useful against 250 RESPIKATORY SYSTEM. asthmatic sufferings resulting from an attack of pleurisy in the chronic eases. Administration same as \rsenicum, except in the latter instance when it must be given at lunger intervals. Cinchona is chiefly useful after severe depletion, to restore the energies of the patient. Administration. °$° or °.i%°, repeated in twelve hours. Lycopodium \° will be found serviceable in similar cases to those in which both Arsenicum and Carbo vegetabilis (or animalis) have been found applicable, also where there are con- siderable dropsical swellings and obstinate constipation. Digitalis 00-° in lower potencies has proved useful in many cases of serous pleurisy with slow fever, small weak pulse, accelerated by the slightest movement; and coldness of tho extremities with internal heat.* In conclusion, Kali carboni- cum may be instanced as serviceable in pleuritis occurring in tuberculous subjects ; and Ipecacuanha as a useful palliative against dyspnoea and convulsive cough in complications with bronchitis. Hellehorus niger has been recommended in some cases of serous, and Scilla in plastic pleurisy, but they, as well as Colchicum, Lachesis, and some others which need not be mentioned here, require the test of further experience to corroborate even the little that has been adduced in their favour in the treatment of pleuritis.f When either through neglect or otherwise, pleuritis has terminated in purulent degeneration, and become chronic, Arsenicum, Carbo, Lycopodium, Hepar s. and Kali carbonicum, will generally be found to be the remedies from which the greatest assistance is to be obtained where cure is at air prac- ticable. Pains in the chest arising from adhesions or from thickening of the pleura, alter an attack of pleuritis, are often * Brit. Journ. of Homoeopathy, No. 1, p. 53. t Rhus toxicodendron has been strongly- recommended in serous pleu- risy :—When low, typhoid symptoms become apparent, tho said remedy will deserve au additional claim on our attention. Tvphoid appear- ances, and important complications of any kind, a bad habit of body, or indications of a purulent, sanious, or hemorrhagic effusion, are all to be held as unfavourable sigus. PLEURODYNIA. 251 relieved by Ranunculus b., Euphorb., Mez., Nitr., Thuja, may also be found serviceable. Sulph., Sepia, Kali c, Am. c, Lye, and Mczer. are useful in chronic pleurisy. Diet. The same rules are to be observed as in Pneumonia. PLEURODYNIA. SPURIOUS OR BASTARD PLEU- RISY. PSEUDO-PLEURITIS. By these terms is here meant that painful affection usually referred to the intercostal muscles, which is productive of many of the symptoms described under true pleurisy, and is consequent- ly liable to be mistaken for the said disease, particularly when attended with febrile excitement, as is frequently the case in hys- terical females. The history of the commencement of the af- fection, together with the aid of auscultation and percussion, enable us to discriminate satisfactorily between the two diseases. When therefore we have satisfied ourselves from the normal condition of the auscultatory phenomena, etc., that the case we have to deal with is one of pseudo-pleurisy, we must select a remedy from amongst the following: Arnica montana, Bryonia, Nux r., Pulsatilla, Ranunculus bulbosus, Sabadilla. In the majority of cases Arnica is the principal remedy, and is occasionally sufficient to effect a speedy cure after a single dose. In other instances, however, the disorder does not yield so readily, and one or more of the other remedies enumerated must be had recourse to. Bryonia. When the pain is of an acute darting description, as if from a sharp instrument running into the side, and is oc- casionally almost insupportable during inspiration or even the slightest movement of the body ; and when the party affected is of a nervous or bilious temperament. Pulsatilla. This remedy is frequently very useful in al- ternation with Arnica; it is more particularly indicated when the pain is occasionally of a fugitive character, moving from one part of the chest to another, becoming increased towards evening, ami sometimes experienced more during expiration than inspiration. Temperament phlegmatic. Nux vomica. Shooting paiusin the hypochondria increased by the respiratory movements of the chest ; especially when tho 252 RESPIRATORY SYSTEM- affection occurs in hypochondriacal subjects or in those who are addicted to indulgence in vinous or spirituous drinks. Temperament bilious or sanguine. It is, moreover, one of the best remedies in this complaint; the characteristic indications are as follows, and show a marked resemblance to the symptoms which are so frequently met with in, and are in some respects peculiar to pseudo-pleurisy; stitch in the side, or shootings, with painful sensibility of the external parts of the chest, but particularly of the intercostal spaces, aggravated by any movement, and especially by taking a deep inspiration, yawning or stretching. Ranunculus nuLnosus. The value of this medicine in pains resulting from adhesions of the pleura has already been alluded to. (Vide Pleuritis.) In acute pains in the chest of every description of a nervous character, depending upon an abnormally exalted sensibility of the pleura, this remedy is one of primary importance. Sabadilla is also useful in this affection. Administration of the remedies. In some cases a sin- gle dose of one or two globules of the 3d or Gth potency is suf- ficient to effect a cure ; in others it will be found necessary to repeat the dose every six, twelve, or twenty-four hours, accord- ing to the severity of the attack, until relief is obtained. (See note, p. 21.) SPITTING OF BLOOD. HEMORRHAGE FROM THE LUNGS. Sputum Cruentum. Haemorrhagia Pulmonum. ll repeated in twelve to twenty-four hours, if necessary.* Bryonia is frequently useful when the disorder affects the joints, and when the pain is exacerbated by the slightest move- ment.' Belladonna, however, is equally appropriate in most affections of this nature. (Sulphur is sometimes required to complete the cure after Bryonia.) Administration. Same as Belladonna. Pulsatilla, when the hue of the skin is less intense, or of a bluish red, and the morbid spots frequently disappear from one place to reappear in another (Erysipelas erratieum). » Vide note, page 21. 282 CUTANEOUS diseases. It is further indicated when the disease affects the internal and external ear, particularly in vesicular erysipelas, after Rhus tor. (Belladonna and Rhus, and, in some instances, Grapht'es aro called for in fugitive or wandering erysipelas.) Administration. \°, morning and evening, until symptoms of improvement result, or another remedy is called for.* Kihstox. is our best remedy in vesicular erysipelas, and also appropriate in erysipelas with gradual but very extensive oedema, (Erysipelas cedematodes,) particularly when the disease has a tendency to extend itself to the brain and membranes, and the symptoms closely resemble those developed in Ence- phalitis. In some instances it is necessary to have recourse to Belladonna and Hepar sulph. to complete the cure,—or to Bel- ladonna and Rhus alternately. (Graphites is also useful in some obstinate cases of vesicular erysipelas.) It may also be remarked, that Rhus is especially suitable to erysipelas arising from particular kinds of food in certain idiosyncrasies; in other cases of this kind, hgwever, Pulsatilla, or Bryonia will be found equally serviceable, according to the symptoms and the temperament of the patient. (Administration. *£■, repeated in six or twelve hours, if necessary; and in severe cases, a drop of the tincture of tho third potency to an ounce of water, one dessert-spoonful every four hours until benefit result, lengthening the intervals or ceasing to exhibit according to results. Nux vomica. In erysipelas of the knee or foot with ex- tremely painful bright red swelling; also successful in pseudo- erysipelas, in irritable subjects, particularly females. (Admin- istration : see Rhus tox.) Arsenicum, when vesicles of a blackish hue, with a ten- dency to degenerate into gangrene, present themselves, (Ery- sipelas gangrenosum) ; still more clearly pointed out, if great prostration of strength be present. This medicine may also be advantageously alternated with Carbo vegetabilis; but as such cases fall especially within the province of the experi- enced homoeopathic professional man, it will be needless to enter into the mode of administration, which must be regula- • Vide note, p. 21. BOIL. 283 ted by circumstances. Lachesis and Rhus are occasionally of great service after, or in alternation with Arsenicum.) Cuprum aceticum. The value of this remedy, upon the testimony of Dr. Schmid, of Vienna, has been already noticed in repercussed eruptions, when a marked metastasis to the brain has taken place. See Scarlet Fever. Sulphur and Arsenic are important remedies when erysipelas has terminated in ulceration. In some chronic forms of the complaint, Acidum nitricum, Euphorbium, Sulphur, Graphites, Silicea, (pseudo-erysipelas,) and Hepar s., have been found serviceable. The alternate use of Bellad., Rhus, and some- times Laches, or Crotal., has removed permanently, a disposi- tion to erysipelas of the face. In Erysipelas Scroti, or Cancer Scroti, (Chimney Sweeper's Cancer,) Arsenicum is the most important remedy; Rhus, Clematis and Lachesis have also been recommended. The greatest care must be observed to avoid the risk of taking cold even during convalescence; such an accident occur- ring during the disease is, as is well known, frequently attended with the most dangerous results. The troublesome itching so frequently attendant upon erysipelas, is often materially re- lieved by the application of wheaten starch, or flour of maize. In conclusion, I may be allowed to remark, that by the fortu- nate discovery of remedies perfectly homoeopathic to most of the forms of erysipelas, we are now enabled to treat this affec- tion with the same facility and certainty as we are other dis- eases curable by well-known specifics. BOIL. Furunculus. Abscessus nucleolus. Diagnosis. Round or rather cone-shaped hard elevations, of different sizes, slowly inflaming and suppurating, discharging matter generally at first tinged with blood, but still retaining a portion of morbidly-altered cellular tissue, which may form the nucleus of another after the first has healed. Causes. A peculiar constitutional tendency; they are, however, frequently critical, as in gout, following acute fevers or eruptive diseases, and sometimes forming the termination of /.v.™™'** PYanthemata. such as itch, &c. 284 cutaneous diseases. Therapeutics. The following aro the remedies most ser- viceable in this troublesome affection : Arnica montana, Sul- phur, Belladonna, Mercurius, Aconitum, and Hepar sulphuris. Aknica is the best remedy in most eases of boils, and will frequently prevent their return; but in the majority of cases, Sulphur is necessary to eradicate the affect ion, which desira- ble result is best accomplished by the use of these two remedies at each attack, for two or three successive times. It sometimes happens, however, that the pain and constitutional disturbance is so great that it becomes necessary to have recourse to one or more of the subjoined remedies : Administration, y, repeated in three days, if necessary ; in other cases, it may be found more advantageous to exhibit A*A in three teaspoonfuls of water, taking one night and morn- ing until finished.* Aconitum, when the boil presents an extremely inflamma- tory appearance, and the affection is accompanied with con- siderable fever and restlessness, is promptly efficacious in subduing these symptoms, and may precede a more specific remedy. Belladonna, should the boil have an inflamed, fiery, or erysipelatous red appearance; or, moreover, should it, if situ- ated upon the extremities, be associated with swelling and tenderness of the glands under the armpit, or upon the groin; dry, hot skin, thirst, headache. Administration. Same as Arnica. Mercurius. Should the swelling refuse to yield to that remedy after the inflammatory redness has been subdued. Administration. The same as Arnica. When matter has formed, Hepar sulphuris will be found conducive to bringing the tumour to a head, and thereby cur- tailing suffering. Administration. *£-, repeated in from six to twelve hours, if necessary. A tendency to frequent returns of this affection is, as al- ready stated, often obviated by the repeated exhibition of Ar- nica and Sulphur ; but when from some innate taint there are * Vide note, page 21. chilblains. 285 not found sufficient, this result is often attained by the employ- ment of Lycopod., Nux-vom., Phosphorus, and Acidum nitr. CARBUNCLE. Anthrax. Furunculus Malignans. Pustula Nigra. Diagnosis. A livid, bluish, or black spot, upon an extend. ed surface, extremely painful, readily running to gangrene, and proving fatal from the extension of mortification. The disease is attended by headache, thirst, foul tongue, sickness, loathing of food, languor, jactitation, and sleeplessness. Therapeutics. The best remedies in this affection are Lachesis, Silicea, and Arsenicum album. Lachesis. When the anthrax presents a livid appearance^ and is disposed to extend rapidly or to burrow. Administration. --6-°, in four teaspoonfuls of water, twice a day, exhibiting at longer intervals, if improvement takes place.* Silicea. When administered from the commencement in simple non-contagious carbuncle, is frequently found sufficient to effect a perfect cure. Administration. 3^, in three dessert-spoonfuls of water, one daily,—to be repeated if required. Arsenicum. When the carbuncle threatens to terminate in gangrene ; it is also the most efficacious remedy when the dis- ease has arisen from contagion. Administration. A few globules of the sixth, or even a drop of the tincture, at the third potency, to an ounce of water, a dessert-spoonful every six, twelve, or twenty-four hours, ac cording to the emergency of the case. In some cases Cinchona, Rhus tox., Pulsa. and Silicea, may be found serviceable in completing the cure, after Arsen. CHILBLAINS. Perniones. This affection is too well known to require any particular de- scription ; the exciting cause is exposure to transitions of * Vidfi note. o. 21. 286 CUTANEOUS DISEASES. temperature, from cold to heat, and ricr vcrsA, but their origin is more deeply seated; the feet are the part most generally at- tacked, but we frequently find the hands also suffer. When they burst, and become ulcerated, they constitute an exceed- ingly painful affection. Severe suffering from chilblains is an indication of constitu- tional taint not to be neglected, and individuals so afflicted should place themselves under a proper course of treatment; for until the system is completely renovated, they are conti- nually subject to their recurrence. Therapeutics. In the treatment of this affection, the fol- lowing medicines will be found valuable : Nux vomica, Pulsatilla, Belladonna, Arnica, Chamomilla, Arsenicum, and Sulphur. Nix vomica fi§°, is particularly indicated when the inflam- mation is of a bright red colour, with swelling, attended with itch'ng, increased by warmth, and when the chilblains evince a tendency to burst. Pulsatilla °£*, when the inflammation is of a livid hue, with itching and beating in the part affected, and when the suf- fering comes on or is exacerbated in the evening or towards midnight. (Sulphur is often very useful after Pulsatilla.} Belladonna fi|, when the inflammation is of a bluish red (but lighter than that indicating Pulsatilla), and very consider- able, attended with a creeping, tingling sensation. Arnica °$0,* when the swelling is hard, shining, and pain- ful, attended with itching. Chamomilla fl§a, when with the inflammation and itching, a burning sensation is present, followed by Arsenicum ££, when the pains are excessively violent, at- tended with severe burning, or when the chilblain bursts, and becomes converted into an irritable sore, with a tendency to fes- ter. Arsenicum may in some such cases be advantageously alternated with Carbo vegetabilis f *. • The Homoeopathic or Arnica Court Plaster, of Hufficient size to cover the chilblain, is frequently of great service in mitigating the suffer- ing.—Ed. corns. 287 r Sulphur -§- is a valuable remedy when the inflammation * and itching are very severe, and the affection has refused to yield to the foregoing. Administration. Two or three globules at the potency given after each medicine, repeated every three days, if neces- sary, until benefit results, or some other remedy becomes indi- cated. In the instance of Arnica we may also apply a lotion in the proportion of one part of the mother-tincture to five of water.* In conclusion, the following remedies may also be consulted : Acidum nitricum, Petroleum, Rhus toxicodendron, Bryonia, Ledum, Mercurius, Cinchona, and Secale cornulum. CORNS. Clavi Pedis. * That these troublesome excrescences not unfrequently arise from an inherent vice of constitution, is evident from the fact that many individuals who wear tight boots and shoes, which are unquestionably the principal excitant, escape them, while others, with every precaution, suffer severely. Such being the case, the main object must be, by a course of properly-selected internal remedies, to eradicate the predisposing cause; among which, Antimonium crudum, (externally as well as internally, as described under the head of Chilblains,) Phosphorus, Rhus, Bryonia, and Ammonium Carbonicum, Lycopodium, Petroleum, Sepia, Acidum Phosphoricum, and Sulphur, will be found useful. Great alleviation of suffering has, however, been found to result from bathing the feet in warm water, and then apply- ing a very weak Arnicaf lotion, (a drop or two of the tincture to an ounce of water,) after having previously pared down the corn carefully. * The external application of the other remedies also, is frequently very serviceable ; in which case we may dissolve a few globules, or a drop or two of the tincture of the same remedy that we are administering inter- nally, in about an ounce or so of water, and bathe the chilblains with the lotion twice a day ; in addition to this, it is sometimes advantageous to envelop the affected parts in a piece of linen which has been dipped in the lotion. t The Arnica plaster may be applied to corns as to chilblains, and will oftnn nflm-H the greatest relief to those corns commonly called soft.—Ed. 288 cutaneous diseases. While upon this subject, it may be remarked that Ni'X vomica has been found serviceable in eases <>f swelling and redness of the heel, resembling chilblains, attended with acute, burning, shooting pains, materially increased by the pressure of the boot or shoe, or by walking. Arnica may be recommended as above, should not Nux vomica be found to relieve. ABSCESS. LYMPHATIC TUMOURS AND DISEASE OF THE CONGLOBATE (iLANDS. Abscess. By this term is meant a collection of purulent matter, resulting from morbid action, contained in a sac or cyst of organized coagulating lymph, furnished with absorbent and secreting vessels. Abscesses are divided into acute and chronic. The former is preceded by sensible inflammation in the affected part, which is soon followed by suppuration. The commencement of the suppurative process is evidenced by a change in the description of pain, which becomes more obscure and throb- bing, the increase of swelling, and, when matter is formed, by the perceptible fluctuation when the abscess is not too deeply seated; lastly, particularly in idiopathic cases, when the formation of pus is in considerable quantity, the fever "Which attended the previous inflammation is lessened, and irregular chills or rigours supervene, succeeded in turn by heat and increase of fever. When the abscess is mature, the tumour points, or presents a sort of conical shape, generally near the centre of the cutane- ous surface; over this spot the skin assumes a reddish hue, becomes thin, and ere long gives way, and allows the contents of the cavity to escape. The signs of the formation or existence of a chronic ab- scess, on the other hand, are in the generality of instances devoid of any apparent disorder, either local or constitutional, until it begins to approach the surface and form an external swelling. The secreted matter is unhealthy, thin, and serous, ABSCESS. 289 and contains substances resembling curds or flakes. When the pus is evacuated, and the air admitted iuto the cavity, inflam- mation of the cyst arises, and is productive of a salutary effect, if the abscess be small; but if it be large, great constitutional disturbance ensues ; the cavity, instead of contracting and filling up under the process of healthy granulation or incarnation, goes on discharging copiously, and hectic fever is produced. Therapeutics. In acute abscesses we may apply poul- tices and warm unmedic-ated fomentations, and forward the suppurative process by the administration of Hepar sul. %, in repeated doses. The lancet is never necessary except when the pus, by its extensive diffusion or pressure, especially when seated under ligamentous or tendinous expansions, is liable to injure important parts; or when, from its situation, there is reason to apprehend its discharge into any of the cavities of the body. When it is necessary to effect an artificial opening by means of the lancet, the incision ought to be made at the most depend- ing point where this can be safely or readily accomplished; and when this is impracticable, in consequence of the great thick- ness of the parts between the purulent matter and skin, the most prominent or pointed part ought to be selected. When, on the other hand, this latter happens to be at the upper part of the abscess, the lancet must be laid aside, and the abscess allowed to open spontaneously, or, still better, through the instrumentality, or at all events the important aid, of Hepar sulphuris, Silicea, and Lachesis. The former two may fre- quefffly be administered in alternation with advantage; the latter is more particularly to be preferred when a considerable portion of the skin has been much distended, and presents a deep red or bluish appearance, or where its structure has been destroyed by the magnitude of the abscess. Mercurius is oc- casionally useful when there is induration.* The subsequent * Cnrbo a. is equally serviceable here, and may follow Mercurius when that remedy fails to answer our expectations. Baryta is also useful in such cases, particularly when there is considerable surrounding swelling as well <.» mrlnrntinn. even after the opening of the abscess. 290 CUTANEOUS DISEASES. treatment is generally more easily conducted, and the healing of the cavity more speedily effected, when the matter has been evacuated by tho aid of tho appropriate medicine, instead of the lancet. In chronic abscesses, it has usually been found nest benefi- cial to make an outlet for the matter as early as possible, X pre- vent a large accumulation, and thereby avoid the consequent frightful constitutional disturbance which is so prone to occur in such cases, from the extent of the inflammation alter tho bursting of the abscess. The opening should be made near the base of the abscess, and merely be large enough to admit of the exit of the matter. When this collection of matter is very extensive, it frequently accumulates again after having been evacuated; hence it has been recommended to heal up the opening immediately, and to make a new one again when necessary, but before the pus has accumulated in any considerable quantity. When the matter has been withdrawn, a dose or two of Mercurius should be administered, followed by Hepar sulph., Silicea, and sometimes also by Calcarea, and Phosphorus. Silicea and Phosphorus have been described as useful when atrophy or consumption resulted in consequence of chronic suppuration. It may here be mentioned that, in Lymphatic Tumours, Sulphur, and in Encysted, (whether steatomatous or other- wise,) Calcarea has been found very efficacious.* Further, that in enlargement and induration of the Conglobate Glands situate in the neck, under the chin, and behind the ears, such as is usually met with in scrofulous habits,—MercuritfH and Dulcamara are two of the most important remedies.t When * Graphites, Silicea, Hepar s., and Sulphur, Causticum, Baryta c, Carbo v., Acidum nitricum, Lachesis, or Phosphorus, &c, may be found useful in some cases. t In old standing or obstinate cases of glandular enlargement and in- duration, Baryta c, Staphysagria, Carbo a. et v., Hepar »., Sulphur, Cal- carea, and Silicea ; as also Kali c, Lycopodium, Iodium, Acidum nitri- cum, Bovista, or Belladonna, etc., are remedies of great utility, and must be selected according to the general features of the cane, when Mercurius and Dulcamara are found insufficient to discuss the swelling, etc. ITCH. 291 suppuration or ulceration ensues, Hepar sulphuris, Lachesis, and Silicc', are more useful. These latter, particularly Hepar sul. and Silicea, together with Sulphur and ('alcarea, in some cases, are moreover extremely useful in materially obliterating the unsightly scars which are so frequently met with in glan- dular swellings which have been neglected or improperly treated by means of stimulating embrocations, caustics, &c. ITCH. Scabies. Psora. This contagious, inflammatory affection of the skin, is characterized by an eruption of pointed vesicles, transparent at the summit, and filled with a viscid and serous fluid. These arc subsequently intermixed with, or terminate in pustules. With the exception of the face, they appear on every part of the body, but much more frequently and abundantly about the wrists, between the fingers, and at the bend of the joints, &c, and are accompanied by incessant and almost in- supportable itching, without fever. Therapeutics. Sulphur is unquestionably the most im- portant remedy in this disorder, particularly at the commence- ment. In the less violent varieties of the malady, and in the purulent species, especially when confined to the fingers and wrists, it is indeed specific. A dose of the remedy may, in such instances, be administered daily for a week or ten days, but discontinued as soon as signs of improvement set in. In some rather obstinate cases, that is, when, after a fortnight to three weeks, but little improve- ment has been effected, we shall find the treatment facilitated by the simultaneous employment of the remedy externally, at the same potency which we are administering it internally, (by adding a few globules, or a drop, to a couple of ounces of water, and applying the liquid as a lotion night and morning). A very speedy or a sudden suppression of the eruption is, on the other hand, not to be regarded as a cure, but as a driving in or repercussion of the eruption. Against other varieties of the disorder, and in neglected cases, Sulphur is not sufficient to effect a cure, aud we are hence, fre- quently, under the necessity of having recourse to Mercurius, 292 CUTANEOUS DISEASES. Carbo v., Hepar s., Causticum, Sepia, Vcra'rum, Lycopod., etc. as follows: Mercurius, when the eruption is aocompanie'1 by intolerable itching, especially on becoming warm in bod"; looks dry and cracking, but consists of minuto vesicles re- sembling papillae, when not narrowly examined, which are slightly inflamed and bleed easily when scratched (scabies papuliformis). These little elevations or vesicles aro some- times intermixed with pustules, which on breaking form scabs. It is sometimes necessary to administer Sulphur in alternation with M'-rcurius, in this form of the complaint, at intervals of four or five days, until an improvement or change in the symp- toms result:— In the event of an amelioration, it is found useful to cease to administer the medicine as long as it continues; but if the improvement soon comes to a close, or a change occurs in the character of the eruption, another remedy must be prescribed; if the affection has retained the papular-looking form, and Mercurius alone has previously been administered, lie par s. may be selected; but if both Sulphur and Mercurius have been employed, Carbo v. may be advantageously alternated with Hepar ; and should any symptoms remain thereafter, Sepia or Veratrum will generally speedily remove them. When, how- ever, we observe that pustules have made their appearance, and are found interspersed amongst the original elevations upon the epigastrium, or other parts, Causticum should be selected. In scahies papuliformis: Mezer. and Silic. In the postular or humid variety {scabies purulenfa), distin- guished by distinct, prominent yellow pustules, having a mod- erately inflamed base, which are usually met with on the hands and feet, and subsequently, if unchecked, on the back, shoulders, arms, and thighs, about the axillae, and near tbe knee- and elbow-joints,—Sulphur, as has been already stated, is the principal remedy; considerable benefit will neverthe- less be obtained by giving Lycopodium in alternation with it. Should improvement ensue, and the eruption take on a drier aspect, Mercurius and Carbo v. will in most instances serve to complete the cure. But if no beneficial effect is produced after two or three repetitions of these remedies at intervals of WHITLOW. 293 four or five days, Graphites must be exhibited at short interval! for three or four successive times, lengthening the intervals at each repetition of the dose; and should no alteration be brought about soon after, Mercurius may be administered in the same manner. When the pustules are large, they coalesce and form irre- gular blotches, which sometimes ulcerate to a greater or less extent; in such cases Clematis and Rhus will be found ser- viceable. When, on the other hand, the pustules assume a prominent and globular form of a yellowish or bluish colour, La'hcsis has been found to be the most appropriate remedy. In Scabies lymphalica, or watery itch, characterized by transparent vesicles of considerable size, without an inflamed base, much the same treatment may be pursued as has been described for the dry or papuliform variety; in some cases thereof, however, the alternate use of Sulphur, Rhus, and Ar- senicum, is requisite. When Scabies has been materially altered in its character by the abuse of Sulphur in allopathic practice, Mercurius, Causticum.,—Rhus and Staphysagria,— or Acid., nitricum, Dulcamara, Calcarea, and Pulsatilla, have been used with success. Finally, Creasote externally (largely diluted) and internally, has been recommended in some obsti- nate cases of Scabies; and Sulphur, Arsenicum, and Carbo v. in cases which have been suppressed or repercussed by powerful ex- ternal applications. Should furunculi appear : Silicea. WHITLOW. Paronychia. Panaris. By this term is understood an abscess more or less deeply seated, forming about the end of the finger, attended with severe pain and considerable swelling; it has much tendency to reappear in individuals who have once suffered from its at- tacks, which clearly demonstrates the advantage of treating it as a constitutional, and not as a merely local affection; in so doing we may have recourse to the following medicines: 3Ier- curius, Hepar Sulphuris, Rhus, Sulphur, and Silicea. Therapeutics. We may generally commence the treat- n.nnt X- M l?m'I7UITTS. 294 CUTANEOUS DISE VSES. Administration -05, repeated every twelve hours, until re- lief is obtained. But should the swelling not decrease after a few doses of Mercurius, or the pain become intense, recourse must be had to the alternate administration of Silicea and Hi par s.* Rhus is more particularly indicated when there is a consi- derable degree of erysipcla'ous inflammation. Administration 434, in the same manner as M' rcurius. Lachesis. In cases where the affected part is of a dark red or bluish hue, and the pains extremely violent, this remedy may be administered, followed by Arsenicum and Carbo v., if an angry-looking, black, and painfully burning sire form on the affected fiiiger.f But we must have recourse to the alternate administration of Sulphur jg, and Silicea |£, at intervals of eight days each, in cases where a constant tendency to a recurrence of the com- plaint exists.J These remedies, particularly the latter, are the most appropriate in those severe cases in which the matter forms between the periosteum and bone, and when the latter has become diseased in consequence. Magnetis Polus Articus. Tho application of the north pole of the magnet for a minute or two to the finger will often afford speedy relief when the pain is so intense as to be almost insupportable. A poultice is also somewhat soothing under such circumstances. IRRITATION OR ITCHING OF THE SKIN. Prurigo. This affection is usually an accompaniment of other dis- eases, and is to be treated accordingly; however, in some * These two remedies are moreover exceedingly serviceable in for- warding suppuration, and are therefore equally useful iu rapidly bring- ing the abscess to maturity, and causing the discharge of the pus, when it is no longer possible to effect resolution ; but when the matter is deep seated, aud evacuation is not spcedly obtained, the lancet must be employed. t Hering's Hausarzt. ', Hepar s. and Causticum have likewise been recommended as useful for the attainment of this desirable end. IRRITATION of the skin. 295 cases it declares itself in an idiopathic form, and is generally caused by scarcely perceptible colourless elevations under the cuticle; at other times, they are of a considerable size, soft and smooth, but without desquamation, or any peculiar erup. tive appearance. Therapeutics. Against this extremely distressing irrita- tion, Sulphur is frequently the specific remedy, particularly when exacerbation ensues on the evening, or when the body is warm in bed; but in other and more ordinary cases, the following remedies will be found serviceable: Ignatia amara, Pulsatilla, Mercurius, Rhus toxicodendron, Hepar sulphuris, Nuv vomica, or Arseni'-um adbum. Ignatia amara. When the irritation is most severe, after going to bed, and resembles flea-bites all over the body, and after scratching,—which relieves—shifts readily from one part to another. Pulsatilla. When the irritation comes on in the warmth of the bed, and is aggravated by scratching. Mercurius. When the irritation continues through the whole night, and Pulsa'i'la proves insufficient; also in cases when the parts affected bleed readily after scratching. (Sul- phur i.s sometimes useful every four or five days, in alternation with Mercurius, in such cases.) Rhus toxicodkndron. When itching is accompanied by violent burning sensation, followed by Hepar sulphuris, if necessary, to complete the cure. Nux vomica alternately with Arsenicum, when the irrita- tion or itching appears on undressing. In obstinate cases of almost all kinds, Sulphur, followed by Carbo v., will be found serviceable. Lycopodium, Graphites, Silicea, &c, may be called for in particular cases. Opium ia often useful in the case of old people. In Prurigo scroti, Sulphur, Acidum nitricum, Dulcamara, and Rlirlodendron, have chiefly been recommended.—Prurigo pudeudi: Sulphur, Sepia, Conium, Calcarea, Natrum m., and Sulphur.—P. ani: Sepia, Acidum nitricum, Thuja, Mercurius, Stdphur, as also Kali c, Baryta c, and Zincum. »_.„.,.„^„ .^rrtM s.s.si in f0iir dessert-spoonfuls of water, 29(5 CUTANBOI S OISEAKKV one daily; to be repeated, if necessary.* Of M>minus and Rhus toxicodendron we may substitute tho sixth for tbe thir- tieth potency. RIXOWORM (HERPETIC OR VESICULAR.) Herpes circinnatus. Herpes serpigo. This affection generally occurs in children. It has been con- sidered contagious from the circumstance of several children ot one family, or at the same school, being sometimes attacked at the same time; but there is every reason to believe that this opinion is erroneous, from the circumstance of none of the other species of herpes being communicable by contact. W hen not complicated with another disease, it is not attt•mled with any general constitutional derangement. The disorder i.s charac- terized by an eruption of small rings or circular bands, the vesicles only occupying the circumference; these are small, and have a red coloured base of greater or less intensity. About the third or fifth day the vesicles become turbid, and then dis- charge', when little brownish scabs form over them. The por- tions of skin within the circlets are usually healthy at first; but for the most part subsequently become rough, of a reddish hue, and scale off as the vesicular eruption dies away. The duration of the eruption frequently does not extend beyond a week or two, but when there is a series of consecutive rings on the face, neck, arms, and shoulders, as more frequently happens in warm climates (where the affection moreover assumes a more serious and obstinate character), or during hot weather in this country, it is necessarily protracted considerably beyond this period. Treatment. In the majority of cases, the affection yields readily under tbe action of Sepia, of which from two to three globules of the sixth potency may be given in a little water, and the dose repeated on the fourth day, if required by any appearance of tardiness in the subsidence of the eruption, or should there be any indications of the formation of fresh rings. • Vide not*, p. 21. RINGWORM. 297 In some obstinate cases, the alternate use of Rhus and Sulph. every four or five days is found necessary. Calcarea and Causticum have been recommended in others. All kinds of outward applications must be avoided. RINGWORM OF THE SCALP. PUSTULAR RINGWORM. Porrigo Scutulata. Tinea Capitis. Tinea Annularis. Farus Confertus. This disease is still more popularly known than the above by the term of ringworm (or ringworm of the scalp). It is unquestionably of a highly contagious nature, being readily communicated among children who make use of the same comb and brush, or even towel, and is of long and uncertain contin- uance,—indeed there are few cutaneous affections which have more frequently baffled the unwearied efforts of practitioners than it has done; and it would have been well had less been attempted by those of the old school in the way of treatment; for in but too many instances the so-called cure has proved worse than the disease. Pustular ringworm commonly attacks children from the age of two years to the period of puberty; it is not confined to the scalp, but also appears on the neck, trunk, and extremities; when confined to the trunk, it proves by no means so obsti- nate and rebellious a disease as when located in the hairy scalp. Diagnosis. The affection is characterized by circular red- coloured patches, on which appear numerous small yellowish points or pustules, which do not rise above the level of the skin, and are generally traversed in the centre by a hair. These pustules, which are much more thickly studded in the circumference than the centre of the circular patches, soon break and form thin scabs,* which frequently unite with the * Sometimes cup-shaped, or concave (characteristic of favus), and at first of a tawny, but subsequently of a light yellow or whitish colour; when they crack and break up, they become reduced to a powder which looks like pulverized sulphur. 29 S CUTANEOUS DISEAtKR. adjacent patches, and assume an extensive and irregular »]■- p«-aranee, but commonly retain a somewhat circular shape. These incrustations become thick and hartl by accumulation, and are detached from time to time in small pieces which bear a clo-e resemblance to crumbling mortar. When the scabs are removed, the surface is left red and glossy, but studded with slightly elevated pimples, in some of which minute globules of matt.-r appear in the course of a few days. By these repetitions of the eruptions, the incrustations be- come thicker, the areas of the primary patches extend, and new ones are formed, so that the corresponding edges become blended, and frequently the whole head thus becomes affected. The circular character of the primary groups is still indicated, however, by the portions of arcs of a circle perceptible in the circumference of the larger incrustations As the patches of clusters extend, the hair covering them usually becomes lighter in colour, and breaks off short, and as the process or scab- bing is repeated, it is thrown out by the mots, and finally there remains only a narrow chaplet of hair round the head. If the hair follicles are destroyed, the baldness remains per- manent. (uses. The disease appears to originate spontaneously in children of scrofulous, flabby, or feeble and emaciated habit, if they be ill-led, ill-lodged, uncleanly, and not sufficiently exer- cised ; but it is chiefly propagated by contagion. Therapeutics. It cannot be denied that, even under ho- moeopathic treatment, the disease frequently proves extremely obstinate; but in many cases the difficulty experienced in ef- fecting a cure arises from the previous treatment which the pa- tient has undergone, or from the culpable conduct on the part of the parents or others in having allowed the disorder to pursue its cturse for a lengthened period, unchecked and utterly neglect- ed, ere proper assistance is sought. The following are the principal remedies employed in the homoeopathic treatment : Rhus, Arsenicum, S'aphysagria, Hepar s., Lycopodium, Dulcamara, Bryonia, Phospluirus, Graphites, Baryta c, Cal- carea, Oleander, Sulphur, &c. RINGWORM. 299 The medicines must be selected according to the various changes which take place throughout the course of the dis- ease; but as it would occupy much more space than would be warranted in a work like the present, to attempt to give directions calculated to meet every case, it will be necessary to give only a few of the general indications for some of the more important remedies, and merely to point out others as being worthy of attention in cases which do not yield to the ordinary remedies. While the patches are in an irritable and inflammatory condition, Rhus will usually be found the most appropriate remedy; the head should at the same time be regularly and gently sponged with tepid water twice a day, and a linen cap worn. Should a dry exfoliation and scab- bing then ensue, Sulphur may be had recourse to; but if, on the other hand, an offensive discharge breaks out, attended by violent itching, without much redness, Staphysagria may be administered, and then again Rhus. If, notwithstanding the administration of these remedies, very little favourable pro- gress is made, or if, on the contrary, the affection becomes rather worse, and the exudation takes on an acrimonious character, and is productive of an extension of the disorder, or of the formation of ulcers, Arsenicum must be exhibited; after the action of which, Rhus will frequently produce a satisfactory effect. These remedies may occasionally be applied externally also with good effect, by dissolving a few globules of the remedy used iu a little water, and applying the liquid once or twice a day to the affected parts. When the foregoing remedies are insufficient to effect a cure, which is unfortunately not a rare circumstance, particularly when strumous subjects are afflicted with the disease, the fol- lowing remedies must be used : Hepar s., when the eruption is not confined to the head, but also appear upon the forehead, face, and neck; when, more- over, the eyes and eyelids become inflamed and weakened, and soreness or ulceration breaks out on or behind the ears. In the latter case, Baryta c, Graphites and Oleander are also useful. Dulcamara, when the glands of the throat and neck are enlarged and indurated (or Bryonia when there is inflamma- 300 CUTANEOUS DISEASE.' tion and tenderness of the said glands); after which Staphysa- gria may be administered, and then one or more of the reme- dies mentioned at the commencement, followed by Baryta c. If these remedies prove ineffectual, Sulphur, Graphites, Calcarea, Lycopodium, Phosphorus, or Oleander, must be ad- ministered according to circumstances. In some eases, the alternate use of two or more will be found advantageous, such as Sulphur and Calcarea.—Sulphur, Rhus, and Graphites.— Graphites and Lycopodium,—Graphites and Phosphorus, and so on. When there is soreness of the ears in addition, Hepar s., Baryta c, Graphites and Oleander claim some preference. A dry, inert, and scaly appearance of the eruption chiefly re- quires Sulphur and Calcarea, but also Hepar, Phosphorus, Rhus, and Arsenicum or Oleander. A humid or moist-looking eruption : Staphysagria, Rhus, Arsenicum, Lycopodium, Sul- phur, Sepia, and also: Baryta c, Calcarea c., Graphites, Ci- cuta virosa, and Oleander. In the other varieties of scald-head, such as the Porrigo lupinosa,* Porrigo furjurans,f Porrigo favosa,\ &c, the same • Characterized by small, dry, circular scabs, of a yellowish white colour, having raised margins, and a central depression, like that on the seeds of the lupine. The incrustations are deeply set in tho skin, to which their edges are firmly adherent. t This variety commences with the eruption of small pustules contain- ing a straw-coloured fluid, which soon discharge dry, and form thin laq^^ nated crusts, or scale-like exfoliations. This affection is confined lo tflP scalp, and is attended with considerable itching and soreness, although there is but slight excoriation ; the hair partially falls off, and occasionally becomes subsequently somewhat lighter iu colour. X Distinguished by the eruption of large, soft, straw-coloured pustules, generally somewhat flalteued, possessing an irregular margin, and sur- rounded by a slight inflammatory redness. They are met with on other parts of the body as well as the scalp, and are accompanied by mueh itch- ing. On breaking, these pustules discharge a viscid matter, which hardens into semi-transparent, greenish-yellow scales. The disease extends to the face, and eventually the ulceration spreads over the entire head, and from the continued discharge the hair and moist scabs become matted to- gether. Pediculi are generated in large numbers, and aggravate the excessive irritation. The incrustations thicken into irregular inuHses, bearing some resemblance to honey-comb. The acrid exudation from the ulcerated patches on the scalp exhales an offensive and pungent vapour. ULCERS. SOI class of remedies are required as above enumerated; whilst against Porrigo deealvans (characterized chiefly by patches of baldness), Graphites, Phosphorus, Bary'a, Lycopodium, and Zincum, have been found the most serviceable; but Sulphur, Calcarea, Silicea, &c, and most of the other aforesaid reme- dies, may be found indicated in particular cases. With regard to the administration of the remedies, it may be stated that at the commencement of the disorder, a dose may be given daily, or every second day, until symptoms of improvement make their appearance, in which case the medicine must be discontinued while the case progresses favourably, and only renewed when matters become stationary or the disorder threatens to extend itself. When no signs of improvement become perceptible, or when, on the contrary, the malady evidently seems to be getting gradually worse, notwithstanding the exhibition of two or three doses of a particular remedy, another must be selected according to the indications. In cases of old standing, the intervals between the repeti- tion of the dose must generally be lengthened, or a dose may be given daily for a week, and then a period of ten to twelve days, and even upwards, allowed to elapse before the medicine is repeated, or another remedy substituted. Undeviating attention to cleanliness must be observed throughout the entire course of the complaint, and the homoeo- pathic diet rules strictly adhered to in the majority of cases. The hair ought to be removed early in the disease. ULCERS. Ulcera. An ulcer may be the result of a wound, bruise, burn, or abscess ; it may also arise from a bad condition of body, par- ticularly when combined with sedentary habits, and gross or unwholesome living. In the latter case, its formation is pre- ceded by a greater or less degree of pain, heat, redness, and swelling in the part. In many instances a little vesicle or pustule appears, which, on bursting, exposes a gap or breach iu the skin. Sometimes there is at the commencement a single small excavation; at others, several contiguous ulcerated 302 CUTANBOTS DISEASES. spots are observed, which speedilv become blended together, and form a s .re of considerable magnitude. When n ' effort at cicatrization or healing is taking place, the ulcer alwajs presents an excavation or hollow, the mar- gins of which are red, sharp, sometimes thick, prominent, rounded, and callous, but often jagged and irregular. The surface of the ulcer at the same time presents a dirty white or yellowish colour, and is usually covered with, and dis- charges a thin watery humour or sanies, frequently tinged with blood, and sometimes so acrid as to inflame and corrode the skin. While the process of ulceration is extending, the edge of the adjacent skin is inflamed and painful; but as soon as a tendency to heal sets in, this ceases, and healthy gran- ulations form, which present a florid colour, are of a firm con- sistence, and have a pointed shape resembling minute cones. The matter secreted is altered to a bland, thick, and whitish or cream-like fluid (healthy pus) not adherent to the granu- lating surface. These granulations do not rise higher than the surrounding skin, and when they have risen to the level of the latter, those at the margin of the ulcer become covered with a smooth thin bluish film, which is at first semi-transpa- rent, but soon changes to an opaque on being converted into new skin. Therapeutics. In the treatment of ulcers in general, the following are the most important remedies : Arsenicum, Carbo v., Lachesis, AI rcurius, Sulphur, Silicea, Sepia, Lycopodium. Arsenicum is chiefly useful when the ulcer presents a livid aspect, or looks bloody, and bleeds at the slightest touch, and, instead of healthy pus, secretes an ichorous discharge mixed with blood; the edges of the sore are at the same time hard and irregular, and the patient complains of great pain, particularly of an intense burning description. Carbo v. is indicated*under similar circumstances, and is therefore very useful in alternation with the former remedy, especially when the discharge from the ulcer is of a very offensive nature, and the burning pains are much exacerbated towards evening and during the night. When the ulcer is large, or seems dis- posed to extend rapidly, or when it is surrounded by ninner ULCERS. 303 ous small ulcerations or pustules; further, when there is con- siderable swelling and discoloration of the surrounding parts, the leg presenting a mottled, dark-blue or purple aspect,— Lachesis forms a most important and eminently useful remedy. Mkrcurius will usually be found very serviceable when the ulcer is deep, and secretes a thin and offensive discharge; but should healthy granulation not supervene on the filling up of the cavity under the action of Mercurius: Sulphur or Sili- cea, or both these remedies, must be prescribed alternately. When the discharge continues thin and offensive notwithstand- ing the employment of Mercurius, Afafw'ida may be admin- istered, provided Arsenicum, or some other remedy, does not merit a perference. Sulphur is almost indispensable in nearly every case of long standing, and is frequently sufficient of itself to effect a cure in many chronic cases. It is more particularly indicated, however, when excessive itching, burning, or gnawing and smarting pains are experienced in the sore, and there is at the same time cedematous swelling, and reddish brown dis- coloration of the limb, when the ulcer is seated in the inferior extremities. Silicea is another remedy of nearly equal importance to Sulph win the treatment of chronic ulcers. It is accordingly of the utmost service in many cases when administered in alter- nation with that remedy, and in those of a very obstinate character, with S-p>a and Acidum nitricum. The secretion of a thick and discoloured pus is a useful indication for Silicea. When the pus is of a deep yellow colour, the margins of the ulcer callous or inverted, and an intolerable itching, sometimes with pain of a burning description, is experienced at night in bed,—Lycopodium may be given with advantage ; also in super- ficial chronic ulcers. In administering the remedies, it is frequently sufficient to give a dose every eight or ten days; in other cases, it is found necessary to dissolve a few globules, or a drop or two of the tincture at the 6th, 12th, or 30th potency, in a pint or so of pure water, to which a tablespoonful of spirits of wine has been added, and order a tablespoonful to be taken daily.* 21. 304 CUTANEOUS DISEASES. When tho ulcer is inflamed or extremely painful, a s<>thitig effect is often derived from the application ot linen dip| cl in warm water; and if the ulcer be seated in the leg, the affected limb should be kept at rest, and not allowed to remain in a de- pending position. In others, and a still larger number of eases, the application of lint dipped in, and kept constantly wet with cold water, is more efficacious, especially when the ulcer pre- sents a sharp, jagized, and undermined appearance, with no distinct formation of granulations, but exhibits a surface con- sisting of a whitish spongy substance, covered with a thin and acrid discharge, and bleeds on being dressed. When, on the other hand, the granulations are sufficiently developed, but of a pale colour, and often large and flabby, with a smooth and glossy surface, the edges of the sourround- ino- skin being at the same time thick, prominent and rounded, the pus thin and watery, intermixed with flakes of coagulating lymph which adheres closely to the surface of the sore, but the pain trifling, and the sore comparatively insensible,— considerable assistance will generally be derived from the employment of a moderately tight and properly applied bandage. The promotion of healthy granulation and cicatrization is, further, materially forwarded by the external employment of the same remedy which we are prescribing internally, (in the manner as described under the heading of Chilblains) ; and in other cases, it will be found sufficient to keep the dressings constantly wet with cold water. We must, however, never omit the internal administration of the appropriate remedy, otherwise the sore will be liable to break out again and again at longer or shorter intervals, though apparently healed up in a satisfactory manner, under the employment of external treatment alone.* In the treat- ment of healthy or healing ulcers, dry lint may be applied to * In chronic indolent ulcers on the inferior extremities, such as are frequently met with in elderly persons, the treatment ought to be exclu- sively internal at the commencement, and the doses administered at inter- val* of a u».-k and upwards. ULCERS. 305 the wound, and the dressing changed only once in forty-eight hours, when the secretion of pus is scanty, and not sufficient to moisten the lint in a shorter period. Ulcers attended with, or arising from a varicose state of the veins, are usually very obstinate and difficult to heal, particu- larly when it is inconvenient or impossible for the affected party to remain at rest. Under such circumstances, it is es- sential that a properly fitting bandage or laced stocking should be worn. The best remedies calculated to effect a perma- nent cure are: Arnica, Pulsatilla, Lachesis, Sulphur, and Silicea ; also Arsenicum, Carbo v., and Acid, phosphoricum. The two first named, when given alternately about once a week, early in the disorder, are occasionally sufficient to effect a cure; but for the most part it is necessary to have recourse to the others, either to complete the cure or to prevent a relapse. The indications for their selection are, in this form of ulcer, much the same as already given in the treatment of ulcers in general. Acidum phosphoricum is extremely useful in cases with more or less lymphatic ulceration, particularly when the patient has previously been powerfully affected with mercury under allopathic treatment. Acidum nitricum will prove of essential service after Acid. phos. if required. Sepia, Arsenicum, Petroleum, Silicea, and Sulphur, are the most serviceable when proud flesh forms on the ulcers. Against the following varieties of ulcers, most of the sub- joined medicines have been found of the greatest utility.* PHAGrED^ENIC. Arsenicum, Silicea, Mezereum, Hepar s., Sulphur; also Conium, Acid, nitricum, and Ranunculus. SCROFULOUS. Sulphur, Silicea, Calcarea, Lycopod., Carbo v., Arsenicum, Acid, mur., Baryta acet., and Belladonna. PUTRID ULCERS, or those occurring in Cachectic, Scor- butic subjects. Sulphur, Silicea, Arsenicum, Carbo v., Hepar s., Acidum muriaticum, Pulsatilla, and, in some instances, Amnion, c ef m. * The characteristic indications for many of the remedies will be found in Baenniughauseu's Manual of Homceopathic Therapeutics, by Chs. Hpmnfil. M. D. 306 CUTANEOUS DISK<-ES. GANGRENOUS ULCERS. Arsenicum, Lachesis, Cin- chona, Sdicea, Belladonna, and Conium ; also Rhus toxieo.len- dron. S, rale cornutwn, and S,ptH/a. CARCINOMATOUS. Arsenica,,,. Lachesis, Conium, Sul- phur, Sdicea, Diadcma aranea, Mercurius; also Aurum, Sta- physagria, and Hi par s. FISTULOUS. Sulphur, SHicea, Calcarea, Lycopodium, Pulsa'i'la, and Antimon.* MKKCURIAL. Hepar s., Acidum nitricum, Acidum / hos- phoricum, Aurum, Carbo veget ibVis, Su'phur, Silicea, Bella- donna, Thuja, Snr.saparilla and Acid, fluor. (especially about the ankle, with more or less implication of the bones). S^ I'HILITIC. M"rcurius chiefly, but also Acid, nitricum, to promote healthy granulation when the former is iiisujjicicn', or to combat mercurial complication when the patient, has previ- ously been subjected to injurious doses of that remedy. In other cases, Lachesis and 'Plmja are requisite to establish the cure. It may be added here, that Thuja and Acidum nitricum, ap- plied externally and internally, are the chief remedies against SYCOSIS. In some cases of this affection, however, Al rcu- riu.s and Sulphur, alternately, or one or more of the following remedies: Acidum phosph., Cinnabar, Lycopodium, Euphrasia, Slaphysagria, and Sabina, will be found requisite. » In fistula in ano: Sulph., Calc, Silcx, Cuus., and Puis., have chiefly been employed with success. In fungous ulcers : Sulphur, Si- licea, Calcarea, Graphites, Sepia, Slaphysagria, Petroleum, Antimo- nium, Iudium, Thuja, and Arid, nitric; and in fungus hamatodes .- Phosphorus, Thuja, Acid. nitr. GENERAL DERANGEMENT OF THE SYSTEM. GOUT. Arthritis. This disease, particularly when it has assumed the chronic form, requires a long and discriminative course of treatment. The chief danger arises from its liability to transfer its seat from the part first attacked, to some of the principal internal organs, such as the head and stomach; in such instances it assumes a peculiarly critical character. From some peculiar predisposition, it is often hereditary; until therefore this tendency is eradicated by a proper mode of treatment, where practicable, it is useless to expect a per- manent cure. Diagnosis. Pains in the joints, with inflammatory or chronic cold swelling, with symptoms of deranged digestion. These signs, however, may only partially declare them- selves, or be marked by some other chronic malady; indeed, there is scarcely any disease of that character with which it may not be complicated. Prior to the attack, we generally find symptoms of general derangement of the digestive function, with slight access of fever- the veins of the feet become swollen, and a sense of numbness, cramps, or twitching, is present, with a deficiency of perspiration. When the attack comes on, which most fre- quently occurs in the evening or during the night, it is gene- rally with a feeling of dislocation in the joints of the feet, and burning or severe scalding pain in the part attacked, more or -fx— - the than sensations disappear, leaving 30* GENERAL DKRANUKMENT. the part red and tumefied ; the fit occurs again at intervals generally diminishing in intensity; in many instances, con- siderable fever is present. Among the ex. iting causes ..f gout may be numl" red the tol- lowing: a luxurious mode of life; stimulating diet or drinks; sudden check of perspiration; mental emotions; sedulous ap- plication to studious pursuits, and neglect of taking proper exercise in the open air; and a use of aperient medicines and tonics. In plethoric habits, the gout shows a considerable in- clination to shift its seat to the head, and in dyspeptic indi- viduals to the stomach and intestines. Tiikraukutii's. Iii general cases of this affection, the prin- cipal medicaments are Aconi'c, Pulsatil'a, Nu.r v., and Bryonia. Aciimtk in plethoric or corpulent habits, when there is con- siderable inflammatory fever, with hard and quick pulse. Administration. °0q in a little water, repeated in six hours if necessary; in very severe cases exhibited as in Inklammv- tory li;vt;n. IVi.s \ti i.i. \, where the pains aro of a shifting nature, exa- cerbated towards erening or in bed, with paralytic or torpid sensation in the part affected, and more particularly when the dyspeptic symptoms given under this medicine (see Indicks- tion or Dvsi'kpma) present themselves, and when the pain is relieved by uncovering the affected limb. When, on the contrary, the pain is increased by uncovering, and relieved by warmth, the patient weak, depressed, and ex- hausted, Arsenicum will be found of material service in affording relief. Pains worse at night, with restlessness and constant ne- cessity to change the position of the extremities; pale and anx- ious or haggard countenance, are generally relieved by Ferrum, or Ferrum and Rhus in alternation; and in other cases by Cin., especially when there is sensibility to the touch, aud aggravation of the sufferings from the most trivial pressure or blow. Administration. *■* repeated in from six to twenty-four hours, according to results.* Nux vomica, when the pains are wor.se towards the morn- ing; a paralytic and torpid sensation, with cramps and Ihrob- bings in the muscles; and moreover, when iu addition to other « Y.4.- ....i... oafW Q.i. GOUT. 309 dyspeptic symptoms, we find constipation and hemorrhoids, or inclination to that affection, and an irritable or choleric tem- perament ; furthermore, when indulgence in wine or fermented liquors has been the inducing cause. Administration. Same as Pulsatilla. Bryonia, where the pains are increased, by the slightest motion; aggravation of suffering at night; coldness and shivering, with general perspiration or fever. For the dys- peptic symptoms present, see article indigestion, p. 95. Administration. Same as Put sal ill a. Each of the medicines here mentioned may successfully follow Aconite, when the febrile symptoms have been in some measure brought under by the administration of that remedy. In chronic cases, the applicability of the following medicines should be consulted : Argent., Lycopodium, Aurum, Sulphur, Calcarea carb., Colocynth, Hepar sulph., Colchicum, Phos- phorus, Conium, Daphne, Kali c, Causticum, Guajacum, Iodium, Rhododendron, and Manganum. Also, as intermediate remedies,—Arnica, Ledum palustre, and Sabina. In ARTHRITIS VAGA the following remedies have been recommended in addition to Pulsatilla: Nux v., Arnica, Man- ganum, Nux moschata: and alse Rhododendron, Plumbum, Daphne, and Asafoe'ida. ARTHRITIC NODOSITIES. Caustic, Lycopod., Au- rum, Ledum, Graphites, Rhododend., Calcarea, Sepia, Staphy- sagria. As also, Agnus, Antimon., Bryonia, Phosph., Sabina, Zincum. ARTHRITIC CONTRACTIONS are sometimes benefited by Sulphur, Causticum, Bryonia, Rhus, Guajacum : —or, Colocyn'h, Silicea, Calcarea, &c. Arthritis occurring in individuals whose occupations compel them to work in the water, i3 chiefly to be relieved by Calcarea, Pulsatilla, Sar- saparilla, and Sulphur.—And in some cases by Arsenic, Dul- camara, Antimonium, Nux moschata and Rhus.—Nux v. is one of the most important remedies against the precursory symptoms of gout; and Belladonna against recent metastasis. In CHI- RAGRA: Nux v., Bry., Lye, Cocc, Ant., Agn., Rhod., Sulph., Lach., Led., &c, are the most generally appropriate remedies. Anrl in PODAGRA: Arnica. Sabina, Ledum; in many cases 310 GENERAL UKRAJtoriirNr. are equally important; liry., Sulph., Calc, Core, Am. c. and muriat., Ambr., Lye, Ac. RI1 EI * M ATIS M Khcumatismus. Diagnosis. Pains in the muscular or membranous struc- ture, generally with swelling of the adjacent cellular tissue, with slight redness and increased generation of heat, caused by taking cold. This tlisease is of two kinds, tho Acute and Chronic; tho former is accompanied by fever, preceded by restlessness; heat alternating with chills; thirst; coldness of the limbs and extremities; constipation and accelerated pulse, followed by pains in the large joints, generally shifting their situation, leaving redness, swelling, and tenderness, of the parts affected ; it is also frequently attended with excessive perspiration and weakness. In the latter, or Chronic Rheumatism, the swelling of the parts, except in very severe cases, is commonly less per- ceptible ; sometimes there is present a feeling of general stiffness or numbness, with little or no fever. Other symptoms incidental to this complaint, we shall notice more particularly under the head of the different medicaments more efficacious in the treatment. The principal exciting causes are damp, chill, or a sudden check of perspiration. People who have resided long in a tropical climate or have been subject to continual exposure to cold or wet, are very liable to suffer from rheumatism in the chronic form. Tiikrapkutics. In the treatment of this affection, the fol- lowing medicaments have been found particularly useful: Aconitum, Belladonna, Bryonia, Chamomilla, Nux vomica, Mercurius, Pulsatilla, Rhus toxicodendron, &c. Aconitum when we find high fever, dry heat, thirst, and redness of the cheeks ; excessive shooting or tearing pains, extremely violent at night; occasionally redness or shining swelling of the parts affected; aggravation of pains by the touch ; excessive irascibility of temper. RHEUMATISM. 311 Administration. -6- in a little water, repeated every six hours, until the fever is lowered ; in very severe cases exhibited as in Inflammatory Fever, which see. Belladonna is useful when the pains are of a shooting or burning description, principally in the joints, aggravated by movement, and worse at night; when the parts attacked are much swollen, very red, and shining, and particularly when there is fever, with determination of blood to the head, with throbbing of the vessels of that part, and redness of the face, heat of skin, thirst, sleeplessness, pain. Administration. e6a in a little water, repeated every twelve or twenty-four hours, according to circumstances.* Bryonia may follow Aconite, or the preceding medicine, with great benefit, or be administered independently. The following are the more prominent symptoms: severe shooting pains, much increased by motion of the affected part, or by a cold draught of air; swelling of the joints of the upper and lower extremities; headache, gastric derangements, and con- stipation ; pains aggravated at night, or particularly on the slightest irritation; irascibility and perverseness of temper; the pains seem situated more in the muscles, and particularly about the joints, than in the bones. Administration. Same as Belladonna. In general cases it is advisable to repeat the medicine in twenty-four hours. Chamomilla when we find dragging or tearing pains, with a sensation of numbness or of paralysis in the parts affected, feverishness; great agitation and tossing; desire to remain lying down; perspiration ; exacerbation of suffering at night, with temporary relief from sitting up in bed, or frequent chang- ing of posture. Aching pains all over on awaking in the morning, and chilliness during the day. Administration. &3-, in the same manner as Belladonna. Nux vomica \-, when there are, sensation of numbness, paralysis, or tightness in the parts affected, with cramps and palpitation of the muscles; pains of a dragging description, chiefly confined to the joints, trunk of the body, back, loins, » Vide note, p. 21. 312 general dkranokmest. and chest, aggravated by cold; gastric derangement; consti- pation; irritability of temper. Cocc. and Ignat. after Mux. Administration. Sain.-as Belladonna. Mercurius is indicated in cases where tho pains are in- creased by the warmth of the bed, or exposure to damp or cold air, aggravated at night, and especially tor-arils morning: also where there is considerable puffy swelling of the parts allected. This medicine is particularly useful when the pains seem seated in the bones or joints; prol'u.se perspiration without alienation of suflering, is also a good indication for its employment. (Lachesis is often efficacious when Mercurius fails to relieve the foregoing symptoms.) Administrai ion. Same as Belladonna. Pulsatilla £§, is useful in shifting rheumatic pains, par- ticularly if attended with a sense of torpor or paralysis, relieved by exposure to cool air, worse at night or in the evening. Ad.ministk.ytion. Same as Belladonna. Ruts toxicodendron °t, is indicated when there are: Sensation of torpor, dullness, and crawling, with feeling of paralytic weakness or trembling of the extremities when at- tempting to move them; sensation of bruising or of laceration, as if the flesh were torn from the bones, or as of scraping of the bones; pains worse during rest, relieved by motion ; in- flammatory or shining redness in the joints, with stiffness, and sometimes a darting pain when handled; aggravation of suffering in cold or damp weather. This remedy may some- times follow Bryonia with considerable advantage. Ferrum is sometimes useful in alternation with Rhus, particularly when the pains are relieved by frequently shifting the position of the limbs. Colchicum. Rheumatism, with gastric derangement and slight fever during the prevalence of cold, damp weather. Administration. Same as Belladonna. Obstinate cases of rheumatism frequently require a long, careful, and discriminative treatment. In some cases much benefit will be obtained from repeated doses of Sulphur ; in others, Calcarea, particularly when the pains are increased at every change of the weather. If, par sulphuris and La- rheumatism. 313 chests alternately havw been recommended in the severest kinds of acute rheumatism. Colocynth is frequently useful against the stiffness which remains. In the event of a sud- den metastasis to the chest, attended with oppressed respi- ration, palpitation of the heart, and excessive agitation, Aco- nitum should be immediately administered in repeated doses until relief is obtained; but should improvement only prove temporary, Sulphur and Pulsatilla have been recommended to be given in alternation. Belladonna and Bryonia may also be of service in dangerous results of this kind. When the heart becomes implicated in acute rheumatism or rheumatic fever, (endocarditis rheumatica,) Bellad. °^°, in repeated doses, is a useful remedy if timely administered; and may in some cases be advantageously employed in alternation with Aeon., and fol- lowed by Spigelia a|a and Digitalis -%&; also Arsenicum. These remedies,'together with Cannabis, Arsenicum, Lache- sis, in some instances are the most valuable in the treatment of idiopathic Endocarditis or Carditis. For Chronic Rheumatism, the following are the principal remedies: Sulph., Lycop., Caust., Hepar, Lach., Phos., Veratr., Clem. When the pains are aggravated or excited by the slightest chill,—Aconite, Calc, Bry., Dulc, Merc, Sulph., Acid, phos., will generally be found the best from which to select a remedy. When the attacks are excited by unfavourable weather,—Calc, Rhus, Dulc, Rhod., Verat., ox Lycop., Carb. v., Lach., Hepar, Maug., Nux m. And when every change of weather brings on a relapse,—Calc, Silicea, Sulph., Dulc, Merc, Lach., Rhus, and Veratrum, are usually the most useful. For rheumatism arising from a chill in the water, or from cold, moist weather,—Calcarea, Nux m., Sarsaparilla, or Sulph., Dale, Carfrv. Rheumatism with paralytic weakness,—Arnica, Ferrum, China, &c. Against unsettled or shifting or rheumatic pains, in addition to Pulsatilla: Arnica, Bryonia, Nux m., and in some instances Rhus, Rhodo., Daphne, Mang., Plumb., or Crocus, Valeriana and Asafoet. Rheumatism from congelation,—Arsenicum, Bryonia, Nux 14 314 GENERAL DEK ANOEMF.NT. LUMBAOO. Diagnosis. Violent pain of a rheumatic character in the lumbar region, either periodical or pennaneiit, frequently ac- companied with a considerable degree of fe\er. Therapeutics. The medicines most valuable in its treat- ment are : Aconite, Bryonia, Nux romica, Rhus toxicodendron, Bi 'la l".-nw, Pulsatilla, and Mercurius. Administration and Potencies of tho remedies. Same as in Rheum vtism, which see. Aconite may be given al the commencement if much fever declare itself. Bryonia where the pains in the back, are of a severe pressive description, constraining the individual to walk in a stooping position; aggravated by the slightest motion, or draught of cold air, and attended with a general sensation of chilliness. Nux vomica is particularly indicated when the pains re- semble those produced by a bruise, or by excessive fatigue ; als.. when they are much increased by mo'ion and turning in bed at night, and attended with considerable weakness; and moreover, when irritability of temper and constipation are present. This is a valuable medicine in chronic cases, and may fol- low Bryonia in acute lumbago with considerable advantage. Rhus toxicodendron may be exhibited when the same indications as those given under the preceding medicine are present, with the distinction of the pains being u..graruled by rest. It is also a useful remedy in chroirtficases. Belladonna, when the pains are deeply seated, causing a sensation of heaviness, gnawing, or stiffness; it may follow Aconite with considerable benefit, when slight inflammatory symptoms are present. Pulsatilla, when the pains, resembling those mentioned under Nt x vomica, are moreover attended with sensation of constriction; it is particularly indicated, as remarked in other INFLAMMATION OF THE PS0A8 MUSCLE. 315 parts of this work, for females, or individuals of mild, sensitive, or phlegmatic temperaments. Mercurius, when the pains are.much of the same descrip- tion as those given under Nux vomica, but considerably aggravated at night, incapacitating the sufferer from taking rest. (See also Rheumatism.) INFLAMMATION OF THE PSOAS MUSCLE. Psoitis. Diagnosis. Pain in the renal region, hip, and downwards to the leg. The limb can neither be stretched nor drawn up- wards without pain ; in walking, there is hobbling in the gait, with the body inclined forward; turning in bed, or lifting any weight, increases the pain. Occasionally, but seldom, we find swelling of the psoas muscle and in the region of the groin ; it in some measure resembles Nephritis, from which, however, it is distinguishable by the absence of disturbances of the urinary system, etc. This disease is generally more painful than dangerous; it may, however, prove fatal from matter forming and discharg- ing itself internally into the cavity of the abdomen, but more frequently abscesses open in the groins, anus, peringeum, or thighs ; it may also produce caries. Therapeutics. The remedies given under Lumbago and Rheumatis.m (which see) are equally useful in most cases of this disorder; however, as there is generally a greater degree of fever present than in that affection, Aconitum, followed by Belladonna, should generally form the commencement of our treatment. The following may be mentioned in addition: Colocynth, when there is a feeling of contraction in the psoas muscles when walking, and the disease is more of a chronic nature. Administration -8a, repeated in from twelve to twenty- four hours, according to circumstances.* 21. 316 GENERAL DKRAN'.IKMENT When shiverings or rig.uirs aro complained of, followed by a sensation of throbbing, and increase of pain in the affected part, and we have reason to apprehend incipient suppuration, we may exhibit S.'uphi/s.igria iu repeated doses, followed by Silicea or Hepar, to bring the abscess to a head as quickly as possible, and thereby relieve the sufferings of tho patient. In by far the greater number of cases of Psoas or Lumbar abs,;ss, however, wo have no premonitory symptoms which might lead us to anticipate such a disease, and aro but too often unaware of the existence of the disorder until an exter- nal tumour is formed. (See Chronic Aiisi-ess.) When the bones have become affected, or when abscess has arisen from diseased vertebrae, Silicea may be productive of all the benefit we can look for in so serious a state of matters. Stapiiysagria may follow the above when a discharge of a peculiarly offensive sanies takes place. Aur nn. Asalwtida, Argentina, Plumbum, or Sulphur may also prove of service in the latter form of lumbar abscess. SCIATICA. Diagnosis. Pain in the region of the hip-joint, which frequently extends to the knee and foot, following the course of the sciatic nerve. It often interferes with the motion of the foot, causing stiffness and contraction. Therapeutics. The remedies arc Aconitum, Arsenicum, Chamomilla, Ignatia, Nm vomica, Pulsatilla, Colocynth and R'uts loxicodenelron. Aconitum. When considerable constitutional disturbance attended with fever i3 present. Administration. ^° in a little water, repeated every six hours till the fever is lowered. Arsenicum. When burning pains are complained of, or sometimes a sensation of coldness in the affected part—acute dragging pains in the hips with great restlessness, obliging patient to move the limb frequently in order to obtain relief occasional intermission of suffering, or periodical return; great sciatica. 317 Weakness and inclination to lie down—mitigation from the application of external heat. It is also useful in those cases of marasmus or emaciation arising from a long continuance of want of rest, the result of pain, and from derangement of the digestive system. Administration. -b-, repeated in from twelve to twenty- four hours.* Chamomilla. More particularly indicated when the pains are frequent at night, attended with excessive sensibility and irritability of fibre ; sensation of torpor in the affected parts. Administration. -~, in the same manner as Arsenicum. Ignatia. When the pains are of an incisive nature, par- ticularly on moving the limb, and more especially when occur- ring in individuals of a mild, melancholic temperament, or in dispositions disposed to alternations of extremely high and low spirits. Administration. Same as Arsenicum. Nux vomica. When the pain becomes aggravated towards morning, and is attended with a sensation of stiffness and contraction so as to interfere with the motion of the foot, and also a sensation of paralysis or torpor and chilliness in the parts affected, and particularly in individuals of an irritable temperament. Administration. Same as Arsenicum. Pulsatilla. When the pains are aggravated towards evening, and during the night, or when seated, but somewhat relieved in the open air; this remedy is best adapted for an individual of mild disposition and leuco-phlegmatic tempera- ment. Administration. Same as Arsenicum. Colocynth is an important remedy in this distressing dis- ease. It has been found of the greatest service in cases where the rio-bt leg was affected, and the pains liable to be excited, or much aggravated by a fit of anger or indignation. Rhus. This medicament is more peculiarly indicated when the pains are aggravated by rest, relieved by motion, or by * V,Ha nnta n 21. 31^ GENERAL derangement. warmth; with disposition X melancholy or an unaccountable feeling of dread. Veratrum, S'apli'y.sagria, Manganttm, Me.cn um, If-par v., Sepia, Phosphorus. Rut a. kali c, Coniu n. etc., may also be found useful in particular cases of this complaint, or \Tavated towards night, and even when in a state of rest. (Acid. nitr. is sometimes useful after Puis.) Administration f, in six teaspoonfuls of water, one daily. • Vide note, p. 21. 320 ULNERAL DIRANT.t.ME.N I Hepar sulphuris is chiefly useful in case of exudation, and may in such instances follow Mercurius with some advantage. Administration. A grain of the trituration at the third potency in an ounce of water, a dessert-spoonful every three or six hours, according to the result. Colocynth •§ is a useful remedy in subacute or chronic cases, when the pain is constant, and of a squeezing description, accompanied by a sensation as if tho entire joint were tightly and painfully bound ; also when the attacks are liable to be brought on or excited by a fit of passion, indignation, or mortification. Arsenicum. Pain or shoots a*ong the interior of the affected limb like a hot stream, increased by every movement or change of temperature: paleness of the face, oppression at the chest, attacks of faintness. The following remedies have also boon found useful in many cases: Sulphur, Silicea, Grtph'tes, Bryonia alba, Calcarea carbonica, Di'ilalis, Argrntum, Arsenicum, Acidum nitricum, Creosotum, Asafa-tida, Aurum foliatum, Cantharides, La toxicodendron. Darting or dragging or tearing pains in the hip-joint, accompanied with tension or stillness ot the muscles, most painful when iu a state of rest ; and severe pain on arising from a sitting posture. Adminisiha i i..N. A drop of the tincture at the third po- tency, exhibited in the same manner as Bc/'adonna. Colocynth has been found of much value in this disorder, either after Bellad. and Merc, or in preference to these modi- cines when, from the commencement, the hip-join^ is described to feel as if firmly and painfully bound by an iron clasp, with pai.t extending down the limb, and stiffness in the knee-joint. Si limiur is called for in chronic ca.es, particularly when arising from a scrofulous or psoric metastasis. Administration £, in six dessert-spoonfuls of water daily. In cases of aliscess or caries in this disease, Silicea and Cal- carea phosphora'a may be pointed out. The following remedies are likewise descrying of attention in the treatment of this serious malady : ( ' dean a, Bryonia, lie- par s , Aridum phosphoricum, Phosphor, and Lachesis. In affections of the Knee-joint, Si.'/eea forms one of the most important remedies, paiticularly when the disease begins in the synovial membrane. Acid, nitr., Aurum, Acid, phosph., Lycopodium, Lachesis, Sulphur, or Calcarea, have, in addition to .S'.- icea, been found useful in inflammation of the suioyial membrane of the joints, in consequence of the effects of .Mer- cury ; and Rhus, Bryonia, Lycop., \ux v., China, or Sulphur, when as a result of gout or rheumatism Sulphur and Calcarea have chiefly been recommended in lymphatic or scrofulous en- largement of the knee; but also the following in .some cases : Silicea, Lycop., Arsenic-, Indium, and Arnica. In the event of suppuration : Sdicea, Mrr., Hepar s.; and in that of serous infiltration: SU,, ,a and Sulph. ; or Cal- carea, Merc, i>d iu in. In glazed or shining, white, soft or DETERMINATION OF BLOOD TO THE ABDOMEN. 323 doughy swellings of the knee : Pulsat. ; also in soft, colourless swellings of tlie knee, whether painful or otherwise. Sometimes the alternate employment of lolium and Pulsat. is required, especially in strumous habits. When the swelling is red, painful: Bryonia, or Bryon. and Iodium in alternation, in scrofulous subjects. DETERMINATION OF BLOOD TO THE ABDOMEN. Congestio visre ■um abdominis. Congestio ad abdomen. This derangement is characterized by a disagreeable or pain- ful sensation of weight, heat, and burning, with hardness and tension in the lower portion of the abdomen. Nux vomica is one of the most frequent sources of relief in those who lead a sedentary life, or are much addicted to over- indulgence in the pleasures of the table, and particularly when the following symptoms are complained of: hardness, tension, and fixed pain in the abdomen, sense of great weakness or pros- tration, rendering it difficult or almost impossible to walk about; constipation, with pain in the loins, spirits oppressed and irritable. Administration, A/0°-, in a teaspoonful of water, repeated in four days. Sulphur will frequently be found serviceable in completing the cure after the above, or it may be selected in preference in cases of long standing, when we meet with the following indi- cations : dull pains, and disagreeable sensation of distention in the abdomen, constipation, tendency to obstinate hemorrhoidal attacks, extreme dejection. Administration. -3flo°> repeated every five or six days until improvement results, or an alteration in the symptoms calls for the employment of some other remedy. Carbo vegetabilis may be selected when the symptoms are accompanied with excessive flatulency, and will frequently be found of great service in some obstinate cases when alter- nated with tbe two preceding remedies. 324 GENERAL DERANGEMENT. Adminmtr ation. fl3°u\ in three dcsscrt-spoonfulx of water; a dessert-spoonful daily ; repeated in the same manner four or five days after. Arsenicum will also bo found useful, .specially when there is a disposition to diarrha-a with extreme weakness: or— Capsicum, when these symptoms occur in individuals of a lymphatic temperament. The two latter remedies may bo administered in tho same manner as is described under Carbo rc.<:ctabilis. Sepia is often of much utility in tho case of females, par- ticularly when tlie symptoms aro analogous to those described under Sulphur. Administration. Same as Sulphur. In particular cases, the following will also be found useful: Pulsatilla, Belladonna, Mercurius, Bryonia, Lycopodium, Chamomilla, Rhus toxicodendron, Veratrum. In consulting the articles on Dyspepsia, and Hemorrhoids, the reader will find further assistance in the selection of the above remedies. Daily exercise in tho open air, together with a careful at- tention to regimen, must be observed by those who are afflicted with this affection. ACUTE INFLAMMATION OF THE EYES. Ojiltl 'ia'miu. Diagnosis. Superficial bright scarlet redness, pain, and beat of the eye, generally with marked sensibility to the action of light; either with dryness or an increased secretion of ophthalmic humours. When severe, accompanied by cepha- lalgia, febrile symptoms, and increased intolerance of light, par- ticularly when the entire eyeball ( O/drhalmi'is) or the sclerotic coat is affected ( Sclero'itis), in which latter case, moreover, the redness presents a pink appearance. This affection may arise from a variety of causes, such as ex- posure to extreme light, the strong heat of a fire, particularly after coming out of an extremely cold atmosphere, external in- juries, or cold. INFLAMMATION OF THE EYES. 325 Therapeutics. The following remedies are those most generally required in the treatment of this affection, according to the form in which it presents itself, namely : Aconitum, Bel- ladonna, Nux vomica, Cinchona, Digitalis, Euphrasia, Ignatia, Arnica montana, Pulsatilla, Mercurius, and Sulphur. Aconitum. Valuable at the commencement of the treat- ment, in general cases of non-catarrhal inflammation ; but even in a simple inflammation of the conjunctiva or simple catarrhal ophthalmia, should the inflammation be considerable and at- tended with Jever. Administration y, repeated in from six to twelve hours, until the inflammation is lowered. Belladonna, if great sensibility to light remains. Also in Acule, Arthritic, Rheumatic, and even Scrofulous ophthalmia, when the following symptoms present themselves : redness in the conjunctiva, margin of the eyelids, and corner of the eyes, with a swollen and tumid appearance; or redness of the sclero- tica, with intolerance of, and pain increased by light; great sensibility of the eyes and eyelids; aching pains above and around the orbits, or pains which penetrate deeply into the or- bits and head, with aggravation on moving the eyes ; flashes of light, sparks or darkness before the eyes, with extreme dimness of vision towards evening ; objects appearing reversed or double; moreover, when there are the following catarrhal symptoms : severe cold in the head, with acrid discharge, causing excoria- tion and sometimes an eruption of pimples under the nose, and on o'r about the lips; periodical return of short, dry, barking, spasmodic cough, aggravated towards night, and severe headache. (Mercurius and Hepar s. are often required to complete the cure after the employment of Belladonna.) Administration %°, in a little water, repeated every six, twelve or twenty-four hours, according to the severity of the * Nux vomica. In catarrhal, arthritic, or rheumatic inflam- mation of the eye, when there are burning, pressive, or aching pains, feeling as of sand in the eye, with stiffness, smarting, • Vide note, p. 21. 326 general derangement. tickling, and itching: foul tongue, and other symptoms of disordered stomach ; slight !«-\er in the morning and (..winds evening; irritable temper; pressure on the eyes and eyeballs on attempting to open them; redness of the eantlii; the eye sircaked, hi .od-shot. and swollen, with adhesion of the cwlids; sensibility to light ; briny lachrymation; affection worse towards morning. A//jt. ami 1'uls-i'illa. aro two of the most useful remedies in simple inflammation of the conjunctiva, particularly at the commencement of the attack ; but Sulphur is often re- quired to complete the cure. Admintsiu \ i ion. y, in a little water, repeated in twenty- four hours, or sooner if required.* Cinchona. When the inflammation is less intense, but the motion of tin- eye painful, and tlie sensati n before noted as of sand iu the eve, with the distinction of the affection, exacerba- tion towards ia ning ; when the pains are of a burning or pres- sive nature, with headache in tho forehead, as if arising from a sujiprcss'un ol he nasal dis hart e. Administration. Same as Nux vomica. 0 Arsenicum chiefly iu catarrhal aud scrofulous ophthalmia, when there exists a violent burning pain, or pains of so severe a description as almost to drive the paticnl distracted ; specks and ulcers on tin: cornea. Administration, Same as Nux romica. Euphrasia. For the exhibition of this medicine, the par- ticular indications are: white of the eye much inflamed and of a pink or rose colour (Sclero'Uis) ; painful pressure ami smarting in the eyes ; profuse and acrid flow of tears, excited or increased by exposure to cold ; copious secretion of niucu3, sometimes sanguinolent; or bright redness of the conjunctiva, with distention of the veins; minute pustules on different parts of the conjunctiva ; white opaque specks on the cornea; exees- sive intolerance of light (scrofulous inflammation of the con- junctiva; ; severe cold in the head, with profuse Jlwnf nasal discharge; violent headache, and aggravation of the .symptoms towards evening. * Vide note, p. '.il. INFLAMMATION OF THE EYES. 327 Administration. Same as Nux vomica. Ignatia may be administered with advantage when there is pressure in the eyes, profuse flow of tears, great intoler- ance of light, but with little or no perceptible redness of the eyeball; severe coryza; in catarrhal, rheumatic or scrofulous inflammation. Administration. Same as Nux vomica. Pulsatilla. Aching, or burning and smarting irritation in the eye as if from the insertion of sand under the lids, with scarlet redness of the eyes and eyelids, and copious secretion of mucus, disordered stomach, foul tongue, and chilliness to- wards evening, followed by febrile heat; or pricking, shoot- ing, piercing pains in the eye, with bright redness of the eyes, and profuse lachrymation, especially on looking at the light, or on going into the open air, and generally of a scalding or acrid nature ; or, on the other hand, excessive dryness of the eyelids,, especially in the evening, with nocturnal aggluti- nation ; photophobia; swelling of the lids; aggravation of the symptoms towards evening; sensitiveness with disposition to Vfeep. (Ferrum is occasionally very serviceable after Pulsa- tilla, especially in scrofulous ophthalmy ; at other times, Su^ hur is preferable.) Administration. Same as Nux v. Mercurius. In many cases of catarrhal, rheumatic, and scrofulous oph'halm'w, as also in irtis, this medicine is fre- quently to be employed with advantage. Its, ordinary indica- tions are : lancinating pains, or painful and irritating pressure as if from sand, especially on reading, or otherwise fatiguing the eyes, but also when at rest in bed; pricking and itching in the eyes, particularly in the open air; rose-coloured redness of the eve (sclerotitis), with injection of the veins; profuse lachry- mation; great sensibility to light, but especially that of the fire or candle; vesicles aud pustules on the sclerotica : ulcers on the cornea ; pus'ules and scabs round the eyes, and at the margins of the eyelids; cloudiness of the sight; violent pains in the orbit and forehead ; renewal of the inflammation on the slightest exposure to cold. (Hepar s. or Sulphur is frequently required after Mercurius.) 32 S GENERAL DBHAMiKMK.M. Sulphur is an important remedy in inflammation of all kinds, whether catarrhal, rheumatic, or scrofulous, when of an obstinate or inveterate character. It is, however, more particularly indicated by the foil .wing symptoms: pressure, smarting, and burning as if from sand; itching in tho eyes or eyelids; dimness of sight, with dusky appearance of specl.s, ve- sicles or jiustules and ulcers on the cornea ; pustules or granular elevations in the eyelids, and scabs round the orbits ; inflam- mation of the iris, with irregularity of the pupil ; copious lachrymation, and encssicc jhotin hobia, and aggravation or suffering on moving the eves; painful dryness of tho eyes, especially within doors ; contraction of the eyelids; imperfect vision, with scintillations; cephalalgia, and 'violent pains in the orbit, etc. Chronic cases of this affection frequently require a long and careful course of constitutional treatment to effect a perfect cure; one of our best remedial agents for this end is Hepar sulphuris, which is also of great service in acute attacks after Bella, or Merc., in individuals predisposed to this affection. Among the other medicines which may be consulted with ad- vantage in catarrhal, rheumatic, or even scrofulous ophthalmia, are: Sulphur, Calcarea carbonica, or Causticum, Graphites, Sipia, Spigclia, Acidum sulphuricum, Pe'rolenm, Lachesis, Acidum nitricum, Ferrum mcluHiciim, Colocynth, etc. If the inflammation arise from external injury, caused by a blow, or the entrance of any foreign body in the eye, we may exhibit Aconitum, and follow it in about twelve or sixteen hours with Arnica \", bathing the eye occasionally at the same time with a lotion of Arnica ; five drops of the tincture to an ounce of water; and should the said treatment not suffice to effect a cure, Sulphur must be had recourse to, followed, if called for, by Calcarea, or any other remedy which may appear better in- dicated. Finally, the following may be pointed out as being eminently useful, or worthy of attention, in the varieties of oph- thalmia enumerated. For CATARRHAL OPHTHALMIA, in addition to those above mentioned : Chamom., Hepar sulph., Lycopodium. INFLAMMATION of the eyes. 329 RHEUMATIC (Sclerotitis :) Bryonia, Chamomilla, Rhus, and Veratrum; Lycopodium, Spigelia ;* in addition to those described under the heading of Inflammation of the eye. SCROFULOUS : Arsenicum, Conium, Hepar s., Sulphur, and Calcarea; also Dulcamara, Causticum, Ferrum, Gra- phites, Sepia, Petroleum; or Aurum, Baryta c. et m., Lyco- podium, Cannabis, Chamomilla, Digitalis, lodium, Mrcurius Corrosivus,t Magnesia, Natrum m., in conjunction with those which have been alluded to as suitable to this variety of the disease at the commencement of this article. SYPHILITIC: Mercurius and Acidum nitricum chiefly; in some cases, Aurum, Lachesis, Suljihnr, Bellad. SYCOSIS : Thuj. Acidum nitr., and sometimes Merc. GONORRHOEAE : Pulsatilla chiefly; also Tussilago pet. ABUSE OF MERCURY under previous allopathic treat- ment : Hepar sulphuris, Acid nitricum, Sulphur, Pulsatilla, and in some cases Belladonna, Lachesis, Staphysagria, Lyco- podium, Thuja, or Cinchona. FUNGUS HJ^MATODES: Thuja, Carbo a., and Phosph.% IRITIS ARTHRITIC A : Cocculus, Staphysagria, Conium, Lycopodium, Calcarea, Nux v., Bryonia. IRITIS MERCURIALIS : H-par s., Acid, nitr., Lach. In ULCERATION OF THE CORNEA, the following remedies have hitherto been employed with the most satis- factory results: Arsenic, Euphrasia, Sulphur, Lachesis, Cal- carea, Bellad, Mercur., Hepar sulph., Silicea, and Natrum m. SPECKS ON THE CORNEA, or Opacity of the same: Belladonna, Euphrasia, Sulphur, Calcjirea, Hepar sulphuris, Pulsatilla; as also: Arsenicum, Acid, nitricum, Cannabis, Magnesia, Aurum, Lycopodium, Silicea, Sepia. * Spigelia is specific in a large number of cases of arthritic and rheu- matic ophthalmia. Aroii.it. is required in the first place. Sulphur, pre- ceded by or alternated with Acon., is of nearly equal efficacy in some in- stances. ■• t Efficacious in the acute scrofulous ophthalmia, with ulceration of the cornea and disposition to staphyloma, hypopyon, etc. t For the description of the cure of an interesting case of fungus hae- matodes of the eye, vide Brit. Journ. of Homaopathy, No. 2. 330 GENERAL DERANCEHENT. CATARACT. The remcdi -s which have chiefly been de- scribed as eilica -iou> in this affection of the eye are : Su'phttr, Silicea, Canntbi.s, Caustic, Conium, Mignc-srt, Phosph., etc.* STRABISMI'S: In addition to the ordinary simple mecha- nical remedies, great assistance has been derived from, and in other instances the cure solely effected by, Bc'ladonna and Hi/ isr-y n.ais, when the affection was ti"t of too long standing. FISTULA L.UTIRYMAUS. The following remedies have been employed with success in this affection : Petrol., Silicea, S'annum, Ca'carca, Pu'sa'i'la, Suljihur, Licit., Acid Jluur. WEEPING or WATERY EVE (involuntaryflow s.s.o^ w}jen ^}ie affection has arisen from a chill or wetting, will, in many cases, prove sufficient for its re- moval ; it is also indicated when the pains increase at night, and are attended with nausea. Camomilla 0fi23°-°-Q., when there are scabbing pains in the ear, as from knives; great sensibility to noise, or even to music ; extreme sensitiveness, susceptibility, and irritability. Against humming or buzzing iji the ears, Nux v. will be found serviceable in recent cases, when the annoyance is worse in the morning; Pulsatilla when in the evening; Dulcamara when at night; or Mercurius when accompanied by sweating. China, Carbo v., and Acidum nitricum when the affection oc- curs in individuals who have taken mercury in large quantities. In chronic cases, Aurum, Petroleum, and Causticum, etc., have been found useful; the last-named remedy, particularly when there is great sensibility to cold, and tendency to suffer from rheumatic pains in the limbs. OTORRH03A. When this disorder results from acute in- flammation of the ear : Pulsatilla, Sulphur, and Mercurius, are the principal remedies. CATARRHAL or MUCOUS OTORRHCEA. Belladonna, Mercurius, Pulsa'dla, and Sulphur, chiefly. PURULENT OTORRHEA. Mercurius, Pulsatilla, Sul- phur, Belladonna, and Hepar,—or Silicea, Calcarea, Causti- cum, Acid, nitricum, Asad'ce'ldi, Lachesis, Petroleum, etc. When the discharge is offensive, Causticum, Hepar, Aurum, Carbo v., Sulphur, and Silicea. SANGUINEOUS OTORRHCEA. Mercurius, Pulsatilla, and Silicea,—also Lachesis and Cicuta, etc. When ^the dis- order has arisen from the abuse of mercury : Hepar s., Acid. nitricum, Aurum, Asafcetida, Sulphur, and Silicea, have proved the most useful; and when over-doses of sulphur appear to have given rise to it, Pulsatilla and Mercurius. When we have reason to apprehend caries of the ossicula au- ditoria: Silicea, Sulphur, Aurum, aud Natrum m., are the remedies from which we may hope to obtain the most assistance, Against the effects of suppressed otorrboea: Belladonna, 336 general derangement. Pulsa'dla, and Mercurius ; and, in some eases, Nux v., Bryo- nia or Dulcamara, may be selected, according to circumstances. Belladonna and Bryonia chiefly when there is fever, headache, or unequivocal signs of cerebral irritation ; .Mercurius, Bi da- donna, and Pulsatilla, followed, if required, by Sulphur, Cal- carea and Hepar, when the glands of the neck or the parotids become tumefied. When orchitis results : Pulsatilla and Nux V. or Mercurius. Iu PYSECOIA or DEAFNESS, the following remedies have chiefly been employed with the most success : Pulsatilla, Mercurius, Sulphur, Calcarea, Causticum, Graphites, Ledum, Acid, nitricum, Phosphorus, Petroleum, Ammonium c, etc. For CONGESTIVE DEAFNESS: Belladonna, Hyoscy- t amus, Sulphur, Silicea, Mercurius, Graphites, Phosphorus, etc., have more particularly been recommended. NER VOL'S DEAFNESS: Causticum, Petroleum, Phos- phorus, Add. phosphoricum, etc. CATARRHAL or RHEUMATIC DEAFNESS : Mercur., Pulsat., Arsenic, Bellad., Ledum, or Sulph., Calcarea, Hepar, Lachesis, Acid, nitr., Chamomilla, and Coffea, Deafness from the repercussion of chronic eruptions: Sulphur and Antimonium;—or, Causticum, (rraphites, etc. When deafness results as a sequel of measles, Pulsatilla is one of the most useful remedies; in other cases, Carbo v. will be found requisite. When after SCARLATINA : Belladonna and Hepar. SMALLPOX : Mercurius and Sulphur. DEAFNESS from the abuse of Mercury is generally capable of being removed, or materially relieved, by Acidum nitr., Staphysagria, Asafcetida, or Aurum ; Hepar s., Sulphuris, Petroleum or Sulphur. When the disorder is attributable to hypertrophy of the amygdalae : Aurum, Mercurius, Add. nitri- cum, and Staphysagria, have principally been recommended. When in consequence of fevers, or other disorders, particu- larly of a nervous character : Phosphorus, Acid, phosphoric., Yirafrum, and Arnica; and when occurring as a result of a suddenly checked discharge from the nose or ears: Hepar, Lachesis, and Ledum',—as also: Belladonna, Mercurius, and Pulsatilla, have genera1^' V>^or- X"^ *^« ~.^«.* «.~~-~—.;«*~ 337 BLEEDING OF THE NOSE. Epistaxis. Bleeding at the nose often appears at the termination of many diseases, such as fevers, epilepsy, etc., and is in such instances salutary; it also frequently relieves or cures head- ache, vertigo, etc., and ought therefore not to be interfered with, unless it be excessive, last too long, recur too frequently, or take place under a debilitated state of the system. The attack is frequently preceded by a degree of quickness of the pulse, flushing of the face, throbbing in the temporal arteries, confusion or dimness of sight, heat and itching in the nostrils, and other signs of congestion. The remedies usually required are: Aconitum, Arnica mon- ta.na, Belladonna, Bryonia, Cinchona, Pulsatilla, Mercurius, Rhus toxicodendron, Secale cornuium ; or Carbo vegetabilis, Graphites, Causticum, Magnes artiflcialis, Ammonium muria- ticum, Ferrum, Kali Sepia, Sulphur, Calcarea, Acidum nitri- cum, Baryta, Bovista, Crocus, Conium, Cina, etc. When the bleeding is excessive, Acon., Am., Bellad., Cin., Merc, Pals., Rhus., or Sec, are the most useful. When the hemorrhage arises from congestion in the head, a preference may be given to Acon., Bellad., Cin., Crocus, Con., or to Graph., Rhus., Chamom., Alum., etc. When from being overheated, or in consequence of indulging to excess in spirituous liquors, etc., Nux vomica, or Aeon., Bel I ad., Bryonia, Thuja. EPISTAXIS in females who have too scanty catamenia: Puh., Graph., Caustic, Sep., or Sec. In those, on the con- trary, who have too copious a menstrual discharge : Acon., Calc, Croc, Sabina. In debilitated subjects, or those who have previously been exhausted by loss of humours, Chin, chiefly, or Sec. and Ac. nitricum. In consequence of physical exertion, Rhus, or Arnica principally. Tn ponseouence of a blow or contusion, Arnica. 33=s GENERAL DERANGEMENT. Bleeding from the nose in children, arising from worms: Cina or Merc. At every attack of COllYZA : Pulsatilla or Arsenicum. When nasal hemorrhage is liable to occur from the most trivial cause : Sulphur, Silicea, Sepia, Calcarea, and Carbo /-., and in some cases, G-aphites and Li/copodium aro the best remedies to eradicate the constitutional tendency. The following arc characteristic indications for some of tho above remedies. Aconitum *§*. Prolonged or violent bleeding at the nose, in plethoric subjects, with a considerable degree of fever, flush- ing of the face, pulsation of the temporal and carotid arteries, or general fulness of tho vessels of the head. Belladonna "Is-. Frequently of the greatest service, after, or in alternation with the above remedy, but also when there is bleeding from the nose at night, which aial.ins the pa'lent from slec, and sometimes returns in the morning ; bleeding from the nose from being overheated. (See Bryonia and Rhus.) Bryonia i§2. Bleeding from the nose, chiefly in the morn- ing, or at ni'hl durng sleep, causing tho patient to awake; epistaxis from suppressed menstruation ; bleeding of the nose from overheating during warm weather, obstinate or irritable disposition. Mercurius . Bleeding of the nose during sleep, or while coughing, with speedy coagulation, so that the blood hangs in clots at the nostrils; bleeding from the nose, preceded by tightness round the head, as if it were bound. Carbo v. \°. Bleeding at the nose during Ihe night, with ebullition of blood; violent nasal hemorrhage in the morning while in bed, followed by pain in the chest; discharge of a few drops of blood from the nose every forenoon; excessive bleed- ing from the nose several times a day, particularly after stoop- ing, or after every exertion, preceded and followed by great paleness of the face. (Sec Rhus.) Graphites °£. Bleeding of the nose towards night, with heat in the face, preceded by determination of blood to the head in the after-part of the day, particularly in females who have scanty catamenia. (See Pulsatilla aud Causticum.) bleeding of the nose. 839 Pulsatilla -§-. Hemorrhage from the nose every after- noon, evening, or before midnight, especially in females with suppressed or scanty catamenia, or in those of a mild and placid disposition. Causticum °|°. Violent bleeding at the nose, chiefly in females in whom the menstrual flux is extremely scanty. Magnes. artificialis. Bleeding from the nose, particu- larly in the afternoon, preceded by aching and weight or pres- sure at the forehead; protracted bleeding after blowing the nose. Arnica °f°. In addition to being the principal medicine in violent nasal hemorrhage from external injury, or from great physical exertion, is, moreover, an important remedy in all cases in which the hemorrhage is preceded by itching in the nose and forehead ; and when the nose feels hot, and the blood discharged is red and liquid. Rhus °|°. Bleeding of the nose from physical exertion, such as lifting a heavy weight, or, when blowing the nose, spit- ting, etc., or nasal hemorrhage, which becomes aggravated or renewed on stooping, or during the night. Ferrum -„-. Nasal hemorrhage in debilitated subjects, with excessive paleness of the face. (Especially after China.) Sepia °g°. Frequent attacks of hemorrhage from the nose, with pale or sallow complexion, especially in females with ob- structed catamenia. Sulphur, either alone or in alternation with Sepia, and sometimes Carbo vegetabilis, Graphites, and Lycopodium, is of great service in removing a susceptibility to bleeding of the nose. (See also the remedies enumerated under nasal hemorrhage from the most trivial cause.) Nux v. °-°. Bleeding of the nose, especially in the morning) from overheating, or after drinking wine, etc., or in habitual drunkards. (Lachesis and Calcarea carbonica are sometimes requisite here, in addition to Nux v.) Dulcamara °|°. Bleeding at the nose after getting the feet wet; flow of hot, clear blood from the nose. Crocus °-f°. Discharge of dark coloured, thick or viscous blood from the nose, particularly in females who menstruate too . , ..:..... r.ll---;ii-«.:nting( 340 oenbral pbrangemfnt. .Moschus «|0. Frequently serviceable when the nasal hemorrhage occurs in nervous, hysterical females. Ammonium c. Bleeding from the nose after a meal. Silicea. Nasal hemorrhage in scrofulous subjects. When the hemorrhage is of an active kind, the patient Bhould be placed in the erect posture, and kept cool and quiet for some time afterwards. Tho diet in all cases must be low, ami unstimulating. When there is reason to fear suffocation from the bleeding continuing inwardly, and getting into the throat, as is liable to happen in extremely debilitated subjects, in whom little or no reaction appears to follow the administration of the remedies, the anterior and posterior outlets from the nose may be plug- ged ; the latter by passing threads up the nostrils, and bringing them out at the mouth, then securing pieces of sponge, or small rolls of lint to the ends; after this, the threads should be drawn back, and tied sufficiently tight so as to bring the plugs somewhat firmly against the orifices. Sprinkling or dashing cold water on the face; exposing the face to a current of cold air ; placing the feet or hands in warm water ; applying a wet cloth round the abdomen, and even dip- ping the head into a pail of iced water, or salt and water, are amongst the best of the popular means, or occasional auxiliary modes of stopping an excessive or prolonged discharge of blood from the nose. With regard to the administration of the remedies, the repe- tition of the dose, if called for, must depend upon the greater or less degree of the severity of the attack. We ought to be in no hurry to repeat in the majority of case3. (See also what has been said on this matter in the Introduction.) SWELLING OF THE NOSE. The remedies for this, as well as all other maladies, must be selected according to the cause, where known. Thus, if the affection has arisen from a contusion, Arnica (externally and internally) must be prescribed. If the disorder is encountered in scrofulous subjects, one or more of the following must be had recourse to : Aurum or SWELLING OF THE NOSE. 341 Asafcetida; or Sulphur, followed by Calcarea ; or B"lla- donna, followed by Mercurius and Hepar s. When the dis- ease has been excited by the abuse of mercury: Hepar s., Acidum nitricum, Aurum, Belladonna, or Sulphur, will be found the mosf efficacious. When attributable to the habitu- al use of spirituous liquors: Ca'earea, Arsenicum, :\ux v., Pulsali'la, Sulphur; or Lachesis, Bellad., Merc, H"par s. Finally, Bellad., Merc, and Hepar have been found most serviceable in eases where the tumefaction was red and very painful; in similar cases of an obstinate character : Bryonia, Sulphu; Ca'earea and Rhus have proved efficacious. When black spots in the nose are met with at the same time, Sulphur and Gra]■kites have chiefly been recommended; and where there are scabs, Silicea, Sepia, Carbo v. and Natrum m., for the most part. Red spots, Acidum phosphoricum. Redness of the point of the nose, Calc, Carbo animal is, or Rhus toxi- codendron. Coppery redness, Arsenicum and Cannabis. WARTS on the nose, Causticum chiefly; but in some cases, also Thuja and Acidum nitr. Against swelling of the interior of the nose (Schneiderian membrane), Teuerium merum verum especially. In CARIES of the bones of the nose, whether of a scrofulous or mercurial origin, Aurum is the most important remedy. When of syphilitic origin, Mercurius is to be preferred, pro- vided the patient has not already been placed under an inju- rious course of that powerful medicine, in which case the affection is as likely to have arisen from the remedy as from the disease, and will consequently require to be combated by anti-mercurial medicines, amongst which Aurum will in this instance form the most valuable remedial agent; the other general antidotes to the injurious effects of mercury on the constitution, such as Hepar s., Acidum nitr., Sulphur, and Calcarea ; or, Lachesis, Carb. v., Staphysagria, Lycopodium, Asafaztida, Acid, phosph,, and Silicea, etc., may in some cases become necessary, particularly when the system generally has become impaired by the cause in question. OZiENA. This disorder consists of an ulcer having ita site in the nose, from which a fetid purulent matter is discharged. 342 GENERAL DERANGEMENT. It usually commences with slight inflammation and tume- faction about the alas nasi, accompanied with sneezing, increased flow of mucus, with which the nostril becomes obstructed, and sometimes slight hemorrhage. The ulceration soon spreads from the sc-hneiderian membrane to the nasal cartilages, the mucus gradually assumes the nature of pus, and if the disease be not checked, the bones become implicated, and caries re- sults; a thin, acrid, offensive matter or sanies is then con- stantly discharged, and often excoriates the lips and throat, and the sense of smelling becomes abolished ; eventually the ossa spongiosa inferior, and also the vomer, and in the worst cases, particularly when there is complication with scrofulous and venereal or mercurial disease, even the palate and superior maxillary bones exfoliate, the bridge of the nose falls in, and leaves a frightful deformity of countenance. Therapeutics. The remedies which have chiefly been employed in this malignant disease are: Teuerium ma rum verum, Pulsatilla, Sulphur; or Mugnes. m., Bryonia, Bella- donna, Lachesis, Lycopodium, Natrum m., Causticum, in the first stage, with mucous obstruction; Mercurius and Aurum in the second, with discharge of pus, and also affection of the bones; followed, if required, in Oz.k.na scrofulosa, by Sul- phur, Silicea, Acidum ni ricum, Phosphorus, Conium, or Po- tassai bich. In SYPHILITIC OZ.FNA, Mercurius forms the principal remedy; but if the patient has already been subjected to an injurious course of that medicine, Aurum is to be prefer- red, and succeeded, if requisite, by Acidum nitricum, Hepar s., Asafce'ida, Lachesis, Conium, or Thuj i. In disease in the Antrum Highmorianum, the following have been recommended: Teuerium marum verum, Arsenicum, Lycopodium, Sulphur, Silex, Aurum, Mercurius, Hepar s., Mezereum, Slaphysagria, Carb. v., Anlimonium c, Kali hydr., Phosphorus; and Spigelia, Nur, China, Phosphorus, as pallia- tives when the pains are very severe* * Goullon considers Arsenicum and Lycopodium as almost specific in this disease. He recommends Arsenicum to be given when Die pains are excessively severe, of a throbbing and splitting, or bursting description, when at their height. Lycopodium when there ia a thick aud yellow discharge. A. H. Z. 2, 21. CANKER OF THE MOUTH. 343 POLYPUS: Teuerium, Slaphysagria, Phosphorus, Sul- • pl'ir; Sep'-a, and Silicea, have chiefly been recommended. CANCER NASI : Arsenicum, C >rbo v., Aurum. Sepia, Si- Urea, Su'phur, and Calcarea, are the remedies which have prin- cipally been pointed out as the most appropriate to combat this serious and frightful malady. CANKER OF THE MOUTH. SCURVY IN THE MOUTH. Cancrum Oris. Gangrcna Oris. Stomacace. This affection consists of a fetor in the mouth, with a viscid, bloody discharge from the gums, which are at the same time hot, red, tumid, spongy, very sensitive, retracted from the teeth, and subsequently ulcerated along their margins. Some- times there is also glandular swellings, salivation, or ptyalism; and usually looseness of the teeth, impeded mastication aud deg- lutition, great debility, and slow fever. Therapeutics. Mercurius is the most useful remedy here, and may generally form the first prescription in almost every case of the kind, as it will rarely fail to prove service- able, if not sufficient to effect a perfect cure. When, how- ever, we have reason to conclude that the symptoms above described have in reality been created by the injurious em- ployment of that remedy, under allopathic treatment, it will be necessary to have recourse to the appropriate antidotes to these effects of the said powerful mineral, amongst which Carbo v. will-be found of primary importance; should the im- provement effected by Carb. v. be only of a partial character, the treatment must be followed up by Hepar s. and Acid. nitricum alternately; or by Slaphysagria, if fungous excres- cences form on the gums. Carbo v. is, moreover, of great service when the disorder has arisen from unwholesome food, the daily use of kitchen-salt in excess, or the prolonged use of salt meat ;* when the gums smell most offensively, and bleed « Constantino Hering recommends a drop of Spiritus atheris nitrosi once or twice a day, in the event of Carbo v. or Arsenicum failing to bring about a favourable action iu such cases. 344 GENERAL DERANGEMENT. during mastication; the teeth loose, mouth lint, tongue much excoriated, and with difficulty to be moved. After the employment of Carbo v. we may have recourse to Arsenicum, if the ulceration continues extensive, and the pa- tient complains of burning pains in the gums, with great prostration of strength; or Arsenicum and China in alterna- tion ; if, in addition to the foregoing, the gums present a black, spongy, and somewhat gangrenous appearance. Nux v. is an admirable remedy in this disorder, particu- larly when it occurs in meagre, dark-complexioned subjects, of bilious temperament and choleric disposition, who lead a seden- tary life; the gums presenting a putrid aspect, and so much swollen as completely to cover the teeth; countenance pale and 6unken. Capsicum has been found useful, under nearly similar cir- cumstances, but the affected party of a plethoric habit and phlegmatic temperament. Dulcamara may be used with advantage after Mercurius, when the glands of the throat are implicated in the derange- ment ; or it may be selected in preference to Mercurius when the disease is prone to be excited by the least exposure to cold, during damp, or cold, raw, wet weather. Natrum m. is frequently a valuable remedy in completing the cure after the administration of Carbo v., Acid, nitr., Hepar, etc. It is more especially indicated when the ulcers are indolent, and do not put on a healing aspect; the gums being at the same time much swollen, very sensitive to heat or cold, and disposed to bleed at the slightest touch ; moreover, when painful vesicles or blisters aie observed on the tongue, inner surface of the lips, and cheeks; which impede speech, and, together with the irritable gums, render the act of mas- tication a work of labour and excessive torture. When, not- withstanding the employment of the last mentioned remedy, the complaint seems disposed to linger, S , phur may be prescribed, and followed or alternated with Acidum sulphuricum, Sepia, or any of the other medicines already treated of, if required by the bent of the succeeding changes in the features of the ease, etc. Silicea, Sub-boras Sodce, Helleb. and lodium may also prove useful in some cases. SCURVY. 345 Lemon-juice, which is well known as a most valuable remedy in scurry, is equally useful as a domestic remedy in stomacace. Sage i.s equally useful in some varieties of the disorder. Rinsing the mouth with brandy has also been found of service. The use of wholesome, easily digested food, with a due pro- portion of vegetables, must be enjoined in order to expedite the cure. SCURVY. (Scorbutus.) This disorder is characterized by excessive debility, pale and bloated countenance; cedematous swelling of the inferior extremities ; hemorrhages; livid spots on the skin, or foul ul- cers ; offensive urine and extremely fetid stools. The gums spongy, or otherwise diseased, as described in the preceding article. It chiefly affects sailors, or others who from circumstances are deprived of fresh provisions and an adequate quantity of as- cescent food, and are exposed to cold and moisture together with fatigue. Intemperance, want of exercise, impure air, un- cleanliness, with depressing emotions, further tend to predis- pose to the disease, when combined with unwholesome food, or the before-said alimentary deficiency. In the cure, as also the prevention of this malady, it is re- quisite, in the first place, to remove the probable cause of its invasion where that is practicable ; and to furnish the patient, if possible, with wholesome diet, fresh vegetables, and those fruits which furnish citric acid, such as lemon, the juice of which made into a drink forms an invaluable remedy. Sour- kraut, and other substances which have undergone the acetous fermentation; cider, spruce beer, and the like, as also vinegar, have, moreover, been recommended. The homoeopathic medicines which may be prescribed with the most advantage against the ulcers and diseased gums are: Carbo v., Nux v.. Arsenicum, Mercurius, Staphysagria, and Sulnhur ; or also, Acid nitr., Cistus, Nat. m., Ammonium c. el 340 GENERAL DERANGEMENT. m.. Causticum, Didcamara, Kreasotum, Acid. mur., Sepia, etc. (Sec the preceding article, and als.. that on Ulceus.) The use of lemon or wine-juice and other acids must bo discontinued during the employment of the homcvopathic reme- dies. GUMBOIL. Silicea, S'apltysagria and Calcarea, but par- ticularlv the former, are the principal remedies against this affection. When there is much inflammation, and considerable swelling, Belladonna may be prescribed, followed by Mercurius and lie par sulph., if little relief is obtained from the | former. Nux v., Pulsatilla, and Sulphur, are sometimes very useful. In swelling of the jaw, with suppuration, whether in consequence of carious teeth, or from the unskilful abstraction of a tooth, Si'ieea is the m >st important remedy. Irritation, arising from the cutting of the wisdom-teeth : Acon'il- and Calcarea ; also Belladonna, Arnica, and Chamomilla, when there is inflamma- tion with swelling of the face. INFLAMMATION OF THE TONGUE. Glossitis. Diagnosis. Tumefaction, with heat and redness of the tongue; the swelling is sometimes so great as to fill the whole cavity of the mouth, rendering swallowing impossible, and threatening suffocation; unless re-solution take place, it may terminate in induration, suppuration, or gangrene. Causes. Besides a general strumous habit, local injuries, acrid substances, rheumatism, catarrh, and metastasis. Therapeutics. The following medicines will be found most appropriate in the treatment of this affection, according to the exciting cause : Arnica, Urtica urens, Mercurius, Aconi- tum, Belladonna, Pulsatilla, Lachesis, and Arsenicum. Arnica, in cases of lesion of the tongue from the points of decayed teeth, etc., or of burns or scalds. (Acid phosph. ia occasionally required after, or may, in severe cases, be given in preference, to Arnica ; in other instances, Sdicea said Sul- phur will be required to complete the cure. INFLAMMATION OF THE TONGUE. 347 Administration. A few drops of the matrix tincture to a cupful of water, rinsing the mouth with the mixture two or three times a day. Urtica urens has been recommended in preference to Arni- ca in burns and scalds of the mouth. Administration. The part affected slightly touched with a soft brush dipped in the tincture. Mercurius is almost specific when it presents itself in the form of a disease of the tongue, attended with excessive in- flammatory swelling or induration. Administration. Half a grain of the third trituration to an ounce of water; a dessert-spoonful of the mixture every two, three, or twelve hours, according to the violence of the disease. Aconitum may, with advantage, precede the above remedy should the inflammation be very intense. Administration. \° ; if needful, repeated in two hours, followed by Mercurius in from three to six hours. Belladonna. When the affection does not speedily yield to Alercu■•'>>' , or when the inflammation is of an erysipelatous or active phlegmonous nature. Administration. A few globules of the sixth potency to an ounce of water; a dessert-spoonful every six to eight hours, until the inflammation abates ; after which we may, in many cases, return to Mercurius. Pulsatilla has been found useful in cases arising from suppressed hemorrhoidal and arthritic affections. Against indications of threatening gangrene, Arsenicum and Lachesis are the principal remedies. They may both be given at the sixth poteucy, and repeated according to results. In some cases when, from great tumefaction of the tongue, suffocation threatens, we must have recourse to longitudinal incisions; and after having thus warded off the more pressing danger, exhibit Cinchona, and then fall back upon the more specific remedies. In some ex'reme cases of this nature, where the disease hav- ing made head before the arrival, it may be found neces- sary to resort to tracheotomy. This is, however, a dangerous 348 GENERAL DERANGEMENT mode of relief from the risk of consequent tracheal inflamma- tion ; but, when it has been found absolutely necessary, we may, by the exhibition of Arnica, V> internally ; and in tho form of lotion, in the proportion of four minims of the mother- tincture to a hundred of wator, materially diminish the risk of this taking place. In eases of soreness or ulceration of the tongue: see Ulcers. Such cases will, however, rarely, if ever, occur to the homoeo- pathic practitioner, if the disease bo taken in time, and his remedies judiciously selected. OFFENSIVE BREATH. The most frequent causes of this unpleasant affection aro : uncleanliness, leaving particles of food in the teeth ; and accu- mulation of tartar ; or carious teeth; a diseased state of the gums; aphthae in the mouth ; derangement of the stomach; or an abuse of mercury. Therapeutics. When there is reason to suppose that the first named circumstance is the chief cause of the complaint, its removal will be readily effected by proper attention, rinsing the mouth with tepid water, and brushing the teeth with a moderately hard brush night and morning, as also after every meal. When attributable to the second cause, a dentist of known skill and respectability ought to be consulted. Lastly, when the annoyance can be traced to any of the remaining sources enumerated, the remedies given under those different headings ought to be had recourse to. When, on the other hand, no apparent cause of derange- ment can be assigned or detected, benefit will often be derived from one or more of the following medicines : Nux v., Silicea, Pulsatilla, Sulphur, and Chamomilla; or A niea, Bellad., Hyos-, etc. If the heaviness or fetor of the breath is chiefly perceptible in the morning : Nux v. and Silicea will frequently be found successful in affording relief. Arnica, Bellad., and Sulph., have also proved effectual in similar cases. If after a meal, Vmt v., succeeded by Cliamo.iii'la and Sulphur. If in the evening, or during the nicrht. Pulsatilla or Snlnhur face-ache. 34' Mercurius, Bryonia, Arsenicum, Hyoscyamus, Agaricus, Ambra, Carbo v. et a., Sepia, Lycopodium, etc., may also prove useful in particular cases. In young girls at the age of puberty, Aurum is often the most appropriate ; but occasionally Pulsa- tilla, Sepia, Belladonna, or Hyoscyamus, will be found pre- ferable here. When the abuse of mercury has evidently been the cause of the evil: Aurum, Carbo v., Lachesis, Sulphur, Hepar, Belladonna, or Acidum nitricum, etc., will be found the most suitable. FACE-ACHE. FACE-AGUE. Neuralgia Facialis. Tic Douloureux. Prosopalgia. This distressing malady consists in an excruciating pain, which has its seat in the branches of the fifth pair of nerves, and is accordingly experienced with great acuteness under the eye, and sometimes before the ear, from whence it shoots over the entire half of the face, and frequently into the orbit and cranium. The paroxysms occasionally continue, with shorter or longer in- tervals, for several days or weeks in succession, and when at their height, are frequently accompanied with spasmodic twitch- ings in the facial muscles. The disease is unfortunately generally of great obstinacy, and, in some melancholy instances, utterly incurable. In its idiopathic form, the remedies which have hitherto been em- ployed in homoeopathic practice with the most success are: Belladonna, Platina, Lycopodium, Colocynth, Arsenicum, China, Mezereum, Veratrum, etc. Belladonna. When the pain chiefly pursues the course of the infra orbitary nerve, but sometimes also the other branches of the fifth; and is prone to be excited by rubbing the usual seat of the sufferings; darting pains in the cheek- bones, nose, jaws, or zygomatic process; or cutting and tensive pains, with stiffness at the nape of the neck, and clenching of the jaws; twitches in the eyelid, or violent shooting and teariug and dragging pains in the ball of the eye; convulsive jerking in the facial muscles, and distortion of the ...1.1.. i*~«* ovri ^nooo in fhe face. The pain is generally 350 GENERAL DERANGEMENT. preceded by itching and creeping in the affected side of the face, and at times becomes so severe as to bo almost in- supportable. Pi.atina. Feeling of coldness and torpor in the affected side of the face, with severe spasmodic, pain, or tensive pres- sure in the zygomatic process, with a sensation of creeping or crawling, and aggravati »n or renewal of the sufferings in the evening, and when in a state of rest; lachrymation ; redness of the face. etc. Lycopodium is often useful, when the symptoms are much the same as described under the preceding remedy with the ex- ception of the torpor and creeping, but particularly when the right side of the face is the part affected. Co Lucy nth. Violent rending and darting pains, which chiefly occupy the left side of the face, are aggravated by the slightest touch, and extend to the head, temples, nose, ears, teeth, etc. Arsenicum. When there is a tendency to periodicity in the attacks or paroxysms, and the pains partake more especially of a burning, pricking, and rending character, and are experienced chiefly around the eye, and occasionally in the temples, the sufferings being occasionally of so severe a description as almost to drive the patient distracted; great anguish ; excessive pros- tration, with desire for the recumbent posture; sensation of coldness in the affected parts; exacerbation during repose, after fatigue, in the evening, when in bed, or after a meal; temporary melioration from external heat. China. Also, as in the instance of the foregoing remedy, when there is a tendency to periodicity in the attacks, and when the pains are excessive, attended with extreme sensibility of the skin, and consequent aggravation from the sligh'est. touch; sensation of torpor and paralytic weakness in the affected part; great loquacity, with ill-humour, paleness of the face, fre- quently followed or alternated with redness and transient heat of the face. Mezereum. Pains which occupy the left zygomatic process, consisting chiefly of a spasmodic stupifying description, and extending to the eye, temple, ear, teeth, neck, and shoulder, PACE-ACHE. PALPITATION OF THE HEART. 351 with exacerbation from partaking of warm food or drink, or on coming into a warm room after being in the epen air. Veratrum. Insupportable pains which almost drive the patient to distraction; excessive weakness even to fainting; general chilliness ; exacerbation of suffering on getting warm in bed, or towards morning; temporary relief on moving about. Spigelia is frequently a useful palliative remedy in all cases when the pain is excessive. In other cases: Lachesis, Phosphorus, Hyoscyamus, Mags. Qrc., Manganum, Merc, Rhus, Ignatia, Arnica, Capsicum, Causticum, Staphysagria, Coffea, etc, may be found useful. When the malady is symptomatic of derangement of the di- gestive functions,—Nux v., Pulsatilla, Bryonia, Chamomilla, or Lyci podium, will usually be found the most serviceable. In Rheumatic Face-ache, or prosopalgia,—Acon'turn, Bryonia, Rhus, Causticum, Mercurius, Phosphorus, Pulsatilla, Alezereum, Phosphorus, Sulphur, Nux v., Lachesis, etc., are those that have generally proved the most effectual. In Arthritic,—Nux v., Rhus, Colocynth, Mercurius, Caus- ticum, etc. ^ Face-ache from the effects of mercury will chiefly require the employment of Aurum, Hepar, Carbo v., Sulphur, China, etc. Finally, in prosopalgia generally, the following have proved more or less useful: Aconitum, Arnica, Verbascum, Sulphur, Calcarea, Capsicum, Pulsatilla, Stannum, Conium, Thuja, Baryta c, Coffea, Kali, Camphora, etc. PALPITATION OF THE HEART. Palpitatio Cordis. When this disorder occurs in plethoric individuals, Aconitum, Belladonna, and Nux v. will be found the most appropriate remedies, followed by Sulphur. Should the affection prove obstinate, Arsenicum and Vera'rum alternately are sometimes useful after Sulphur, when the palpitation has resulted especial- ly in consequence of the suppression of an eruption, or the sudden healing up of an old sore. Causticum and Lachesis are also occasionally useful in the latter case. 352 GKNERAL DERANGEMENT. When it results after debilitating losses, such as hemorrhage, etc.. China is the principal remedy, but may require to bo fol- lowed by Acid, pi <>sph., Sulph r, Ca! area, or \ux v. Palpitation of the heart from a fright, usually yields readily to Opium : from fear or anguish, to Vera'rum ; after sudden joy, to Coffea; and if from contradiction, or a tit of passion, Acon., Cham., or Nm r., and Ignatia. When the derange- ment occurs in nervous individuals, and particularly hysteri- cal females, Pulsa'dla, Coffea, Cocculus, Veratrum, Lachesis, Chamomdla, and Asafcetida will generally be found the best adapted to afford relief. In other eases, Aurum, Cocculus, Phosphorus, Spigelia, Ferrum, or Acid, niir., etc., will bo required. CRAMP IN THE LEGS. Veratrum, Nux romica, Sulphur, Ca'earea, Lycopodium, Acidum nitricum, Sepia, Camphora, Ar gilla, Colocynth, and Rhus, are amongst the best remedies for cramps in the calves of the legs. Veratrum has been recommended as one of the most useful remedies in eradicating the tendency to frequent returns of this painful and troublesome disorder, succeeded by Sulphur and Coloeyn'h, should it not suffice to effect a cure. Rhus when the attacks occur during the day when sitting, as well as at night. Sepia, Lycopodium, and A id. nitr. when it occurs chiefly in walking. Sulphur, alter Nux v. or Rhus, when the attacks occur chiefly during the night. Cal- carea when stretching out the limb brings on the cramp. Ar- gilla in cramps on crossing the legs, or even on descending stairs. Colocynth is frequently beneficial when stiffness and pain are always experienced in the limb for some time after the attack. GOITRE. BRONCHOCELE. This disfigurement arises from a tumefied state of the glan- dula thyroides, a large glandular body situated on the front of the throat (upon the cricoid cartilage, trachea, and horns of the thyroid cartilage). As the enlargement increases, it GOITRE. SWEATING FEET. 353 is productive of a considerable degree of obstruction to free inspiration, from the pressure which it exerts against the windpipe. The disorder is most frequently encountered amongst the inhabitants of mountainous districts. Women are more prone to be afflicted with it than men, and particu- larly those who have suffered from severe labours. An inhe- rent constitutional taint seems, however, to be the chief pre- disposing cause. In the treatment of this affection, Spongia marina has been found the more generally useful remedy, administered in re- peated doses, from the sixth potency downwards. In cases of long standing, one or more of the following remedies may prove of service in materially diminishing the size of the tumour, if not sufficient to disperse it entirely: Calcarea, Staphysagria, Lycopodium, lodium, Ammonium c, Causticum, and Natrum c et m.; or Ferrum, Sepia, Thuja. SWEATING FEET. Some individuals are much troubled with a disagreeable, clammy, sweating of the feet, to such an extent as to render it necessary to change the stockings several times daily. This evil is, moreover, a source of extreme annoyance to others, from the offensive odour which is usually exhaled at the same time. The utmost attention to cleanliness is insuffi- cient to remedy the state of matters; and to attempt to sup- press the secretion by cold water, or powerful astringents, is highly culpable, from the dangerous consequences which are liable to ensue from a sudden suppression thereby effected.' Amongst the homoeopathic remedies, through the instrumen- tality of which, a safe and permanent cure has most frequently been brought about, Rhus toxicodendron and Silicea merit priority of notice. A few globules of the first named, may be taken every four days for a fortnight or three weeks; at the expiration of which period, a few days may be allowed to elapse, and if improvement then set in, the medicine may be continued at intervals of increasing length until the cure is effected. But should no melioration result, Silicea may be 354 GENERAL DERANGEMENT. had recourse to in the same manner. After Silicea, Rhus may again be resorted to, if required. These two remetlies are also the most appropriate to be administered against the dele- terious consequences of a suddenly checked foot-sweat. Other remedies may be requited in obstinate cases of this complaint, or in those where derangement of the system gen- erally coexists. The following may thereforo be pointed out as worthy of being referred to in such cases: Mercurius, Baryta c, Graphi'es, Kali c, Cyclamen; or Sulphur, Cal. carea, Lachesis, Carbo v., Lycopodium, Sepia, Acid, nitr., etc. SLEEPLESSNESS. Agrypnia. Sleep is essential to renew the vital energy which has been exhausted during the day, as also to assist the function of nutrition. When, therefore, anything occurs to deprive us of this indispensable necessary for a protracted period, or, at all events, so materially to disturb it as to render it inadequate to fulfil its requisite purpose, the health will, as an all but inva- riable rule, eventually give way under the deprivation. The average duration of sleep is from six to eight hours; but it is liable to variation from several causes. Some, from peculiarity of constitution, require less, others a little more. Habits of idleness, etc., tend to prolong it; and it may here be remarked, that when not restrained within proper limits, instead of repairing, it exhausts the strength ; and is, as well as the derangement of which it is our object at present to treat, consequently productive of serious, diseases, such as madness and idiocy,—these distressing maladies> having un- questionably been traced, in some instances, to indolent habits "of prolonging sleep beyond the period required for healthy recreation. In almost all cases, sleeplessness is but symptomatic of some other disease, and can only be remedied by the removal of the abnormal source. It frequently, however, forms so prominent a feature as to render it necessary that we should treat it as an idiopathic disease, and direct our attention to the selection of medicines comformably. SLEEPLESSNESS. 355 Intense mental application, continued up to the period of going to rest; sedentary habits; the habitual use of coffee, (often for the express purpose of warding off inclination to sleep,) also weakness of the digestive functions, are frequent causes of sleeplessness. Under such circumstances, Nux v. will generally be found the most appropriate remedy; but, unless the acquired habits above detailed are given up, or materially altered, no permanent benefit can be expected from the employment of the remedy referred to. Overloading the stomach, particularly towards night; the habitual employment of stimulating, or rich, indigestible food; thereby producing constipation, excessive flatulence, and other signs of derangement in the digestive functions, are additional fertile sources of disturbed sleep, which can only be obviated by the observance of a more simple mode of living. The attainment of the desired relief may, however, be considerably forwarded by means of a dose or two of Pulsatilla. Mental emotions often originate sleeplessness. When excessive joy is the assignable cause, Coffea is a useful remedy. When from dejection, caused by grief, un- pleasant ideas, vexation, etc., Ignatia. If attributable to fear, or fright, or when the sleep is disturbed by fantastic or fright- ful visions, Opium; followed, if required, by Belladonna in the latter instance; and when anxious, annoying, or agitating events disturb or retard sleep, Aconitum. Sleeplessness arising from nervous excitement in sensitive or irritable subjects will often yield to Hyoscyamus, or to Bella- donna where there exists a strong but ineffectual desire to obtain sleep. The latter medicine is further indicated when agitation or anguish, with frightful visions, timidity or terror, apprehension of real objects, etc., are complained of; or when the sleep is disturbed by frequent starting, and is attended with extreme sleeplessness early in the evening, or towards morning. Moschus is a useful remedy in sleeplessness occurring in hysterical or hypochondriacal individuals, arising from nervous excitement. Acid, phosph. and Sepia are also occasionally useful iu such cases. 356 GENERAL DER\N0EMENT. Stvnnum has been recommended as a general remedy.™) in sleeplessness* Sleeplessness in old people can scarcely be considered a disease. But when it occurs in children, it almost invariably arises from s .me bodily ailment, which ouv.lit to be attended to and removed as early as possible, if practicable, as depriva- tion of sleep is more detrimental during infancy and childhood than at any other period of life. (See Sleeplessness in Children, Part. III.) L X.ldne bulk, or from the contraction of adhesions : and strangulated, when the protruded parts are not only incapable of being returned, but are moreover affected with constriction, pain, and inflammation, attended with nausea, frequent retching, or vomiting, tension of the abdo- men, obstruction of the b.wcls, quick, hard pulse, and more or less fever. If the return of the intestine be not effected under such a state of matters, an aggravation of all the said symptoms at first ensues, and subsequently the Vomiting is exchanged for a convulsive hiccough, with frequent bilious eructations; after the abdominal tension, fever and extreme restlessness have continued for a few hours in an increased degree, tho patient suddenly becomes relieved from pain, tho pulse low, feeble, and intermittent, the eyes dim and glassy, the belly ceases to be tumid and tense, and the skin, particu- larly that of the extremities, cold and moist; the hernial swelling disappears, and the skin over the part often changes to a livid hue, but invariably conveys an emphysematous feel or crepitus to the touch, indicative of the establishment of gangrene; finally, spasmodic rigours and convulsive twitching in the tendons supervene, and death soon terminates tho Bcene. Therapeutics. When the disease has not been neglected, or is not of long standing, it may be cured by the action of in- ternal homoeopathic remedies. No truss should be applied until the hernia is completely reduced, and care should be taken that the truss fits properly, as it is intended only to keep the hernia from protruding, and not for effecting the cure. In effecting the reduction of a hernia by the taxis, the patient should be laid upon his back, and a pillow placed under the chest and pelvis, so as to curve the trunk of the body, and thereby relax the abdominal muscles. If the case be one ofi.^iiaal or femoral hernia, the muscles, etc., of RUPTURE. 365 the thigh must also be relaxed, by putting the limb in a state of flexion, and rotated inwards, then gently compressing the tumour, and pushing upwards^and outwards in the case of inguinal hernia; and first backwards and then upwards in the case of femoral, if the tumour be small; but first downwards, and then backwards and upwards, when it is large and re- flected over Poupart's ligament. * In most cases, the following simple method may be pursued by the uninitiated: place the left hand on the swelling as if for the purpose of grasping it, then introduce the fore and middle fingers of the right hand between the thumb and fingers of the left, on the top of the tumour, and rub and press it gently ; persevere softly and pa- tiently for half an hour and upwards when the hernia is con- siderable.f The palm of the hand should also be occasionally employed, by giving it a rotatory motion combined with gra- dually increasing pressure, especially when the tumour begins to diminish in bulk, or when it has been small from the first. Even strangulated hernia is capable of being reduced by the taxis with facility, after the employment of the proper reme- dies, particularly Aconite and Nux vom,, and the operation, which is always more or less dangerous, thereby avoided.— When the rupture is painful, and very tender to the touch, medicine must first be prescribed to remove the irritability; after which the protrusion has often been found to recede of itself. In some cases, the application of warm fomentations to the part reduces the hernia, and the general relaxing effects of a warm bath are well known as being useful in facilitating reduction. The following treatment has been strongly recom- mended when the symptoms encountered are as described. Aconitum ---. When there is considerable fever, with quick, hard, full pulse, inflammation of the affected parts, with excessive sensibility to the touch; violent burning pain in the abdomen; bitter, bilious vomiting; agonizing restlessness and cold perspiration. A second dose to be given, if required, an hour after the first. In the majority of cases, marked benefit has resulted after the administration of the first dose of Aco- * In Umbilical hernia the pressure is to be made directly backwards. 366 GENERAL DERANGEMENT. nitum, under the circumstances mentioned; but when no change for the better resulted after tbe third exhibition, or when the bilious eructations, and vomiting become converted into an acid character, Sulphur must be prescribed, *«d tl the patient fall asleep thereafter, he should be allowed t« re- pose quietly. When the tumour is not so painful or tender to the Xueh as above mentioned, and the vomiting less severe, but the respi- ration oppressed and laborious, and the strangulation has arisen from errors in diet, the effects of exposure to cold, from being overheated, or from a violent fit of passion, etc., JSnx v. is to be preferred, and may be repeated every two hours or so.* If no change results in about two hours after the socond doso of Nux v..—Opium should be prescribed, or this remedy may be had recourse to from the first, and repeated every quarter of an hour, until improvement takes place, should there be hardness and distention of the abdomen, putrid eructatiom, or even vomiting of fecal matter. (Plumbum may be given after the third or fourth dose of Opium, if no decided change for the better become perceptible.) When there is retching and vomiting, with cold moist skin and coldness of the extremities,—Veratrum should be admin- istered, and repeated in from half an hour to an hour or so ; and in the event of no favourable turn taking place after the second dose,—Belladonna should be prescribed. When the case has been neglected, or the progress of the malady already advanced so far on reaching the patient, that the integuments over the rupture have assumed a livid hue, and there is reason to apprehend the invasion of gangrene, the patient may yet be saved by the administration of Lache- sis in repeated doses'; if no relief follow in the space of about two hours, Arsenicum may be tried. Rhus has also been spoken of as being serviceable in extreme cases. The operation should not be delayed when symptoms of a serious character do not speedily yield to be remedies indicated; but the latter should always be tried first, as no bad consecuences • Vide note, page 31. FAINTING. 367 will result from the delay under the precautions stated; on the contrary, the subsequent manual treatment has been found to be thereby facilitated. FAINTING. SWOONING. Syncope. Individuals of weak nerves and delicate constitutions, par- ticularly of the female sex, are frequently subject to faiuting fits, which, although rarely dangerous, yet when utterly neg- lected, or inappropriately treated by violent or very debilita- ting means, are prone to become serious, and even fatal. The usual causes are : ming on in the morning, and afterwards becoming lancinating; or pain com- ing on in the morning, disappearing in the afternoon, and returning again in tho evening with great violence, when it is attended with a sensation as if the head were pressed to- gether; burning, tearing pain over the entire head; shootings in one side of the head. The pains arc increased by movement, and are attended with irascibility, ami disposition to chilliness or shivering; they are sometimes relieved or terminated by a fit of vomiting. Nux v. and Rhus often serve to complete tho cure of the foregoing symptoms, or, at all events, to curtail or remove each attack after the previous administration of Bryonia. Kins 00-0. Shooting and rending pains, extending to tho ears and root of the nose; burning or pulsative pains; headache after a meal, with desire to assume tho recumbent posture, and remain quiet; fulness and weight in the head; renewal of the headache at the slightest contradiction, or on going into the open air; undulation of the brain at every step; or sensation as if water were in the head, or as if the contents of the cranium were in a relaxed or loosened state, and shifted about with every movement of the head; feeling of creeping or crawling in the head. Sepia a6* Periodic cephalalgia, aggravated by mental emotion, particularly in hysterical subjects; the pain is either of a lancinating description, aud affects the whole head, or is merely seated under the eye, or occupies the one half of the head or forehead; in the latter case, the pain is experienced chiefly in the morning, and is frequently attended with ex- treme sensibility of the eyes to the light. Sep,a is also very efficacious in cases of chronic hemicrania, with violent pierc- ing or rending pain, intermingled with lancinations, so excru- ciating that the patient is afraid to move, and can only obtain a trivial degree of relief by remaining perfectly quiet with the eyes closed; at other times, the pain is so violent as to cause the patient to scream out, and is attended with heat in headache. 373 the head, or faintness and giddiness, followed by nausea and vomiting. Silicea -6-, is especially useful where a Sensation is expe- rienced as if the brain were about to protrude through the forehead or orbits ; or pain so severe as if the head would split; or semilateral, shooting, rending pains, commencing at the tem- ple, and extending to the nose, the upper and lower jaw-bones, and teeth of the same side. When there is a tendency to frequent sweating of the head, or when there is frequently great tenderness of the scalp, Silicea is further indicated; as also in cases where the parties affected are subject to the for- mation of small tubercles on the head. Hepar sulphuris a°-°- is also a good remedy to follow Bel- laelonna in the treatment of headaches, when only partial relief has been obtained from the said medicine, or it may be admin- istered alternately with Silicea in cases where there are pain- ful tubercles on tbe head. The pains chiefly piercing, gene- rally aggravated at night, and frequently limited to a small fixed spot, with a sensation as if a nail were being driven into |he head. Against this latter species of headache, (clavus hystericus,) Nux vomica, Ignatia, Coffea, Mosch-, Magn., and Staph., are also most important remedies; the former may be selected when the following symptoms are complained of: Pain commencing with a slight pressure, or a sensation of cold- ness at the part which is subsequently affected; succeeded by throbbing, and then an intense shooting, piercing, rending, or stunning pain confined to a small space, which can frequent- ly be covered with the point of the finger, and is extremely sensitive to the touch; or the pain causes a sensation as if a nail were driven into the head; at other times, the pain ex- tends over the nose down to the lip, and also to the gums; or, on the other hand, it commences at the eyelid or the orbit, causing constant lachrymation, and extends over the forehead and temples to the ears, back of the head, and nape of the neck: or it is seated in the crown of the head, and produces a sensation as if the head would split, or were being opened at the coronal suture; intense, piercing pain, confined to a small -i— n,\,\oh nan frequently be covered with the point of the 374 GENERAL DERANGEMENT. finger; or rending, aching pain, affecting only ono side of tho head, sometimes combined or alternating with shootings; the pain becomes heightened to 6ucb a degree occasionally, and more particularly in the morning, as well nigh to drive the patient to despair, or deprive him of consciousness ;* great heaviness of the head, and sensation as if the brain were bruised or lacerated; tenderness of the scalp. The pains are aggravated by movement, such as walking or stooping, or by reflection; also after eating, or on going into the open air, and are frequently attended with considerable giddiness or confu- sion in the head; the headache is generally attended with ex- treme irascibility, and is renewed or aggravated after partaking of coffee, the constant habit of drinking which is not tin unfre- quent cause of the complaint; sudden attacks of it are frequently excited by a fit of passion, a fright, the effects of a chill, or an i overloaded stomach. Ignatia °-§-° is, as already stated, also an excellent remedy in cases in which the pain is confined to a small space, and causes a sensation as if a nail were driren into the brain; nau- sea; dimness of the sight, and sensibility of the eyes to light; paleness of the face, aud temporary alleviation from change of posture; aggravation from noise or strong odours, or after par- taking of coffee. Ignatia is sometimes serviceable in complet- ing the cure after the previous administration of Nux v., dr Ptdsuti'lu. ■ It is especially applicable to nervous, hysterical fe- males of a mild and sensitive disposition. Coffea -§-. In cases of megrim, brought on by medita- tion, vexation, or exposure to cold, attended with irritability, sensibility to noise, great anxiety; and chilliness, and a sensa- tion as if a nail were driven into the brain, or a feeling as if the brain were bruised, occurring in individuals who are ex- tremely impatient under suffering, and who are not habituated to the use of coffee, this remedy is frequently a very effica- cious one. Pulsatilla ^a. Megrim, characterized by rending or shoot- ing pains, with heaviness of the head, dimness of the sight, sensibility to light; or buzzing or singing in the ears, and ear- * Compare with Belladonna and Ami.ia,.um. HEADACHE. 375 ache; nausea; paleness of face, lowness of spirits; headache with pain in the nape of the neck; aggravation of the head- ache, with chilliness towards evening, during repose, or par- ticularly when sitting ; melioration in the open air. Disposition mild ; temperament phlegmatic. China --3--. Headache worse at night, accompanied with a sensation as if the head would split; or dull, aching, pressive, or boring pains, particularly at the crown of the head, in- creased by movement, or by the open air; tenderness of the scalp; great sensibility to pain; taciturnity and obstinacy. Veratrum °s°. Headache preceded by coldness and shiv- ering ; pain in the head as if the brain were bruised or lacer- ated ; or lateral aching, constrictive, and throbbing pains, some- times attended with a sensation of constriction or tightness in the throat; feeling of coldness at the crown of the head, as if ice were placed upon it; or sensation both of coldness and heat on the exterior of the head, with deep-seated or internal burn- ing heat; headache with paleness of the face, nausea and vomiting, and preceded by a copious discharge of colourless urine ; headache, with pain at the pit of the stomach, or pain- ful stiffness of the neck; headache with extreme weakness and melancholy ; painful sensibility of the hair to the touch ; chilli- ness, with general cold perspiration. Arsenicum and Acidum phos. are sometimes useful after Veratrum. Lachesis a6°-. Deep-seated pains in the head, or severe aching pain in the occiput, in the sockets of the eye or above the orbits, with stiffness of the neck, particularly at the nape; heaviness and feeling of expansive pressure, sometimes to such an extent as if the head would burst; tension in the head as if caused by strings or threads drawn through the occiput towards the eyes ; lancinations in different parts of the head; headache every morning on waking, or after dinner, or at every change of weather. Mercurius -~. Rending and burning or lancinating and piercing pains, generally lateral, sometimes extending to the teeth and neck, with shootings in the ears; tightness round t':e head; excessive nocturnal aggravation of the heaJaches, ifteu accompanied by profuse sweating. 376 GENERAL DERANGEMENT. Colocynth °y>°. Nervous headaches attended with smart- ing in the eyes; excruciating lateral action ; rending, dragging pains; nausea and vomiting; feeling of compression in tho forehead, increased by stooping or Ling on the back ; head- ache every afternoon or evening, with groat anguish and ex- cessive restlessness, rendering it impossible to remain in the recumbent posture; offensive perspiration; profuse discharge of colourless urine during the headache. Chamomilla q°°. Headaches occurring in individuals who are extremely impatient under suffering, and whom the slightest pain exasperates or calls forth symptoms and expressions of suffering apparently uncalled for by the nature of the com- plaints; the headaches are often confined to one side of tho head (hcmicrania), and the pains are of a rending, aching, or shooting character, and sometimes extend into the upper and lower jaw; sweating at the head is a frequent concomitant symptom. Chamomilla 00-°, is further occasionally very useful after the previous administration of Coffea when not (tilled for from the commencement. Or in hcniicrania attended with extreme excitability arising from the daily use of black coffee, but which is generally relieved for the time by partaking of a cup of cof- fee, will generally be materially relieved, if not cured, by Cham- omilla ; sometimes a subsequent dose or two of Nur, is required to complete the cure. Sulphur -£-. Chronic headache; headaches occurring daily, or every eight days ; worse in the morning, or during the night, aud attended with heaviness of the head, aching or pres- sive pains in the forehead above the eyes, (causing the patient to knit the brows, or keep the eyes closed,) or over the entire head; incapability of mental exertion from the pains in the head; pains as if the head would split; or rending, shooting, dragging, jerking, pains on one side of the head; aggravation of the headaches from meditation, the open air, or from move- ment ; extreme tenderness of the scalp to the touch ; falling off of the hair. Calcarea *£■. Chronic headaches frequently attended with a sensation of extreme coldnets, either interiorly or on tho HEADACHE. 377 scalp; the pains either affect the entire head, or merely the forehead, the side, or the crown of the head, and are chiefly of a -stunning, aching, throbbing, or hammering description, compelling the patient to retain the recumbent posture; at times the head feels as if compressed in a vice; or the fore- head feels as if it would burst open, particularly when in the open air; headache, with humming noise in the head, confu- sion of ideas, with aggravation from intellectual employment, or from movement; falling off of the hair ; Calcarea is generally very useful after Sulphur; and Silicea, Lycopod., Ac nitr. after Calc. Arsenicum ~. Headaches so intolerable as almost to drive the patient to despair, occurring periodically and aggra- vated by partaking of food ; the pain sometimes extends to the gums, where it is so excruciating as to render it impossible to fall asleep; tenderness of the scalp to the touch; temporary amelioration of the headaches from the application of cold water. Aurum -~. Headaches in hysterical persons attended with buzzing or other noises in the head; and pain as if the head had been bruised, especially on rising in the morning, or during mental occupation. Eugenia -■§-. Severe one-sided headache (megrim) coming on in the evening, attended with a sensation of pressure or forcing outwards behind the eyes, lachrymation, and sometimes nausea and vomiting which produce exacerbation ; aching pains in the entire head at night (cephalaea) with burning in the eyes, thirst, and copious discharge of urine. One remedy is seldom sufficient to effect a cure of cephalalgia of long standing, particularly when of a nervous character: in some cases of this description, it is only possible to effect a degree of melioration. In comparatively recent cases, the medicines may be repeated at intervals from an hour to six or twelve hours,* when the headache is excessively severe; but in those of a more chronic and obstinate nature, in which it is necessary to have recourse to such remedies as Sulphur, Calcarea, Silex, &c, considerably longer intervals must be * ViHa note, page 21. 378 GENERAL DERANGEMENT. observed between the doses, when our object is to attempt to eradicate the disorder, or destroy the susceptibility to headache from trivial causes. HEADACHE— ADDENDA.-" Headache is one of the most frequent and annoying ail- ments with which the human organism is afflicted. It requires distinct consideration. Although it is generally associated with or dependent on other maladies, it so often predominates that its phenomena should no doubt occasionally control the selection of the appropriate remedy, which should, however, include as far as possible the totality of the suffering. It may also depend on accidental causes; still the remedy, while anti- dotal to them, must carefully embrace all the existing symp- toms. Again, it may occur perfectly independent of any assign- able cause, and thus render the following arrangement of the remedies essential to the successful selection of the therapeuti- cal agent. Congestive Headaches, or those attended with pressure of blood to the head. Examine carefully the symptoms of Con- gestive Headache under the following remedies : Aconite, Arnica, Belladonna, Bryonia, Coffea, Ignalia, Mercurius, Nux vomica, and Pulsatilla. Catarrhal Headache. Examine Aconite, Belladonna, Mercurius, Nux romica, and Pulsatilla. Rheumatic Headache. Aconite, Belladonna, Bryonia, Chamomilla, M:rcurius, Nur. vomica, and Pulsatilla. Nervous Headache. Aconite, Arnica, Belladonna, Bry- onia, Chamomilla, Coffea, Ignatia, Nm vomica, and Pulsa ilia. Digestive or Gastric Headache. Anlimonium crudum, Bryonia, Nux romica, and Pulsali'la. * In the British edition of Laurie, from which the third American was reprinted, no article on Headache was inserted. We supplied the omis. eion at Ihe time, and, although Dr. Laurie has furnished a chapter for hie last edition, we do not find it sufficiently complete to obviate, in all respects, the repetition of our own paper. We consulted Hahnemann, tiering, Jahr, and other best authorities of our school in its composition. — Lo. headache. 379 Headache from Heat. Aconite, and Bryonia. Headaches from Changeable Weather, Currents of Air, Cold, Cold Drinks, and Bathing. Aconi'e, Anti- monium crudum, Belladonna, Bryonia, Chamomilla, Nux vomica, and Pulsatilla. Headache from Tobacco. Aconite, Antimonium crudum, and Ignalia. Headache from Suppressed Eruptions. Antimonium crudum, and Sulphur. Headaches from Mechanical Injuries. Arnica and Belladonna. Headaches from Debauch and Spirituous Drinks. Belladonna, Coffea, Nux vomica, aud Pulsatilla. Headache from Coffee. Chamomilla, and Nux vomica. ■■ Headache from Anger. Chamomilla, Ignalia, and Nux vomica. Aconite. Aconite deserves attention in headaches connected with Congestion to the head, Catarrh, Rheumatism, Neuralgia, and those caused by Heat, Currents of Air, Cold, Bathing, or To- bacco ; and fox females, children, and nervous invalids. Aconite is indicated in Congestive headaches, when a violent throbbing pain seizes the forehead and temples, with a sensa- tion of ardent heat through the entire brain, red and bloated face ; redness of the eyes, visible pulsation of the neck, exces- sive sensibility to the least noise or movement, and, sometimes, great irritability or delirium. When congestive headaches are habitual, the patient should sponge the forehead and temples every morning with cold water, or take a shower-bath and drink one or two tumblerfuls of cold water on retiring and rising, night and morning. In Catarrhal headaches the indications are: dull, pressive, and constrictive pains and heat in the forehead, especially above the root of the nose, with flowing from the eyes, run- ning at the nose, but more frequently obstruction of the same, dry heat in the uose, buzzing in the ears, colic, frequent chilli- 380 general derangement. ness, alternating with feverishness, occasional cough; ameliora- tion of the symptoms in the morning, and in the open air ; aggravation in the erening, and from speaking and exercise. Tho Rheumatic headache is characterized by darting or rending pains, sensitive to the touch, which fly from one part of the head to another, as from the nape of the neck to the ears, temples, vertex or forehead, are sometimes connected with rheumatism of tlm neck and shoulders, arc attended with active fever, dry and hot shin, thirst, redness or varying pallor and redness of the cheeks, are insupportable at night with mental disquietude and vexation, are palliated by silling, and aggravated or renewed by wine, stimulants, or great mental excitement. The Nervous headache generally occurs above the root of the nose or on one side of the head. The pains, which are in- tolerable, especially at night, aro throbbing, darling, and sling- ing, producing by their intensity, lamentations, inconsolable anguish, fear of death, and, at times, temporary insensibility, and are attended by thirst, /lushed cheeks, small, quick, weak, and occasionally, intermittent pulso, and intolerance of touch, light, and sound. Headache from exposure to Heat usually assumes the characteristics of the Congcslir", which are re- corded above. The headaches which arise from Currents of Air, Cold, or Bathing, are in every respect analogous to the sufferings we have described as Catarrhal. The Tobacco headache, whether from chewing or smoking, is very similar to the Congestive headache of Aconite, marked, particularly by sensation of great weight on the vortex and over the eyes, nausea and amelioration in the open air. All the preceding forms of headache to which Aconite is applicable, have the distinctive peculiarities of an increase of suffering from motion, rising from a recumbent position, speaking and drink- ing ; and a diminution in the open air. Administration -"°-. The Aconite may be repeated in severe forms of headache every two or three hours; in milder forms, from six to twelve hours, increasing the intervals in pro- portion to the improvement effected. We have acquired great service from Aconite in acute paroxysms of headache, by using HEADACHE. 381 it as a precursor to, or in alternation with, Arnica, Belladon- na, Bryonia, Chamomilla, Nux vomica, Pulsatilla and Vera- trum. Thus a single dose of Aconite may precede the admi- nistration of these remedies some two or three hours, or may be alternated with them every three or four hours. Antimonium crudum. Antimonium crudum °^° has been used for headaches de- pendent on Chills, Suppressed eruptions, Tobacco, or Indi- gestion. They are characterized by a pain in the forehead as if it would burst, or dull, boring, rending, piercing, spasmo- dic pains in the forehead, temples and vertex, with a sensation as if in the bones of the head, especially of the vertex. The pains are increased by ascending stairs, and mitigated in the open air. If the headache arise from Tobacco, it is attended with dizziness. If it depend on Indigestion, it is frequently preceded by nausea, want of appetite, aversion to food, eruc- tation, and efforts to vomit. It is sometimes followed by loss of hair. The Antimonium may be taken every twelve or twenty-four hours, and is often more efficient after the use of Pulsatilla, especially for the headache of Indigestion. Arnica. Arnica is indicated in headaches connected with Conges- tion to the head, Neuralgia, and in those caused by Mechanical injuries. The Congestive headache is characterized by a spasmodic pressing in the forehead, as if the brain were contracted into a hard mass, principally when near the fire, whirling dizziness with nausea, heat and burning in the head with coldness of the remainder of the body, and occasional prickling or numb sensations in one or more of the extremities. The Nervous headache manifests itself by crawling, prick- ing and stinging pains in one or both temples, or on one side of the head, which feel as if they had been bruised, or by an intense pain, as if a nail had pierced the brain. Tho ho.idache which follows Mechanical injuries, such as 382 U. ENERAL DERANGEMENT. blows,falls, or strains, in the same as the Congestive, attended, at times, by pressive sore pain in the part injured or over one or other eye, and green vomiting. This remedy is the more appropriate when the sufferings aro aggravated at erening or night, after eating, or by menial or physical exercise. Administration. ifi3-4 .1 mica follows and alternates ad- mirably with Aconite when the febrile arion is prominent, and may precede the use of Belladonna, Ca'earea and Rhus. The rule of repetition is the same as that given for Aconite. Belladonna. Belladonna obtains in headaches, complicated with Con- gestion lo the head, Catarrh, Rheumatism, Neuralgia; and those from Heal, Spirituous drinks, Mechanical injuries, i 'old, and Currents of Air. It is especially suitable for females and children. It is appropriate in Congestive headache when the indica- tions given for this form of suffering under Aconite, are not promptly or permanently relieved by that remedy; also if the pains are more deeply seated, are violent, pressive, henry and full, as if the brain would protrude through the forehead or side of the head, with pale, haggard face, drowsiness, loss of consciousness, murmurs and delirium; or if this form of headache develop itself after eating, with great lassitude, drowsiness, painful stiffness of the nape of the neck, imperfect speech, distortion of the face, especially of the mouth, and other symptoms of Apoplexy. The Catarrhal headache is marked by pressive aching in the forehead aud congestive feeling of the entire head, as if it would split open, with sneezing, swelling, redness and excoria- tion of the nose, profuse flow of acrid water from the nose, or flowing from one nostril, or alternating with stoppage of the nose, smell too acute, especially for tobacco smoke, or too ob- tuse, shivering or feverish heat, thirst and pains in the limbs. (Hejiar sulphuris or Mercury may precede or follow Bella lonna for this variety of Catarrhal headache.) Rheumatic headache is attended by violent sliooling and HEADACHE. 383 burning pains, especially of one side of the head, congestion to the head, swelling of its veins and visible pulsation of its arte- ries, redness of the eyes and face, and fever. The Nervous headache is characterized by burning, shoot- ing pains, generally of one side of the head in the mildest form of attack, attended by sensitiveness of the scalp, disten- tion of the veins of the head and hands, roaring and buzzing in the ears, and clouded sight. In a severe form, the pains become pressing, burning, shooting, rending, and distracting, appearing on one side of the head or above the eyes and nose, with a sensation as if water fluctuated or undulated in the head. The neuralgic pain may also commence very gently, increase in intensity through one side of the head, producing irritability, lamentations, and delirium. The headache which arises from Heat is similar to the Con- gestive, and indicates Belladonna, especially, when the head seems as if it would split open and the suffering is increased by walking and mental excitement, and is attended by hot fever, thirst, vomiting, sleepiness, anxiety, tears, lamentation, despair or rage, and delirium. Spirituous drinks produce pressing aching in the forehead with congestive fulness of the entire head, red and bloated face, loss of appetite, especially for meat, thirst and feverish- ness. The headache from Mechanical injuries is similar to the Congestive, and requires the Belladonna, most frequently, after the previous use of Arnica. The effects of Cold and Currents of Air accord with the Catarrhal headache, attended at times by imperfect vision, sore throat and indigestion. All these symptoms of Belladonna are aggravated chiefly at night, also about three or four o'clock in the afternoon, and after sleeping, also by the warmth of the bed, recumbent posi- tion, motion, especially that of the eyes, the slightest touch, shock or noise, open air or currents of air, contradiction, even the slightest, and mental excitement; they are mitigated by flexing the head backward and supporting it. *......—™. ■""« B.0 0 0 Belladonna is frequently preceded 384 GENERAL DERANGEMENT. by, and alternated with Aconite, and Mercury. Its rule of repe- tition and alternation is the same as that directed for Aconite. Bryonia. Bryonia is available in headaches associated with Conges- tion lo the head, I) rangement of the stomach, Neuralgia and Rheumatism, and those caused by Heat and Changeable weather. Congestive headache is manifested by severe pain in both sides of the head, pressing from without inwardly, with a sensation as if the contents of the skull would protrude through the forehead, especially on stooping; bleeding at the nose, affording no relief; burning of the eyes, effusion of tears, and constipation. The Bryonia is of the greatest value if this form of headache occur with Constipation of the bowels. It ia generally worse in the morning. For headaches of the S'omach, see Indigestion. Nervous headache has pressing, burning, rending and shoot- ing pains, as if a tumour were forming under the skin, and aa if the brain would press through the forehead, which seize the forehead, dart to one or other side of the head, or extend to the cheek-bone, shooting aud pulsating at times violently; rheu- matic and passionate patients suffer most from this form of headache. Rheumatic headache is complicated with local or general rheumatism, manifested by rending and shooting pains which fluctuate from the nape of the neck, sides of the head, and forehead, attended by coldness or shivering, or fever and per- spiration of the head or entire body, and aggravated by the least movement and at nigh'. Changeable weather frequently excites the Rheumatic headache. Headache from Heat is marked by pressing pain and fulness of the entire head, attended by want of appetite, especially in the morning, nausea, vomiting and diarrhoea, thirst, fever, agi- tation, trembling and apprehension of the future. The Bryo- nia, may be used in alternation with Belladonna, when that remedy is not promptly efficient for headache from he a, as de- scribed under Belladon ,u HEADACHE. 385 The headaches of Bryonia appear most frequently in the morning and-aper meals, and are aggravated by motion, walk- ing, stooping, &c., and touch. Administration. --3°-. Nux vomica may be used after and alternated with Bryonia. The repetition and alternation of the dose the same as directed for Aconite. Chamomilla. Chamomilla is useful for Digestive, Nervous, and Rheu- matic headaches, and those caused by Coffee, Anger, and Cold; and for females, children, and persons excited by the slightest pain. For Digestive headache, see "Indigestion." Nervous headache is characterized by drawing, rending and pulsative pains of one side of the head which extend to the jaw, sometimes attended by a benumbed sensation, or sen- sibility which renders the touch intolerable; acute shooting pain in the temples, heaviness and throbbing above the nose; bloated face, redness of one cheek and paleness of the other; hot perspiration of the head and scalp, and painful and con- gested eyes. Rheumatic headache is similar to the above, occurring in persons of a rheumatic habit or labouring under rheumatism. Headaches dependent on Coffee and Anger are recognised by the same peculiarities. The headache from Cold is marked, in addition, by weeping eyes, sore throat, hoarseness, and catarrhal irritation of the chest. Administration. 0(y)0. Chamomilla may be used after Aco- nite and Coffea, and may precede Belladonna and Pulsatilla. Coffea. Coffea is applicable to Congestive and Nervous headaches to those caused by Debauch or Spirituous drinks, and to ner- vous persons and children. Congestive headache may arise from excess of joy, is attended by lively exaltation of the mind, heaviness of the head, with oc- casional violent pain of one side, redness of the eyes and sleep- lessness, and is exasperated by speaking. 17 ssr, GENERAL DERANGEMENT. Nervous headache is marked by a sensation as if the brain were bruised and rent, or by severe rending pains of one side of the head, as if pierced by a nail, which seems insufferable ; frequently caused by Debauch or Spirituous drink, meditation, vexation, and influenza; attended by extreme sensitiveness to noise aud music, by agitation, great anguish, tears, cries, dis- traction, throwing about, chilliness, aversion to fresh air, and distaste for coffee. Administration. *■%*■• The Coffea may be repeated fre- quently, from half an hour to two and three hours, according to the relief afforded. Ignatia, Nux vomica and Pulsatilla, may precede, and Aconite and Chamomilla succeed the use of Coffea. Icnatta. Ignatia -~ relieves Congestive, Hysterical, and Nervous headaches, those dependent on Grief, Anger, and Tobacco, and those of nervous persons and children. Congestive headache is characterized by a painful sensation of fulness and expansion of the head, as if it would burst, espe- cially when conversing, Teading, or listening to another; also by a pulsative and deep-seated pain, especially in the forehead, and above the root of the nose, attended by trembling of the body, palpitation of heart and great despondence. Hysterical headache ia generally owing to a high degree of mental excitement, and particularly Grief or excessive. An- ger, and is marked by piercing, darting pains, which pene- trate the brain deeply, either in the forehead or on one side of the head, by alternations of extravagant gayety, and laugh- ter, and extreme despondence and tears, imperfect sight, very red or pale face, nervous agitation and physical rest- lessness. Nervous headache is attended by rending, boring, throbbing, and. lancinating pains, which seize ihe forehead as if a nail were driven through it deep into the brain; or pressing pain in the forehead and above the nose, which progresses from with- out inwardly and is mitigated by stooping; paleness of face, nausea, darkness before the eyes, intolerance of light, profuse headache. 387 colourless urine, fickleness of disposition, sensitiveness, strong fears, taciturnity, sadness, mildness, &c. Ignatia may be used as an antidote to a headache caused by Tobacco, when the symptoms are similar to those we have given as characteristics of Ignatia. The headaches of Ignatia are aggravated by coffee, tobacco smoke, brandy, noise, and strong smells; aggravated or miti- gated by stooping; mitigated by lying down and change of po- sition ; and are renewed after a meal, lying down in the evening and rising in the morning. Rule of administration the same as for Aconite. It may be used to advantage after Chamomilla, Pulsatilla and Nux vom. Mercurius solubilis or vivus. Mercurius solubilis or vivus, is most efficient in head- aches connected with Catarrh, Congestion of ihe head, and Rheumatism. The Catarrhal headache frequently prevails epidemically, and is distinguished by pressing, aching pain in the forehead, frequent sneezing, profuse discharge of serous mucus, which is offensive at times, redness and excoriation of the nose with itch- ing and aching pains on pressing the nose, chills or fever, noc- turnal perspiration, violent thirst, pains in the limbs, and in- creased suffering from either heat or cold. (It may precede or alternate with Belladonna in this form of headache.) Congestive headache has a full and croicded feeling of the head as if the forehead would fly apart, or as if the head were firmly bound by a band, especially with aggravations at night, when the pains become boring, burning, rending and darting, and are attended by easy, frequent and profuse perspiration, which affords no relief. (Here it is useful after Belladonna arid Opium.) Rheumatic headache is attended by burning, shooting, throb- bing and rending pains, which affect one side of the head, ex- tending to the teeth and neck, with pulsatory dartings in the ears. The pains seem to be imbedded in the bones, and the external flesh is frequently tumefied. It may be used before or _/•... ¥».7?.J_____~- Tf........'.. 388 GENERAL DERANGEMENT. It is a distinct peculiarity of the Mercurial headaches, that they are aggravated at night, towards morning, by the warmth of the bed, damp and cold air, heat and touch ; and are attend- ed by profuse perspiration, which affords no relief. Administration °£°. The Mercury may be given in extreme cases every four hours, and in alternation with Belladonna every three or four hours. In ordinary cases it is preferable to administer a single dose in the erening. Nux VOMICA. Nux vomica is a very prominent agent of cure in Catarrhal, Coii'gesjre, Gastric, Nervous and Rheumatic headaches, and those dependent on Coffee, Spirituous drinks, Intellectual la- bour, Anger, Chills or Currents of air, Prolonged watching, and Constipation* ('■tarrhal headache is marked either by heaviness in the forehead or shooting and rending pains; obstruction in the nose, or else fluent coryza of a mucus which is sometimes brown and corrosive iu the morning and dry in the erening or at night, with parched mouth and absence of thirst; bruised sen- sation throughout the body; burning heat and redness of the cheks : heat of the head and entire body, and alternations of chills and fever, especially in the evening; and hard faeces or constipation. Gastric he id ohe : vide Indigestion. Congestive headache is attended by excessive heaviness of the head, especially on moving the eyes, and during mental ex- ercise, with a feeling as if the skull would fly apart; painful sensitiveness of the brain, either from motion or external pressure; pressure on the temples; imperfect sight, with desire to shut the eyes, and inability to sleep; and aggravated in the morning and open air Nervous headache appears in the form of rending, shooting and jerking pains principally on one side of the head, as if pierced " The Xux is most indicated in persons of a lively temperament, red face and full habit, who make a free u^c of Coffee and Liquors, and especially iu those who lead a sedentary life and suffer from Constipated habit. headache. 389 by a nail, with nausea and vomiting of sour water; also, prick- ing, stinging, or oppressive sensation of one side of the head, which commencing in the morning, gradually increases in in- tensity, until the patient becomes distracted and insensible; also, as if the brain were rent asunder, with pale, haggard face, dizziness when walking, buzzing noise, excitation, &c. Rheumatic headache is marked by 1ensive"drawing pains af- fecting the forehead on one side of the head, attended by a bruised sensation of the head and similar pains in the back, loins and joints, a sensation of torpor or paralysis in the parts affected, with cramps and palpitatwn in the muscles; shivering and constipation. (It is mainly indicated for Rheumatic head- ache after Aconite, Chamomilla, Ignatvr, or Arnica.) The headaches dependent on Coffee, Spirituous drinks, In- tellectual labour, Anger, Prolonged watching, or Constipation, are Congestive or Neuralgic, and require a careful study of their respective indications. The headache from Chill or Currents of air, is Catarrhal, which see. The Nux headache is aggravated in the morning, after meals, by coffee, wine, tobacco smoke, noise, bright light, me- ditation, watching, and windy and chilly weather; it is miti- gated by sitting or lying down without change of position. Administration, bro The ^y^ may succeed Aconite, or alternate with it every three or four hours in acute febrile con- ditions. It may precede or alternate with Bryonia or Pulsa- tilla by the same rule. Administered singly, the interval of repetition should vary from 4 to 24 hours, according to the severity of the case. Pulsatilla. Pulsatilla applies to Catarrhal, Gastric, Congestive, Ner- vous, and Rheumatic headaches, and to those caused bv De- bauch, Spirituous drinks, Intellectual labour, Chill, Bathing, or Cold drinks. It is especially suited to females, and persons of phlegmatic temperament, mild character and lymphatic constitution, with pale complexion, light hair, blue eyes, &c. Catarrhal headache is marked by dull heavy aching in the 390 GENERAL DERANGEMENT. root of the nose, forehead, or over one cue, or confusion of the head, and is attended by loss of appetite, taste ami smell; swelling and obstruction of the nose ; discharge of blood or of a thick and offensive mucus, sometimes yellow, and some- times green; and absence of thirst, with chilliness. For Gastric headache, see Indigestion. Congestive headache manifests itself by wearying, debilita- ting, and oppressive pains, which seize one side of the head ; or progress from the occiput to the forehead or root of the nose, or conversely proceed from the root of the nose to the occiput; attended by heaviness of the head, dizziness, paleness of tho face, agitation, and inclination to weep. Nervous headache offers rending pains, in single spots or in every part of the head, which are augmented toward evening ; or throbbing, darting and pricking pains, after rising in the morning or lying down in the evening; or jerking, rending, darting and pricking pains in one side of the head only ; attend- ed by heaviness of the head, frequent dizziness, obscure vision, intolerance to light, sickness at the stomach, buzzing, darting, rending, and pricking in the ears, paleness and varied expression of the face, loss of appetite and thirst, agitation and chills, bleeding at the nose, and palpitation of heart. Rheumatic headache is characterized by similar pains to those of the Nervous; and are connected with rheumatic pains of the body, which pass rapidly from one joint to another, with sensation of torpor in the parts affected, dartings and coldness on change of weather, and shiverings increasing in proportion to the intensity of the suffering. For headaches arising from Debauch, Spirituous drinks, and Intellectual labour, carefully consult the indications of Nervous and Congestive headaches; and from Chill, Bathing, or Cold drinks, look to Catarrhal headache. The Pulsatilla headache i3 aggravated or renewed in the evening after lying down, or at night, or in bed in the morning; at rest, especially when seated ; and mitigated in the open air by movement, walking, external heat, and firm pressure. Administration. -$- Pulsatilla follows, and is of great service in alternation with Aconite ; may precede Bryonia and PAINS IN THE LOINS. 391 Nux, and succeed Chamomilla and Ignatia, with which it may occasionally alternate. The repetition and alternation the same as advised for the Aconite.—Ed. PAINS IN THE LOINS. Notalgia. As these pains are frequently purely symptomatic, the treat- ment must be directed against the disease from whence they ori- ginate. Thus as Haemorrhoids, Leucorrhcea, Metritis, Myelitis, etc., are frequent sources of the complaint, the reader is re- ferred to the treatment of these affections in their respective chapters. When they arise from the habitual indulgence in wine or spirituous liquors, coupled with confirmed sedentary habits, as late hours, an occasional dose of Nux v. (three to four globules of the 6th potency in a teaspoonful of water) will generally afford relief; and when a strain from lifting a heavyweight or from any sudden twist on turning the body, or throwing up a window, etc., has given rise to the pain, Rhus tox. must be had recourse to; followed, if required, by Sulphur and Calcarea* (Vide also Lumbago, Rheumatism, p. 314, etc., and for pains in the back, or lumbo-sacral pains, occurring in females during pregnancy, see that Article, Part IV., p. 518.) DELIRIUM TREMENS POTATORUM. This malady consists of an affection of the brain, and is nearly peculiar to drunkards, hence its name. There are a few instances on record, in which it has arisen from exhaustion caused by excessive depletion ; from the effects of lead, and also from the prolonged use of opium. The intemperate use of ardent spirits, vinous or strong malt liquors, is, however, beyond comparison, the exciting cause in by far the major number of instances. The disease generally comes on in drunk- ards in the state of prostration which ensues when they have in a great measure given up, or been suddenly deprived of their accustomed stimulus. The first symptoms of the malady are generally indicated 392 GENERAL dehangemf.nt. by extreme irritability of temper, weakness of memory, but constant activity of mind, anxiety, and iiioontrollaUe restless- ness with increased muscular mobility. The appetite is often pretty good, but more frequently im- paired iu consequence of the previous habits, and the tongue sometimes foul aud moist. Soon after these premonitory signs, vigilance sets in, and little or no sleep can bo obtained ; or it is unrefreshing and disturbed by frightful dreams, imaginary visions and sounds. Fixed ideas then take firm possession of the patient's mind, such as the supposition that some one ia bent upon poisoning him or doing him some other grievous injury, etc., yet he generally dreads being alone. The speech ia frequently stuttering and inarticulate; the countenance quick, wild, and exceedingly variable, according to the prevailing im- pression on the mind; the face in most cases pale or sallow; the eye rolling, expressive, and restless, and the conjunctiva blanched; the skin damp, or covered with sweat, chilly and re- laxed, very rarely above the natural temperature ; the hands are commonly tremulous, and muscular twitchings are o'ten observable. As the disease advances, sleep i.s completely ban- ished ; loquacity with perpetual bustling occupation, becomes in- cessant ; and when it is fully developed, delirium supervenes. The pulse is soft and compressible, and rarely quick when not agitated by the struggles or exertions of the patient, for his corporal activity keeps pace with that of the mind, and it ia difficult to confine him to his bed or apartment; at the same time, exhaustion is liable to come on very rapidly after great exertion, and the patient is prone to drop down from fa- tigue. Occasionally convulsions take place, but though some- times serious, they are usually not of a fatal character. The history of the case, together with the distinctive nature of most of the above described syraptoma, enable us to discern this disorder from that of inflammation of the brain or its membranes. Therapeutics. Nux v., Opium (provided, of course, the attack has not been excited by the effects of Opium or its alkaloid, in large doses), Aconitum, Belladonna, Lachesis, Hy- oscyamus, Sulphur, and Calc, form our main remedial agents. DELIRIUM TREMENS. 393 Nwx v. i.s particularly useful in the first stage of the dis- order, and may frequently be the means of arresting its furtl r progress when administered at that period. The fi0:a, or a£a, or -fi^th potency may be used, and the dose repeated in from six, twelve, to twenty-four hours, according to the effects pro- duced.* But when the disease has become fairly established, and the patient is affected with delirium or convulsions, and an ag- gravated degree of all the symptoms remarked at the commence- ment of the attack, we must have recourse to Opium, (potency ogo or 00.0^ ;n freqUentiy repeated doses. The curative pro- perties of this drug, in this malady, do not, as is errone- ously supposed by the majority of allopathic practitioners, arise from its property of producing sleep, but from its homaso- pathicity, or specificity, if I may use the expressions; the pa- thogenetic properties which it possesses being exactly similar to those which are developed in the course of the disease as it occurs in drunkards. In some cases, particularly where the patient exhibits ex- treme irritability of temper, with more or less derangement of the digestive functions, considerable advantage will be attained from the alternate employment of Nux v. and Opium. In some rarer varieties of the affection, which are more liable to occur in young, robust, or plethoric subjects, we meet with symptoms indicative of active cerebral congestion, which call for the administration of a dose or two of Aconite, follow- ed in a few hours by Belladonna, or by Belladonna and Lache- sis alternately, if only partial benefit is obtained from the action of Belladonna alone, and the trembling of the hands and arms forms a very prominent symptom. Hyoscyamus may be prescribed in preference to Belladonna, when the patient's in- sanity is more particularly apparent in the exhibition of exces- sive and uncalled-for jealousy. In extremely obstinate attacks, Sulphur, Opium and Nux v. may be given in alternation, at longer or shorter intervals ac- cording to the greater or less severity of the symptoms. Cal- carea is also a remedy of considerable importance in such * Vide note, p. 21. 17* 394 GENERAL DERANGEMENT. cases, but more especially in plethoric habits. Finally, Stra- monium may be mentioned as likely to be useful when Be la- donna, Ilyosciamus, and even Opium, fail to do much good, and the spasms or convulsions are very severe. Coffea and Cam ihora have likewise been named as likely to prove ser- viceable against the vigilance, or the mental and bodily activity, when the remedies already enumerated fail to answer expec- tation. But it may safely be averred, that there aro lew in- stances in which Nux v. and O/ ium, when timely administered, will not succeed in subduing the more violent features of the disease; and Sulphur, Opium, Nur v. and Calcarea, in re- moving any inveterate sequela-. These medicines, together with Arsenicum ami Acid, sulphuricum, administered at inter- vals of from four to eight days, have also been recommended as useful in correcting the vice which gives rise to this disease as ordinarily met with. Delirium tremens arising from exposure to the vapour of lead, chiefly requires : Opium, Belladonna, and Nux v.; and that from poisonous doses of Opium : Nux v. and Belladonna chiefly. (See Poisons.) EPILEPSY. Epilepsia. Morbus sacer. This well known aud truly distressing, complaint would re- quire a treatise of itself were we to enter minutely into the treatment of the different forms in which it shows itself; it must therefore be sufficient for our purpose, at present, merely to enumerate the various remedies which have been employed against it with the most success. In cases of recent origin the following are generally the most appropriate : Belladonna, Ignatia, Chamomilla, Nu.r v., Opium, Ipecacuanha, Camphor, &c. In chronic: Sulph., Calcarea, and Silicea ; or, Causticum, Cuprum, Stannum, Bel- ladonna, Hyoscyamus, Stramonium, Veratrum, (Ji cut a, Zincum, Lachesis, Hepar, Arsnieum, Agaricus, &c. When the reper- cussion of an erupti.n, or the suppression of an accustomed discharge has given rise to the malady: Sulphur, Calcarea, Causticum, Lachesis, Stramonium, Ipecacuanha, have chiefly been recommended. When the disorder is symptomatic of ASTHMA. 395 other diseases, such as derangement of the digestive func- tions, worms, teething, etc., our attention must necessarily be directed to the treatment of the primary malady. During the epileptic seizure, all that is usually requisite- is to take true measures to guard against any injury accruing to the patient in his struggles; further, to remove anything which is calculated to obstruct the circulation, from the neck. A dose of Aconite °b° followed by Belladonna if relief be not speedily obtained, is necessary in some recent cases, when the fit occurs in plethoric subjects, and is attended with strongly marked signs of congestion of the vessels of the head and neck. ASTHMA. This affection is characterized by the following phenomena : difficulty of breathing, recurring in paroxysms, attended with a sensation of suffocating constriction in. the chest, cough, and wheezing. The paroxysm is frequently preceded by a sense of coldness, languor, headache, heaviness over the eyes, sickness or flatulence, and a sense of oppression in the chest. During the attack, the patient feels much worse in the recum- bent posture, and consequently sits up, requests the door or window to be thrown open, to admit more air into his apart- ment, and uses every effort to dilate and empty the lungs. There is great restlessness, and frequent attempts to force something out of the air-passages which "he thinks impedes the breathing, by coughing. The face is pale or livid, and wears an anxious expression. The extremities, and even the nose and ears, are frequently cold, and the face and chest covered with cold perspiration ; the heart palpitates; the pulse is in various states, sometimes quick and full, small and quick, or weak and irregular; often intermitting. These symptoms continue with a greater or less degree of violence for some hours or even days, until expectoration takes place, which af- fords relief as it increases in quantity. A remission also sometimes takes place soon after the occurrence of an acces- sion of copious perspiration, or a profuse discharge of urine. 396 GENERAL DERANGEMENT. The disease is more frequently met with at an advanced than an early period of life, and oftener in men than women. The attacks occasionally ct me on in the afternoon, or on retiring to rest, hut much more frequently curing the night, and in the midst of a sound sleep, from which the patient is suddenly awoke by a sense of suffocation. The recurrence as well as the duration of the attacks ia very various. One attack generally leads to another, and the paroxysms commonly become more aud more frequent and distressing; still, if no organic disease result, patients who are subject to returns in considerable frequency, sometimes survive to an advanced age. But this is unfortunately not often the case: for unless the disease be arrested, the repeat- ed obstruction and disturbance which is offered to the respi- ration and circulation, seldom fails, in the majority of cases, to induce organic lesions of the heart and large vessels of the lungs, with the usual concomitants of water in the chest or abdomen. The quantity of expectoration is small, and even entirely absent in some cases of asthma, whilst in others it ia exceedingly copious; and hence, the disease has been divi- ded into dry and humid asthma. In the former (As/hna sic- cum), the attack is usually sudden, violent, and of short dura- tion; the cough slight; the expectoration scanty, appearing only towards the termination of the fit, arid in some instances entirely wanting. In the latter, (Asthma humid win), the pa- roxysm is gradual and protracted; the cough severe; the ex- pectoration supervenes early, is at first scanty and glutinous, and afterwards copious, and productive of great relief. Therapeutics. In nervous or convulsive asthma (As'hma sicca) the remedies which have been employed with the most satisfactory results are: Arsenicum, Cuprum, I; ecacuanha, Nux v., Bryonia, Pulsatilla.—Opium, Tar'arin, Sambucus.— Aconitum, Belladonna, Phosphorus.—Sulphur, Lachesis, Sam- bucus.—Ferrum, Veratrum, Mos-hus, S annum, Hyoscyamus, Stramonium, Chamomilla, Carbo v.. Aurum, Lycopodium, Acidum nitr., Ignatia, Kali, Ambra, Mercurius, Silicea, Cairo* rta. Dulcamara, Coffea, Lobelia inflata, etc. Iu moist, humid, ASTHMA. 397 pituitous asthma (asthma humida) : Pulsatilla, Dulcamara, Stannum.—Sulphur, Sepia, Tartarus, Cuprum, Sambueus.— Ipecacuanha, Belladonna, Bryonia.—Ferrum, Calcarea, Lachesis, Graphites, China, Silicea, Hepar, Baryta c, Conium, Camphora, Zincum, Mercurius. In flatulent asthma : Nux v., Cinchona, Carbo v., Lycopodium, Chamomilla, Phosphorus, Sulphur, Opium, Zincum, &c. In asthma spasmodica, Pul- monary spasm (cramps in the chest) : Cuprum, Nux, Bryonia, Belladonna, Hyoscyamus, Arsenicum, Lachesis, Stramonium, Co, cuius, Nux m., Sambueus, Tartarus, Zincum, Sulphur, Kali, Causticum, Sepia, Slannum, Lycopodium, &c. Asthma arising from exposure of irritating vapours (asthma vaporosum), such as copper or arsenic: Ipecacuanha, Mercurius, Hepar s. —Camphora, Cuprum, or Arsenicum. From the vapour of sulphur : Pulsatilla chiefly; and when caused by the con- tinued inhalation of stone-dust, and other irritating particles : Sulphur, Calcarea, Silicea, Hepar, have principally been recommended; and in some cases, also the following: Arseni- cum, Belladonna, Nux v., Phosphorus, Ipecacuanha, and Cin- chona. Where the repercussion or retropulsion of an erup- tion, or the suppression of a habitual discharge has been the occasional cause ([asthma melastasicum) : Sulphur, Carbo v., Arsenicum, Bryonia, and Phosphorus, are the most appropriate in the majority of cases. If from suppressed catarrh : Arsenicum, Ipecacuanha, Nux v., &c. Where a chill has given rise to an attack of asthmatical breathing, Ipecacuanha and Arse- nicum; or, Dulcamara, Aconitum, Belladonna, Bryonia, Cha- momilla. And when mental disturbance has brought on a paroxysm of dyspnoea: Aconitum, Chamomdla, Ignatia, Coffea, Nux v., Pulsatilla, Veratrum. When Congestion of blood in the chest forms the occasional cause of dyspnoea, see that article. When the disorder occurs as a sequela of bron- chitis, see Bronchitis. The remedies which are best calculated to afford relief dur- ing a paroxysm of asthma are: Ipecacuanha, followed by Arsenicum if the former produces but little benefit. In other cases: Cu}>rum, Moschus, Opium, Tartarus, and Sambueus; or, Nux v., Bryonia, Chamomilla, Belladonna, Cinchona, Nux 398 GENERAL DERANGEMENT. moschata, or Pulsatilla, will prove more useful. And those which have principally been recommended to eradicate the ten- dency to suffer from repeated recurrences of the disorder, where that is practicable from the absence of serious organic disease, Arc, are as follows: Sulphur. Calcarea, Arsenicum, Nux v., Antimonium.—Stannum, Sepia, Silicea, Cuprum, Lachesis, Carbo v.—Lycopodium, Causticum, Graphites, Acidum ni- tricum, Phosphorus, Ammonium c, Ferrum, Zincum, Tu.ssi- lago. In ordinary cases the subjacent remedies will be found serviceable, when the leading symptoms are in accordance with those which are described. Ipecacuanha b^s. During the paroxysm of acute asthma, this remedy is one of the most frequently useful, whether the attack occurs in children or adults. It is more especially in- dicated when the patient is awoke from a sound sleep, with a suffocating sensation of constriction in the windpipe, with quick, laborious breathing and gasping for breath ; wheezing and mucous rattling in the chest; short dry cough ; paleness and coldness of the face, sometimes alternately with heat and red- ness; coldness of the feet; anxiety and dread of suffocation; feeling as if dust were inspired during the act of respiration, and caused the suffocating feeling in the chest; spasmodic rigid- ity of the body, and livid hue of the face. After a dose or two of Ipecac, it is occasionally requisite to have recourse to Arsenicum to afford further relief. In other instances, Nux v. or Bryonia will be found better adapted to remove the remain- ing symptoms. Arsenicum bio j8 chiefly canej for (e;tber jn acute or chronic asthma) when, during the attack, the respiration appears to become more and more laborious, and is attended with extreme agitation, moaning, and jactitation ; great ex- haustion, and anguish, as if at the point of dea'h, with cold perspiration. In confirmed asthmatics, it forms a most im- portant remedy, when the breathing is liable to become much oppressed when walking rather quickly, or when going up a hill, or ascending stairs; and when, particularly in the case of old people, even the effort of laughing, or the exertion of getting into bed, brings on a fit of dyspnoea. Arsenicum, as ASTHMA. 399 well as Ipecacuanha, is further indicated when the paroxysms of asthma are most liable to occur on retiring to rest, or before midnight, the patient being disturbed from sleep by a sense of spasmodic constriction in the chest and larynx, which is soon followed by laborious, ranting, and whistling respiration, with gasping for breath. These symptoms are occasionally relieved by remissions, but the attack is prone to recur on using the slightest exertion; for the most part, however, the paroxysm continues with more or less intensity until relieved by the ac- cession of a fit of coughing, with expectoration of viscid mucus filled with vesicles. Arsenicim, though principally called for in cases in which the attacks come on at night, is also useful when they are prone to be excited during the day, on exposure to a cold bracing air, or on going out during the prevalence of disagreeable, damp, or stormy weather ; likewise when changes of temperature, or tight and very warm clothing, are likewise liable to cause a fit of dyspnoea. Sensation of burning heat in the chest during the fit of asthma, is an additional indication for Arsenicum. Bryonia -|-. As already mentioned, this medicine is fre- quently useful after the previous employment of Ipecacuanha. The indications are chiefly: Obstructed respiration at night or towards morning, with frequent cough, pains in the hypo- chondria, and inability to recline on the right side, and not without inconvenience on the left, so that the patient is con- strained to lie on the back; frequent coughing, with expecto ration at first frothy, and subsequently thick and glutinous, and frequently attended with retching or vomiting; aggrava- tion of the dyspnoea from talking or from the slightest move- ment ; frequent efforts to obtain sufficient air by deep inspira- tions, accompanied with moaning, palpitation of the heart, and great anxiety. The attacks are often attended by shootings in the chest, on taking a full inspiration, also on coughing, or after any movement of the arms or trunk. At other times there are eructations of the taste of the food partaken of, colic, irritability of temper, and disposition to find fault with every- thing. (Bryonia and Nux v. are often administered with great advantage in alternation.) 400 r.r.NERAL dkrancement. Nux vomica •,l»0. Nocturnal attacks of .suffocating tightness, especially at the loner part of the ches', preceded by disagreeable or anxious dreams; also when the paroxysms are prone to occur in the morning, or after a meal, and are attended with anxiety, aching and pressive pains in the precordial region, as also in the hypochondria; feeling of distention in the abdomen and epigas- trium; flatulence; tension, pressure, and aching in the chest; palpitation of the hi art; short hacking cough, with difficult ex- pectoration ; inability to bear the slightest pressure from the clothing, particularly around the chest and waist ; the (lotlies seem to fit tightly and increase the difficulty of breathing, when in reality they are quite the reverse; dyspnoea when walking and conversing in the open air, especially if tho temperature be somewhat cold; dyspnoea after trivial corporal exertion of any kind. Melioration of the asthmatic sufferings when reclining on the back, or on changing from one posture to another, such aa Bitting up, and then lying down again, or turning from one side to the other. Disposition irritable and passionate. Pulsatilla °|°. Oppressed, rapid, and laborious breathing from a feeling of spasmodic constriction in the chest, especially at tie inferior portions; or suffocating feeling in the wind-pipe, as if caused by the vapour of Sulphur ,- tension, and sensation of fulness, pressure and aching, attended with mucous rattling in the chest; short fits of coughing in rapid succession, and ap- pearing to threaten suffocation; or cough with copious e.ipecto- ral-ion of mucus. The attacks usually coming on at night, or in the evening when in a horizontal posture ; extreme anguish, pal- pitation of the heart, and sometimes lancinating pains in the chest during the paroxysms. Pulsatilla -§-, is generally more suitable for hysterical fe- males or individuals of a mild, timid, sensitive, or fretful disposi- tion. In dyspnoea, with mucous rattling, and cough, occurring in children from taking cold, it is likewise a most useful remedy. Tartarus emeticus £^. Dyspnoea with suffocating cough and anxious oppression at the praecordia, arising from an exces- sive secretion of mucus in the bronchi; this remedy is frequently of great service, either in aged persons or in children. Opium AJtt. Obstructed breathing, either from congestion or ASTHMA. 401 from pulmonary spasms, with suffocating cough and livid hue of the face; loud mucous rattling in the chest, with extreme an- guish from dread of suffocation; dyspnoea during sleep resem- bling nightmare (incubus). China "-go. Paroxysms of asthma at night, as if caused by an accumulation of mucus in the wind-pipe; wheezing in the chest during inspiration ; difficult expectoration of thick trans- parent mucus ; oppression at the chest, palpitation of the heart, and inability to breathe, unless the head and shoulders are propped up with pillows; great weakness, and tendency to copious sweating at the slightest exertion, or when too warmly clothed. Sambccus ■a~. Rapid and laborious respiration, with loud wheezing ; oppression at the chest as if from a weight, attended with anguish and dread of suffocation, and sometimes swelling and livid hue of the face and hands, general heat, tremour, in- ability to talk much above a whisper; suffocating cough ; ag- gravation of the symptoms in the recumbent posture. In the case of children this remedy is often of great service, when, in consequence of a chill, they are seized with spasm in the chest, and awake from sleep with a start, and exhibit many of the symptoms detailed. (See Spasms in the Chest.) Moschus -§-. Acute asthma occurring in hysterical females, or in children from exposure to cold ; sense of spasmodic con- striction in the larynx and bronchi; or oppression at the chest with paroxysms of suffocating feelings, as if caused by the inhalation of the vapour of sulphur, commencing with a fit of couching, and succeeded by distressing oppressive constriction, sometimes to such a degree, as almost to drive the patient to exasperation and distraction. Belladonna °£°. Difficulty of breathing, particularly when occurring in females of an irritable habit, and subject to spasms, with tension in the chest, and lancinating pain behind the ster- num ; dry cough at night, with moaning respiration which is sometimes deep and full, at others, short and rapid, with gasp- ing for breath and great efforts to dilate the chest to the utmost to obtain a sufficient supply of air; sensation of constriction in iv,a Wwn-e- nnd feftlino- as if suffocation would ensue on putting 402 GENERAL DERANGEMENT. the hand to the larynx, or on turning tbe neok; paroxysms of asthma, with loss of consciousness, etc. Lachesis 0°;f headache resulting from a contusion or from stum- bling, aud .4r»/c« docs not afford much relief. Belladonna <>$° may be given;* the patient should at the same time remain quiet, and avoid any exertion, whether 01 the body or mind, un- til the pain is removed. SPRAINS. In the treatment of these troublesome casualties, at the commencement, prescribe a lotion of Arnica, when there is much tumefaction and redness, with great pain on tho slight- est movement. Alter the employment of the Arnica, we may have recourse to Rms toxicodendron, which is, properly speaking, more specific to this description of external injury, in the same manner, and two or three globules of the third or sixth potency may also be taken internally. If severe pain continue notwithstanding the employment of Arnica and Rhus, the fol- lowing remedies have been recommended: Bryonia, Ammonium c and Ruta, and in some instances, Belladonna, Pulsatilla, Nux v., \., in wounds from splinters, ^f}°- or bbs.^ etc. (For poisoned, wounds, see Hydrophobia, p. 420.) DISLOCATIONS. LUNATIONS. Violent pain, swelling, distortion of the joint, loss of motion, with an alteration iu the shape, length, and direction of the limb, characterize the exist- ence of this injury. Therapeutics. The reduction of a luxation ought to be effected as soon as possible by tho surgeon. When such assistance is not immediately to be had, and there is exces- sive pain and inflammation, a dose of Arnica ought to be given, followed by Aconitum in an hour or two if tho pain continues violent, and the inflammatory symptoms active. Cold water, or very weak arnicatcd water, (a few drops of the tincture to a teacupful of water,) should be applied locally. When the luxation is reduced, the same treatment may be pursued if called for; and the usual beneficial mechanical measures em- ployed, such as the application of an appropriate bandage to support the joint, and prevent a recurrence of the displace- ment, together with frequent but careful flexion and extension of the joint. In compound luxations, the same treatment must be pursued in the first instance as above described; and * *§* Aconitum after amputations, extirpations, and other surgical operations.—Dr. Thorer employed, in preference to an Arnica lotion, the tincture Cnlrmlula officinalis as a lotion, especially in incised, punctured or lacerated wounds, and those with considerable loss of substance. Even after amputations, the cure was effected by the first intention, and in almost every instance where it was impossible to avoid suppura- tion. FRACTURES. 415 the wound treated so that it may be healed if possible by the first intention. (See Wounds.) FRACTURES. The symptoms of fracture are: pain, swelling, deformity, and sometimes shortening of the limb; loss of power, with preternatural mobility when we attempt to bend the limb, and crepitation on rubbing the broken surfaces of bone together. Fractures are divided into transverse, ob- lique, and longitudinal; and also into simple, compound, com- plicated, and comminuted. By a simple fracture is understood one in which the bone is broken, without there being at the same time a wound of the soft parts. A compound fracture consists, not only .of a solution in the continuity of the bone, but also in the coexistence of an external wound, caused by the protrusion of the extremity of one or both fragments of tie bone through the integuments. Again, a fracture is termed co nplicated, when it is attended with a wound of a large artery, extensive laceration of the soft parts, or with dislocation of a joint. Lastly, it is designated comminuted, when the bone is broken into several pieces. v Therapeutics. As soon as a limb is discovered to be fractured, the patient ought to be placed on a litter of any kind which happens to be at hand, such as a board or shutter, and removed to some neighbouring place of shelter, or to his own abode if it be not far distant, and a surgeon sent for. Great care and gentleness ought to be exercised in lifting and transporting the patient from one place to another; otherwise a fracture, originally of the simple kind, is liable to be con- verted into a compound, or at all events into a complicated one, from laceration of the soft parts, etc., caused by the ser- rated extremities of the fractured bone, whereby the proba- bilities of recovery will be rendered much more unfavourable, particularly if the accident has happened to a debilitated or a,n-cd individual. In the case of a simple fracture, the reduc- tion should be immediately effected by placing the limb in the position best calculated to relax the principal muscles attached to the broken bone; it should be then gradually extended,' until the upper and lower fragments are brought into their 416 CASUALTIES. proper position; after the accomplishment of which, splints and bandages must be applied to retain the fragments in their situation. When all this is accomplished, a dose of .-tniira should be administered, for the double purpose of preventing the invasion of undue inflammation, and of promoting the reunion of the fracture. Symphitum officinale has also been most favourably spoken of, as being extremely valuable in facilitating the last-named most desirable end.* Those who have had ample opportunities of testing the virtues of these two remedies, and of the homoeopathic treatment generally, in eases of fracture, unhesitatingly declare that the patients are thereby enabled to regain the use of their limbs, and to bo dis- charged with safety from the hands of the surgeon, at an earlier period than when treated according to the old rules ; aud further, that the formation of false joints is, under the said mode of treatment, of less frequent occurrence. In fracture complicated with a wounded artery, or with a dislocated joint, the artery should be ligatured, and the luxa- tion reduced before the bone is set. In compound fracture, the protruded extremities of tho bone should be restored to their natural position as soon as possible, the limb supplied with splints, etc., and the external wound attempted to be healed by the first intention. Con- secutive inflammation and constitutional disturbance must be suppressed by the measures alluded to in the treatment of wounds. When the protruded part of the bone cannot be reduced by the ordinary method, the wound may be enlarged, and in those cases where it is evident that that will not prove of material assistance, it is recommended to remove a portion of the ex- posed bone. When a false joint is formed, in spite of every care and attention, (as is prone to occur when the limb has been kept in constant motion by patients in a state of delirium, or under other circumstances—also when the fracture has taken place in an aged person, or in one of an extremely bad habit of body,) most surgeons advise the ends of the osseous fragments to be cut off, or a seton passed between them. * Ruta has likewise been mentioned as useful in some ca»uk. BURNS AND SCALDS. 417 It is foreign to our intention to occupy further space by en- tering into a description of the means to be adopted in the i e- duction of the various specific fractures which are liable to lie encountered in different parts of the body : such a proceeding would come more within the province of a purely surgical work. Let it suffice therefore to remark, in closing these observations, that in all cases, the same medical treatment is to be pursued, as has been previously noted for that of con- tusions, wounds, and fractures in general:—Finally, it may be stated, that from the great success which has attended the homoeopathic practice, as employed by continental surgeons in the treatment of those numerous and serious diseases which are usually considered of a surgical character, it is earnestly to be hoped that their colleagues in this country may be induced to emulate their example, and thereby become enabled to raise their important branch of the profession to a still higher standing than it already, in many respects, has attained. BURNS AND SCALDS. Ambustiones. We shall here content ourselves with merely treating of these lesions in their simple form. In slight burns or scalds, the injured part should be held for a couple of minutes to the fire; a temporary increase of pain will be amply repaid by the prevention of future suffering and annoyance. If, however, the injury be more severe, we may bathe the affected part with heated alcohol, or oil of turpentine, taking care to keep the surface continually moist, and well protected from the ex- ternal air. The application of raw col Ion to the part, is frequently found very efficacious, particularly when the injury presents a large surface • having previously punctured any blisters that may have arisen, and bathed the sore with tepid water, cover it with carded cotton or wadding, in three layers; when sup- puration sets in, remove the upper layer only, and substitute fresh. Exhibit at the same time Hepar sulphuris, a grain 18* 41* CASUALTIES. of the third trituration to an ounce of water, a dessert-spoon- ful every twelve hours, desisting after the fourth administra- tion. Soap, a remedy generally at hand, is extremely serviceable in burns where not only the cuticle but the true skin has been destroyed : pure white or curd soap is the best for this pur- pose. The following directions for its application may be found useful: make a thick lather or paste, by means of tepid water, and spread it upon linen, in the form of a plaster; apply it to the injured part, and secure by a bandage. Any blisters which may have formed should, as before prescribed, be care- fully punctured, and any loose skin removed. This application will, as in the instance of dry heat, &c. at first increase the pain ; but this temporary inconvenience will be superseded by a marked amelioration ; after a lapse of about twenty-four hours, the plaster maybe gently removed, and a fresh one substituted; generally speaking, however, we must he guided by the feelings of the patient, and renew it as often as a return of pain is complained of; and so continue until the injury is completely healed. Sapo communis, °3°> may a^so be given internally from time to time. Acomtim, V, may be exhibited when we find considerable ferer present; and repeated in a few hours, if required. Opium, -§§- on the tongue, when the system has received a severe shock from fright at the time of the injury. Lrtica urens has recently come into repute as a specific remedy in burns of erery description ; but not having yet had an opportunity of proving its efficacy, I cannot offer any testi- mony of its virtues in this respect. The mode of application recommended is, applying linen cloths, saturated with the mother tincture, to the injured part; and in severe cases, a drop of the tincture may be taken internally also, either in a Httle water, or on a piece of lump sugar. Kreasote water has likewise been recommended as a lo- tion in burns of all kinds, either at the commencement or sub- sequently, to induce healthy granulation and cicatrization. Crocus suticus (applied externally) has also been favourably spoken of as most serviceable fur the latter purpose in burns or FATIGUE. 419 wounds with considerable loss of substance, and disposition to mortification and sloughing. (See Ulcers.) FATIGUE. When a feeling of contusion is experienced in all the limbs, Arnica will generally be found the most appropriate remedy to afford relief. Administration -6-, repeated in twenty-four hours, should any of the symptoms remain. When the feet have become swollen and painful, they ought to be bathed in arnicated water. Pain in the joints, &c, arising from lifting heavy weights, or from violent physical exertion of any kind, are usually speedily removed by Rhus toxicodendron. Administration. Same as Arnica. Cinchona ---, will frequently assist in renovating the strength when there has been profuse perspiration. Veratrum fi3-0a, when tendency to fainting ensues from the effects of extreme fatigue ; and Coffea -3-0-, when abstinence from food, combined with violent exercise, has produced a state of exhaustion. Cocculus -j-2-, when fatigue occurs after the most trivial exertion of either body or mind. ( Veratrum and Calcarea are necessary when Cocculus does not give much relief.) In fatigue from long watching, Cocculus is the most gene- rally useful medicament; but Nux v., Ipecac, Puis., and Carbo v., are also of utility occasionally. Aconitum is a valuable remedy when dyspnoea, with palpitation of the heart, pain in the side, or aching in the extremities, arises from running a short distance, or even from walking quickly. (Bryonia is sometimes necessary when these symptoms con- tinue notwithstanding the employment of Aconitum. At other times Arnica will be found more efficacious, particularly when the pain resembles what is termed a stitch in the side. Ranunculus bulbosus is also very useful in the latter case.) Administration. Same as Cinchona. 420 STINGS OF INSECTS. The severe pain and febrile irritation which sometimes ensues from the stings of insects, such as bees, wasps, &c, is frequently speedily alleviated by the olfaction of spirits of Camphor. Should, however, considerable inflammation with swelling supervene, Aconitum $, should be administered, and subsequently Arnica, internally and externally, as described under Wounds. Should the tongue or any part of the mouth be the part where the sting has been inflicted—as occasionally happens to children when biting a piece out of an apple or pear, &c, into which a wasp may have greedily inserted itself —the mouth ought to be rinsed with diluted Arnica tincture; and should that not suffice, Belladonna should be ad- ministered, as follows : *%-, in a wine-glassful of water, a dessert-spoonful every hour, until relief is experienced. In some instances it will be found necessary to have recourse to Mercurius after Belladonna. Administration. £f-, in the same manner. The bites or stings of gnats require an Arnica lotion; lemon-juice will likewise be found useful in relieving the pain and itching caused thereby. Immediate relief when a person has been severely stung by nettles, will often be found by the application of a lotion of Ar- nica, prepared according to the formula given under Bruises. SEA-SICKNESS. Therapeutics. The medicaments found most useful in the treatment of this distressing and painful malady are, Nux v., Cocculus, Tabacum, Arsenicum, Ipecacuanha, Petroleum. Nux vomica B.3.s.ia.s.f should be taken fasting, from six to twelve hours before embarkation; this precaution will in some cases prove sufficient to ward off the attack. {Nux r. and Ar- senicum alternately every hour or so, at the commencement of the voyage, or oftener should a degree of nausea have already come on, frequently ward off the sickness, or at all events, SEA-SICKNESS. 421 afford great relief. As soon as decided improvement is expe- rienced, the remedies must be discontinued, or taken at much longer intervals.) Should, however, a feeling of giddiness, or a sensation of emptiness in the head, be experienced, shortly after going on board, attended with headache, nausea, and inclination to vomit, as the motion of the vessel increases, which is aggravated by standing erect, Cocculus °£° may be had recourse to, and re- peated every one, two, or three hours, as those symptoms recur. (This remedy has also been found useful in sickness arising from travelling in a carriage.) Tabacum boos.oo^ Excessive giddiness attended with dis- tressing nausea, headache, and deadly paleness of the face; or nausea, with sickness, or a sensation of burning in the stomach, renewed by the slightest, movement of the head or body. This remedy is further indicated, when the symptoms are somewhat relieved by exposure to the fresh air. Arsenicum ° ° \° ° °, is extremely valuable when the sickness becomes excessive, and is attended with a feeling of utter pros- tration and. helplessness, violent retching, burning sensation in the throat, and the other severe concomitants of this malady. It should be administered between the paroxysms, and will rarely fail of relief. This medicine may be followed by Taba- cum or Cocculus, to dissipate the symptoms of nausea and swimming in the head that may supervene. Ipecacuanha "'y00, is useful in attacks of vomiting un- attended with the great prostration of strength given under Ar- senicum. Of course, in order to avoid interfering with the action of the medicines, the homoeopathic regimen should be carefully observed during the period of their administration. Petroleum,* Silicea, and Therideon. from the close ana- logy of their symptoms to those of the ordinary forms of this distressing malady, deserve a trial. ° %Q °. Administration of the above remedies : six globules of the medicament, at the potency mentioned, in an ounce of water, a teaspoonful every hour, and then until relief is experienced. * Dr. Chase found that Petroleum is the best specific for sea-sickness. 422 APPARENT DEATH. Asphyxia. Apparent death. Asphyxia. In every instance that an individual has to all appearances suddenly expired from exter- nal causes, animation may only be suspended; there are many cases of course where sudden death is no mere suspension of animation, but there are others where apparent death is far from uncommon; in all cases where there is the least uncertainty, care should be taken to do nothing that may cause death, and interment should be avoided until certain signs of putrefaction set in.* Apparent death from hunger. Give small injections of warm milk repeatedly; great care must be taken to give the food, when the patient begins to rally, in the smallest possible quan- tity at a time. Milk may be given drop by drop, and gradually increasing it to a teaspoonful, and after some interval a small quantity of beef-tea and a few drops of wine. After a sound sleep has succeeded, but not till then, a small meal may be given, but it is best that the patient should eat little at a time, but often, so that he may gradually return to his natural mode of living. It must be borne in mind, that in all persons suffer- ing from starvation, eating too much and too quickly, is in tho highest degree dangerous. Apparent death from a fall. Place the patient cautiously on a bed, with his head high in a place where he can remain quiet; put a few globules of Arnica on his tongue, and wait till a medical man visits him to see if there is any fracture, or whether there are still signs of life; a bleeding here may be sometimes of benefit, but it requires great caution. Arnica may be repeated, and also Arnica in injections. If the patient has been bled, give China ; but it is obvious that if much blood has been lost by the fall or wound, venesection would be injurious. •The subjoined directions have chiefly been taken from IXring'i Hausarzt apparent death. 423 Apparent death from suffocation, (hanging, pressure, chok- ing.) Remove all tight clothing. Put the patient in a proper position, the head and neck rather high, the neck quite easy, not bent forward. Begin by rubbing gently but constantly with cloths, give an injection of a dozen or two globules, or a drop of Opium, dissolved in half a pint of water, and injected slowly. This may be repeated every quarter of an hour, whilst the ribs are being rubbed gently. Hold from time to time a mirror before the mouth, to see if the breath dims it; open the eye- lids, and see if the eyes contract; put warm clothes on; hot stones wrapped in blankets to the feet, between the thighs, to the sides, neck and shoulders. If in an hour no change is pro- duced, take a bitter almond, pound it fine, mix it in a pint of water, put a few drops into the mouth, or into the nose, and give the rest in injections. Apparent death from lightning. The body should'be im- mediately removed into a current of cool fresh air; cold water dashed frequently on the neck, face, and breast. If the body be cold, warmth with friction must be employed in the same manner as recommended for the drowned; as well as the means therein adopted for inflating the lungs. A few globules of Nux vomica may be put upon the tongue, and repeated in half an hour; if no effect is produced, a little .Nux vomica in water rub- bed on the neck, and some injected, may be of service. It has also been recommended to place the patient in a half-sitting, half-recumbent posture, and to cover bim over with newly-ex- cavated earth, (leaving the face alone exposed, which should be turned towards the sun,) until the first signs of returning ani- mation become apparent, after which Nux v. is to be had re- course to as above directed. Apparent death from drowning. Observe the following cau- tions : 1, lose no time; 2, avoid all rough usage ; 3, never hold up the body by the feet; 4, do not roll the body on casks; 5, do not rub the body with salts or spirits ; 6, do not inject smoke or infusion of tobacco, though clysters of warm water aud salt, or spirits and water, may be injected, and the following means should not be delayed :— 424 casualties. 1. Convey the body carefully with the head and shoulders in a raised position, to the nearest houso. 2. Strip the body and rub it ; then wrap it in hot blankets, and place it in a warm bed in a warm room, or in warm sand or ashes. 3. Wipe and cleanse the throat, mouth and nostrils. 4. If the foregoing measures produce no reaction, place a few globules of Lachesis on the tongue, and in injections, and resume the rubbing. Solatium mumosum has also been recom- mended, and may be tried after Lachesis, when that remedy fails to do any good. 5. Again, should our efforts still fail, or should the medicines quoted not be at hand, we may, in order to restore the natural heat of the body, move a heated covered warming-pan over the back and spine. Place bottles, or bladders filled with hot wa- ter, or hot bricks, to the pit of the stomach, the armpits, be- tween the thighs, and soles of the feet. Place the body in a warm bath, in the sun or at a proper distance from the fire; use friction with hot flannels, flour of mustard, or other stimu- lants; rub the body briskly with the hand; at the same time do not suspend the use of other means. To restore breathing, introduce the pipe of a common bellows into one nostril, carefully closing the other and the mouth, at the same time drawing downwards, and gently pushing back- wards, the upper part of the windpipe, to allow a more free ad- mission of air; blow the bellows gently in order to inflate the lungs till the breath be a little raised, the mouth and nostrils should then be set free, and a moderate pressure made with the hand upon the chest; continue this process until signs of life appear. 6. Electricity, or a stream of galvanism passed through the chest, promise to be of great service. 7- Apply pungent salts, as sal volatile or spirits of hartshorn to the nostrils. These means should be persisted in for several hours, and till there are evident signs of death. When the patient shows signs of life, and can swallow, small quantities of warm wine or spirits and water may be apparent death. 425 taken ; but till then, nothing should even be poured down the throat, cither by a flexible tube or otherwise. At this period the patient should never be left alone, as some have been lost for want of care who might otherwise have been saved. Apparent death from being frozen. When an individual is found in a state of frost-bitten asphyxy, arising from exposure to intense cold, he should be removed with great gentleness and caution to guard against any injury, as fracture, etc., to a place of shelter, such as a barn or unheated apartment, since even a moderate cWree of heat might annihilate all hope of restoring animation f%t the same time the patient ought to be protected against the slightest draught. He should then, especially if the limbs have become stiffened by the frost, be covered over with snow to the height of several inches, the mouth and nostrils alone being left free. The patient ought to be put in such a position that the melted snow may run off readily, and its place supplied by fresh. When there is no snow, a cold bath, the temperature of which has been reduced by ice, (or a bath of cold sea or salted water,) may be substituted, and the body immersed therein for a few minutes. The process of thawing is by these means to be effected, and when every part has lost its rigidity, the patient should be undressed by degrees, and the clothes cut from the body if requisite. As the muscular or soft parts become pliable, they may be rubbed with snow until they become red; or the body wiped perfectly dry if snow is not to be had, placed in flannel In a moderately warm room, and rubbed with the warm hands of several parties simultaneously. In the event of no signs of returning animation declaring themselves soon after the foregoing treatment, small injections containing Camphor may be administered every quarter of an hour. As soon as any symptoms of approaching restoration become perceptible, small injections of lukewarm black coffee (coffee without milk) may be thrown up ; and as soon as the patient is able to swallow, a little coffee may be given, in the quantity of a teaspoonful at a time. 426 casualties. The measures above detailed ought to be persevered in for several hours. Against the excessive pain which is getiorally experienced when life is restored, Carbo v. should bo pre- scribed in repeated doses,* and if it fails to relieve the suffer- ings, Arsenicum m&y be given. The party rescued must avoid subjecting himself to the heat of the fire or stove for a conside- rable length of time after his recovery, as serious consecutive ailment, and particularly disease of the bones, is liable to result therefrom. Apparent death from noxious vapours. The traftkuent con- sists in removing tho body into a cool, fresh cuffbht of air ; dashing frequently cold water on the neck, face and breast; if the body be cold, apply warmth, etc., recommended to the drowned; inflation of the lungs ; early and judicious applica- tion of electricity or galvanism,—after life has been restored, give Op. or Acon. HYDROPHOBIA. It is acknowledged that no allopathic cure has hitherto been found for this disease when fully established. The plans of treatment which have been reported to have been successful in some few instances having generally failed in all others; thus rendering it probable, that in these supposititious cases of suc- cess, the persons bitten might have escaped without any treat- ment whatever. But it is not to my purpose to enter into the multitude of ineffectual remedies which have been recommended by the Allopathists. Hydrophobia is a disease which arises in consequence of the bite of a rabid animal, and sometimes spontaneously, particu- larly in the course of some other disease; in which form it is known under the term of symptomatic hydrophobia. Ere proceeding to the homoeopathic treatment, a few re- marks, descriptive of the disease as it appears in the human subject, may not be misplaced. The first symptoms that * Vido note, page 21. HYDROPHOBIA. 427 show themselves in a person who has been bitten, are usually, general uneasiness, anxiety and disturbed sleep; the eyes are glassy, inflamed and sensitive to light; there are also ringing in the ears, giddiness, and paleness of countenance; frequent paroxysms of chilliness; oppressed respiration, and quickness of pulse, which latter is usually at the same time small, con- tracted and irregular, and loss of appetite. These symptoms generally come on at some indefinite period, occasionally after the bitten part seems quite well. In the second or convulsive stage, the wound, which may have already become completely cicatrized or healed, begins to assume a somewhat inflamed ap- pearance, and a slight pain and heat, now and then attended with itching, are experienced in it. It now breaks out afresh, and an ulcer, with elevated margins of proud flesh, which se- cretes a dark-coloured and offensive discharge, is subsequently formed; and wandering, drawing, and shooting pains from the lacerated part upwards towards the throat, present themselves. These symptoms, with the state of testiness and anxiety, in- crease daily; and the patient complains of a state of confu- sion in the head, or giddiness, with sparks before the eyes; is afflicted with sudden startings, spasms, sighing, and is fond of solitude; the pulse is small, irregular, and intermittent; the breathing laborious and uneasy; the skin cold and dry, and general chilliness, especially in the extremities, is complained of; then hiccough, colic and palpitation come on; the patient looks wild, and the eyes have a fixed, glassy, and shining ap- pearance ; the act of deglutition is impeded by a sense of pres- sure in the gullet, which occasionally renders every attempt to swallow liquids impracticable; convulsions also take place in the muscles of the face or neck. In this stage, however, the deglutition of any solid substance is performed with tolera- ble ease. In ordinary cases the sufferer remains affected in the above manner for a few days, after which, the disease passes into the hydrophobic stage, in which it is utterly impos- sible for him to swallow the smallest drop of liquid ; and the moment that any fluid, especially water, is brought in contact with the lips, it occasions the individual to start back with y, at the same time, suffer 428 CASUALTIES. the most excessive thirst ; even the sight of water, or the very noise produced bv pouring it from one vessel into another, in fact, anything that tends to remind him of that fluid, pro- duces indescribable anxiety, uneasiness, convulsions, and even furious paroxysms of madness ; he dreads even to swallow his own saliva, and is constantly spitting; vomiting of bilious mat- ter soon comes on, succeeded by intonso fever, great thirst, dryness and roughness of the tongue, hoarseness, and fits of delirium or madness, with disposition to bite and tear every- thing within reach, followed at intervals by convulsive spasms. These attacks commonly last for a quarter or half an hour, and at their expiration, the patient is restored to reason, but remains in a state of great despondency ; finally, tho parox- ysms come on more violently and frequently, and in some in- stances a fit of furious'delirium closes the frightful scene; in others, nature sinks exhausted after a severe attack of convul- sions. The disease may be communicated to tho human sub- ject, from the bites of cats and other animals not of the canine race, which have been previously inoculated with the virus. It may be remarked in this place, that the best and most experienced of our writers upon this subject, consider the hu- man species as the least susceptible of contagion from the hy- drophobic virus : scarcely one out of twenty, or even thirty, of those actually bitten by an animal in a state of rabies, suffer- ing from its effects. I consider it my duty, while making this statement, which I hope may prove a means of relieving the minds of many from painful apprehensions, to enforce at the same time, the necessity of taking those precautions which are about to be pointed out against the danger. It may also be added, before proceeding to the treatmenf of the malady, that the possibility of the poison being communi- cated through the medium of the epithelium is exceedingly questionable; but scarcely a doubt exists of the incapacity of the cuticle to absorb it. As many have been made wretched from having allowed a dog who has afterwards shown symp- toms of rabies to lick their hands, it may be stated with eon. fidence, that if no abrasion of surface exists, there is not the zlijhtcst danger. HYDROPHOBIA. 429 In the homoeopathic treatment of this disease, and its pre- vention, the following are the principal remedies employed: Belladonna, Lachesis, Hyoscyamus, Stramonium, and Cantha- rieles* * The use of dry or radiating heat in this disease, and in envenomed wounds by snakes, etc., is recommended by Dr. Heringof America, whose directions for the treatment of envenomed wounds in general, are as fol- lows : Envenomed wounds. The best remedies against the bites of venomous serpents, mad dogs, &c-, is the application of dry heat at a distance. Whatever is at hand at the moment, a red-hot iron or live coal, or even a lighted cigar, must be placed as near the wound as possible, without, however, burning the skin, or causing too sharp pain ; but care must be taken to have another instrument ready in the fire, so as never to allow the heat to lose its intensity. It is essential also that the heat should not exercise its influence over too large a surface, but only on the wound and the parts adjacent. If oil or grease can be readily procured, it may be applied round the wound, aud this operation should be repeated as often as the skin becomes dry ; soap, or even saliva may be employed, where oil or grease cannot be obtained. Whatever is discharged in any way from the wound ought to be carefully removed. The application of burn- ing heat should be continued in this manner till the patient begins to shiver and to stretch himself; if this takes place at the end of a few minutes, it will be better to keep up the action of the heat upon the wound for an hour, or until the affections produced by tlie venom are ob- served to diminish. Internal medicines must be judiciously administered at the same time. In the case of a Bite from a Serpent, it will be advisable to take from time to time a gulp of salt and water, or a pinch of kitchen salt, or of gunpowder, or else some pieces of garlic. If, notwithstanding this, bad effects manifest themselves, a spoonful of wine or brandy, administered every two or three minutes, will be the most suitable remedy ; and this should be continued till the sufferings are re- lieved, and repeated as often as they are renewed. If the shooting pains are aggravated, and proceed from the wound to- wards the heart, and if the wound becomes bluish, marbled, or swollen, with vomiting, vertigo, and fainting, the best medicine is Arsenicum It should be administered in a dose of 3 globules (30th) in a tablespoonful of water ; and if after this has been taken, the sufferings are still aggra- vated, the dose should be repeated at the end of half an hour ; but if, on the contrary, the state remains the same, it should not be repeated till the end of two or three hours ; if there is au amelioration, a new aggravation must be waited for, and the dose ought not to be repeated before its ap- pearance. 430 CASt ALTIES. Belladonna. HAHNEMANN, the noble founder of our science, states, in the introductory article to Belladonna, w bis Materia Mr lira Pura, that he considers the smallest done of that medicine, repeated every three or four da\s, to be the In cases in which .ir*. ext rcises no influence, though i.|.. al.-.l several times, recourse must be had to Bell.; Sen. also frequently proves cfl.ca- CIOI1S. A-ainst chronic affections arising from the bite of a serpent, Phos.-ac. and Merc, will generally be most beneficial. For the treatment of persons bitten by a mad dog, after th- application of dry heat, as directed aud described above. (See Hydrophobia, on tho other side.) If morbid affections or ulcerations exhibit themselves in consequence ot a bite from a rabid man or animal, hydrophobic, a dministered in ho- ma-opathic dc+es, will often render essential service. For wounds that are envenomed by the introduction of animal substan- ces in a state of putrefaction, or of pus from the ulcer of a diseased man or animal, Ars. is generally the best medicine. Lastly, as a Preventive against bad effects, when obliged to touch morbid animal substances, envenomed wounds, or ulcers of men and animals under the influence of contagious diseases, the best method that can be pursued is the application of dry burning heat at a distance. To effect this purpose, it will be sufficient to expose the hands for five or ten minutes to tin- greatest heat that can be borne ; and after this, it will be proper to wash them with soap. The use of Cldnriue and muriatic acid, in similar cases, is well known. Hydrophobia. Apply distant heat to tho recent wound, as described under " envenomed wounds," or until shudderings appear ; and continue this practice three or four times a day, until the wound is healed, with- out leaving a coloured cicatrix. At the same time the patient should take, every five or seven days, or as often as the aggravation of the wound requires it, one dose of Bell, or Lucli., or also of hydrophobine, till the cure is completed. If at the end of seven or eight days, a small vesicle shows itself under the tongue, with feverish symptoms, it will be necessary to open it with a laucet or sharp-pointed scissors, and to rinse the mouth with salt and water. If the raging state has commenced before assistance can be procured for the patient, the medicines that ought to be administered, will be ac- cording to circumstances, especially, Bell, or Lach.; or else again, Canth., Hyos., Merc, or also Strum or Verat. Sen the indications above given for Belladonna, Lachesis, llij>scyamus, Stramonium, and Cantharides. HYDROPHOBIA. 431 most certain preventive, against hydrophobia; and when we refer to the pathogenetic powers of that medicine, described in the aforesaid work, it is impossible not to be struck with the great resemblance which many of them bear to the symp- toms of that malady; and it is from this circumstance, ac- cording to Hahnemann's doctrine of similia similibus* that Belladonna is found to be both a prophylactic and curative remedy. Administration. A drop of the third tincture in an ounce of water, a teaspoonful morning and evening, for two days. These precautions taken, the patient may be allowed to pursue his usual occupations, care being taken by those around him to avoid making any allusion Which may tend to remind him of his misfortune. Belladonna, in the same dose, should be given on the third or fourth day, and subsequently at longer intervals. The effect of each exhibition should be attentively watched, and care taken that a fresh one be not given, as long as any symptoms of the action of the previous dose are per- ceptible. Generally speaking, from two to three administra- tions may be deemed sufficient to prevent the outbreak of the disease; or, at all events, to modify it in such a manner, as to render it less dangerous, and more easy of removal, by one or more of the other remedies, which must then be selected ac- cording to the symptoms that present themselves. Lachesis, however, may generally be administered at the commencement of the convulsions. Administration. -§-, repeated every two or three hours, or at every return of the convulsions, until benefit result or decided symptoms of medicinal action make their appearance ;t but should this remedy appear to exert no perceptible influence in checking the progress of the malady, we must again have recourse to Belladonna, particularly when the following characteris- * The curing of a disease by tbe administration of a remedy which has been found to possess the property of producing a train of symptoms in a healthy person, similar to those observed in the disease. + ViHo note. p. 21. 432 CASl Al.TIES tics are present : drowsiness, with constant but useless efforts to sleep, chiefly in consequence of excessive anguish and great agitation ; sense of burning; great burning in tho throat, with accumulation of frothy mucus in the mouth or throat, fro- quent desire for drinks, which are immediately pushed aside when presented, or a suffocating or constricting sensa'ion in the throa', on attempting to perform the. act of drylu'dion, or complete incapability of swallowing, with glowing redness and bloated appearance of the face ; pupils immovable, and gene- rally dilated ; great dread ; occasionally desire to strike, spit at, bite, or tear everything; inclination to run away; continual tossing about, and great physical activity, with twitching in various muscles, especially those of the face; ungovernable fury, with foaming at the mouth, and tetanic convulsions. Administration. °£° or °-«° to be placed on the tongue at every threatening of a return of the convulsions, the same precaution as enjoined under Lachesis. See also remarks upon this subject in the I.ntiiohlctton, Article—Administration and Rf.pktition op tiii: Mkdk intcs. Uyoscyamts is more particularly indicated cither before or after Belladonna, when the convulsions are severe and of long dwation ; where there is not bo much inclination to bite or spit, but a desire to injure those that stand around, in some manner or other. The spasms in the throat are not so violent, but great dryness and burning are complained of, attended with a sense of shooting or pricking, which causes a difficulty in swallowing, resembling a sensation of constriction in the throat, and threatening to produce suffocation on attempting to satisfy the thirst; dread of I'upiids in consequence of the pain and difficulty that is experienced in deglutition, with ejection of the saliva from the same reason; excessive convulsions, wi'h loss of consciousness, come on soon after the distressing act of swaltoiring has been performed. There is, moreover, foaming at the mouth, with constant raving; sometimes tbe patient seems wrapped up in his own thoughts, or is full of fear, and inclined to run away from the house, being afflicted with a sort of Anlhropophobia ; there are also attacks of ex. HYDROPHOBIA. 433 cessive fury, attended with apparently supernatural physical power; or excessive anguish and fear, alternating with fits of trembling and convulsions; the individual exhibits a peculiar dread of being bitten by animals; the pupils are dilated; sleep much disturbed by great nervous excitement; starts, and agonizing dreams. Administration. Same as Belladonna. Stramonium is chiefly indicated in this disease, when we observe severe convulsions taking place whenever the eye be- comes fixed on brilliant objects, or on whatever tends to re- mind the patient of water; great thirst; dryness of the mouth and throat, with horror of water anel all liquids; spasmodic constriction in the gullet, with foaming at the mouth and fre- quent spitting; mania, with great loquacity and gesticula- tions ; fits of laughter and singing, sometimes alternately with acute fits of passion and moaning; the convulsions, when severe, are generally attended with ungovernable fury, restless, agitated sleep, sudden shrieks, and starting up with wild gestures; insensible and dilated pupils; and great disposition to bite, or tear everything with the teeth. Administration. Same as Belladonna. Cantharides. This medicine also possesses various patho- genetic properties, that bear a close resemblance to the symp- toms that are met with in many cases of this disorder,* and should be selected in preference to any of the foregoing remedies, when we meet with the following symptoms: great dryness and burning in the mouth and throat, much aggravated on attempting to swallow; paroxysms of fury, alternating with convulsions, which are renewed by any pressure on the throat or abdomen, and also by the sight of water; fiery red- ness and sparkling of the eyes, which become prominent and * Drs. Hartlaub and Trinks consider Cantharides to be the most certain prophylactic against hydrophobia, when administered early ; they recom- mend a drop of the 30th potency, to be given every three or four days, and are of opinion that the virus is not eradicated as long as the cicatrized wound presents a livid hue, and is attended with induration, but affirm the danger to be over as soon as the part assumes a healthy and natural appearance. (Vide Hartlaub and Trinks, R. A. M. L., vol. i.,p. 173.^ 434 < ASl A I. 1 IKS. frightfully convulsed; spasms in the throat, excited by the pain produced by the act of swallowing, especially flui.ls; continual burning, titillation and other irritating sensations in the lower part of the abdomen, etc. Administration. Same as Belladonna. We have thus enumerated and described the characteristic indications for the principal Homoeopathic remedies which have been successfully employed against Hydrophobia ;* others have also been strongly recommended, but those mentioned have ge- nerally proved sufficient, when administered early, and ex- clusively adhered to throughout the course of the disease. Bel- ladonna has frequently been tried by the AUopathists, but the cases in which it seemed to fail were evidently attributable to the improper manner in which it was administered. We shall not treat of the several remedies which have from time to time appeared, and have by their inventors been highly eulogized, as time and experience alone will prove whether they possess any virtue or not; it is to be feared, however, that like many other once celebrated "specifics," (?) they will soon fall into oblivion. In fact, no medicine can be confidently relied upon for the cure of this or any other disease that has not been carefully tested by, and found in accordance with, tup, orf.at law of si- milar it n:« POTRONH. When any poisonous substance has been taken into the stomach, our first care must be its immediate evacuation by producing vomiting, or its neutralization by its antidote; our next, the removal of any injurious consequences that may re- main after warding the more imminent danger. To promote a speedy evacuation of the contents of the stomach, the stomach-pump should be immediately put in re- quisition, particularly when any vegetable or narcotic sub- stance has been swallowed; but when the poison is of a cor- rosive nature, an antidote which will prevent its action upon * Vide Hartmann's Acute Di-^asei, by Dr. C. If. /.i|.il, vol 2, p. 17R, POISONS. 435 the coats of the stomach, or neutralize it by chemical affinity, should be forthwith resorted to. Vomiting should be promoted by the following means : Swallowing large quantities of tepid water, tickling the throat or fauces with a feather, and, if these fail, placing snuff or mustard mixed with salt upon the tongue; or still better—par- ticularly with those who are habituated to the use of tobacco—a tumbler of warm water, to which a teaspoonful of the flour of mustard has been added, should be taken at one draught, and then again warm water, as before. Finally, in extreme cases, the desired object must be effected by means of a clyster of tobacco-smoke. It is not my intention to enter at any length into this sub- ject, but merely to point the means which have been recom- mended to be adopted against the most common poisons, in order to give time for proper assistance to be sent for. MINERAL POISONS. The mineral poisons and acids are, almost without exception, of a corrosive nature. When such have been swallowed by accident or design, soap-water in large quantities, the carbonate of magnesia—two or three drachms to half a pint of water, or the same quantity of chalk in Water, or common potash or soda, should be swallowed; enemas of the same may be also exhibited, particularly when the poison seems to have affected the lower intestines. When the pain and vomiting have ceased, mucilaginous drinks, such as barley- water or milk, must bo given in large quantities, to lubricate the surface of the stomach. After mineral poisons, when vomiting ensues, in consequence of the substance swallowed, we must promote and sustain it by copious drinks, of the same nature. Arsenic If vomiting sets in, sustain it by the means above mentioned ; if not, provoke it, and give soap and water— white of egg in water—sugar and water, or milk in large quan- tities ; the specific action of Arsenic being upon the stomach and rectum, inject also soap and water. The various prepara- tions of iron, so much lauded some time back, although, no fimiht nnssessino- a chemical affinity for this acid, and forming 436 C VSL'AI.TinS with it an arseniate of iron, aro pronounced by the best I on- cologists to be extremely uncertain in their action. Oxalic acid. The best antidote to this powerful poison is new milk iti large quantities; if taken immediately, it rai ly fails to neutralize its effect. Lead. Its antidotes aro Epsom or -uanh i, Cinchona, Nux vomica, and Veratrum. Administration. 5&&£ or one drop of the tincture. Ipecacuanha may first be exhibited to allay the irritation of the stomach, and the tendency to nausea and vomiting, fitt0-"-. Cinchona, if great irritability, with disturbed sleep and febrile motions during the night, remain behind, --j-"-. Nux vomica. Worse during the day, and especially after sleeping, with constipation or loose slimy evacuations, o0-00. Veratrum, if after Ipecacuanha there still remain nausea, vomiting, heat, and coldness in the body, and prostration of strength. °°J>». VEGETABLE AND NARCOTIC POISONS. The sub- stance must be dislodged from the stomach as soon as possible; or if this be impracticable, among tbe best means to counteract its effects, are camphor by olfaction, sometimes spirits of ammo- nia, and strong black coffee taken internally; the patient must poisons. 437 be kept continually in motion, and his attention roused by every means in our power; electricity has also proved useful in many instances.* Mushrooms, poisonous. Provoke vomiting; give copious draughts of cold water, and administer charcoal in sweet oil, at the same time applying sal volatile to the nose of the pa- tient. After narcotic poisons have been evacuated from the sto- mach, vegetable acids may be used with advantage. ANIMAL POISONS. Sebacic acid. This poison develops itself in the rancid fat of pork, or hog's lard ; against it, vinegar diluted with an equal bulk of water, or the juice of a lemon in strong black coffee, or better still, strong black tea, are the antidotes. If any dryness of the throat remain after the more immedi- ate danger has passed off, we may have recourse to Bryonia, a drop of the third potency in a little water, repeating it as of- ten as the symptoms seem to require. In some instances also benefit has been derived from the employment of Acidum phos- phoricum, Arsenicum, and Kreasoium, °-6-°. Muscles. Antidote: charcoal mixed with sugar and wa- ter ; afterwards, camphor by olfaction, and strong coffee with- out milk or sugar. Poisonous fish. Antidote: charcoal in a small quantity of brandy; if this does not speedily relieve, strong coffee—and this failing, sugar and water in large quantities ; or again, if it should not relieve, vinegar with twice its bulk of water. After-treatment. Belladonna, should an eruption or redness of the skin declare itself, particularly if accompanied with swelling of the face and angina. Acidum hydrocvanicum. Prussic acid. The inhalation of Ammonia, or one drop of liquid ammonia dissolved in 12 oz. of water, and a teaspoonful taken every five minutes. * In the case of Opium, a few doses of Ipecac, often do good after the previous use of strong black coffee or vinegar ; aud when any morbid se- quela; remain, after Ipecac.: Bell., Nux v., or Mercurius, may be had re. course to. 438 CASUALTIES. Afterwards, strong black coffee should bo administered in largo quantities, both as a potion and as an enema. The vapour of Camphor or Vinegar have likewise been found useful, as also the cold affusion. When tho first alarming symptoms have disappeared : Coffea, or Ipecacuanha, and Nux v., have been mentioned as being use- ful against any remaining effects. Recently, a compound of per- and prol-oxide of Iron has been recommended by the Messrs. Smith, chemists, Edin- burgh. MENTAL EMOTEOXS. I shall conclude this part of the work with the consideration of those particular Mental Emotions which exercise so great a control over the human organism, among the more prominent and continually recurring of which we find fright, passion, or an- ger, and concentrated grief. Therapeutics. The remedies found most serviceable for derangements of the system arising from the above-mentioned causes are: Opium, Aconitum, Pulsa'illa, Belladonna, Ignalia amara, Chamomilla, Nux vomica, Staphysagria, Arsenicum album, and Bryonia, e'e Opium, when the sufferer has been exposed to sudden fright, with terror, horror, or fear, is generally efficacious if adminis- tered immediately, in restoring the patient, and obviating any evil consequences, such as convulsive fits, swooning, lethargic sleep, involuntary evacuations, diarrhoea, etc. (When Opium is not sufficient to remedy the mischief, Aconitum may be ad- ministered, or Aconitum and Opium alternately. In other cases Ignatia will answer better than Aconitum, especially when the convulsions continue ; Belladonna or Hyoscyamus, and Ve- ra'rum, are also serviceable in some cases, when none of the other remedies are sufficient to remove all the effects. Causti- cum is a useful remedy when a constant dread haunts the child, after a previous fright, etc.) See also Samb. MENTAL EMOTIONS. 439 Administration of Opium. °T° or °/, repeated in from half an hour to an hour or so. * Aconitum is the appropriate remedy when the system is la- bouring under the joint influence of fright and passion; and es- pecially when there is headache, feverishness, heat in the face and head, (congestion,) fear. Administration. %■% in the same manner as Opium. Pulsatilla, in cases of fright, fear, or timidity, particularly where accompanied with an effect upon the stomach and bowels, as also heat of the body with coldness of the extre- mities ; or passion in people of generally mild temper; it is also suitable for highly nervous but not easily irritable temper- aments. Administration. £§, repeated if required in from six to twenty-four hours. Belladonna ~, where there is present particular liability to be startled by trifles, or extreme general nervous excitement, after a fright, See. Administration. Same as Aconitum. Ignatia where the cause is gnawing, inward grief. Acid. phosphoricum and Staphysagria are sometimes requisite after Ignatia. Administration. q^, every three or four days, watching the effect. Chamomilla, where suffering has arisen from vexation, or a disposition to irritability, or great anguish and mental de- pression are present. Administration. Same as Pulsatilla. Nux vomica, suffering arising from a sudden fit, or outbreak of passion or rage. Administration. %\°, repeated from six, twelve to twenty- four hours if necessary. Staphysagria Yo0* Anger and vexation, arising from just cause. t Administration. Same as Nux vomica. Arsenicum is useful where passion is followed by great weakness and dangerous prostration of the vital powers. * Vide note, p. 21. 140 CASUALTIES. Administration. Same as Ignatia. Bryonia b&, \<. indii-:it«-d where a fit of passion is followed by coldness and shivering over the whole body, great irascibility, want of appetite, nausea, vomiting, ami bilious suffering*. Administration. In the same manner as Pul.sa'illa. Colocynth 4§°. Where indignation accompanies the abovo described effects of a fit of anger. Against the injurious effects which occasionally result after excessive joy, such as headache, trembling, and tendency to fainting, Coffea -§- is the most useful remedy. But when tho consequences are more serious, and violent headache, with con- gestion to the head, vomitings, diarrhoea, swooning, &c., result, Opium must be given. Hyoscvami s b.iih js tlie most useful remedy against any in- jurious consequences arising from jealousy, or disappointed love. In the latter instance Ignatia and Acid, phosphoricum are also beneficial. Against the effects of mortification, or wounded vanity or self-esteem : Colocynth, I u Italia, Staphysagria, Pulsalil:a, Platina, or Belladonna, have proved useful, -£- or -°a. Sambucus 2§-. When oppression at the chest, with stertor- ous breath, has ensued in consequence of a fear or fright, and not yielded to the influence of Opium. END Of PART II. . ;Wis^*'i&£.' PART III. TREATMENT OF INFANTS AND CHILDREN ; AND OF THEIR PECULIAR AFFECTIONS. INTRODUCTORY REMARKS. The homoeopathic system of medicine possesses many ad- vantages in the treatment of the diseases of infancy and child- hood. In the first place, when any constitutional taint exists, by the selection of suitable remedies, it meets disease upon the very threshold of life, and destroys it in the germ; it substitutes a rational mode of treatment for the nostrums of the nursery, since the application of the remedies requires, even in the most trifling cases, a certain degree of education, and a careful study of medicinal action. How many lives, sacrificed by the over- weening self-confidence and prejudices of those intrusted with the life of man, at the most precarious period of his existence, might have been preserved, had this system been more exten- sively known and acted upon ! As before remarked in the Introduction, to which the reader is referred, the receptivity of the infant organism to the influence of homoeopathic remedies, has been established by experience. Here again our system possesses the faculty of modifying the energy of the remedial agents used, aud to ad- minister them of sufficient power to overcome disease, without incurring the risk of danger. The tasteless nature of the medicaments is another point of no small importance in affections of infants and children, and by means of which, nausea and aunoyance are avoided. This has been touched upon in another part of this work. In such complaints as occur at all periods of life, and which have been treated in the Second Part of this work, we should be 19* 442 TREATMENT OF INFANTS. guided in the selection of the drse by the age of the patient ; with infants we may use the highest potencies, and rarely over in acute diseases give mere than a single globule ; children from four to eight years of age may take about one-fourth to one-third of the dose prescribed for an adult, and abovo that age one-half to two-thirds. A great deal, however, depends, upon the constitution of the patient, whether delicate or robust, and upon their susceptibility to medicinal influeiiee, a point only to be determined by experience : in very acute diseases we may sometimes be called upon to administer as low as the sixth po- tency, a single globule ; from the great receptivity, however, of the system, above remarked, we should be particularly careful in repeating the medicines. ' TREATMENT AFTER 1JIRTII. As soon as the child is born, it should be wrapped in fine flannel, with a piece of soft linen rag inside, the flannel itself being too rough for its delicate skin; the wrapper should be heated to a temperature of 98 degrees, as it is only gradually that the infant becomes inured to the temperature of the sur- rounding atmosphere. The skin should be gently washed with a little lukewarm water and bran, applied with a sponge, taking care not to continue the first washing too long, for fear of irritation; soap must on no account be used ; the room should be kept rather dark, and perfectly quiet, and all strong- ly scented substances removed. After washing, the body ought to be dried immediately, to avoid the risk of taking cold ; the child should be bathed twice a day, to keep up the action of the skin, gradually lowering the temperature of the water, after weaning. The best time for bathing the infant is in the morning, when < - re- taken out of bed, and again on returning to it for the night; immersing the whole body, with the exception of the head, is preferable to any other mode of washing, as the practice of placing it in a tub, with part of the frame alternately laved with tepid water, and exposed to the action of the atmosphere, is apt to bring on a chill. Nothing can be more evidently opposed to nature, and the dictates of common sense—although like many of the absur- dities bearing the impress of custom,—than the practice of ASPHYXIA. 443 swathing and bandaging the tender bodies of infants, and load- ing them with a superfluity of clothing, which, by its weight and length, presses upon their lower extremities, and is the frequent cause of deformity and weakness in after-life; in this opinion we are fully borne out by the corroborative testimony of the most eminent practitioners of the old school. ASPHYXIA. The first danger that the infant incurs on its entrance into life is Asphyxia. Diagnosis. Suspension of the functions of vitality, of res- piration, circulation, and motion. Causes. Natural debility; difficult parturition; injury from the forceps; pressure of the umbilical cord round the neck; tying the navel-string too tightly; accumulation of mucus in the throat; too sudden an alteration of temperature, the respi- ratory action of the lungs not having commenced. The usual mechanical means, under the direction of a competent person, must, of course, be instantly had recourse to; I shall, there- fore, simply content myself with pointing out the homoeopathic remedies most useful in such cases. ' They are Tartarus emeticus, Opium, Cinch., and Aconitum. Tartarus emeticus, Administration of. A grain of the first trituration in eight ounces of water, a few drops into the mouth of the child every quarter of an hour. Opium. If after half an hour no change for the better take place, and the face is livid and bluish. Administration. A few globules of the third, in a wine- glassful of water, a few drops into the mouth of the child every ten or fifteen minutes, until some effect is produced. Cinchona ~s-. If the face be pale, also when the infant is reviving and respiration commencing—if the same indication presents itself. Administration. Same as Opium, Aconitum. When the child is reviving and beginning to breathe, if the face has been previously flushed red or of a blu- ish tint. Administration. % on the tongue, repeated if necessary, after -1—*„,. nr- lnno-nr interval, according to the effects produced. 444 TREATMENT of infants SWELLING OF THE HEAD. Immediately after birth, the head of the infant appears more or less swollen; this is in most cases but a trifling affeetion, and generally goes off of itself. The administration of Arnica /„■ or 3°0-, will materially hasten its disappearance; should, however, the swelling be at all excessive, bat lie the part affected in a weak lotion consisting of three drops of the tincture of Arnica to a wine-glassful of water. Occasionally a considerable swelling in tho larger mould, (fontanel,) consisting of fluid, is observable; this is of greater import than the other, though seldom dangerous ; if it does not disappear in a day or two, we may administer Rhus toxico- dendron 3°(T in globule to the infant. Calcarea carbonica T\ repeated in six days, in cases where the fontanel is long in closing. In some instances Silicea or Snip bur is also requisite in addi- tion, if not in preference to Calcarea. NAVEL REPTILE IN INFANTS. In cases where there is an evident tendency to navel rup- ture, we may take the half of a nutmeg, cover it with very soft linen, like a button, and sew it X a bandage, with the base of the cone in the centre; then press the apex into the umbilical opening, and secure it there by the bandage, which should be of sufficient length to pass two or three times round tho body of the child. This mechanical process* will usually prove sufficient to effect a cure; if not, we must exhibit Nux vomica 597, dissolving it in six teaspoonfuls of water, and administering one, which, if no alteration takes place, may bo repeated in the same manner in five or six days, and if no effect declare itself, * The following is a Bimple and commonly efficacious mode of applying a compress:—Take a piece of lint, jusl sufficiently large, that when folded five or six times, it will cover the rupture effectually ; th.n press in tho protrusion, and . keep it reduced with the hand until the compress is rightly adjusted aud secured in its position by means of two strips of adhesive plaster (which have been previously warmed by being held at the fire, so as to make them adhere) placed over the compress in the form of a cross. (It is still better, however, to get an efficient bandage made to measure l) an intelligent and experienced maker.) meconium. 445 again repeat, bearing in mind the directions upon the Repeti- tion of Medicines given in the Introduction; if, however, we dis- cover no amelioration from the administration of Nux v., we may have recourse to Veratrum ^°„ in the same manner. Obstinate cases are frequently found to yield to the application of the North pole of the Magnet.* All these medicines are equally useful in those cases of inguinal hernia, or rupture in the groin, we occasionally meet with, generally effecting a cure with won- derful promptitude. (See Hernia, Part II., p. 361.) This disease being frequently brought on by the violent fits of crying that delicate children are subject to, the bandage may be worn, and retained for some time after the cure, as a precaution- ary measure against its return. In cases of soreness of the um- bilicus or navel, remaining after the falling off of the ligature, or even before, we may give Sulphur 3°g, a single dose, and re- peat in six days. If, however, during that time no amelioration has been observable, we should exhibit Silicea d?„, which, if marked benefit resulted, may be at the same interval repeated with advantage. MECONIUM, EXPULSION OF. After having been permitted to sleep for five or six hours un- disturbed, the infant should be applied to the breast as soon as the mother feels herself sufficiently recovered to permit it, which is generally from six to eight hours after delivery, and should never be deferred, as we elsewhere observed, longer than twelve; the milk of the mother exciting a mechanical action of the alimentary canal, and assisting in the expulsion of the meconium. Here again we cannot too strongly reprobate the too general practice of administering laxative medicines for this purpose, possessing, as they.do, a most deleterious effect upon the tender organism of the infant, and, if not productive of jaundice—a too frequent consequence of their repeated administration—at least laying the foundation of bowel complaint, debility of the stomach, and a host of diseases in after-life. * Chamomilla, Aurum and Sulphur, are occasionally found necessary, particularly the last-named, in order to effect a permanent cure. 446 treatment of infants. Mothers need not be under apprehension should a temporary delay occur in the passing of the meconium; far greater evil re- sults from the violent methods taken for its expulsion, than could possibly occur from its continuance in tho alimentary canal for a few hours later than ordinary. Should, however, an unusually long period elapse, and the child appear costive, which in many instances arises from the mother having indulged in the use of ptisans, such as chamo- mile tea, Ac, or in coffee, the administration of a few teaspoon- fuls of warm sugar and water will generally answer every purpose; if it fail of immediate relief, we may then make use of a lavement of equal parts of sweet oil (or pure honey) and water; if these simple means do not effect the desired object, and the infant appear to suffer from inconvenience, more par- ticularly when the origin of the constipation seems to be from the mother or nurse, we may administer Nux vomica, Bryonia, Tinctura sulph. -^ or Opium § to the female herself—for tho indication of which medicines see Constipation. sucklim; of the infant. While upon this subject, we shall quote the expressions of a well known writer, in whose opinion, in this respect, we perfect- ly coincide. " Unless very peculiar urgent reasons prohibit, a mother should support her infant upon the milk she herself secretes. It is the dictate of nature, of common sense, and of reason. Were it otherwise, it is not probable that so abundant a supply of suitable food would be provided to meet the wants of an in- fant, when it enters upon a new course of existence. " It is difficult to estimate the mischief resulting from infants being deprived of their natural nourishment; for, however near the resemblance may be between food artificially prepared and breast-milk, still reason and observation demonstrate the superiority of the latter to the former." (Conquest's Outlines of Midwifery, p. 193.) And again :— " As a further inducement, it should be remembered that medical men concur iu their opinion, that very rarely does a suckling. 447 constitution suffer from secreting milk ; whilst the health of many women is most materially improved by the performance of the duties of a nurse." (Ibid., p. 194.) Upon the same subject, he says in another place: " But few mothers, comparatively, are to be found who, if willing, would not be able to support their infants, at least for a few months, and parental affection and occasional self-denial would be abundantly recompensed by blooming and vigorous children. " Presuming that the laudable determination is formed to in- dulge the child with that nutriment which is designed for its support, it becomes necessary to state, that unless very strong objections should exist, twelve hours should never elapse before the infant has been put to the breast. Instinct directs it what to do, and the advantages of allowing it to suck soon after birth are many and important, both to the mother and child. " By this commendable practice, the patient is generally pre- served from fever, from inflamed and broken breasts, and from the distressing and alarming consequences resulting from those complaints. " If the breasts should not have secreted milk previous to de- livery, the act of sucking will encourage and expedite the se- cretion. Thus the mother will be saved from much of the pain connected with distended breasts. Besides which, if the infant be not put to the nipple till the breasts become full aud tense,^ the nipple itself will sometimes almost disappear, on account of its being stretched; and without much, and often ineffectual labour on the part of the child, it cannot be laid hold of, and even then the pain endured by the mother is exquisitely severe, and not unfrequently the cause of sore nipples." (Ibid., p. 195.) Having premised thus much upon the advantages resulting to both mother and child from following the law of nature, which enjoins the female to nourish her own offspring, and having, moreover, elsewhere noted some of the causes which may pre- vent its being fully carried into effect, we shall now proceed to that important point—for those who do not intend nursing their own children—the choice of a nurse, and the regimen to be ob- served, which is equally applicable to both parties. 448 treatment of infant? THE CHOICE OF A MUSE. In the selection of a nurse, the medical attcrdant ought gen- erally to be consulted; the following points merit particular attention : She should be apparently of sound health, full and moderate plumpness, with a fresh complexion, and clear eyelids J nc J ram any appearance of redness, scurfiness, or thickening. She should be thoroughly exempt from glandular enlargements ; possess deep red lips without cracks, sound white teeth: and well-formed, moderately firm breasts, with nipples free from ex- coriation or appearance of eruptions ; the child of the nurse is one of the best criterions to judge by—its being plump and healthy is a great point iu her favour. We should also endea- vour to discover if she is free from any hereditary taint; she should, moreover, be of a mild, patient, and equable temper, not irritable, nor disposed to fits of passion, or nervous; of reg- ular and temperate habits, neat in person, and fond of children. She ought also to be about the same age, and delivered about the same time, or, at least, within three months of the same pe- riod as the mother; with respect to the age, we must, of course avoid extremes. A women, having given birth to a child very late in life, should choose a nurse several years her junior, and fully qualified for her duties ; the reverse of the rule applies to extremely young mothers. DIET DURING NURSING. As regards her diet, it should be simple and easily digested, and she ought to live upon a proper proportion of animal and vegetable food. Nature generally provides for the increased call upon her powers, by the suppression of the menstrual dis- charge, and moderate increase of appetite, which may be safely indulged; but all food of a highly concentrated, nourishing na- ture, is injurious, causing the milk to become too rich, and un- suited to the delicate digestion of the infant; the best guide is the regular homoeopathic regimen, which may be consulted with advantage. supplementary diet of infants. 449 I cannot too strongly repudiate the too prevalent, but deeply erroneous idea, that women, during the period of suckling, re- quire stimulants to keep up their strength ; under this impres- sion, both wine and malt liquors—and, among the latter, more particularly porter—are frequently resorted to. Porter is not only injurious from its stimulating properties, but the deleterious effect of the different ingredients which enter into its composi- tion have upon the milk, forms one of the most prolific causes of the many evils that attack infancy. My opinions in this respect are corroborated by the physicians of the old school, though, I regret to say, not to the same extent. I shall here content my- self with a single quotation from a well-known medical writer: " There is an evil too generally prevalent, and most pernicious in its consequences on individuals and society, and by no means confined to mothers in the lowest classes of the community, which cannot be too severely reprobated; it is the wretched habit of taking wine or spirits to remove the languor present during pregnancy and suckling. It is a practice fraught with double mischief, being detrimental both to mother and child. The relief afforded is temporary, and is invariably followed by a greater degree of languor, which demands a more powerful stimulus, which at length weakens, and eventually destroys the tone of the stomach, deteriorates the milk, and renders it alto- gether unfit to supply that nutriment which is essential to the existence and welfare of the child." SUPPLEMENTARY DIET OF INFANTS. Unfortunately, some mothers do not possess sufficient milk for the proper nourishment of their offspring; if this arise merely from a deficiency in the secretion, and the female is in other respects healthy, we must have recourse to supplemen- tary diet, to make up for the diminished quantity of the natural nutriment. Goats', asses', and cows' milk, are excellent substi- tutes, especially the latter, diluted with one third of water; goats' milk being apparently objectionable from its peculiar aroma. The milk, therefore, of the cow ought, when possible, to be obtained, and, if given undiluted, boiled ; cows' milk be- 450 TREATMENT OF IM'ANTS. ing generally considered too heavy, which boiling in a great measure obviates: it ought also to be slightly sweetened, so as to resemble as closely as possible that of the nurse ; it should, moreover, be about the same temperature, say ninety-six to ninety-eight degrees, a point less regarded than it should be, and easily determinable by the thermometer. If any constitu- tional taint exist in the mother, the sooner the child is trans- ferred to another breast, the better for both parties; if a nurse be not procurable, the above will generally prove sufficient nou- rishment until the front-teeth appear, which is a clear indication that the digestive organs aro prepared for more solid food ; if, however, tho milk diet appears to disagree with the infant, we may mix a little thin arrow-root, rusk, or well-toasted bread in water, to which the milk may be afterwards added; such alter- ations in diet are, however, but rarely required. We may remark, that no portion of the milk ought to be re- tained for a subsequent meal, from the quickness with which it becomes sour; the same remark applies to any of the above preparations, in which milk forms the principal ingredient. In the cows' milk, which was at first diluted, we may, after two or three weeks, gradually diminish the quantity of water, as the digestive organs become stronger; but we cannot too stringently press the point, that where it is at all practicable, the child ought to derive as great as possible a portion of its nutriment from the breast, as no food can efficiently supply the place of that which nature intended for it at its birth. When it is necessary to give supplementary nourishment, a suckling-bottle ought to be used, as the best imitation of na- ture in giving the food slowly; particular care being taken to observe the utmost cleanliness. The child ought, in feeding, to be kept in a reclining, not supine, position, as the latter fre- quently causes it to incur the risk of suffocation ; and when it evinces disinclination to its food, no more should be offered. When the front teeth appear, which is about the fifth or sixth month in healthy children, an alteration may take place in the diet; and a well-made panada, diluted milk sweetened, and thickened with a small quantity of arrow-root, sago, semolino, or rusk, may be given twice a day. When milk, even prepared DURATION OS SUCKLING AND WEANING. 451 with farinaceous substances, disagrees, barley-water, fine well- boiled gruel, or weak chicken-broth, and beef-tea, may be sub- stituted, adhering to that which seems best to agree with the infant, and taking care to vary as circumstances require it, as too long an adherence to barley-water may occasion looseness in the bowels, while the animal diet is liable to lead, if too long continued, to a contrary result ; the best precaution in these cases, when the predisposition becomes evident, is an immedi- ate change of aliment. The child should be accustomed to take its nourishment from each breast alternately; as, if this precaution be not adopted, inflammation is likely to arise in the one not used, and the child is apt to become crooked from being always retained in the same position. The physician is frequently asked, how often the child ought to be applied to the breast ? The best rule is to give it when the infant appears to desire it, and to withdraw it when it ap- pears satisfied. As it increases in strength, it may easily be accustomed to regular hours, giving it the breast late at night, and again early in the morning ; but during the first six weeks or two months, three times during the hours of rest, late in the evening, middle of the night, and early in the morning, will generally be found sufficient. DURATION OF SUCKLING AND WEANING. The period of suckling ought seldom to last longer than forty weeks; but in this we must be guided, in a great measure, by the constitution of the infant; weak, ill-conditioned children, in whom the teeth are long in making their appearance, it has been recommended to continue at the breast for eighteen months, or even a longer period. Weaning ought, in fact, to be regulated both by the constitution of mother and child; the full development of the front teeth, which in healthy children is from nine to ten months, but in delicate or scrofulous constitu- tions, is delayed for several months later, is the best indication for weaning. If, however, the strength of the mother appear unequal to the task, and the supply of milk begin to fall off, the child may be gradually weaned, even before the teeth appear; 452 TREATMENT OF INFANTS. but if the infant is healthy, a continuance of suckling beyond the tenth month is injurious to both parent and child. Wean- ing should not take place suddenly, but the infant should be gradually accustomed to other food, and a less frequent admin- istration of the breast, till entirely weaned; the time to com- mence thU gradual course, is from the first appearance of tho front teeth, so that the weaning terminate with their full devel- opment : thereby the secretion lessens by degrees, preventing all evil consequences of swollen or inflamed breasts, and the child also becomes quietly reconciled to tho deprivation. Weaning ought not, however, to take place, if tho child suffers considerably from the irritation of teething, or any acute infan- tile disease. When, however, it is found absolutely necessary to wean, Belladonna ^ should bo given as a precautionary measure airainst the inconveniences and not un'requcnt dan- gers which sudden weaning entails. Among these may be mentioned, restlessness, sleeplessness, fretfulncss, and excita- bility, nay, even a degree of irritability sometimes amounting to inflammation of the brain. The value of this remedy in affections of that organ has already been commented upon in several parts of this work. Although, perhaps, slightly out of place, it may be remarked that Phosphorus is the remedy best calculated to prevent inflammation of the breasts conse- quent upon a sudden cessation of suckling.* Sec the articles relative to this subject in Part IV., Treatment of Females and their peculiar Affections, p. 496. After the child has been weaned, his nourishment should generally consist of the same simple food before mentioned, with an occasional light pudding, without spicc or eggs, made from semolino, tapioca, or other farina'-eous substance The transition to a more substantial diet ought to be extremely gradual and guarded, and no material alteration made, till after the appearance of the eye-teeth. SLEEP. SLEEPLESSNESS. The sleep of the child is the next consideration ; from the inability of the infant itself X maintain a proper degree of * Vide A. H Z., p. 8, No. i.'J. SLEEP. 453 warmth, it should sleep by its mother's or nurse's side, for at least the first six weeks, particularly during winter or early spring. Care must be taken not to over-burthen it with bed- clothes, and to place it in such a position as to prevent it slip- ping under them, and thereby becoming exposed to the risk of breathing a vitiated atmosphere, or even of suffocation ; after six or eight weeks, when the organism becomes stronger, and able to preserve a proper degree of natural warmth, placing it in a separate bed or cradle, will be more conducive to its thriving; this _change of arrangement will be found beneficial to both parties—to the child, by its breathing a purer air, and by the continual appetite for the breast being dimin- ished ; and the mother being freed from the necessary watch- fulness and restlessness consequent upon its sleeping with her, will enjoy better health, and be more likely to secrete good and nutritious milk. Moreover, it is generally known, that sleeping in the same bed with an adult, is detrimental to the health and proper development, not only of infants, but even of children : a child sleeping in the same bed with a very old person, will very soon begin to exhibit signs of a falling off in its general appearance. With regard to the kind of bed best suited for the infant, the suspended cradle seems the most eligible; we must, however, be careful not to allow "the nurse to abuse its use by continual rocking, which frequently causes irritation of the brain; it should not be closed up with curtains, but the room may be a little darkened; in cases where there is danger of draughts, a screen will answer every purpose. As to the length of sleep allowed, the chief business of the first months of its existence being sleep and nourishment, we may safely leave the point to nature, and not attempt to coerce the inclinations of the child; if the infant is lively on waking, we may conclude it has not slept too much; as it increases in vigour, with longer intervals of wakefulness, we may proceed (recollecting that night is the proper period for sleep) so to re-ulate its habits of taking its food and rest, as to accustom it to a uniform system, and particular hours. Children, up to two vears of age, require rest during the day, and the nurse ought 454 TREATMENT OF INFANTS. to endeavour to get them into the habit of taking it in tho fore- noon, for if in the afternoon, it generally interferes with the night's sleep. Whether by night or day, we must carefully exclude both light and noise from the nursery, for although they may be insufficient to arouse the infant, still they cause its sloop to be disturbed and unrefrcshing, and by acting upon the nervous sensibility, predispose it to convulsions or spasmodic attacks from slight accidental causes. It is true, that during the first month, the infant sleeps imme- diately on leaving the breast, and no evil consequences ensue; but it must be borne in mind, that it takes but little at a time, and the tenuity of the milk is at that time wisely adapted to its delicate digestion; but as the secretion becomes richer, and suited to the increasing power of those organs, it is injurious to put the child asleep immediately after a full meal; his rest is then restless and disturbed, from the process of digestion being interfered with, more particularly when nurses foolishly endeavour to force nature, by resorting to the baneful practice of rocking. Nothing causes greater annoyance, and even anxiety, to tbe mother, than a disposition to wakefulness on the part of her infant. A healthy child should always be prepared for its rest at the usual hours; if, instead thereof, it appear restless, fret- ful, and disinclined for its accustomed sleep, it is an evident indication of some derangement of its general health; fre- quently through ignorance, nurses, instead of attending to this warning voice of nature, which by the sleeplessness of the infant demands appropriate relief, endeavour to stifle it, and sometimes to free themselves from a little temporary annoy- ance, administer opiates, which induce an unrefreshing slumber, and not unfrequently a deep stupor, mistaken for sleep, while the original evil still continues to make head against the vital power. This baneful practice has not only been the ruin of many con- stitutions in after-life, but to it, conjoined with diet, drinks, car- minatives, and other quack medicines, together with the highly erroneous practice—sanctioned though it be by names of medi- cal repute—of a frequent administration of that active mineral preparation, calomt', in infant maladies, to say nothing of laxa- EXERCISE. 455 tives, an infinite number of diseases and deaths are annually attributable. Every mother should not only caution her nurse against the use of opiates, but use her utmost vigilance to de- tect any breach of her injunctions, which should be visited with the immediate discharge of the person so offending r for she must be truly unfitted for such an important trust who, after be- ing warned of its injurious tendency, will persevere in a prac- tice placing in jeopardy the life of her infant charge. Amongst the homoeopathic remedies which have been found the more generally useful in removing restlessness and sleep- lessness in children, Coffea, Opium, Chamomilla, and Bella- donna, deserve notice. Coffea ^, is very efficacious when the child seems unusually lively, restless, and wakeful; but will commonly fail to answer its purpose when the nurse is in the daily habit of taking coffee as a beverage. In such circum- stances, Opium | may be substituted, particularly if the face of the child looks red. Chamomilia r\ will do good when the child is tormented with flatulence, and distention of the bowels, and appears to suffer from colic, indicated by drawing up the legs, screaming, etc. Against the sleeplessness after weaning, Belladonna § is the most efficacious remedy. When these remedies do not seem indicated, or fail to relieve, an ex- perienced homoeopathist ought to be consulted. (See also Cry- ing and Wakefulness, p. 462.) EXERCISE. V For the first six or seven months the great business of nature seems to be the proper development of the infant organism, and of the respiratory and digestive functions. During this period the cartilage is gradually forming into bone, and its delicate muscles acquiring power and strength. We find also that consciousness is yet indistinct, and the infant evinces no anxiety to indulge in voluntary motion, the muscles of the neck and back not possessing sufficient power to support the head, or to keep the body in an erect position; for this reason, children during this period should, when carried in the arms, be kept in a reclining position, so as to avoid an undue pressure upon 156 TREATMENT OF INFANTS. the vertebral column; a neglect of this precaution, and a pre- mature earning of the infant in an upright position, arc u too frequent cause of deformities of the spine, and derangenient of the internal functions in after lie. As its powers gradually develop, the infant seems inclined to exercise them, and evinces a desire to sit upright, which wo may safely indulge, taking care that they be not overtasked by keeping it sitting up during the greater part of the time it is awake. A careful attention to nature in this, as in all other cases, is the best guide. The practice of dandling the child in an upright position, seems rather to proceed from the pleasure of indulging tic feeling of parental affection, than from any benefit the child can, by any possibility, be expected to derive from it; in fact, it is highly injurious, even at a rather more advanced period, as exciting a premature involuntary exercise of the muscles, and consequent deformity. The act of respiration bringing into play a great variety of muscles, occasionally crying secnia sufficient active exercise during this period. In mild spring and summer weather the child may, after the first fortnight has elapsed, be carried out into the air for a quarter of an hour, and the period of exercise gradually in- creased ; in fact, if the weather be fine, it can scarcely be too much in the open air. Should its birth occur in winter, ad- vantage may be taken of a fine day, after it is a month or five weeks old, as the frame is gradually acquiring the power of generating heat; but at the same time great care must be taken to prevent its catching cold; and should it exhibit the slightest sign of being affected by the atmosphere, the practice should be immediately discontinued, and it should be carried up and down in a well-ventilated room, the nurse moving it quietly in her arms from side to side. Many children are lost through a foolish idea of making them hardy, by accustoming them to endure cold; this can occur only through ignorance, for nature, in very early infancy, does not possess sufficient energy of re- action to overcome the power of a sudden or long-protracted chill. wi may recommend an occasional gentle friction of the hand over the body aud limbs, which materially assists in the exercise. 457 promotion of the circulation of the blood, and will, in unfavour- able weather, serve in some measure as a substitute for exer- cising the infant out of doors. In carrying the child, it should be from time to time trans- ferred to different arms, as a continuance on one side is a fre- quent cause of deformity, and in some cases of squinting. The child, as the organization develops itself, seems to evince a desire for independent movements, iu which it may very pro- perly be indulged, by removing every impediment in its dress, and allowing it to roll about, or crawl upon a soft carpet. The practice of assisting children to walk, or of exciting them to a premature exercise of their powers, is highly reprehensible, causing curvature of the limbs, the bones not being yet suffi- ciently formed to bear the burden imposed upon them. By allowing nature to act, the infant's powers will become more gradually, but at the same time, more fully developed, its carriage will be more firm and erect, and its limbs straight and well-formed; moreover, it will walk with greater confidence and independence by the expiration of the first year, than those who have been taught to walk by the assistance of the nurse, leading-strings, or mechanicaL-inventions. When the period at which a child should make attempts to walk is re- tarded by evident debility of constitution, Homoeopathy af- fords us the means of obviating this evil, by acting against the constitutional cause. Dr. Gross has found Calcarea 3°^, -very useful in a case of this nature; and Dr. Hartmann has frequently administered Causticum -g% with great effect. (Silicea, Sulphur, Belladonna, Mercurius, or Staphysagria, etc., may be required in particular cases.) 20 DISEASES OF INFANCY. INFLAMMATION OF THE EYFS IN NIAV-EOBN INFANTS. A si-dden exposure to the strong light of day, or the glare of a fire, is the general cause of this affection; and no doubt many children who are, what is vulgarly denominated born blind, owe their misfortune to the neglect of those precautions which we have so strongly enforced under the head of Treat- ment of infants, in many cases the external indications of this affection being so very slight as to escape observation. As soon, however, as, on a careful examination, wo become aware of the existence of this evil, we should administer Aco- nite 2*^. which will generally be found promptly efficacious in its removal. When, from the constitution of one or both of the parents, we have reason to suppose that the exposure to light has been merely the exciting cause, but that the real origin of the evil is more deeply seated; or" if the Aconite seems to produce no effect, and the disease continues to aggravate, we may have re- course to Tinctura sulphuris /q, and in some cases Calca- rea 3°„, alternating them every eight or ten days, if wc find it necessary to resort to the Calcarea—the Tincture of Sulphur having been found in many cases to act as a specific. Chamomilla x-3, is useful some weeks after birth, when the perceptive faculties are more developed, and the child exhibits great intolerance of light; also when redness, swelling, and agglutinations of the eyelids, with other indications, given under Acute Inflammation of the Eye (Part II., p. 324), are present. Lycopodium may also be named as a useful remedy in some inveterate cases. HICCOUGH. This affection, though in itself of slight importance, frequent. ly causes no small degree of uneasiness to young mothers ; it HICCOUGH. COLD. 459 # generally arises from exposure of the body, even in a warm room, to the atmospheric air, even during the operations of dressing and undressing the new-born child ; wrapping it warmly in the bed, or, better still, applying it to the breast, will frequently lead to its cessation; should it, however, con-' tinue, the administration of a small quantity of white sugar as much as will cover the end of a teaspoon, dissolved in a tea- spoonful of water, will effectually abate the evil. COLD IN THE HEAD. CORYZA. This affection frequently becomes exceedingly distressing to the infant, when it appears in the form of an obstruction of the nose, impeding the action of the suckling, by not allowing the breath to pass through the nostril, obliging the infant to re- lease the nipple frequently in order to breathe, causing it to become fretful and irritable, sometimes leading to irritation and excoriation of the nipple, and thus in its repeated efforts to suck causing suffering to both itself and the nurse. Whilst this state continues, it operates considerably against the infant's thriving, both by hindering it from taking a suffi- cient quantity of nutriment, and by the impediment it causes to respiration, preventing the child sleeping at night. When the nose is dry, and the secretion of mucus suspended, we may, while administering a remedy calculated permanently to remove the evil, afford relief, by imitating the natural secretion by the application of a little almond oil or cream to the interior of the nostrils with a feather. This malady is often excessively obstinate, and presents itself under many different phases, which of course demand remedies suited to the entire group of the symptoms. Among these, Nux vomica ^\, has been most frequently successful^ particularly when the following symptoms are present :— Obstruction of the nose, with dryness or nocturnal obstruc- tion, slight discharge during the day; irritability and peevish- ness. Sambucus niger, -|, is frequently efficacious when Nux v. fails to relieve ; but is also of service in cases when there is an 460 DISEASES OF INFANCY. accumulation of thick and viscid mfrcus in the nostrils; or when, in addition to the cold in the head, there is a suffocating cough, with wheezing in the chest, and quick laborious breath- ing, Tartarus should bo had recourse to if Sambueus docs not soon relieve the latter symptoms; and if no amelioration quickly appear, we may without hesitation have recourse to a globule of the first dilution, and repeat the dose every four to six hours, or oftener, if apparently called for,* until improvement is effected, or another remedy required. Chamomilla, *.j, is very useful when there is cold in tho head, with a watery discharge from the nose, more particularly when there are febrile symptoms, soreness of the nostrils, and redness of one cheek. Carbo v. i.s chiefly useful in obstinate cases, and particular- ly when the cold in the head becomes aggravated towards evening. Calcarea, when the nose is stuffed with mucus, and the affection occurs in stout, lymphatic children. Pulsa- tilla, thick discharge from the nose, attended with frequent sneezing. Ai)ministr\tion. The doses already given repeated in from one to two days. (See also Coryza, Part II., p. 193.) CRYING AND WAKEFULNESS OF NEW-BORN CHILDREN. As we have already remarked, the occasional crying of new- born children is a wise provision to bring the respiratory organs into play, and to expand the chest. When, however, the crying becomes excessive, and threatens to prove injurious, we must, in the first place, endeavour to discover its origin, which frequently will be found to be some mechanical cause, such as derangement in the infant's dress, or a pin sticking into its flesh, etc. Therapeutics. When, however, no exciting cause or guiding symptoms of disease presents itself, and the infant is peevish and irritable, with incessant whimpering and wakeful- * Vide Introductory Remarks. CRYING AND WAKEFULNESS. 461 ness, or prolonged fits of crying, Belladonna, ^\* will fre- quently be found sufficient to remove the evil. When a fit of crying comes from the child having been irrita- ted or excited by any cause, such as suddenly rousing it from its rest, and when it seems willing to sleep, but finds a difficulty in composing itself to slumber, Coffea cruda, j, will prove efficacious. (Aconitum, ^T, may follow Coffea when there is considerable heat of skin, and extreme restlessness.) Chamomilla, T°2, is often more efficacious than Belladonna when the infant is of a very spare and delicate habit; or when we can trace the fits of screaming and wakefulness to a derange- ment of the digestive functions, and the child appears to suffer from griping pains, indicated by contortions of the body, draw- ing up of the little limbs upon the abdomen; and when a whitish, yellowish, or greenish, or watery excoriating diarrhoea is present. Jalapa, f, in similar cases, but without diarrhoea, or with motions tinged with blood. In other cases, when the screaming and vigilance are attend- ed with colic and flatulence, Senna, b, wiH answer best. Rheum, f, is more appropriate when, in addition to scream- ing and wakefulness, combined with griping, there are also ineffectual efforts to relieve the bowels by frequent straining, or when, at the utmost, only scanty, sour-smelling motions are passed, of grayish appearance, and seem to afford no relief. When flatulent colic, accompanied by constipation, appears to be the source of the disturbance, Nux v. s%, will commonly succeed in restoring ease to the little sufferer. Pulsatilla, ^\, is very efficacious when it arises from over- loading the stomach, or improper food, and the crying or wake- fulness is accompanied with flatulence and diarrhoea, or with constipation. Remarks. The milk of a nurse who has suckled for some mouths previously is much too heavy for a new-born infant; * See the Introductory Remarks to this Part of the work, as also those in the Introduction, (Part I.,) for directions as to the repetition of the dose, etc. 462 DISEASF.S OF INFANCY. hero, the only alternative is a change of nutriment. When, however, the above-named or any other infantile derangement arises from congenital weakness of the stomach, the most useful remedies in addition to Nux v. and Puis, are Sulphur, Calca- rea. carbonica, and Baryta c, #. REGURGITATION OF MILK. ACIDITY, l'LATU- LKNCE, ETC. Children, in sucking, sometimes overload their stomachs, and regurgitate a portion of their milk; so far, mothers have no cause for uneasiness, nor is medical assistance requisite; but when this changes into vomiting, and the whole of the nutri- ment is returned from the stomach, or when sickness and re- gurgitation of food occur in children who have been weaned, at times followed by mucus and watery fluid, and even bile, it must be looked upon as a disease, and treated accordingly Therapeutics. Ipecac uaniia, $, will generally afford re- lief, and may be repeated, if not followed by some amendment, giving the medicine from twelve to twenty.four hours to allow time for its action.* In the case of spoon-fed infants, or in children at a more advanced age, this remedy is equally effica- cious, when the derangement is evidently owing to their having been over-fed, (a most culpable error, which most nurses are prone to fall into by cramming the stomach of their little charges, and but too often with food of an indigestible nature, whenever they are seized with a fit of crying.) Should the vomiting or flatulence, and also the diarrhoea when present, not decrease after some doses of Ipecacuanha, Pulsatilla -r% may be exhibited in a similar manner, and succeeded in turn by Antimonium crudem, ~, or T\ if the symptoms continue, though in a mitigated form. Nux vomica, -fz, in the same manner as the above, and that failing, Bryonia, ^, in case the disease is attended with flatu- lence, constipation, uneasiness, or irritability of temper. Gentle friction with the extended hand, which has pre- viously been warmed, is a simple and frequently efficacious * Vid-j note, page 21. spasmodic asthma, spasms in the chest. 463 mode of affording temporary relief in cases of flatulent disten- tion of the stomach and bowels. But permanent relief is only to be attained from Pulsatilla, Nux v., Chamomilla; or Carbo v. and Sulphur, when the former are insufficient. The diet must at the same time be attended to, and altered if of an indiges- tible nature and the undoubted cause of the mischief. When there is diarrhcea and excessive flatulency, China is very useful. Chamomilla. Same dose as described for Ipecacuanha, when attended with convulsions, or diarrhoea, as described elsewhere under this medicine. (See those articles). A single dose of Sulphur, ^, followed by Calcarea carbonica, -g-g, in from five to ten days, and then again one or more of the preceding remedies, according to indications, will often be the means of effecting a cure in inveterate cases. SPASMODIC ASTHMA. SPASMS IN THE CHEST. Children are sometimes seized during the night with sudden attacks of suffocating spasm in the chest. The little patient suddenly awakes from sleep, and utters a shrill cry, in con- sequence of the feeling of suffocation which is experienced. The countenance soon assumes a livid hue, and is expressive of extreme anxiety. A dull, hollow-sounding, dry cough, usually accompanies the attack, and the breathing is rapid, very la- borious, and painfully distressing to witness. In such cases a globule or two of Ipecacuanha (potency 3 or 6) ought im- mediately to be dissolved in about a wine-glassful of water, and a few drops of the liquid put into the mouth of the patient. If relief follows, the medicine must be allowed to act, and only repeated when the symptoms threaten to become worse again. But in the event of no favourable signs resulting in from a quarter of an hour to half an hour or so, according to the severity of the symptoms, Sambueus may be given in the same manner. In other cases, Arsenicum § will be found more efficacious than cither of those; or the employment of Ipecacuanha and Arsenicum alternately every ten or twenty minutes, until im- provement takes place. Whenever a sudden aggravation 464 DISEASES OF INFANCY. ensues after the administration of any of these remedies, no- thing further should be done, as on waiting patiently for a few minutes, if the change arise from the effects of the medicine, the symptoms will subside, and gradually give way to un- equivocal signs of improvement. (See Asthma ot Millar, p. 4SG.) Some children arc liable to be seized with obstructed re- spiration or asthma, although otherwise in good health, when- ever they are exposed to sudden changes of temperature, or to a cold and high wind. This form of asthma is always attended with considerable, hard, distention of the pit of the stomach and region of the lower ribs ; the child aflceteil is at the same time thrown into a state of great anxiety and uncontrollable restlessness, attended with crying or screaming, tossing about, etc. Against this indisposition Chamomilla % has repeatedly proved to bo an effectual re- medy. A dose ought therefore to bo given as soon as the attack declares itself. MILK-CRUST. MILK-SCAB. Crusla lactea. Porrigo Jarvalis. Tinea faciei. This affection, as it occurs in infants at the breast, usually consists of an eruption of numerous small whitish pustules, which appear in clusters upon a red ground. These generally show themselves in the first instance on the face, particularly the cheeks and forehead, but sometimes spread over the whole body. The lymph contained in them soon becomes yellow, dark, or even sanguineous, and, on their bursting, forms into thin yellowish crusts. Frequently there is considerable surrounding redness and swelling, with distressing itching, which renders the little pa- tient excessively restless and fretful, and causes it to keep con- tinually rubbing the affected parts, by which the discharge and crusts are repeatedly renewed, often increased in thick- ness, and often to such extent, that the whole face becomes covered; the eyes and nose alone remaining free. Tho eyes milk-crust, milk-scab. 4C-5 and eyelids, as also the parotid and mesenteric glands, occa- sionally become inflamed, and sometimes marasmus supervenes. Therapeutics. The following medicines have been found serviceable in this affection: Aconitum, Rhus toxicodendron, Viola tricolor, Sulphur, Belladonna, Hepar sulphuris, Eu- phrasia, Staphysagria, Arsenicum, etc. Aconitk ^V should commence our treatment, when we find excessive restlessness and excitability produced by this affection, and when the skin around the parts is red, inflamed, and itching. As soon as we have found beneficial effects result from the administration of the above remedy, we may follow it up with Viola tricolor, which is often sufficient to effect a cure in the simple uncomplicated form of the disease. Administration. a^a, in four teaspoonfuls of water, one night and morning. The prescription to be repeated in four days, or another remedy selected, if the affection threatens to extend, or otherwise become worse. Rhus toxicodendron may sometime succeed or supersede Viola, tricolor, when the scalp is considerably affected and thickly studded with incrustations. Administration. ^, repeated in two to three days, if the same appearances remain. If, after the employment of Rhus, the affection is found to have made but little favourable progress, as not unfrequently happens in debilitated or in strumous subjects, Sulphur ^, may be given and repeated in four days. The alternate use of Rhus and Sulphur every four or five days, has been found very efficacious in cases of the aforesaid description, and when the eyes are a good deal affected. Administration. 3&0, dry upon the tongue. Sarsaparilla and Mezereum have also been strongly recom- mended in Crusta lactea; also Arsenic. ^. The former in the earlier stage of the malady, when small, burning, itching pus- tules appear on the face. Mezereum, when from the bursting and discharge of the contents of the pustules, incrustations have formed from which an acrid exudation flows, and gives rise to a fresh c /uption of vesicles wherever it comes in contact. 20* 466 DISEASI s OF INFAM'Y. (iraphites, as also Sepia, lienor, Baryta c, Lycopodium, etc., have been recommended as likely to prove of service in compli- cated cases. But the remetlies above mentioned will rarely fail to cure the affection as ordinarily met with, if had recourse to in due time. (See also Scald Ukad.) Tiiursir. or aptiue. This disease commences by the formation of small isolated, round, white vesicles, which, if not checked, become confluent, and sometimes present an ulcerated appearance, filling the whole of the cavity of the mouth, and in severe cases extending to the throat. This affection, although of itself neither malig- nant nor dangerous, frequently causes not only considerable suffering to the child by preventing it from sucking, but great pain and inconvenience to the mother by its being communi- cated to the nipples, and causing excoriation, etc. The complaint is most generally produced by tho want of a proper attention to cleanliness, both as regards the constant personal laving of the infant, but especially from the suckling- glass, when employed, not having been carefully washed after use. Improper aliment is another of the principal causes; thus we find that children who are what is commonly cSlled reared by tbe hand, cither partially or wholly, are more liable to this affection than those whose sole nourishment has been from the breast. One of the remedies in this affection, although perfectly ho- moeopathic in its action, has long been in use, in its external application, by practitioners of the old school, namely, Borax ; and a weak solution applied to the mouth with a brush has not unfreijuently been found efficacious. Or we may prescribe this remedy, to be taken internally, as follows: We may dissolve a few globules of the third or sixth potency in an ounce of water, and administer one teaspoonful morning and evening for two days, then allow an interval of three days to elapse; if at that period no amelioration has taken place, we must have recourse X Sulimiur b-0, given dry. thrush, constipation. 467 In cases where there is much salivation, and the thrush indicates an inclination to ulceration, we may administer Mercurius solubilis y0^, twice in forty-eight hours, followed, in a few days, by Sulphur, and then Acidum sclphuricum ^\, after a similar interval if necessary. In very bad cases, when the aphthse assume a livid, blue, or violet appearance, attended with excessive weakness and diarrhoea, Arsenicum 3-0, is high- ly useful. Great cleanliness ought to be observed in all cases. When the disease frequently, notwithstanding every precau- tion, reappears in infants at the breast, we may safely infer that it arises from some virus in the constitution of the mother, or nurse, who ought to be changed, or immediately put through a proper course of treatment, under the direction of an expe- rienced homoeopathic practitioner. CONSTIPATION. Obslructio Alvi Neonatorum. This generally appears in children who are either wholly or partially reared by the hand, and also in those whose mothers or nurses are similarly disposed, which if it arises from a pecu- liar diet or want of exercise, such as too much animal food, &c, on the part of the last mentioned, may be removed by a proper attention to these points; but in many instances it is necessary for them also to have recourse to proper remedial agents at the same time with the infant. Therapeutics. Nux vomica, Bryonia alba, and Opium, are the principal remedies; and in more obstinate cases, Sulphur, Veratrum album, Lycopodium and Alumina. Most of the medicaments have been already mentioned under Constipation (Part II., p. 123), which see. Administration. 3-0 of the three first-mentioned remedies, every three to four days, until relief is obtained, or another remedy called for ;* and of the last, the same dose at intervals of a week. An enema of tepid water may be occasionally had recourse to, if required, until the medicine has remedied the irre- gularity. * Vide note, p. 21. 46* DISEASES OF INFANCY. BOWEL COMPLAINTS OF INFANTS. Diarrhaa Neona'oritm. Diarrhoea, like constipation, is to be regarded merely as a symptom, nut as a disean ; the real disease here oonsists in irritation of inflammation of the mucous membrane ol the in- testines, arising from the effects of aperients, indigestible food, cold, fright, Ac. I have already mentioned, (article Miconmm,) that much mischief is too often occasioned by the deleterious practice of administering laxative medicines, and even drastic purgatives! to the tender new-born infant, for the purpose of hurriedly ex- pelling the blackish green-looking matter, technically known by the name of Meconium, that collects in the large intestine of the foetus during the last month or two of its uterine exist- ence. This unwarrantable and extremely reprehensible con- duct is frequently persevered in even for some time alter the expulsion of the first discharge has taken place, and is in many cases the undouhtkd cause of bowel complaints and other suf- ferings in infants. I cannot, therefore, refrain from again ex- pressing a warm disapprobation on the subject, and am con- vinced that in so doing, I but give utterance to the conjoint opinion of every experienced and enlightened practitioner, even of the allopathic school. The introduction of unappropriate, indigestible food, such as thick gruel, &c, into the delicate stomach of a new-born infant, is another very frequent source of intestinal derangement; this unpardonable error is not unfrequently committed by ignorant nurses, in order, as they say, to keep it from starving during the few hours of necessary repose to which the mother is left after delivery. This disturbance is, moreover, likely to be excited in those cases in which, either from a deficiency in the secretion of milk or other causes, it becomes incumbent to administer supple- mentary diet to make up for the diminished supply ; and again at the period of weaning, when serious disturbances arc occa- sionally produced in the stomach and bowels, from want of proper attention and caution in the selection and admiuLtra- BOWEL COMPLAINTS. 469 tion of the food. (See art. Supplementary diet of infants, p. 451.) Fright and exposure to cold are, as already noted, two other most frequent exciting causes of the disorder. Therapeutics. A healthy infant on the breast soils on an average, from four to six napkins in the twenty-four hours, but in some instances the evacuations are more frequent, yet, with- out in any degree affecting the health of the child, (as is like- wise often the case when a constipated state of the bowels ex- ists ;) in such cases then, little or no interference ought to be made so long as the stools remain free from fee/or, possessing merely the slightly acid smell peculiar to the infantile state, and are evidently unattended with pain, or any other abnormal indication. When, however, the stools become green and wa- tery, or yellow and watery, brown and frothy, or white and frothy, as if fermented, mixed with mucus, or consist entirely of mucus, and emit an offensive odour, and are generally pre- ceded or accompanied by signs of suffering, it becomes imper- ative to have recourse to remedial aid. As already observed, the minuteness of the doses, and the absence of all nauseous taste in the homoeopathic medicines, not to mention their other more important virtues, render them peculiarly well adapted to the treatment of children, and thereby spares many an affec- tionate and anxious parent tbe pain and difficulty which is so frequently encountered in inducing the little sufferer to swallow the nauseous allopathic drugs. The following are the principal remedies employed in homoeo- pathic practice against this derangement: Aconitum, Belladon- na, Chamomilla, Rheum, Pulsatilla, Ipecacuanha, and also Mercurius, Nux v., Arsenicum alb., Sulphur, Sepia, Opium, and Verat. alb. When there is inflammation, the constitutional symptoms are pretty clearly indicated by heat of the surface of the body, quick- ness of pulse, and by rigours; in this case, we must have imme- diate recourse to Acomt. ^\, and follow it if necessary by Belladonna; when the more acute symptoms have been removed, but the infant continues to suffer much and scream constantly. (Lachesis may be preferred to Belladonna, when 470 DI8EA8ES OF INFANCY. constipation suddenly supervenes, attended with swelling and apparent tenderness to the touch over the entire abdomen, but especially at one particular spot. Mercurius may follow Lache- sis if the symptoms do not yield to the latter remedy. Administration. *£, in six teaspoonfuls of water, one every six to eight hours, until relief is obtained.* Chamomilla is one of the most invaluable remedies in the treatment of the diseases of children, and particularly in bowol- eoniplaints, whether arising from irritation caused by indigest- ible food excited by a chill, or occurring during teething; when the following symptoms are apparent : redness of the face, or of one cheek, hardness and tension, and fulness of the abdo- men, attended by severe colic, which is indicated by the state of peevishness, restlessness, constant crying, and drawing up of the legs towards the abdomen, sickness, frequent evacuations, of a bilious, watery, slimy, or frothy description, of a whitish, yellowish, or greenish colour, sometimes bearing a resemblance to beat-up eggs, of an offensive odour, similar to that of rotten eggs. Chamomilla may be preferred to Belladonna after Aconite in cases of inflammation, when any of the above symp- toms present themselves. (See also Infantile remittent, p. 4H8.) Administration. £, in four teaspoonfuls of water; a tea- spoonful every six hours, until benefit results.f Rheum is another remedy of great utility in the treatment of this affection, provided the disorder has not been actually ex- cited by frequent use of. this medicine itself in allopathic doses, in which case it will be necessary to have recourse to Pulsa- tilla, Chamomilla, or Mercurius, as antidotes, according to the nature of the symptoms. Rheum is particularly appropri- ate when acidify or bilious derangement has been generated by indigestion, or has arisen from the prolonged use of antacids, such as magnesia, &c, and when there is flatulent distention of the abdomen, colic, crying, restlessness, tenesmus before and after the evacuations, which are either' of the consistence of Vide note, page 21. t Ibid. BOWEL COMPLAINTS. 471 pap, or watery and somewhat slimy, occasionally of a grayish, or of a brown colour, and when a sour smell is emitted from the body of the infant. It is sometimes necessary to give Chamomilla after Rheum, to complete the cure. Administration. ^, in the same manner as Chamomilla. Pulsatilla. Diarrhcea, arising from "indigestion," or from a chill, with watery, slimy, whitish, or bilious, greenish- looking evacuations, occurring chiefly at night; want of appe- tite, fretfulness. Pulsatilla, as stated, is also very serviceable in obsinate cases, where the affection has been brought on by the abuse of Rhubarb, or by Rhubarb and Magnesia, when the symptoms are as aoore described; it is further often efficacious under similar conditions, when fright, has been the exciting cause, and Opium has not sufficed, or has been administered too late. (See Veratrum, p. 474.) Administration. ^, in six teaspoonfuls of water, one every twelve hours, until improvement ensue. Ipecacuanha is particularly valuable when the diarrhoea is excited at the period of weaning (weaning-brask), from the sudden change of food, which the stomach is unable to digest; and when the following symptoms result in consequence: bilious derangement, with repeated attacks of vomiting, pale- ness of the face, frequent crying, diarrhoea with stools of a bilious, slimy, or greenish yellow, sometimes blackish, or streak- ed with blood, and of a putrid odour ; on other occasions, evacu- ations resembling matter in a state of fermentation, or con- taining substances like white flocks or flakes, followed by strain- ing. When this remedy is insufficient to effect a complete cure, wc should have recourse to Pulsa'illa or to Antimonium crudum, should the vomiting not speedily subside. Administration, g, in four teaspoonfuls of water, a tea- spoonful night and morning. Mercurius. This medicine will be found very serviceable in some cases where the irritation owes its origin to the abuse of aperients, such as Rheum, etc., or when it has arisen from A chill. The following are the principal indications : watery, slimy, or bilious stools, (sometimes streaked or mixed with blood,) of a blackish, " greenish,'" or of a whitish yellow colour : DISEASES OF INFANCY. frothy, or having the appearance of beat-up eggs : attended with symptoms of severe colic, and frequently also with scecre tenesmus and protrusion of the intestine. Administration. t°5, in the same manner as Chamomilla. It is necessary to state, however, that the employment of mercury in the form of calomel or some other mercurial prepa- ration in allopathic- doses, is a fruitful source of bowel complaints in children; when, therefore, the complaint is attributable to the abuse of that powerful mineral, the homoeopathic Mercu- rius must of course be avoided, and its place supplied by an antidote, which will generally be found in He] ar sul\ kuris or Acidum nitricum, should the former not suffice. Dulcamara. This is an admirable remedy in derangements of every description arising from exposure to wet; and is indi- cated in eases of diarrhtea from this cause, with the following symptoms : Watery, bilious, or slimy evacuations, of a greenish yellow colour, and occurring chiefly at night. Administration. § or Tn7, in a teaspoonful of water, and repeated in twenty-four hours, if necessary, {Alere. or Cham. may be required to complete the cure in some instances.) Nux vomica is very useful in cases arising from a chill, or from indigestible food at the period of weaning, or earlier ; it is also useful in some cases in which the disorder has been cre- ated by the frequent employment of laxative medicines. Its indications are : very frequent but scanty evacuations of watery, slimy, whitish, or greenish stools, attended with colic and tenesmus, sometimes followed by protrusion of the intes- tine; extreme fretfulness. This medicine is also of gnat service in many cases when the diarrhoea alternates with con- stipation. Administration. 3cum, Mezereum, Petroleum, and Rhus* (See Atroi-iiy, p. 493.) INFANTILE REMITTENT FEVER. By infantile remittent is here chiefly meant that form of fever which occurs in infants and children, arising from mor- bid irritability, inflammation or even ulceration in the mucous membrane of the stomach and bowels. The affection is usually preceded by languor, irritability of temper, want of appetite, nausea, thirst, slight heat of skin, and very restless nights. Ere long these symptoms present them- selves in a more aggravated form, together with an acquisition of abnormal phenomena, such as hurried and oppressive breath- ing, quickness of pulse, with occasional flushes in the face, vomiting of food or bile, distention and tenderness of the abdo- men; obstinate constipation ; sometimes diarrhcea, or frc-<|tu-nt desire X go to stool with but little effect; motions discoloured, • The author begs to refer the reader to a somewhat interesting case of Rachitis, which he published iu the Brit. Journ. of Homoeopathy, No. 10, p. 105. INFANTILE REMITTENT FEVER. 489 fetid, frequently mixed with mucus, and occasionally with blood. The hands and feet are often cold, while the rest of the body is parched; the head hot and heavy, or attended with other symp. toms resembling hydrocephalus, such as coma, etc. The tongue, at first moist, loaded, and occasionally very red along the mar- gins, often becomes dry over a triangular spot at the point. When the febrile exacerbation takes place at night, it is ac- companied by vigilance and jactitation ; when during the day, there is, on the other hand, drowsiness and stupor. An annoy- ing cough with bronchitic indications, succeeded by wheezing and expectoration, sometimes appears. Although, as is charac- teristic of remittent fever, the febrile symptoms never entirely subside, still the patient will frequently appear to be steadily recovering for a time, and the unwary or inexperienced may consequently be led to pronounce an unduly favourable progno- sis, which will too often be contradicted by the occurrence of a relapse, followed perhaps again by another encouraging but de- ceptive remission; and so on, unless the progress of the disease be checked until either the mesenteric glands become affected, dropsical effusion into the cavity of the abdomen ensues, or un- equivocal signs of cephalic disease become established, or the little sufferer is so emaciated and reduced by protracted disease, that the vital powers give way, and he sinks exhausted. Therapeutics. In mild attacks occurring in tolerably healthy children, the disease is generally readily subdued in a few days by means of one or more of the following remedies: Ipecacuanha, Pulsa'illa, China, Nux v., Aconitum, Belladonna, Mercurius Bryonia, Lachesis, Chamomilla, and Sulphur, com- bined with light farinaceous diet. Solid food must be strictly prohibited, even although the appetite should be good, which it occasionally is, and even ravenous at times. With regard to the indications for the remedies quoted, Ipe- cacuanha may be given if, as is generally the case, the attack has been excited by over-feeding, or by indigestible food, and particularly when the patient has contracted a habit of bolting the food without having previously masticated it properly, and the symptoms encountered are as follows :—General dry heat, or harsh and parched skin, especially towards evening; thirst, 21* 490 PISF.ASES OF INFANCY. extreme restlessness, burning heat in the palms of the hands; perspiration at night, quick oppressed breathing, foul tongue, nausea, vomiting, or fastidious appetite with sickness alter eating; great languor, apathy, and indifference. Should these symptoms remain unaltered after several doses of Ipecac, or should tbe bowels become very relaxed, the motions fetid, whitish, bilious, or of variable colour at different times, and ac- companied with griping and distention of tho abdomen; fever during the night—Pulsalilla must be prescribed, followed, it required, bv Cinchona, especially if the nausea or vomiting has subsided, liut the b.wels remain relaxed, and are considerably di. tended, or tense and tympanitic. Nux vomica § is also a most efficient remedy in mild cases, or in the early stage of the disorder of any variety, when the bowels are confined, or very costive, with frequent inclination to go to stool; or when there is tenesmus, followed by scanty watery motions, generally mixed with mucus, or occasionally with a little blood ; abdomen tumid and rather painful; further, when the child is excessively peevish and ungovernable ; the tongue foul ; appetite impaired, or there is nausea with disgust at food ; restlessness; fever towards morning, but also in some degree during the night. Chamomilla § is sometimes useful after Nux v. when burn- ing heat of skin continues, or when bilious vomiting or diar- rhoea supervenes; the tongue red and cracked, or coated yellow ; sleep lethargic, or restless and agitated, attended with frequent starts and jerkings of the limbs; flushes of heat in various parts of the body. Also when the little patient is of a plethoric habit, or in all cases in which the head is hot and heavy, the skin dry or parched, the face flushed, the pulse quick; and when there is thirst, foul tongue, nausea, bilious vomiting ; no mo- tions, or frequent and scanty evacuations, with tenesmus. Bf.lladonna § may succeed the former remedy if the head continue hot, the pulse excessively quiet and full, the tongue loaded, or coated white or yellow in the centre, and very red at the edge-; thirst; nausea or vomiting; great heat of the ab- domen with tenderness on the slightest pressure ; oppressive breathing. If the more active inflammatory symptoms yield to INFANTILE REMITTENT FEVER. 491 the action of Belladonna,—Mercurius § will often serve to complete the cure; but more particularly when the following symptoms remain: loaded tongue, nausea or vomiting, with continued tenderness of the abdomen; thirst, sometimes with aversion to drinks when offered; no motions, or diarrhoea with excessive tenesmus. If, on the other hand, the head continue hot and heavy, the pulse" quick, the tongue foul, and other symptoms of gastric derangement prominent, together with a tumid and painful state of the abdomen, constipation, excessive restlessness, and quick, laborious respiration, particularly at night, with drowsiness during the day, Bryonia is to be preferred. Lacuesis £ may follow Belladonna % or b. Mercurius when the signs of intestinal irritation or inflammation continue with but little abatement. Or it may precede these remedies, when the tenderness and distention is more marked at one particular spot (the most trivial pressure there being intolerable) than over the entire abdomen ; and when the fever is highest at night. Sulphur b may be given with advantage to complete the cure in many cases, after the previous employment of any of the foregoing medicines. It is, however, when the attack is characterized by the following features that this remedy is more directly called for : feverish heat, especially towards even. ing, but also in the morning, or during the day; flushes alter- nately with paleness of the face; dryness of the skin; hurried and laborious breathing; palpitation of the heart; nocturnal perspiration; languor and great weakness, particularly in the inferior extremities; tense, tumid and painful abdomen; dry, hard, or loose and slimy motions. These, then, are the more generally useful remedies in cases of the above description, and will materially tend to facilitate recovery, and prevent the disease from assuming an obstinate character. When, however, the malady occurs in children of relaxed and feeble habits, or of a decided strumous diathesis, it becomes, especially if neglected, and not checked at the com- mencement of its course, a most intractable and frequently fatal disease, from the proneness which it then has to become com- plicated, and terminate in one or other of the serious forms alluded to in the diagnosis. 492 DISEASES OF INFANCY. The remedies from which the most benefit is to be antici- pated under such unfavourable circumstances arc, in addition to those previously mentioned : Silica, Sulphur, Calcarea, Baryta c, Arsenicum, Cocculus, Cina. Sabadilla, etc. Silicea #, when there is great emaciation, languor and de- bility, paleness of the face, want of appetite, or craving for (lain- ties; shortness of breath on movement; feverish heat in the morning or towards evening. This remedy is also a most im- portant one when the patient is afflicted with worms, and when the disease is in a great measure attributable to invcrmination. Cina and Sabtrldla may likewise be found useful along with Sdicea in the latter instance. (See Invermination.) The indications for sulphur have already been given. Calcarea $. Great debility, with flabbiness of the muscles, dryness of the skin, and excessive emaciation ; frequent flushes, or general heat, followed by shivering towards evening ; ex- haustion, or dejection after speaking ; impaired, fastidious appetite, with weak and slow digestion, or, on the contrary, extreme voracity; perspiration towards morning, hard, tense, and tumid abdomen. (Baryta c is sometimes useful after Calcarea. Arsenicum f. Extreme prostration of strength and ema- ciation, with desire to remain constantly in the recumbent pos- ture ; drv, burning heat of the skin, with great thirst, but desire to drink little at a time, or merely to moisten the lips, which are frequently parched; impaired appetite, and some- times excessive irritability of stomach, so that very little food can be retained; hard and tense abdomen ; restless, unreiresh- ing sleep, and frequent starts, or subsultus tendinum ; fretful and capricious disposition. Cocculus ^. Great weakness, with excessive fatigue, depres- sion, and tremor, after the slightest exertion ; heavy, expres- sionless eyes; flushes of heat in the face; nausea, or aversion to food, distention of the abdomen, constipation ; oppressed respiration; pe'spiration on attempting any trivial exertion; lowness of spirits ; mildness of temper. Belladonna, Lachesis, or Baryta c, will be required when the head becomes much affected. The former especially when there is heat, heaviness, flushing and delirium; or deep and ATROPHY. 493 protracted sleep with subsultus tendinum, coldness of the hands, pale cold face, small quick pulse, hot, tumid, and tense abdomen. Lachesis :—Either, before or after Belladonna, when we encounter deep prolonged sleep; grinding of the teeth; or somnolency alternately with sleeplessness; tremu- lous, intermittent, or scarcely perceptible pulse. Baryta. -2. Lethargy, jactitation, or agitation, moaning and muttering, feeble and accelerated pulse. (See Hydro- cephalus.) Other remedies, such as Antimonium, Acid, phosphoricum, Phosphorus, Hepar s., Kali, Acidum nitr., Lycopodium, Rhus, etc., may be required according as the symptoms happen to vary; we have merely given some of those medicines which have been found of valuable service when the indications were as above given. It may be added, that when the skin is hot and parched, the sleeplessness and restlessness is often tempo- rarily removed by sponging the body with tepid water: this is, however, only to be had recourse to when the remedies fail to afford this relief, and that in a more permanent degreev (See also Atrophy.) ATROPHY. Atrophia. The medicines from which the most appreciable assistance has hitherto been obtained in this serious malady are :—Sulph., followed by Calcarea; also Ars., Bar. c, Bell., Chin., Nux vom., Phosph., and Rhus. Sulphur § in almost all cases at the commencement of treatment; craving appetite ; enlargement of inguinal or axil- lary glands; slimy diarrhoea or obstinate constipation; pale complexion, sunken eyes, &c. Calcarea, f. Great emaciation, with craving appetite; en- largement and induration of the mesenteric glands; great weakness, clayey evacuation, a dry and flabby skin; too great a susceptibility of the nervous system. Arsenicum, §. Dryness of skin, which resembles parch- ment ; hollow eyes ; desire to drink often, but little at a time ; excessive agitation and tossing, especially at night; short sleep interrupted by jerks; faeces of greenish or brownish colour, -.i —~.*.,.,»;r.«a nfinnresta: extreme prostration. 494 DISEASES OF INFANCY. Baryta, f. Enlargement of the glands of the nape of the neck ; continual desire to sleep ; great indolence, and aversion to exertion aud amusement. Bell., §. Capriciousncss and obstinacy; nocturnal cough, with rattling of mucus; enlargement of the glands of the neck; unquiet sleep; precocity of intellect, blue eyes, and fair hair. China, *. Excessive emaciation; voraciousness; diarrhcea at night, with frequent white evacuations, or of ingesta; fre- quent perspirations, especially at night; unrefreslnng sleep. Cina, §. Yerniiculous suffering; wetting the bed. (See Worms.) Rut s. Slimy or sanguineous diarrhu-a ; debility; voracity. In children past the age of infancy, great attention should be paid to the diet; pure air and exercise are also of great im- portance. VACCINATION. This is an operation purely homoeopathic, and one which, from its efficacy in the prevention of a disease exhibiting analo- gous symptoms, has been frequently quoted by our Great Founder and his disciples, as one of the best illustrations of the immutable law of similia similihus curantur. Vaccination, when the child is strong and healthy, may be Bafely performed during the fourth and fifth month ; but when the smallpox is rife as an epidemic, we may have recourse to this prophylax with infants of a still more tender age. If, however, we are allowed a choice of time, summer is the best period for performing the operation, as then the infant, after having taken the infection, incurs least risk of catching cold. It is of the utmost importance to obtain the lymph from a perfectly sure source, as experience has too truly proved, that other diseases have, from a neglect of this precaution, been frequently transmitted to healthy children. For this reason, a child that has suffered from eruptions of the skin, affections of the glands, or soreness of the eyes, or one born of scrofulous parents, is an unfit subject for taking the vaccine matter from, ilthough at the time apparently in health. PART IV. TREATMENT OF FEMALES, AND their peculiar affections. CHLOROSIS. Emansio Mensium. This complaint generally declares itself in young females about their fourteenth year. Its proximate cause is an ob- struction of the first menstruation ; a disease very similar may be produced by great loss of blood. Diagnosis. Pale blanched complexion and lips (sometimes with flushes of heat and redness), a depravity of appetite, a longing after innutritious substances, such as chalk, &c, and a general languor both mental and physical; the patient com- plains of weariness, lassitude and debility, and becomes emaci- ated ; the lower extremities frequently assume an cedematous appearance, generally attended with cold in those parts, aud headache, with flatulent distention of the abdomen, particularly after meals, and in the evening; bowels irregularly confined ; sometimes at a later period very easily irritated and relaxed; a harsh harassing cough, occasionally with periodical expecto- ration of dark-coloured coagulated blood, and hurried respira- tion, frequently declares itself, if the affection has been allowed to proceed unchecked; and to an inexperienced eye, the suf- ferer appears to be on the verge, or even passing through the different stages, of a decline. Therapeutics. The predisposing causes of this affection are very remote ; we shall therefore be satisfied with confining ourselves to the treatment of the complaint in its more simple sta^e, as when we find an extremely obstinate case, we may feel confident that it requires a regular course of treatment, or 496 treatmf.nt of females. originates in some organic derangement. The medicines hither- to fuund most useful in ordinary cases ot this affection are, Pi.lsa'il'a, Sepia, Bryo ia, Su'phur, and A tram in. Administration. Six gl .hides of the potency mentioned after each medicine, in six tea-spoonfuls of water, one daily ; and so on until benefit results, or it is found necessary to choose another remedy.* Pulsatilla, °fV» or in li^1lt cascs> ;>> globules taken dry, when the complaint has been the effect of dampness, or caused by damp or cold air, or when it is accompanied by frequent at- tacks of semi-lateral headache, with shooting pains, extending to the head and teeth, sometimes shifting suddenly to the other .side ; also when we observe aching in the forehead, with pres- sure at the crown of the head, and sallo •■ complexion, alterna- ting with flushes of heat; difficulty of breathing, and sense of suffocation after the slightest movement; palpitation of the heart; co'dness of the hands and fee', often changing to sudden heal ; disposition to diarr/iaa and, leucorrhcea; pains in the loins; sensation of weight in the abdomen ; spasms in the sto- mach, with nausea, inclination to vomit, and vomiting ; periodi- cal expectoration of dark coagulated blood ; hunger, with repug- nance to food, or want of appetite with dislike to food; great fatigue, especially in the legs. This medicine is peculiarly adapted to females of mild or phlegmatic disposition, disposed to sadness and tears. Graphites, °g°T°, when there is retention of the period with congestion of the vessels of the head and chest; dark red flush- ing of the face, oppression at the chest; and a feeling of anxi- ety when in the recumbent posture. Graphites, together with Caus'icum, form two of the most important remedies in scan'y, insufficient menstruation. Belladonna is often called for when the congestion of the head and chest is of an active character, with violent throbbing of the carotids. Sepia, yj, is also a very valuable remedy in this affection, when many of the above symptoms are present, with, at the Bame time, hysterical megrims ; complexion so'low, with dark- coloured spots; frequent colic and pain as of a bruise in the * Vide note, p. 21. CHLOROSIS. 497 limbs. When the above symptoms declare themselves, advan- tageously follow Pulsatilla, if the latter have failed to relieve. Bryonia, -Jj-. Frequent congestion in the head or chest; bleeding at the nose; dry cough ; coldness and frequent shiv- ering, sometimes alternated with dry and burning heat; con- stipation or colic; bitter taste in the mouth, tongue coated yel- low, sense of pressure in the stomach, as if from a stone; iras- cibility. Sulphur, °|°,ismore particularly indicated when there is pressive and tensive pain in ihe back of the head, extending to the nape of the neck ; or pulsative pain in the head, with de- termination of blood; humming in the head; pimples on the forehead and round the mouth ; pale and sickly complexion, with red spots on the cheeks ; voracious appetite ; general ema- ciation ; sour and burning eructations; pressive fulness and heaviness in the stomach under the lower ribs and in the abdo- men ; bowels irregular; difficulty of breathing; pain in the loins and fainting; excessive fatigue, especially in ihe legs, with great depression after talking; great tendency to take cold; irritability, and inclination to be angry; or, sadness and me- lancholy, with frequent weeping. Irt some cases, one or the other of the following medicines : Conium, Kali carb., Phosph., Ferrum, Ignatia, Lycopod., Acid, nitr., etc. Calc. carb. Y20' nas °ften completed a cure in the worst cases, with oedema of the extremities and extreme dyspnoea. It is necessary to follow up the treatment, on the disappear- ance of the more important symptoms under the employment of Calc, with Ferrum carb. in repeated doses, to prevent a relapse. Ferrum is required when the pale and sickly hue of the face continues, notwithstanding the previous. use of Calc. When Ferrum was given at the commencement, it did.not aggravate the anxiety, cough, and other pectoral symptoms. Where there is a complication with tubercular diathesis, accompanied by cough, etc., coeval with the first appearance of chlorosis, Sulph. and Calc, often prove beneficial in alternation. During the employment of Calc, a dose of Lycop. is required, when there is constipation aud extreme languor, or Sepia, when there is oppressive headache. Sometimes the menses do not appear 498 treatment of females. for some time afterwards, although health may have been re- novated. Valeriana •$•, has been found of great servico in daily- repeated doses, when a feeling of constriction was experienced in the gullet or chest, accompanied with signs of threatened suffocation, and followed by frequent yawning, as soon as tho patient sat down to dinner. Natrum muriaticum, potency *£*, cyy., or o°. is a most valuable remedy in many obstinate cases, either exhibited as above described, or by giving a dose twice or thrice a week. Plumbum aceticum has been found useful in cases with dys- pnoea, oedema, and anasarca. AMENORRHCEA. Supprvssio Mensium. Suppression of the menses occasionally takes place suddenly from some accidental cause, such as exposure to cold, power- ful mental emotions, &c. In other instances the suppression is symptomatic of some other disease, either organic or functional, and can only be removed by the cure of the primary malady. It is of the former that we here propose to treat. When a suppression takes place from the sudden effects of a chill, we may have recourse to Pulsatilla, when the symptoms generally correspond to those of that remedy, as detailed under Chlorosis. In other cases arising from this cause, Nux mos- chata, Dulcamara, Sepia, or Sulphur may be necessary. (See Chlorosis, for indications for Sulph. and Sep., which are reme- dies of great service in a large number of cases, when the affec- tion becomes chronic.) When a sudden fright has given rise to the affection, Aconi- tum should be immediately administered, followed by Lyco- podium, Opium, or Veratrum, if the bad consequences which frequently result do not yield, or if only partial relief is obtained from the employment of Aconitum. (Sec- Mental Emotions, Parts II. and III.) In chronic cases occurring in weak or debilitated individuals, in addition to Sulphur and Sepia, the following remedies are useful : Natrum m., Conium, Arsenic, Cinch., Graph., Caust., lodium- Whilst in those which occur in plethoric subjects, amenorrhea, menstruatio nimia. 499 whether of a chronic or recent description, Aconit., Bellad., Sul- phur, Bryon., Nux v., Sabina, Opium, Platina, &c, will chiefly be found the most serviceable. When there is not a complete suppression, but the menstrual discharge is scanty and insuffi- cient, Graphit., Causticum, Kali, Conium, Natrum m., Phosph., Pulsat., Sulphur, Lycopod-, Magnesia, Silicea, Veratrum, or Zincum, are the most important remedies. Dose : see Admi- nistration, under Chlorosis. MENSTRUATIO NIMIA. MENOCHASLA. MENORRHAGIA. The quantity of the menstrual discharge varies a good deal in different women. Considerable influence is for the most part exerted by climate, constitution, and the manner of living. The duration of the discharge and the period of return are also variable. In some, it continues from four to ten days, in others, it lasts only a few hours; from three to six days is, however, the most usual. The regularity is, in many, exact to a day, or even an hour, while in others a variation of several days is a usual occurrence, without the slightest disturbance to the ge- neral health resulting therefrom. When the discharge is ex- cessive, and attended with pains in the back, loins, and abdo- men, resembling those of labour, it becomes necessary to pre- scribe remedies calculated to arrest it, and to correct the ten- dency thereto. Amongst these the following are of great utility : Ipecac, Crocus, Sabina, Cinch., Nux v., Cham., Pla- tina, Sulph-, Calc, &c. Ipecacuanha is generally useful in severe cases of this de- rangement, as well as in flooding after labour, and may in most instances be administered first, unless there are strong indica- tions for a preference being given to any of the others. Administration. fi§a, repeated in from six to twenty-four hours* Crocus is more especially called for when the discharge is of a dark colour, viscid, and very copious; and the menses have appeared before the usual time. Administration. Same as the above. * Vide note, page 21. 500 treatment of females. SvniNA. when the discharge is excessive, of a bright colour, and occurs in plethoric females who are prone to miscarry, rneu- niati.- pains in the head and limbs: great weakness; pains in the loins similar to those of labour. Administration. a*", repeated in from six to twenty- four hours. Cinchona is of considerable utility after the previous em- ployment of the foregoing, and in all cases where there is great debility in consequence of a more copious menstrual discharge than natural. Administration. **■, repeated in twenty-four hours. Nix v., when the discharge is of too frequent occurrence, too profuse, and of too long duration ; and when it commonly stops for a day or so and then returns, attended with spasms in the abdomen; sometimes nausea and fainting, especially in the morning; pains in the limbs; restlessness; irascibility. Nux v. is especially serviceable when the above symptoms occur in fe- males who are addicted to the daily or frequent use of coffee, liqueurs and other stimuli. Administration. ift or b± during the existence of the menstrual discharge, and a globule or two in a teaspoonful of water every fourth day during the interval before the next pe- riodical return. Chamomilla is frequently useful after Nur v.. but particu- larly when there is a discharge of dark, clotted blood, with se- vere colic, or pains like those of labour; great thirst; paleness of the face, and coldness of the limbs. Administration. Same as Nur. Ignatia is of considerable service when the derangement happens in hysterical females. Administration. e§ or b& during the period; the dose to be repeated once during the interval Platina. Preternaturally increased menstrual discharge, with painful bearing-down pains, and venereal orgasm; thick dark-coloured menstrual blood; great excitability. Administration. fi°- during the discharge; to be repeated in tweuty-four hours ii the pains continue. DYSMENORRHEA. HYSTERICS. 501 Veratrum. Too early or too copious menstrual discharge, always attended with diarrhcea. Administration. °t°2° or -3-/, repeated in twenty-four to forty-eight hours, if required. Sulphur administered thrice during the intervals, allowing ten or twelve days to elapse between the second dose, and fol- lowed by Calcarea, in the same manner, has frequently -been found successful when any of the previous remedies afforded but temporary relief. In other cases Belladonna, Bryon., Natrum m., Magnesia m., Sepia, Silicea, or Phosphorus, &c, may be useful. Dose: Same as Nux v. DYSMENORRHEA. In painful and difficult menstruation, or menstrual colic, the most important remedies are the same as those enumerated un- der Menorrhagia and Chlorosis, but particularly Chamom., Pulsatilla, Belladonna, Nux, Coffea, Sulph. and Calc., &c.,* when the disorder occurs with great vehemence at the critical age (tour el'age). Lachesis is of invaluable assistance, and particularly when diarrhoea, attended with almost insupportable tormina, usually sets in before and after the menstrual period; but the following are likewise of considerable utility : Pulsatilla, Sepia, Sulphur, Cocculus, Ruta, Conium. Against uterine spasms, Cocculus, Pulsatilla, Ignalia, Platina, Cuprum, form the most valuable remedial agents; but in some instances, Nux v., Cinchona, Sul- phur, Graphites, Conium, or Natrum m., &c, may be more ap- propriate. Dose: see Administration under Chlorosis. HYSTERICS. Hysteria. Passio Hysterica. This disease appears in paroxysms, is preceded generally by depression of spirits, anxiety, effusion of tears, dyspnoea, nausea, and palpitatio cordis; also with pain is the left side, which seems to advance upwards till it gets to the throat, when it feels as if a ball were lodged there, (globus hystericus;) if it * We have derived immediate relief from Sabina when all other ex- pedients proved inefficacious.—Ed. 502 treatment of femalks. advanced further, there is sense of suffocation, stupor and in- sensibility, with spasmodic clenching of the jaws; the trunk of the body is moved about, and the limbs agitated ; alternate fits of laughing, crying, and screaming; incoherent expressions; the foaming mouth ; relief ensues generally with eructation, and frequent sighing and sobbing, followed by a sense of soreness over the whole body. Hiccough is sometimes a concomitant, and a very distressing one, in hysteria. These are the usual symptoms accompanying this disease, but the complaint ap- pears in a great variety of forms ; and in many cases the pa- tient is attacked with a violent spasmodic pain in the back, which extends from the spine to the sternum, and eventually becomes fixed at the epigastric region, and is often so intense as to cause clammy perspiration, a pale cadaverous countenance; coldness of the extremities; and a feeble thread-like, or scarcely perceptible pulse. « Hysteric affections are more frequent in single than in mar- ried life, and usually occur between the age of puberty and that of thirty-five, and generally about the period of menstruation. The disorder is readily excited in those who are subject to it, by sudden mental emotions. They have been known to arise from sympathy and imitation. Women of delicate habit, and of extreme nervous sensibility, are chiefly prone to be affected with hysteria, and are predis- posed to the attack by an inactive or sedentary life, distress of mind, suppression or obstruction to the periodical illness, exces- sive depletion, or constant use of spare or unwholesome diet. Those of a nervous, sanguine or plethoric temperament are chiefly liable to this disease. The best medicines against hysterical affections are Aurum, Bellad., Calc, Caust., Core, Cor.., Ignat., Lach., Mo.srh., N. mosch., Nux v., Phosph., Plat., Puis., Sepia, Sil., Slram., Sulp., Verat., Valeriana, etc. When the affection arises from Chlorosis or Amenorrhea, see the remedies mentioned under these headings. When from Menorrhagia; see that article. Mcntal Emotions ; see the same. When the attacks are attended with clenching of the jaws, observations on pregnancy. 503 or general spasm, coldness of the extremities, and clammy sweat, particularly on the face and forehead, Veratrum is a valuable remedy. (See also the remedies mentioned under Tetanus, and likewise Lockjaw in Infants.) When violent spasmodic hiccough predominates: Nux v., Bellad., and Stramonium:—Hyoscyamus, Veratrum, Ignatia, Pulsat., Cicuta, Bryonia, and Sulph. will be found the most frequently useful. Dose : see Administr. under Chlorosis. OBSERVATIONS ON PREGNANCY. This period may be looked upon as one of the most inte- resting eras of a woman's life. She is now no longer acting for herself alone, but becomes invested with a new and serious re- sponsibility, and upon some of the most apparently trifling of her actions may depend the future health and happiness of a being bound to her by the fondest ties. From the mass of evidence, collected by careful observers of the operations of nature, we are warranted in drawing the con- clusion, that the actions of the mother exercise a great influence over, not only the constitutional and physical, but also the mental organization of her offspring. Keeping this fact in view, we shall endeavour to point out the course that mothers, who prefer the welfare of their future offspring to their own in- dulgence, should pursue, from which they will derive a double benefit,—an improvement in their own health, with exemption from suffering, and the delight of seeing their children pass safely through the anxious period of infancy; while in after life beholding them flourishing around them, in the full enjoy- ment of health and vigour, they will reap the rich reward of a slight temporary self-denial, in the delightful consciousness of having performed their duty. The leading causes of a weak and sickly offspring are, ill health, or constitutional taint of both or either of the parents; very early or late marriages; great inequality between the 504 OBSERVATIONS ON PKKUNANCY. ages of the parties ; errors in dress, diet, and general habit^ of life; and lastly, powerful mental emotions. The first of these causes, medicine, under the present en- lightened system, possesses powers considerably to obviate, not only by materially modifying or destroying the hereditary taint in the parents, but also by nipping it in the bud when trans- mitted to the infants. While upon this subject, we may remark, that in many families hereditary diseases are fostered and even exacerbated in virulence by intermarriages between their dif- ferent members, sometimes disappearing in one generation, and again declaring themselves in the next; but when the habits or mode of life of communities become more adapted to the natural law, and Homoeopathy, as it must do eventually, completely su- persedes the present erroneous system of medicine, we may safely calculate upon the gradual extinction of all hereditary diseases ; and so far, at least, children shall not have to suffer for the follies and faults of their progenitors. Females should seldom, at least in this country, enter into the marriage bond before their twenty-first or twenty-second year; prior to that period, their organization is scarcely ever fully developed; those who marry at sixteen or eighteen years of age incur the risk of a severe after-suffering themselves, and of giving birth to weak and delicate children. How very often we see the first children of such marriages perish in in- fancy, or, after contending through a childhood of continued delicacy, sink into a premature grave! Women who marry late in life incur considerable personal risk and severe suffer- ing in giving birth to children, and the offspring is seldom healthy. The children of old men, although by a young wife, are very often extremely delicate and susceptible to illness ; they not unfrequently precede their father to the grave, or linger on earth but to drag on a miserable and wearisome existence. In concluding these observations, we may remark, that so far is the period of pregnancy from being destined for one of suf- fering or danger, that nature has taken every precaution for the protection of the female and her future offspring. While pregnancy runs its equable and uniform course, the expectant AIR and exercise. 505 mother enjoys an almost complete exemption from the power of epidemic or infectious diseases, and chronic complaints are fre- quently suspended; in fact, with the exception of some slight morning sickness, and occasional trifling uneasiness, a well-con- stituted organism should enjoy as good health during pregnancy as at any other time; and many pass through this period, and give birth to vigorous children, without even the most trifling inconvenience. Though, as we have said, nature seems, during this period, to adopt every possible precaution for the health and preservation of the parent and her future offspring, yet are her wise arrange- ments, in too many instances, rendered nugatory by a direct contravention of her laws. The expectant mother should there- fore bear in mind, that the incumbency of a regular and sys- tematic course of life, so essential to every individual, devolves upon her with double force, since every neglect or breach of these ordinances of nature upon her part, is frequently visited with fearful energy upon her yet unborn infant. AIR AND EXERCISE. Nothing tends more to the preservation of health than a proper attention to these two important points, and yet, unfor- tunately, there are perhaps few more completely lost sight of. Neither air nor exercise is individually sufficient, and those of the more opulent classes in this country, who merely take the air in their carriages, and shun the slightest physical exertion, from long-continued habits of acquired indolence, and who feel any attempt of the kind at this period attended with increased inconvenience, can scarcely expect to enjoy the benefit that na- ture has annexed to the observance of her laws in a course of pregnancy free from suffering, and the production of a fully- developed and healthy organized offspring. During this epoch, passive or carriage exercise is not suffi- cient ; walking brings not only the physical, but the whole of the organic muscles into play, and communicates the increasing vigour of the mother to her offspring; oh the contrary, continual passive exercise iu a carriage has been found particularly in- i—;™,o rlnrincr .and towards the end of the second period of 506 OnSERV4TION9 ON PREGNANCY. pregnancy; and is frequently the cause of promaturo and$M>- normal births; exercise on horseback, even not taking into consideration the risk of fright or accident to the rider, and the fearful consequences that may thence result, is still more ob- jectionable for many reasons. A second class, that of thrifty housewives, take a great deal of exercise, yet without a corresponding benefit, from their work occupying them wholly in-doors; this is a strong proof of the inutility of exercise of itself, unless combined with pure air. Moreover, these females, from too great activity of temperament, and others, coerced by hard necessity, frequently over-fatigue themselves, go to bed lato, rise early, and sometimes unrefreshed, and thus in a manner deaden the energies of the organic powers, to their own injury, and that of the unborn child. A third class of females injure their health, and frequently induce miscarriage, through their excessive levity and thought- lessness, by unrestrained indulgence in active exercise, riding on horseback, but more particularly dancing. A female ought to recollect that, if through her own folly she has brought on miscarriage, the greatest possible care is necessary to prevent its recurrence; that a second attack increases her liability in future; and that she who has suffered twice or thrice from this misfortune, even when she escapes it, rarely attains her full time. Moreover, continued casualties of this nature not unfrequently terminate in premature death, from that serious and painful disease, uterine cancer. The best exercise, therefore, for a female during this epoch is walking every day (when the weather permits it) in the open air. In order to prove beneficial, and not to interfere with the process of digestion, exercise ought to be taken two or three hours after a moderate meal, about mid-day, or in the after- noon, except during hot weather, when the evening may be preferred, care being taken to avoid the night damps, by not remaining out too late. CLOTHING The dress of the female should of course be suited to the season, and if she pass from a warm into a eold atmosphere, CLOTHING. 507 she'ought to have her neck and throat well protected, so as to avoid any risk of taking cold ; but a point of far greater im- portance is the adaptation of her clothing to the form, so as, as much as possible, to preclude any pressure upon any part of the frame calculated to interfere with the functions of those important organs destined for the birth and nourishment of the infant; therefore lacing, at all times most objectionable, is par- ticularly so during this period, inasmuch as it cramps the na- tural action of the body, and acting directly upon the abdo- minal muscles, the blood-vessels, lymphatics and the whole intestinal economy, produces narrowness of the chest, disturbed circulation, and induration or other derangements of the liver, and exercises a most baneful effect upon the breasts and ute- rus. We should bear in mind that a pressure upon these or- gans during development, is acting in direct contravention of the operations of nature. Females, in their efforts to preserve the elegance of their shape during pregnancy, are little aware that the constringing force exercised upon the abdominal mus- cles, destroys their elasticity, prevents a proper retraction after parturition, and thus proves one of the most common causes of permanent abdominal deformity; moreover, to the culpable vanity of their mothers, many, it is probable, owe their club- feet and other malformations; in addition to these evils, this practice not unfrequently deranges the position of the foetus, which displacement, with the consequent want of energy in the muscles, and the parts concerned, generally brings on pro- tracted and dangerous labours. Besides this, continual pres- sure on the uterus is liable to produce premature labours. To tight-lacing also may be attributed the difficulty many women of the present day experience in suckling their offspring, from the incipient process for the subsequent secretion of milk being deranged from the unnatural pressure on the beautifully con- structed mechanism of the mamrase ; from this also sometimes result those dangerous indurations, cancers, and other affec- tions of the breast, and retraction and diminution of the nipple, from which the act of suckling is rendered difficult, and in some cases impracticable. Young girls of seventeen or eighteen are frequently found f)0^ OBSERVATIONS ON PREONANCV. with pendulous breasts, from the artificial support having taken the office of the muscl.-s. intended by nature for that purpose, and throwing them out of employment. Carters too tightly bound are generally injurious, more particularly to pregnant females, for the pressure thereby ex- ercised upon the blood-vessels encourages the development of varicose vessels in the inferior extremities (to which affection the system is already sufficiently predisposed), which in many instances become exceedingly painful and troublesome. DIET. The greatest simplicity should regulate the diet of the preg- nant female; she should avoid taking too great a quantity of nourishment, because any excess in this respect, besides caus- ing dyspepsia and general uneasiness, has a bad mechanical effect upon the future offspring; and, moreover, the foetus shares in the derangements of the mother. Much depends upon the tpiuliiy of her food ; nothing should be taken that is not of a simply nutritive nature, and every thing possessing a medicinal property avoided. Coffee and strong tea should be laid aside. Wine, liqueurs, malt, and other stimulating beverages, are also injurious. If the female has been long habituated to wine, it may be taken, if of good quality, in extreme moderation and diluted with water; but better far if stimulants of erery kind are altoge'her avoided; indeed, the usual homoeopathic diet (for which see tbe article Regimen, in Introduction) should be adopted as closely as possible during pregnancy. EMPLOYMENT OF THE MIND AND HABITS DURING PREGNANCY. It is not sufficient that the body may be in perfect health ; the mind must also be kept in a state of serenity. An easy cheerfulness of temper is essentially useful in promoting the well- being of the unborn infant. Experience has presented us with many instances, in which the predominant tec ling on the mind of the mother during pregnancy has influence on the future mental organization of the child. This shows how essential it MENTAL EMOTIONS. 509 is for females to keep their minds well employed during this period, to avoid both improper meditation, dissipation, and reading works not calculated to improve their understanding. Nothing can act more effectually against the future mental and corporeal health of the unborn infant than an oscillatory state of intellect, in combination with physical indolence; the late hours, turning day into night, and other practices of fashionable life, injurious as they are to the most robust constitutions, are doubly reprehensible on the part of the expectant mother. INFLUENCE OF EXTERNAL OBJECTS UPON THE UNBORN INFANT. The effect of any unpleasant or unsightly object upon the imagination of the mother, and its transmission of that effect to the offspring, evidenced in various mental or physical peculiari- ties after birth, is a theory as old as tradition; without entering upon the various arguments brought forward both for and against it, we would simply advise females to keep as much as possible out of the way of such objects, to preserve both body and mind in a state of health, which will lessen every fear of being affected by such occurrences; and endeavour, as constantly as possible, to direct their attention to pleas- ing subjects; as it must be perfectly evident that brooding over such unpleasant impressions can scarcely fail of being both physically and mentally injurious. MENTAL EMOTIONS. This subject has already been treated of in Part II., to which the reader is referred, as the remedies there mentioned are equally applicable to affections arising from these sources in either sex. A not unfrequent symptom during pregnancy, is great despondency of mind, and uneasiness about the future; some females, whose spirits are generally good at other times, suffer much from this affection during this period; and with others, we find the same feeling and excessive low spirits dur- ino- the time of nursing; although not permanent, and when 510 observations on PREGNANOY. commencing early in gestation, usually disappearing before de- livery, without material injury to the general health. Therapeutics. As this affection is apt to create some un- easiness, both X the sufferer herself and her friends, we have thought it advisable to mention it, and point out remedies which will frequently be found efficacious. Such are Aconitum, Bryonia alba, Nux vomica, ?>ulrum muriiticum, Phosphorus, Calcarea carbonica, and Cinchona. Administration. Four globules of the potency mentioned after each medicine in four dessert-spoonfuls of water, one daily, after which the medicine may be allowed to exhaust its action ; in the case of those who are known or found to bo extremely susceptible to the impressions of the medicines, one or two glo- bules may be given, and only repeated after an interval of from four to eight days or so, according to the effects produced.* Aconitum 6. If the state of despondency is preceded by one of excitement, marked by heat of skin, and frequency of pulse, attended with apprehension and presentiment of ap- proaching death. Bkyonia 30. Great inquie'ude and fear of the future, at- tended with irascibility and derangement of the digestive functions. Nux vomica 30. Morning sickness and melancholy, with great uneasiness, impaired appetite, constipation, fretfulness. Natrum muriaticum 30. Melancholy, with weeping, un- easiness about the future, also obstinate cases of morning sick- ness, not yielding to Nux vomica. & When this affection comes on during lacfation, arising from an over-secretion of milk, so that this fluid escapes involunta- rily, and it is attended with great emaciation, melancholy, and apprehension of the future, we may give Phosphorus 30. Calcarea 18, is also efficacious when the above symptoms present themselves, and .more particularly so, when there is ex- cessive dejection with great lassitude. * In the treatment of pregnant women of exalted nervous sensibility, considerable caution is frequently requisite in the repetition of the doses. See also the rules laid down for the repetition of the dose in ordinary cases, in the Introduction, Part I.) MENSTRUATION. 511 This remedy is further very serviceable when there is sup- pression of the secretion, and also excessive obesity, or the in- dividual is of plethoric habit. Both these remedies are also valuable when there is a disposition to consumption. When there is lowness of spirits, attended with dyspepsia, which may arise from the energies of the mother being too severely tasked in the nourishment of her offspring, either from keeping the child too long unweaned, or from rearing twins, we may administer Cinchona 6. The practitioner will further find occasion to select the following remedies in particular cases: Belladonna, Pulsatilla, Veratrum, Stramonium, Platina, Au- rum, Cuprum, Lachesis, and Sulphur. DERANGEMENTS DURING PREGNANCY. MENSTRUATION. Virtual diseases during gestation are of rare occurrence, but when they do happen, they ought to be treated accordingly. A continuance of menstruation is not an actual disease, but rather an exception to the general course of nature; nor must we here mistake their operation for an indication of the utility of the lancet, for neither in this nor in any other case, can the artificial supply the place of natural bleeding; however, when the female appears to suffer from the continuance of the men- strual flux, we must call in the assistance of medicaments, among which the principal are: Cocculus, Phosphorus, and Platina. Administration. -3-0-, repeated every twenty-four hours until improvement takes place, or another remedy appears called for. (Vide note, p. 21.) Cocculus. A sanguineous mucous discharge, and very se- vere spasmodic pains in the lower part of the abdomen. Phosphorus. Discharge of blood, with incisive pains in the back, and occasionally vomiting. Platina. Discharge very profuse, attended with a severe pain and bearing-down. (See also the remedies given under Painful and difficult menstruation. Excessive menstruation.) 512 DERANGEMENT DURING PREGNANC . MORNING SICKNESS. Morning sickness, nausea, vomiting, and heartburn, are the most distressing symptoms attendant on the course of pregnan- cy; these troublesome complaints harass women most upon their first rising from a horizontal position in bed. They generally disappear soon after quickening, but sometimes continue during the whole period. The numerous palliative remedies recom- mended by AUopathists—leeches, cupping-glasses, blisters, aperients, sedatives, etc. etc., unfortunately too often fail in effecting their object; and in severe cases, when the stomach brcomes enfeebled, the hazardous resource of artificially pro- duced premature labour is resorted to. Tucrapki tics. The homoeopathic treatment of this de- rangement, at once simple, prompt, and efficacious, has in almost all cases been stamped by the signet of success. In in- stances free from complication, with a tendency to relaxation of the bowels, Ipecacuanh \ is generally sufficient. Administration. °§°, in four tea-spoonfuls of water, one morning and evening. (Vide note, p. 21.) Nux vomica. When there is nausea or vomiting every morn- ing on rising; heartburn, depraved appetite, or craving for chalk, earth, beer, etc., constipation, and irritability of temper. Administration. °^%°> repeated every fourth day, but if no improvement results after the second or third dose, another remedy must be substituted, such as Pulsatilla, or Natrum m., etc., and then again Nux v , if required. Arsenicum. Excessire vomiting after eating or drinking, with attacks of fainting; great weakness and emaciation. Administration. Same as Ipecacuanha, but at the twelfth or thirtieth potency. Pulsatilla. Nausea after every meal; vomiting of ingesta, heartburn, depraved appetite, or longing for partiiular articles, such as acids, beer, wine, etc. Disposition peevish and sensi- tive, though naturally mild. Conium, Acidum nitricum, Magnesia, Phosphorus, Bryonia, and Lycopodium, etc., will also be found useful in particular cases. When this affection shows itself in a mild form, it may be constipation, diarrhcea. fainting. 513 left to nature, adopting at the same time the homoeopathic rules for regimen, and be careful not to overload the stomach. 1 1 severe cases depending upon plethoric tendency, Aconitum is an excellent substitute for the venesection recommended by the old school. CONSTIPATION Is a very common attendant upon pregnancy, and those usually suffer most who are naturally of a costive habit; when it does not arise from a mechanical cause, active exercise in the open air, and partaking frequently of cooked, or fully ripe sub- acid fruits, (at the same time avoiding coffee and other stimu- lating liquids,) are generally sufficient. When nature requires further auxiliary :— Nux vomica bbs.^ taken at bed-time, will often answer; if after the completion of its action, there still remains some inconvenience, Ignatia, —-, should be given as an interme- diate, followed by a lower potency of Nux vomica (a£a); iu other cases, when Nux vomica does not show a marked im- provement, and the temper is extremely irritable, Bryonia -§- will sometimes cure, or Opium -%-, which is especially indi- cated to follow Nux romica when there appears to be a weight in the stomach, dryness of the mouth, and deep flushing of the face. In other cases, Sepia, Lycopodium, Alumina, etc., will be found useful. (See Constipation, Part IL, p. 123.) Dysuria. Pulsa'illa, Coccuhis, Nux v., and Acid, phos- phoricum, as also Sulphur and Conium, have chiefly been recommended. DIARRHCEA DURING PREGNANCY. See Diarrhcea, Part II., p. 137, and Diarrhcea in Lying-in Women, in this division of the work. FAINTING AND HYSTERIC FITS. Many delicate and nervous females are frequently attacked with fainting fits during pregnancy. The attack generally passes over easily and without deleterious consequences; ex- ercise in the open air, and attention to the rules of regimen, 514 DERANGEMENTS DURING PUEonancy. are the best safeguards ; but in cases wh< re these are insuffi- cient, and the attacks prove distressing, we must endeavour to ascertain their origin. If from tight-lacing, warm moms, or any other obvious excitant, its simple removal is sufficient; should the sufferer remain long in>ensililc, the speediest means of revival is sprinkling the face with cold water. When arising from plethoric habit."returns of the at tuck may be prevented by Aconite, of which we have had occasion to speak several times, as a general regulator of the circulation. Chamomilla «*, when the fainting is excited by sudden fits of anger. Nux vomica 1M when from general irritability of system, and consequent gastric derangement. Belladonna wjt when there is determination of blood to the head, with simultaneous flushing of face and perceptibly increased action of the arterial system. (Alternately with Aconite when required.) Cinchona }%, when arising from general weakness, and especially from loss of blood. Pulsatilla t§. General excitability and disposition to hysteria, with hypochondriasis and great general susceptibility. Coikka. Abdominal spasms, with oppressed respiration, subsultus tendinum, cold perspiration, and uncontrollable agi- tation and jactitation. When the symptoms are generally pre- ceded by a pain which proceeds upwards from the lower part of the bowels, left side, into the stomach, and from thence into the throat, where it creates a disagreeable and suffocative sen- sation, as if a ball were lodged there, Lachesis, Belladonna, Sepia and Plumbum, or Ignatia, Sulphur, Nux v., Conium, etc., will prove useful, a preference being given to that remedy which corresponds the most closely to the whole features of the case. Ignatia t£, when the patient suffers from severe headache, as if a nail were driven into the head; sadness ; concealed sor- row, and sighing. (See Swooning.) Administration of the above remedies. The dose is given, repeated, if necessary, every two to four days, according to the urgency of the symptoms, until relief is obtained, or another remedy required. (Vide note, p. 21.) TOOTHACHE. 515 TOOTHACHE Is a frequent affection with pregnant women, aud is some- times too valuable an indication of some taint lurking in the constitution to be neglected; the female should, as soon as she is in a proper state, put herself under a course of treatment, as until this tendency is eradicated, no remedies can prove otherwise than palliative. We must particularly caution females in this situation against having teeth extracted, as the affection frequently occurs in sound ones. Therapeutics. To relieve the sufferings, the following medicines may often be given with advantage: Sepia, Calca- rea, Alumina, and Magnesia carbonica. For the Administration of the remedies, see Toothache, Part II., where, moreover, other useful remedies will be found. Sepia e3a0a, is particularly indicated when there is pulsative shooting, drawing toothache, with pain, extending to the ears, or to the arms and fingers, excited by compressing the teeth, or by cold air, and attended by impeded respiration, swelling of the cheek and enlargement of the submaxillary glands. Calcarea °-^-, when it is excited or aggravated by cold air, or anything hot or cold, and attended with painful sensation of the gums, and pulsative gnawing or shooting pains, which are aggravated by noise. Alumina -~, when the pains are excited by mastication, or in the evening in bed, and when of a tearing nature, extending to the cheek-bone, temple, and forehead Magnesia carbonica °ff. Nocturnal pains in the teeth, insupportable when lying down, and compelling the patient to get up and walk ; pains generally boring, burning, drawing, tearing, and resembling those of ulceration, attended with swel- ling of the cheek of the side affected ; throbbing and shooting in the teeth after a meal; pain aggravated by a cold. The above are the four leading medicines, though there are others which are demonstrable by peculiar symptoms. (See Tooth- ache, Part IL, p. 77.) r>16 derangements during pregnancy. SWELLED FACE. Tumefaction of the cheek arises from different causes; fre- quently it is the consequence of toothache, and will then be cured, or at all events much diminished, by the remedy given for the removal of that affection. Sometimes it happens, nevertheless, that from the employment of the proper remedy the toothache diminishes, but the swelling of the cheek remains unaltered. In this case Arnica is generally of great service, especially when the swelling is hard and stiff. If this treat- ment is of no avail, we may have recourse to Pulsatilla °§°, or to Mercurius vivus <^0-, which is of especial service if the swelling of the check is accompanied by a drawing, tearing pain, and increased flow of saliva, and considerable erysipelatous redness; followed by Belladonna and Hepar s. */, if the inflammation threatens to extend. (Sec Erysipelas.) Cham., Bryonia, bb, etc., are also occasionally of service. Should we have neglected to employ the appropriate remedy at the proper time, or should the swelling have been mal- treated by some external application, the swelling is frequently rendered of an obstinate character. In most cases, however, the dispersion of the tumour, or, when matter is forming, the speedy completion of the suppura- tive process and consecutive bursting of the abscess, will be readily enough effected by means of Hepar sulphuris, one grain of the third trituration, repeated if necessary in from six to twelve hours. In obstinate cases, Lachesis and Hepar, or Mercurius and Hepar, in alternation, are sometimes required; and occasionally Silicea, particularly in strumous habits. The application of a poultice to the cheek, or a fig boiled in milk and placed in the mouth between the affected cheek and gums, is sometimes useful. If the tumour has^urst, and the opening is internal, no especial care need be taken of it; but if it has burst exter- nally, a simple bandage, smeared with melted suet or fresh butter, must be applied. Dese *£*, twice a day. VARICES. 517 VARICES, or SWELLED VEINS. Many females suffer much during pregnancy from distention °f veins in the thigh and other parts, which becoming more exacerbated, eventually cause great pain and inconvenience. These varicose veins generally arise from obstructed circulation caused by the pressure of the gravid uterus upon the blood- vessels, but are also frequently a sure indication of the existence ot constitutional debility, particularly when they occur in an aggravated form. They are much increased by partaking of stimulating liquids, which should consequently be avoided. Considerable alleviation is experienced by constant bathing with water, or with diluted alcohol; also by bandaging from the foot upwards with a gentle and equable pressure, and by preserving a recumbent posture, which is requisite in severe forms of the complaint accompanied with considerable swelling of the feet, ankles, &c. In order to afford a considerable relief, we may have recourse to the following remedies :— Pulsatilla -f^- is one of the most useful medicines, par- ticularly when there is excessive pain and swelling, with a good deal of inflammation, or when the veins are of a livid colour, which is imparted to the whole limb. Should Pulsatilla give some relief, but the swelling and livid discolouration continue in much the same state, Lachesis may be substituted. Arnica is of material service when the occupations of the patient render it impossible for her to lay up, or avoid much standing and moving about in discharge of her domestic duties. Arnica and Pulsatilla in alternation, every six or eight days, have been found of great efficacy in such cases. Nux vom. b±j> « when attended with constipation, hemor- rhoids, and irritability of temper. Sulphur is sometimes very beneficial after Nux v. Arsenicum -°%-, when the veins are of a livid colour, and are attended with severe burning pain. Carbo veget. -—-, where the former is not sufficient to subdue the constant scalding or burning. Belladonna -§5-. Varices, with considerable erysipela- tous inflammation. Lycopodium °f§°, has been employed with success in some 518 DKRANCEMINTS DURING PREGNANCY. Administration. Four globules of the potency named after each medicine in as many teaspoonfuls of water, one to be taken night and morning. (Vide note, p. 21.) The simultaneous application of the remedy employed, is oc- casionally attended with benefit. For a permanent eradication, a course of treatment is requi- site, in which—Sulphur, (Graphics, Carbo veget., Sepia, &c, are useful (Sec Ulcers, Part II.) PAINS IN THE BACK DURING PREGNANCY. Lumbo-sacral pains. Some females suffer much from pains in the lower part of the back during pregnancy, which occasionally prove extremely dis- tressing, particularly when they occur during the night, and tend to disturb sleep. They generally consist of an almost in- describable aching, or of an obtuse, heavy pressure, as if caused by a dead weight resting on the affected part. Kali carb. has repeatedly been employed against them with the most satisfac- tory results, especially when they partake of the character de- scribed. In other cases, Bryonia, Rhus, Sulph., Lycopodium, Pulsa'ida, Nux v., Sepia, or Causticum, Sec, may be given with advantage. If hemorrhoidal sufferings become adlcd to these troublesome pains, and Kali c prove insufficient to relieve the complaint in this complicated form, Nux v., Sulphur, or Sepia, may be prescribed with advantage. (See Hemorrhoids; as also the indications given for the remedies under the heading of False Pains.) Dose : «f • or Sg&. MISCARRIAGE. Abortus. From the increasing number of homoeopathic practitioners in this country, a point already alluded to in the Preface, we are justified in looking forward to a period, not far distant, when there will be no difficulty in obtaining professional assist- ance in misfortunes of this nature. I shall here endeavour as briefly, but at the same time as clearly, as possible, to point out the treatment best to be pursued both in preventing its occur- rence, and in obviating the consequences it entails when medi- cal aid has been called in too late, or when it has been found impracticable to avert the evil. miscarriage. 519 Women who have once suffered from this affection are ex- ceedingly obnoxious to its recurrence, aud this liability is still further increased if the event have taken place a second or third time. It may occur at any period between the first and seventh month, but in the majority of cases takes place about the third, or the beginning of the fourth. When before or about this period it is frequently attended with but little pain or danger, although repeated miscarriages, from the great dis- charge that is generally present, break down the constitution, and frequently develop severe chronic diseases. When miscar- riage takes place at a more advanced period, it assumes a very serious complexion, and is often accompanied with a consider- able degree of peril to the sufferer. The premonitory and accompanying symptoms of miscarriage vary much in their nature; sometimes the discharge is exceed- ingly profuse, at others moderate or inconsiderable'; the pains, in many instances, extremely severe and protracted, are in others very slight and of short continuance. Sudden mental emotions, or great physical exertion, mechani- cal injuries, a luxurious mode of life, fashionable habits, power- ful aperients, neglecting to take air antl exercise, are a few of the exciting causes of this affection, which is particularly apt to occur in both highly plethoric or delicate and nervous habits. An abnormal condition of the constitution is undoubtedly the predisposing cause. Miscarriage is, in most cases, preceded and attended by the majority of the following symptoms:—A sensation of chill, fol- lowed ny fever, with more or less bearing-down, particularly when occurring late in pregnancy ; also, severe pains in the ab- domen, drawing and culling pains in tlie loins, or pains fre- quently bearing a close resemblance to those of labour; dis- charge of viscid mucus, and blood, sometimes of a bright red, not unfrequently mixed with coagula, at others dark and clot- ted followed by the emission of a serous fluid. The miscar- riage generally takes place during this discharge, which occa- sionally continues, if not properly checked, to flow for hours after, placing the sufferer in considerable jeopardy. When the pains increase in intensity, and the muscular contractions become 520 DERANGEMF.NTS DURING PREGNANCY. generally established, with their characteristic regular throes, and efforts to dilate the mouth of the womb, miscarriage is al- most inevitable. Therapeutics. As preventives of this affection, the princi- pal remedies are: Sabina, Secale cornuium, Kali c, Lye, -*>'/'•> and Calc When the premonitory symptoms declare themselves, ( ha- momilla, Nux vomica, Ferrum metallicum, Ipecacuanha, Sa- bina, and Calcarea. The same with tho additions of Hyoscya- mus, Crocus, and Secale cornuium, after the misfortune has taken place. Cinchona is also valuable when the indications which we shall give for that medicine arc present. In cases where there is an evident disposition to miscarriage, or where, from a variety of reasons, it is apprehended, the ad- ministration of Sabina, b&s.^ Jn the early stage of pregnancy, will frequently prevent its occurrence. Administkation. We may allow four or five days to elapse between the first and second dose, and gradually lengthen the interval for each successive administration, until the period of danger be past, being careful, however, on watching the effect of each dose, discontinuing the medicine whenever any indi- cations of its action on the system become apparent, and not repeating until the symptoms attributable to the medicine have passed away, and then only with increased caution, and at long- er intervals. Hartmann* strongly recommends Secale cornutum bb as useful in similar cases, but particularly when this misfortune has already occurred more than once; it should be administered every fourteen days, commencing immediately after the cessa- tion of the monthly period, and continuing until the period at which miscarriage usually occurs is past; one dose more, at the utmost, being allowed after this period. Both these remedies are also extremely valuable after mis- carriage has taken place, the latter particularly in weak or ex- hausted persons, or in those cases of hemorrhage in which the discharge consists of dark liquid blood, and is followed by con- * Hartuiaua's Acute Diseases, by Chs. Hempel, M.D., vol. iii., p. 164. MISCARRIAGE. 521 siderable debility; this remedy is also efficacious in cases of inevitable miscarriage, attended with feeble expidsive efforts; the former (Sabina) when there are dragging and forcing pains, extending down the back and loins ; profuse, bright-coloured hemorrhage ; sensation of sinking or faintness in the abdomen; frequent desire to relieve the bowels; diarrhoea-; nausea or vomiting ; chilliness and heat, with fever. Lycopodium and Kali carbonicum -%- have also been recom- mended as useful preventive remedies against habitual tendency to abortion, the latter especially when the symptoms are always preceded or attended by severe pain in the loins. We shall now treat of miscarriage when the premonitory symptoms have set in, giving under the same head the indica- tions for the use of the medicaments, where the result is una- voidable or has already taken place, as even in these cases their administration is decidedly beneficial in obviating further inju- rious consequences, and in alleviating the sufferings of the patient. The remedies in these cases are, in addition to the two above mentioned, Arnica, Chamomilla, Nux vomica, Ipe- cacuanha, Hyoscyamus, Belladonna, Crocus, Ferrum metalli- cum, and Calcarea. Arnica flja. When the symptoms have been excited by an accident, such as a fall, blow, or concussion, etc., this remedy should be immediately administered. Chamomilla °£°, when there are present: excessive rest- lessness, convulsions, twitching in the back and limbs; severe pains in the loins and back, worse at night, generally of a sharp cutting description, extending downwards, strongly resembling those of labour; sometimes also abdominal spasms, with a species of sanguineous discharge; or discharge of deep red or dark coagulated blood; frequent yawning; coldness and shivering. Nux vomica -§-. Obstinate constipation, with a varicose condition of the internal organs of generation; also when the patient has been accustomed to a stimulating diet, and the use of coffee; severe burning, or wrenching pains in the loins; painful pressure downwards and mucous discharge. (Bryonia is sometimes of benefit, when Nux v. fails to do much good.) 522 DERANGEMENTS DURING PREGNANCY. Ipecacuanha •$•. Chill with heat; violent pressure down- wards; flooding; cramp and rigidity of the frame; sometimes convulsions; vomiting, or desire to vomit; disposition to faint whenever the head is raised; cutting pains in the umbilical region. (Platina or Cina have been recommended when Ipe- cac fails.) Hyoscyamus °3°6°, when the convulsions are very severe, with erics, great anguish, oppression of the chest, and loss of consciousness. Belladonna °|°, is perhaps more frequently required either at the commencement, or subsequently, than any other remedy. The following are its leading indications : great pains in the loins and entire abdomen ; severe bearing down, as if the whole of the intestines would be pressed out; pain in the back, as if it were dislocated or broken ; bruised pain in the sacral region; sensation either of spasmodic constriction, or of expansion in the abdomen. It is also particularly valuable in cases of pro- fuse hemorrhage, the discharge of blood being neither very bright nor dark-coloured after miscarriage. Platina is some- times to be preferred to Belladonna, when, along with bearing. down pains, there is a thick and dark-coloured discharge, attended with venereal orgasm. I'erkum mktallicum °g°, is a useful medicine in cases of miscarriage attended with fever, labour-like pains, and conside- rable sanguineous discharge. Crocus °|°, is especially indicated in cases which are at- tended or followed by discbarge of dark, coagulated or viscid blood, with a sensation as of something moving or fluttering about in the umbilical region, and increased sanguineous dis- charge on the slightest movement. This remedy is frequently useful in obstinate cases, after the employment of one or more of the above-mentioned remedies. Cinchona boo^ -1S valuable in tbe restoring the exhausted energies, after the hemorrhage, or materially assists in checking the discharge should there be spasmodic pain in the womb, or bearing-down sensation, with considerable discharge of blood at intervals. Calcarea -£-, is a remedy of considerable importance in the miscarriage. 523 treatment of cases where the affection has apparently been in- duced by a varicose state of the veins of the parts. It is also of value as a preventive, and especially where the patient is of a plethoric habit, with a tender or irritable skin, and other stru- mous appearances. Sepia, ^§. In threatening attacks of abortus from general plethora, or from local congestions and obstructed circulation, with sensa'ion of weight in the abdomen, determination to the head and chest, and excessive nervous excitability, this remedy has been employed with success. When Mental Emotion has given rise to the symptoms of miscarriage, see the remedies given under that heading, Part II. Administration. A few globules, or where necessary, one minim in an ounce of water, a teaspoonful every few minutes to half hour, hour, or only every three or four hours, according to the nature of the case, lengthening the intervals or discon- tinuing the medicine when decided benefit, or a stoppage of the hemorrhage is effected. When a favourable effect does not follow after the second or third dose in serious cases, another remedy must be had recourse to. Vide note, p. 21. When violent hemorrhage is present, and does not cease under the em- ployment of any of the before-mentioned medicines, Acidum nitricum may be administered. Cold water is also useful. I have thus enumerated some of the principal homoeopathic remedies which are employed in the different stages of this mis- fortune, and have endeavoured to point out the peculiar indi- cations for the selection of the proper medicament as succinctly, and at the same time as fully, as it is possible to do in a work like the present. In concluding the subject, I shall briefly notify a few precautionary measures that the patient ought to observe while threatened with, or after having suffered from the affliction. When miscarriage is threatened, the individual must assume the recumbent posture, and in some cases, indeed, should be strictly confined to bed, sleeping with few bedclothes; the apartment should be kept cool, and every means must be em- «lovfid to ensure perfect tranquillity of mind. The diet pre- 524 teatment before parturition. scribed in cases under homoeopathic treatment should be closely followed, and warm fluids generally avoided. \\ hen the mis- fortune has proved unavoidable, or has a-tually taken place, before assistance has been sought, the patient ought still to be confined to bed for a few days, lest a fresh discharge should be brought about by too early a change from a horizontal to an upright posture ; and on future occasions, when a similar period comes round, great care should be taken that the mishap may not again occur; in the attainment of this desirable object, we feel confident that nothing will tend so fully to ensure success, as a timely exhibition of one or other of the preventive remedies already commented on. TREATMENT BEFORE PARTURITION. PREPARATION OF THE BREASTS. Young mothers frequently find great difficulty in suckling their children, in consequence of organic defect or incapacity of the nipple. In every case, a preparation of the breasts is ne- cessary some weeks before delivery, in order to prepare them for their future offices. In many instances the structure of the breasts is disorganized from an ignorant nurse having com- pressed them in childhood, from the idea that such a process was needful for the expulsion of some matter in the breasts of the child—a vulgar error—a practice against which mothers ought to be particularly watchful. Inability of function is also likely to occur from the pressure of stays in after life, by which the cuticle is rendered so tender, as to preclude suckling. The first two cases are beyond the power of art. If suck- ling be attempted, induration of the nipple and mamma ensue, attended with severe suffering ; when, however, a simple ten- demos of tbe epidermis exists, this evil is much alloviated when the nipples are bathed with brandy twice a day, for several weeks anterior to delivery. Another difficulty, fre- REMEDIES BEFOfoE LABOUR. 525 quently accompanying this state, is a shortness or retraction °f the nipple, so that the infant cannot take hold of it; this defect is frequently the cause of the first, from the ineffectual efforts of the child to suck injuring the part; in this case ap- propriate shields of soft wood may be applied to accustom the mpple to elongate and protrude, so as to present sufficient hold tor the infant, when the period for suckling arrives, when the efforts of the child will still further contribute towards the effecting of this object. In this case also, bathing with brandy Will naturally tend to correct any tenderness of the skin, and prevent subsequent excoriation. It may also be here remark- ed, that when any tenderness exists during the period of lacta- tion, between the intervals of the infant being applied to the breast, the shield should be resumed, and the bathing continu- ed, due care being always taken to lave the nipple carefully with tepid water, before it is again offered to the child.* REMEDIES BEFORE LABOUR. Many things are recommended by the old school previous to labour, such as frequent bloodlettings and aperients ; but these, instead of promoting the object desired, have a contrary effect, by lowering the energies requisite at such an eventful period, and by placing the nervous system in an abnormal state of irritation and excitement; when this loss of humour is brought about in the first period of pregnancy, it defeats its own object, by what are commonly called ple-'horic symptoms, induced by the reaction in the organism, to supply this uncalled-for waste, and this always taking place with a correspondent expenditure of vital power. It is a species of infatuation to disturb the regular course of nature, by the ill-directed efforts of art, where an evident plethoric state exists ; this object is much more safe- ly and effectually attained, by the internal administration of a specific remedy, such as a dose or two of Aconite ^§2, which may be followed by Belladonna, should there be symptoms of * When severe pains are experienced in the breast after each applica- tion of the infant, the employment of Phellandrium aquaiicum has been 526 TREATMENT BEFORE PARTURITION. active congestion with fiery redness of the face, accelerated action of the carotids, etc. An artificial evacuation, previous to delivery, may be obtained by a lavement of lukewarm water, repeated, with a small quanti- ty of linseed oil, when necessary, from a failure in the first at- tempt to obtain the desired effect. FALSE PAINS. Before proceeding to notice parturition, a few words may be said upon the so-called false, spurious, or intestinal pains brought about by congestion of blood to the uterus, errors in regimen, emotions of the mind, effects of chill in the abdomen, and a variety of other causes :—they sometimes precede labour but a few hours, but in many cases come on some days, and even weeks, before delivery ; they chiefly differ from labour- pains in the irregularity of their recurrence, in being uncon- nected with uterine contraction, and chiefly confined to the ab- domen, with sensibility to touch and movement, and in not in- creasing in intensity as they return ; sometimes, from their close resemblance, it is extremely difficult to discriminate between them and the real labour-pains, but in such cases we must be chiefly guided by the period of gestation ;* and our safest mode of procedure is, to endeavour to mitigate the patient's sufferings, if they be considerable, or come on a week or two before labour is expected, by the administration of a proper remedy, as, if we allow them to proceed unchecked, they not unfrequently con- tinue till the moment of delivery, rendering the labour much more painful, exhausting, and difficult. Therapeutics. The following medicaments may be had recourse to with effect: Bryonia, Nux vomica, Pulsatilla, Dulcamara, and Aconitum,—selecting the one most suitable for the affection, according to the causes and symptoms. Bkyonia, when there are pains in the loins resembling a dragging weight, attended with constipation and irritability, much increased by motion, with abdominal pains preceding * If the os uteri be found unaltered, and consequently not enlarged or elongated, it may with certainty be concluded that the puins are spurious. FALSE PAINS. 527 those in the back. (This remedy is more particularly indicated when the above symptoms have been excited by a fit of passion. ) Administration. i£Y12i m f°ur teaspoonfuls of water, one morning and evening, or oftener if necessary, until relief is obtained. (Vide note, p. 21.) Nux vomica. Similar pains in the abdomen, and back; also when there is pain in the region of the pubis, as if from the effects of a bruise; the symptoms arise chiefly at night. When the exciting cause appears to be constipation, or mental irritation, or when a too luxurious mode of living, stimulants, coffee or spirituous liquors, there is additional reason for select- ing Nux v. Administration. ^-°, taken in a little water at bedtime, repeating it in six, twelve, or forty-eight hours, according to ne- cessity, if required. Pulsatilla £§-. -Similar abdominal pains; pains in the loins resembling those from continued stooping, or the pressure of a tight bandage, attended with a sensation of rigidity, and painful dragging and aching in the thighs; constipation or relaxation; mildness of temper or great sensibility. This remedy is parti- cularly valuable when these pains appear to have arisen from indigestion brought on by rich, indigestible food. Administration. Same as Nux v. Dulcamara r|, is chiefly useful when the origin maybe traced to cold, and the pains are of a violent shooting and drawing nature, situated in the small of the back, generally coming on at night. When spurious pains arise from emotions of the mind, we may consult Mental Emotions. Aconitum. When these pains occur in young plethoric subjects, attended with accelerated and strong pulse, flushing of the face, and increased temperature of the skin. Administration. 00\0,*,m four dessert-spoonfuls of wa- ter one every six, twelve, or twenty-four hours, according to the relief obtained or the violence of the symptoms. The employment of this remedy completely obviates vene- Bontion. 528 TREATMENT BAFORE PARTURITION. PARTURITION. Natural labour takes place at tho end of the ninth month of pregnancy; the uterine contractions are regular and effective, and the whole process does not continue beyond twenty-four hours, rarely above twelve, and very frequently not longer than six. Were it not for the acquired habits of civilized life— improper diet—the proportions of the female frame being dis- torted by tight lacing, Ac.,* and their regular functions there- by disturbed—diseases generated by the want of proper air or exercise, or both—hereditary maladies, Ac., parturition would be comparatively free from pain and remote from danger, as in fact it is, even at the present day, generally found amongst savages. TEDIOUS OR COMPLICATED LABOURS. When labour is protracted beyond the normal period stated, or is attended with an excessive degree of suffering, as is more prone to happen when the female is of a slender form and of a highly nervous and sensitive habit, it becomes incumbent on us to avail ourselves of all the means which art affords, in order to endeavour to alleviate those sufferings as much as possible. Amongst the medicines best suited to attain this desirable result, we shall frequently find Coffea cruda of considerable service in mitigating the pains when they are extremely vio- lent and occur in rapid succession, scarcely allowing the fe- male an interval of ease, and are attended with excessive agi- tation, bordering on despair. When Coffea ° -°- ° affords but little relief, which is generally the case when the patient has con- stantly or frequently been in the habit of using coffee as a bev- erage, Aconitum should be resorted to, followed by Chamom. 4§*, if required. Administration. Four or five globules of the remedy se- * It is to be regretted that the attention of mothers ia not more particu- larly directed to the development of the female frame by means of calia- thenic exercises, instead of distorting its symmetry by means of stays and tight-lacing; health being destroyed for the Hake of that fashionable and unnatural absurdity—a thin waist! tedious labours. 529 lected, in two tablespoonfuls of water, of which a teaspoonful may be administered every five or ten minutes, until some relief is experienced. If little or no benefit ensue after several doses, another medicine may be prescribed. When we find that the throes are insufficient to accomplish their object, and the female becomes exhausted by the protracted nature of the labour,— Bklladonna, -~, has been found of the greatest value, and will generally prove serviceable in almost every case of tedious labour which arises from the rigidity and unyielding state of the parts, (as is so frequently the case with elderly females giving birth to their first child;) but it is more particularly where labour is protracted by a spasmodic contraction of the inferior portion of the uterus, owing to which circumstance, notwithstanding the existence of powerful throes, the os uteri does not become correspondingly dilated, that the Belladonna is indicated. On the other hand, this valuable remedy is fur- ther of equal efficacy, when, on the escape of the waters, an al- most complete cessation of the labour-pains ensues, or the ute- rine contractions are rendered so feeble as scarcely to be per- ceptible, and are only made known to the patient by a periodic sensation of pressure and aching at the sacral region—while the dilatation of the os uteri is found, as in the above instance, to make no further progress. The following remedies will also occasionally claim attention : Nux v., Pulsatilla, Secale cornuium, and Opium. Nux v. °|°, when the labour is somewhat protracted, from the irregularity and insufficiency of the pains, and the female complains of a continual urgency to relieve nature. Pulsatilla fljp, where the labour-throes arfe imperfect, and frequently extend upwards from the sacral to the epigastrio region, attended with spasm of the stomach and vomiting; or when they are almost unfelt, and at long intervals, attended with acute pains in the loins, and painful drawing sensations in the thighs, which tend much to weaken the woman, without furthering the labour. When Pulsatilla has not had the desired effect, and there is a continual deficiency of uterine contractile power; or when the labour-pains return every quarter of an hour, not increasing in 23 530 treatment before parturition. intensity, Secale cornutum § or £ ought to be administered. Again, when we find the pains, although powerful at first, sud- denly cease, followed by a trcmour of the whole body, occasion. ally interrupted by violent jerkings, and when the patient falls into a sort of lethargic slumber, with open mouth, stertorous breathing, eyes half closed—and there is great difficulty in arousing the sufferer, even by violent means, Opium °£° is indicated. Administration. A few globules of the remedy at the po- tency mentioned, may be dissolved in about an ounce of water, and a dessert-spoonful given between each pain, until benefit results, or a marked action of the remedy calls for a pause. When the pains suddenly disappear without other indications, one or two drops of the Mother Tincture of Cinnamon have proved of service, especially where the labour is far advanced. We have now, in a great measure, treated of the course to be pursued when nature seems to call for our assistance to fur- ther her exertions; but we must at the same time reprobate a rash and ill-advised interference with her operations; and we cannot, in common with most men of eminence of the other school, too strongly reprehend the practice of administering spi- rituous beverages, or stimulants, such as chamomile tea, and other ptisans, coffee, and even opium, under the absurd impres- sion of thereby facilitating delivery. Spirituous liquors are objectionable, from their accelerating circulation, and consequently producing difficult labour, and too great a loss of blood; Coffee, from its causing high nervous excitability; Chamomile, from its pathogenetic property of producing or creating a tendency to metrorrhagia; ptisans, whose peculiar properties we need not enter upon here, are all more or less of a stimulative or irritative nature. Opium, given merely as a palliative of the severity of the throes, mate- rially retards delivery. As a general rule, every substance, possessing a medicinal property, administered upon the false premises above noticed tends to injury, and must therefore be carefully avoided. With regard to the after-birth, when common, gentle and SPASMODIC PAINS. 531 rational mechanical means* for its expulsion fail, we may have recourse to Belladonna, Pulsat., Secale corn., or Opium, °f °, selecting by the symptoms already mentioned, and will rarely be disappointed in our expectations of their beneficial effects. When the parturition is complete, the Administration of Arnica, *£* in a little water, is always followed by the hap- piest results, frequently preventing much severe after-suffering; and we are convinced, that many critical cases of inflammation, &c, might thereby be warded off. In instances where the la- bour has been very protracted, the Arnica in lotion, one tea- spoonful of the Tincture to two ounces of tepid water, applied externally, will be found to afford great relief. SPASMODIC PAINS, CRAMPS, AND CONVULSIONS. We sometimes, in complicated labours, find spasmodic pains set in, which occasion considerable suffering without advancing the birth. Therapeutics. The principal remedies against these affec- tions are: Chamomilla, Belladonna, Hyoscyamus, Stramonium, Cicuta virosa, Ignatia, Ipecacuanha, and Cocculus; with re- gard to their Administration, two globules of the potency men- tioned may be administered in a teaspoonful of water, and re- peated after a shorter or longer interval if necessary, according to the effects produced, being guided in their selection by the following symptoms: * We do not understand by the said term the exercise of brute force; it is truly melancholy, and almost impossible to conceive, that men who have undergone a medical education, and have had opportunities both of reading and hearing the warnings of enlightened and experienced obstetric practitioners, against the distressing and serious consequences which almost inevitably result from the employment of harsh and inconsiderate measures whenever the expulsion of the placenta happens to be somewhat tardy, could be guilty of the perpetration of such culpable and infamous conduct. Some of these reckless individuals do not appear to wait for any signs of tardiness, but as if in anticipation of an obstinate and pro- longed retention, they set to work with their ruthless proceedings imme- diately, and are consequently, but too frequently, the authors of all the mischief, danger, and even the fatal termination, which sometimes result after the natural process of labour. 532 TREATMENT AFTER DEl.ivr.ni. Chamomilla, y, where there is extremely acute pain, chiefly of a cutting description, extentliiig from the lumbar to tin- hypogastric region, attended by spasmodic convulsions; red- ness of the face, especially of one cheik; excessire sensibility of the nervous si/stem, and excitement. Bklladonna, -n6'\ when the bearing-down is ccessivc, as if the eidire contents of the abdomin were about lo be pro'ruded ; convulsive movements in the limbs; great agitation with con- tinual tossing; occasional throbbing and distention of the ves- sels of the head; bloated redness of the face, with profuse sweat. (See also the indications for this invaluable remedy at page 528.) Hyoscyamus Q6°, when the convulsions are still more severe, accompanied with great anguish and cries ; oppression of the chest and It ss of consciousness. Stramonium, °6q, convulsions, without loss of consciousness, and trembling of the limbs. Icjnatia, y, spasmodic and compressive pains, with sensa- tion of suffocation ; confused feeling in the head. Cicuta virosa, -6°, general convulsions, or cramp-like con- tortions of the limbs; pallor or sallow hue of the face. Ipecacuanha, ~b, spasmodic convulsions; paleness or bloat- edness of the face, occasionally with desire to vomit. Cocculus, *-, cramps or convulsions of the limbs and whole body, more especially in the lower part of the abdomen, with heat, redness, and puffiness of the face. Acidum hylrocyanicum, Platina and Cina, have also been recommended against convul- sions during labour. Dose: b&s. or ooo * TREATMENT AFTER DELIVERY. After the termination of delivery, both body and mind must be kept in a state of perfect repose; every thing which may tend to arouse the excitability of the patient, such as noise strong light, and odour, must bo carefully avoided, and the AFTER-PAINS. 633 room kept at a moderate temperature. After the birth, the female should be allowed to enjoy that slumber, which in natu- ral cases generally follows, without interruption ; but it is com- mendable to feel the pulse from time to time, to ascertain if a healthy action is going on. Sometimes this desirable state of rest is kept off by great nervous excitement on the part of tho fern ile, with incessant tossing in bed and restlessness. A few globules of Coffea cruda will often suffice to dissipate these symptoms, and to procure a refreshing slumber; should it fail, and any febrile symptoms be present, Aconite will generally produce the desired effect. When these remedies, which an- swer in the majority of cases, fail of their accustomed success, we must endeavour to trace the cause, and will generally dis- cover symptoms, printing out a different remedy, which, if judi- ciously chosen, will, with almost absolute certainty, afford a sa- tisfactory result. The practitior.er will generally find but little difficulty in the selection of the fitting medicament; but there are so many circumstances to guide his choice, that it would be wholly foreign to our purpose, in a work of this kind, to enter upon the several contingencies applicable to individual or iso. lated cases. (See the article Sleeplessness, Part II.) Here again, we must severely reprobate the practice of ad- ministering stimulating, and even spirituous, beverages, to fe- males after delivery, which, far from possessing a strengthening property, tend only to excite and irritate the whole nervous system. For some time after parturition, nature calls for but little nourishment; it should be given only when the female herself expressly feels the want of it, and then be of the light- est and most digestible kind, and in very small quantities. It is highly reprehensible to endeavour to induce a female to par- take of food, under the absurd idea of strengthening her. We must allow nature to pursue her own course, which prescribes but little nourishment for the first five or six days after deliv- ery, and thereby avoids the necessity of calling the bowels into action, which state of Constipation (if it may so be called) is ordained for the wisest purposes, and attended with the most beneficial results; while the temporary inactivity of the ali- mentary canal is compensated by the vicarious action of the 534 TREATMENT AFTER DELIVBRY. Bkin (demonstrating itself by increased perspiration), and the balance of the system thus kept up. We cannot, therefore, sufficiently condemn the use of aperients, which only tend to promote irritation, and bring on puerperal fever, and other evil consequences: in many cases, also, this artificial relaxation in- terferes with the proper secretion of milk. After the fourth or sixth day, nature generally acts spontaneously, and when it ap- pears necessary to afford mechanical assistance, we may do so by the application of warm friction to the abdomen, or the employment of a simple lavement, consisting of tepid water, with a little linseed oil or thin gruel. When this state, which seldom happens, continues so long as to cause inconvenience, Bryonia, or Nux vomica, Pulsatilla, and Opium, may be re- sorted to. (See article Constipation.) Dose: °§° or °§°. AFTER-PAINS. These pains are considered salutary, and perhaps justly so to some extent; at the same time, when they occur in an ag- gravated form, and are unduly protracted, as frequently occurs in females of exalted nervous sensibility, they tend to deprive the female of her rest, and ought, under such circumstances, to be subdued as speedily as possible; their early mitigation, in all cases, by means of homoeopathic remedies, is, moreover, never attended but with the most satisfactory results. In many instances the employment of Arnica, internally and likewise externally, as a lotion, (a few drops of the tincture to an ounce or so of tepid water,) when the labour has been somewhat severe, is sufficient to prevent their excessive de- velopment, as also in most cases to ward off fever and inflam- mation.* But when the pain still continues, and the patient is highly excitable and sensitive, we should give a few glo- bules of Chamomilla in a little water, followed in about an hour by Nux v. if no change is effected by tbe former. If the * The soothing effects of Arnica are properly appreciated by those fe- males who have had opportunity and occasion for its employment ; and we believe there are few, who having once experienced the beneficial effects of the homoeopathic treatment generally, during the entire period of confinement, would willingly return to the old method of treatment. DURATION OF CONFINEMENT. 535 pain is of an in supportably intense description, or followed by convulsions, coldness and rigidity of body, Coffea cruda ought to be selected. We may give Pulsatilla when the convulsions do not supervene, but the pains are protracted and the patient is of a mild and gentle disposition, but sensi- tive and easily alarmed about herself. Again, when the after- pains are very severe, and there is a continual inclination to relieve the bowels when in a recumbent posture, passing away when rising, followed by spasmodic pains in the lower parts of the abdomen, they are usually readily relieved by Nux vomica. Dose: 'I'or25-0. Skcale cornutum and Cuprum metallicum have been strongly recommended iu preference to any of the foregoing remedies, in severe and protracted after-pains occurring in females who have already borne many children. Administration. With regard to the dose, we may dis- solve a few globules at the potency named, in a wine-glassful of water, and give a teaspoonful every hour, or only every three or four hours, according to circumstances; carefully watching the effect produced, and discontinuing the medicine as soon as relief is afforded; in many cases a single dose will suffice. When, on the other hand, no improvement follows after a dose or two of the same remedy, another must be selected. In the event of flooding, the following remedies must be had recourse to : Ipecacuanha—or Crocus, Platina or Sabina ; also Belladonna, Chamomilla, Cinchona, in particular cases ac- cording to the symptoms. (For indications, see Miscarriage.) DURATION OF CONFINEMENT. Even in strong and healthy females, during the first five days, the patient should remain in bed ; in the four following, if she feels herself perfectly strong, and desirous to rise, she may gradually accustom herself to longer periods of sitting up ; the great risk is from the extreme susceptibility of the system to cold. After this period, females who still find themselves weak and languid, should prefer the horizontal to the half-recumbent posture; and if this prove wearisome, she may sit up for an hour or two, but not so as to fatigue herself. The diet should 536 DISEASES following parturition. be extremely light, and not of a very nutritious quality; she ought only gradually to partake of food of a more nourishing nature, never having recourse to any thing in the least degree stimulating; and all strong odours from flowers, or other aro- matic substances, are to be carefully avoided, the mind kept in a state of perfect tranquillity, and the room dark. DISEASES FOLLOWING PARTURITION. SUPPRESSED SECRETION OF MILK. It is of paramount importance that the normal operations of the organism peculiar to-^this state, proceed with due regu- larity. Among these, the secretion of milk takes a prominent position, and its sudden suppression is apt to be followed by internal and local inflammation, determination of blood to the head, and the usual array of symptoms which form the dis- ease commonly denominated puerperal fever, which however also result? from internal injuries, consequent upon difficult or protracted labour; but if the precaution of administering Arnica, already enjoined, has been taken, that source of danger will almost always have been effectually guarded against. When, however, puerperal fever arises or threatens to set in, from a sudden suppression of the lacteal secretion, the im- mediate administration of Pulsatilla -^ or °T°2° m a tea" spoonful of water, repeated in six, twelve, or twenty-four hours, according to necessity, will frequently be found suffi- cient to check it at the outset, restore the flow of milk, and re-establish the equilibrium of the organism ; if any unpleasant symptoms still remain, they will, in most cases, yield to the ad- ministration of Calcarea °T°g° followed by Zincum %%° if it appear called for. In other cases, particularly where serious metastases result, Belladonna, Bryonia, Rhus, or Sulphur, may be required. If the suppression of the secretion arise from any sudden rr-tnta! emotion, we must consult that article for- the suitable EXCESSIVE SECRETION OF MILK. 537 remedy, giving perhaps a preference to Bryonia, Chamomilla, Pu'saiVla, or Coffea. Should active feverish symptoms, such as hot dry skin, &c, set in, Aconite |, should be dissolved in six teaspoonfuls of water and a teaspoonful given at short intervals, according to the intensity of the symptoms;—when there is excessive rest- lessness along with the above, considerable advantage will accrue from the alternate use of Aconi.um and Coffea. We may here refer back to our remarks upon the evil effects of aperients, which, by their action upon the in- testines, frequently cause a suppression of the lacteal fluid, and the consequent fever. EXCESSIVE SECRETION OF MILK. Sometimes, on the other hand, it happens that too abundant a secretion, takes place, causing distention of the breasts, aid involuntary emission of milk, productive of extreme emacia- tion, and sometimes development of phthisis. Calcarea t7 will be found useful in this affection; or should it fail to relieve, Phosthorus ^^. Administration. Six globules of the medicine at tho potency mentioned, may be dissolved in an ounce of water, and a teaspoonful taken night and morning. Vide note, p. 21. When febrile symptoms arise from distention of the breasts, induced by excessive secretion, and indications of what is gen- erally denominated milk-fever, (which, however, frequently arises from other causes,) we may administer Riirs toxico- denron £, in six teaspoonfuls of water, a teaspoonful night and morning. (Vide note, p. 21.) Aconite -6-> as a precautionary measure when there is high febrile action of the whole system, and we are ignorant of the exciting cause. The dose to be repeated every six hours, or oftener, if necessary, until the rapidity of the circulation is di- minished, and the skin rendered moist. PFRSPIRATION AFTER DELIVERY, SUPPRESSION OR EXCESS OF. The increased perspiration which takes place after childbirth is as we have before observed, a substitute for the suspended 23* 53^ DISEASES FOLLOWING PARTURITION. action of the alimentary canal; consequently its sudden suppres- sion is unavoidably followed with an injurious result, and not unfrequently puerperal fever. Exposure to cold, or a sudden chill, is the most frequent cause of this affection ; we consequently find that the immediate adniiui-tration of Dulcamara **■*, will often suffice to restore the action of the skin, and prevent further injurious consequences. Should it fail, Nux vomica %**, will frequently be found effica- cious; or Chamomilla «g*. in three teaspoonfuls of water, a teaspoonful every six hours; this latter remedy, particularly when there is excessive restlessness and excitability, with colio aid relaxation of the bowels. When severe one-sided headache arises, combined or not with distressing pain in the neck, Bella- donna may be prescribed. In other cases, Bryonia or Sulphur may be called for, *§*. On the other hand, an excessive perspiration is almost equally prejudicial; it is generally brought about by keeping the room of the female at too high a temperature, too great a quantity of bedclothes, or stimulating beverages ; it is chiefly injurious from the extreme debility and high susceptibility to taking cold it occasions. Our first care must be a removal of the exciting causes ; and should the malady still continue, we may adminis- ter Sambucus mger, which will generally be found effectual in its removal. In other cases, China, Cocc, Sulph., etc. Administhation. -|. in six teaspoonfuls of water, a tea- spoonful every twelve hours, until the desired relief is obtained. MILK FEVER. The secretion of milk must be looked upon rather as an operation of nature than one requiring medical aid for its regu- lation. Nevertheless, many females suffer some slight uneasi- ness for a few days following confinement, during the first period of that process; but when any of the under-mentioned group of symptoms present themselves, the affection is known by the name of milk fever :— Thirst, shivering, and heat, terminating in perspiration ; the pulse, at first weak, changing to various phases, sometimes quick and frequent, at others soft and regular; in some instances, MILK FEVER. 539 these symptoms are attended with a drawing pain in the back extending to the breast, a disagreeable taste in the mouth, thirst, oppressed breathing, anxiety, headache, and diminution or suppression of the secretions of milk, etc.; the exacerbation declares itself regularly about evening, and towards morning perspiration comes on, with alleviation of suffering, or temporary termination of the attack, which not unfrequently recurs on the following day, but rarely rises to such a height as to threaten danger ; nature herself, if not disturbed by improper treatment, will, in most cases, suffice to restore the equilibrium of the sys- tem. When the secretion is re-established, and the lochial dis- charge resumes its normal course, the derangement generally ceases: should, however, the affection become aggravated, we may dread the setting in of puerperal fever. When the symptoms are as above described, and medical assistance is required for their alleviation, we must, if possible, in the first place, endeavour to discover the exciting cause ;* when the affection is traceable to mental emotions, we may consult that article for the remedy. Aconite, -§-, maybe had recourse to in all instances where considerable fever is present, or administered alternately every six hours, with Coffea, when there is extreme restlessness, anx- iety, and dread. Bryonia may with great advantage follow Aconite, when the active febrile symptoms are in a great measure subdued; and is further particularly indicated, when there is oppressed and laborious breathing, intense headache, and obstinate con- stipation. Administration. *■*■*, in a teaspoonful of water, and re- peated in six, twelve, or twenty four hours, according to circum- stances. (Vide note, p. 21.) Pulsatilla will be found particularly useful in severe cases especially when caused by taking cold, and bearing a closer approximation to a rheumatic affection than to the ge- neral symptoms of milk fever; this medicament is very effica- * Neglecting to put the infant sufficiently early tor*J^™* "J" sequent absorption into the circulation of the milk which has been secret- ed, is a frequent source of the derangement. 540 DISEASES FOLLOWING PARTURITION. cious in restoring the lacteal secretion, and may be regarded as a prophylactic against puerperal fever, especially when the pre- cautionary measure of the administration of Arnica has been neglected Administration. -*.,-. in a teaspoonful of water, repeated every twelve or twenty-four hours, according to the urgency of tbe symptoms, until benefit results. Bklladonna is very useful in particular eases ; a reference to Inflammation of tiie Bkeasts, and other places where that medicament is mentioned, will serve to point out in what in- stances it is most likely to prove efficacious. Rous is also of considerable service in some cases of milk fever. (See the indications given for this remedy under the heading of Excessive Secretion of Milk.) IRREGULARITIES OF TIIE LOCHIAL DISCHARGE. This varies considerably in different females; with some it continues for several weeks, in others only a few days ; some- times it is thin and scanty, at others so profuse and long con- tinued, as imperatively to call for medical assistance, which may be frequently traced to sitting up too soon after confine- ment, to errors in regimen, keeping the chamber of the female at too high a temperature, or mental emotions. If, after nine days, the discharge continues profuse, containing pure blood, whereby an abnormal state is indicated, Crocus, Bryonia, and Calcarea, are the principal remedies. Crocus. In most cases where the discharge is of too long duration, and particularly when the blood is of a black or dark colour, and viscid consistency. Administration. f,* in an ounce of water, a dessert- spoonful night and morning. (Vide note, p. 21.) Bryonia. When of a deep red, with internal burning pains in the region of the uterus. Administration, f. in the same manner as the above. Calcarea is more particularly indicated when there is an itching kind of sensation in the uterus. • In some cases the 3d, 2d, and even the 1st attenuation, or potency, of this medicine has been exhibited with marked benefit, when a higher number appeared to produce but little effect diaprhcea ix lying-in women. 541 4tTr™- "•in sk ""P"-1* °f —. - t.mesare,fromava™tyof external causes, such as mental m„t1()ns, ctc., , d frQm th.s sQurce ^ * J the danger may frequently be warded off by the administration ofPntsiTUl4,a¥ropeate<1 in six_ tJ> ^ nours, according to circumstances. When the sudden suppression arises from fright, with febrile symptoms Aconite ^o;Will generaUj be found ^^ m upturn, --0-, when the indications given under Mental Emo- tions are present. (See also the other remedies mentioned under that heading.) tr ^ When caused by exposure to cold or damp, Dulcamara ra-, will be found efficacious, and may be advantageously fol- lowed by Pulsatilla A2,0. On the other hand, when the discharge continues, but becomes sanious, fetid, and offensive, Belladonna Ofla in six teaspoon- fuls of water, one daily, will generally suffice to restore it to its normal state; (vide note, p. 21); if it prove inefficient, we may administer Carbo animalis JL in the same manner; and if the occasion still seem to require it, Secale cornutum °-°, in a teaspoonful of water, repeated every twelve hours until be- nefit results. Silicea, when pure blood follows with the lochia each time that the infant is applied to the breast. Administration. . JL Jn the same manner as directed for Belladonna. The following remedies may also prove useful: Nux-v., Hyoscyamus, Zincum, Colocynth, Vera'rum and Secale cornutum, chiefly in the event of a suppression. And Platina, Secale cornutum, H:par-s., Rhus, against too copious or pro- tracted lochia. DIARRHCEA IN LYING-IN WOMEN. Diarrhcea, during this period, is a state to be looked upon as highly injurious, and immediate means should be taken for its sup- pression, by the administration of Dulcamara, Hyoscyamus, Rheum, Antimonium crudum, Phosphorus, and Acidum phosphoricum, etc. 542 DISEASES FOLLOWING TARTURITION. The first remedy, «|*. is generally indicated by the cause, being the check of the natural increased perspiration in lying-in women, from a chill; and when timely administered, it will generally be found sufficient to answer the purpose required. In painless and almost involuntary evacuations, Hyoscyamus *S» is most effectual. Rheum *i°, and Antimonium crudum V, in watery, or very offensive evacuations; the former when they emit a sour smell. In very obstinate cases, when the discharge is watery, almost involuntary, and painless, Phosphorus %°, followed, if necessary, by Acidum phosphoricum, f? or §f (Vide also Diarrhcea, in the second part of this work, and administer or repeat the remedies as there directed.) ABDOMINAL DEFORMITY. Although, in natural cases and healthy constitutions, no abnormal derangements should follow parturition, still we frequently find that a number of unpleasant symptoms, generally arising from maltreat- ment,supervene. Among these we may mention the thickening of the abdominal coats, occasionally ending in a permanent mal- formation and pendulous appearance. This affection is more com- monly incident to females who have borne many children, or who present a predisposition to corpulency; and is found especially difficult of treatment, when tight stays, which we have already remarked upon as one of the principal exciting causes, have relaxed the abdominal muscles, and by so doing, increased the existing bias. When, however, it is caused by the natural strain upon these muscles during pregnancy, the inconvenience may be con- siderably alleviated by the internal and external use of Rhus toxicodendron. The internal administration of Sepia "^ is recommended by Dr. Gross as still more effectual, who at the same time advises the adoption of an elastic bandage, laced at the back, and exerting an equable pressure over the whole of the abdominal region. In some cases where there is a tendency to this affection, particularly in corpulent habits, we may, soon after delivery, have recourse to mechanical aid, by transferring the weight from the abdominal muscles to the shoulders, by the aid of a properly-constructed ap- paratus ; but we must in the strongest manner object to this or any other pressure being exercised upon the abdominal region during pregnancy as calculated to entail malformation, such as club-feet, &c., upon the offspring. TREATMENT AFTER DELIVERY. 543 FALLING OFF OF THE HAIR. Another evil that some females, particularly those who nurse their infants themselves, suffer after confinement, is the falling off of the hair of the head. This frequently arises from an innate delicacy of constitution, against which the following medicaments have proved efficacious, and may be repeated every eight days : Tinctura sulphuris 3%, Natrum muriaticum /^, and Carbo vegetabilis /n, Sepia ^, Lycopodium t\, and Calcarea t%. The latter, particularly in those cases in which the lochial discharge has proved very profuse, or in which the catamenia are generally too abundant. With regard to the other medicines, we would in most instances recommend a commencement with Tinctura sulphuris. LEUCORRHCEA AFTER PARTURITION. A third evil is Leucorrhcea, which, although at the commence- ment merely a consequence of the relaxation of the internal uterine economy, after the completion of the lochial discharge, and at first of an innocuous character, frequently proves exceedingly trouble- some, and finally puts on a morbid appearance, becoming acrid, and productive of excoriation. We generally find a predisposition to the disease in scrofulous, torpid, and leuco-phlegmatic tempera- ments ; in some families this malady is hereditary, and only to be removed by a careful course of anti-dyscratic treatment. It is frequently of a very obstinate character, requiring the exercise of considerable study and attention on the part of the medical attend- ant, on the one hand, with much patience and strict attention to dietetic rules on that of the patient, on the other, ere a successful result can be attained. The remedies which have been found the most efficacious against the affection, either occurring after parturition or at other times, are ■ Pulsatilla, Sulphur, Sepia, Bovista, Calcarea, Lycopodium, and Carbo v., Causticum, Conium, Mezereon, Natrum, Magnesia c and m., Ammonium c, Cannabis, lodium, Petroleum, Stannum, etc. Dose: •§• or T- INTERNAL UTERINE SWELLING AND PROLAPSUS. A swelling of the interior economy is frequently the result of a 544 DISEASES FOLLOWING PARTURITION. difficult labour, and in some cases of mismanaged parturition; we sometimes find it complicated with uterine or vaginal prolapsus; if the precaution of exhibiting Arnica 'B , which we have before noted, (page 411,) have been taken, this will frequently be prevented ; if, however, symptoms of prolapsus set in, attended with a painful burning sensation, and bearing down, a dose or two of Nux vomica will generally remove the evil. Sepia, Belladonna, Aurum, Mercurius, Lycopodium, Stannum, Cannabis, China, Pla- tina, and Culriirea, etc., have been employed with material benefit in cases of this description of long«-r standing, as also in other uterine affections, such as Metritis, Uetroversio uteri, etc. Dose : WEAKNESS AFTER DELIVERY. We frequently find a high degree of weakness or exhaustion remaining after delivery ; when it has been caused by very con- siderable hemorrhage, during or after that period, Cinchona is par- ticularly indicated, and will generally be found efficient in restoring the vital energies. Administration. "J0, in a teaspoonful of water, repeated in three or four days. When however the derangement depends upon nervous weak- ness, and is attended with restlessness and want of sleep, we may administer Aconite, followed, if necessary, by Coffea, or substi- tute Veratrum for the latter medicine, when the prostraiion of strength is excessive. In some instances we must have recourse to Kali carb., or to Sulphur, Calcarea, or Acid phosph. Dose °B°. INFLAMMATION OF THE WOMB. (Inflammatio uteri. Metritis.) Continuous burning, pricking, or shooting pain in the hypogastric region, with a sensation of weight. The utero-vaginal secretions are suppressed, sometimes also the evacuation of faeces and urine ; and, in lying-in-women, the secretion of milk is likewise arrested. Causes: Severe, unnatural labours, harsh manual interference, and powerful stimulants, etc. Aconit. J , a few doses, when the ac- companying fever partakes of a synochal type.—Bellad. T> when suppression of the lochia, sensation of weight, dragging or bearing down in the hypogastric region; burning, shooting pains in the OBSTACLES TO SUCKLING. 645 jower part of the abdomen; shooting pains in the hip-joint; severe pain in the back, as if it would break ; tenderness of the abdomen to the touch.—In consequence of severe labour, with laceration of the parts : Arnica in alternation with Aconit. °§°. Nux v. °^° , in uterine derangements of a shooting or cutting description, suppres- sion of urine, constipation, tenesmus, etc.—Merc. in as many teaspoonfuls of water, a teaspoonful to be taken every six or eight hours, until improve- "Whtn^wevcr, a degree of induration still remams Mer- curius solubilis, ff, should be given, and repeated from two o three days; in more severe cases, Acidum phosphoricum should be resorted to, or Hepar sulphuris, when suppuration has al- ready commenced. trituration AnMiNisTRATioN, ofthe latter, one grii" U1 in tn ounce of water, a dessert-spoonful to be given three or four m an ounce , suppurative process, when it ro-sl^y neceU to bring .he ma,.er «o a head aS speedily as possible. 643 OBSTACLES TO SUCKLING- In instances in which we find a fetid and serous discharge, which is frequently brought about by neglect or by improper treatment, such as the application of deleterious salves, etc , Silicea V»u> repeated in five or six days, will generally be amply sufficient to restore the breast to its former condition; in some extreme eases, however, it will be found necessary to follow up the treatment with Phosphorus, Calcarea, or one or more of the remedies above mentioned, such as Mercurius. and Hepar sulphuris If this disease evidently arise from the effect of a sudden chill, Dulcamara fought to be given immediately, and will frequently obviate all injurious consequences. In cases where the disease has arisen from external injury, Ar- nica °£° should be administered, and a lotion, one part of the tinc- ture to seven of pure water, locally applied. In strumous habits, Tinctura sulphuris, Calcarea and Graph- ites, will occasionally be found necessary to complete the cure, after Btlladonna has removed the active inflammatory symptoms. MENTAL EMOTIONS AFFECTING THE MILK. It is a well known fact, confirmed by numerous examples, that Mental Emotions have a most powerful effect upon this secretion, in a moment changing it from a source of nutriment into a substance most injurious to the infant. Mothers ought to bear this in mind, and after having suffered from fright, passion, etc., should desist from suckling until they are perfectly composed ; and ere the in- fant be again applied to the breast, a portion of the milk should be drawn off. fortunately, for evils arising from these causes, Ho- moeopathy presents prompt and efficacious remedies, (for which, see Mental Emotions,) which, if at hand, should be administered immediately, according to the cause and symptoms. DEFICIENCY IN THE SECRETION OF MILK. SUPPRESSED SECRETION OF MILK. Sometimes a deficiency of milk is found to arise from a want of energy, either functional or general. For disturbance of the secre- tion arising from an inflammatory action, Vide Inflammation or the Breasts. When the deficiency or suppression arises from the first cause, the chief medicines useful in restoring a proper and healthy flow of ZtT VTTtU-\! CA,'CAREA' a»d ^-,cum. The physician is the best judge ,„ the application of these remedies, as there are many minute symptoms by which his choice must be guided in the MOTHERS NOT SUCKLING THEIR CHILDREN. 549 selection—in simple cases, Vitex agnus castus and Pulsatilla will frequently be found efficacious ; but it is more generally requi- site for the female to undergo a complete course of treatment, if she is anxious to persevere in nursing, in which the two latter, to- gether with Aconitum, Bryonia, Chamomilla, Belladonna, Sulphur, Sepia, lodium, will be found of great value. Dose : °§° or °|° . DETERIORATION AND DISCOLORATION OF MILK. If the milk becomes too clear and watery, (or otherwise deterio- rated in quality, or is repugnant to the child,) Cina °g° and Mer- curius solubilis 2™, ought to be administered alternately every twenty-four hours for three or four days ; or Silicea $°°, in obsti- nate cases, (and particularly if the infant vomits immediately after Suckling), will frequently bring about an amelioration. Rheum will frequently be found of efficacy when the milk becomes thick and yellow, and disagrees with the child, rendering it restless and fretful; a globule of the third or the sixth potency ought to be given to the child while the mother is under the action of the same remedy. MOTHERS NOT SUCKLING THEIR CHILDREN. In the present state of society, there are many mothers who, from a variety of circumstances, find themselves necessitated to engage the services of a nurse for their offspring; in such cases, a female, who has the slightest regard for her health, should be par- ticularly careful in her diet, and until the secreting process has entirely ceased, she should live as low as possible. The employment of dry cupping at the outer surface of the arm, a little below the shoulder, or to the inferior extremities, will materially hasten the suppression of the lacteal secretion. At the same time, material aid will be derived from the internal administration of Pulsatilla ; indeed, the employment of that remedy alone will often be found sufficient to stop the secretion. A few globules of the third or sixth potency may be dissolved in a wine-glassful of water, and a tea- spoonful taken night and morning. When suffering from inflamma- tion ensues, we may have recourse to Phosphorus, Belladonna, and Bryonia, for which indications are given under Inflammation of the Breasts; Calcarea is serviceable when the breasts are considerably distended with milk. These same directions will serve as a guide during the period of weaning. GLOSSARY OF EMPLOYED l> Abdomen. The cavity situated be- tween the lower part of the thorax and the region of the pel- vis, containing the intestines ; the belly. Abnormal. A deviation from the course of nature; in medicine, unhealthy. Abortus Miscarriage; abortion. Abrade. To excoriate. Abrasion-. Kxcoriatiou. Abscess. A collection of pus seat- ed in any particular organ or tis- sue. Absorbents. In anatomy, this term is applied to small, delicate, transparent vessels which take up and convey any substances from the surface of the body, or from any cavity, into the blood. Acetabulum. A cavity of a cuplike form, receiving the head of the femur or thigh-bone. Adhksion. In surgery, the reunion of parts that have been divided, by means of a special kind of in- flammation denominated the ad- hesive. In pathology, the morbid union of parts which are naturally contiguous, though not adherent, through the instrumentality of adhesive inflammation. Adhesive Inflammation. The pro- cess by which wounds are united. It is often synonymous with union by the first intention. Adypsia. The absence of natural thirst. Agglutination. Adhesion. Agrypnia. Sleeplessness. Agustia. Loss of taste. Al,e Nasi. The lateral cartilages of the nose. W i n gs of the nose. Alkali. A substance which unitea MEDICAL TERMS this work. with acids in definite proportions, so as to neutralize their proper- ties more or less perfectly, and to form salts. It changes vegetable blues to green. Alkaloids. Substances having some of the properties of alkalis. Allopathy. A term used by ho- moeopathic writers to designate the old practice of medicine in contradistinction to their own, now generally employed by both parties ; literally implies curing one disease by another. Alvine. From the stomach or in- testines. Amenorrhea. Absence or stop- page of the menstrual flux. Amnesia. Loss of memory. Amygdalae. A popular term for the exterior glands of the neck, as also the tonsils, whjch are so called from their shape bearing some resemblance to that of an almond. Anasarca. Dropsy of the cellular tissue, or membrane, immediately under the skin. Anchylosis. Stiffening of a joint, either from deposit of ossific or bone-forming matter, or contrac- tion of the muscles or ligaments ; adhesion of the articulating sur- faces. Aneurism. Morbid enlargement of an artery. Angina. Sore throat. The term is also applied to diseases with difficult respiration. Angina Membranacea. Croup. Angina Parotidea. Mumps. Angina Pharyngia. Inflammation of the membrane which forma the pharynx. GLOSSARY. 551 Anorexia. Want of appetite. Antacid. Substances possessing the property of neutralizing acid- ity. Anthrax. Carbuncle. Anthropophobia. A dread or hor- ror of the human species. Antiphlogistic. Applied to re- medies employed in the old system against inflammation; literally, against heat. Antrum-highmorianum. The max- illary sinus. A hollow or cavity above the teeth of the up- per jaw, in the middle of the su- perior maxillary bone. Anus. The inferior opening of the rectum. Apepsia. Loss of appetite. Aphonia. Loss of voice. Aponeurosis, plur. Aponeuroses. Tendons expanded upon a wide surface. Apoplexia. Apoplexy; a loss of voluntary motion and conscious- ness. See Diagnosis under this head. Apyrexia. The intervals between febrile paroxysms. Arc. A segment of a circle. Arthritis. Gout. Ascaris* plur. Ascarides. Thread- worms. Asphyxia. Apparent death. Asthenic. Low ; applied to dis- ease ; literally, want of strength. Astringents. Medicaments used in the old practice to contract the animal fibre. Atony. A want of tone or energy in the muscular power. Atrophy. A morbid state of the di- gestive system, in which the food taken into the stomach fails to afford sufficient nourishment. A wasting of the whole, or of indi- vidual parts of the body. Auscultation. The defection of symptoms by the ear in disease. Biliary. Connected with the se- cretion of bile. Blepharitis. Inflammation of the Borborygmus. Rumbling in the intestines, caused by flatus or wind. Bronchia ; Bronchi. The^ tubes into which the trachea or wind- pipe divides. Bronchial Sounds. Those which are heard in the bronchi. Bronchitis. Inflammation of the ramifications of the windpipe. Bronchophony. The resonance of the voice heard over the bronchial tubes. Bulimy ; Bulimia. Canine, or ex- cessive hunger. Cadaverous. Resembling a corpse. Caecum. The blind gut; so called from its being perforated at one end only. Calamine. A preparation of zinc. Calculus, plur. Calculi. A con- cretion in the human body. Cal- culosus. Afflicted with the stone. Canine. Belonging to the dog species. Canthus. The angle of the eye. Carcinoma. Cancer, adj. Carcino. matous. Cardialgia. Spasm of the sto- mach. Carditis. Inflammation of the heart. Caries. Ulceration of the bones. Carminatives. Medicaments used against flatulency. Carotids. The name of two large arteries of the neck. Carphologia. Picking at the bed clothes. Cartilage. Gristle. Catamenia. The menstrual flux. Catarrh. Cold ; used also to ex- press inflammation of the mucous membrane. Catarrhal Ophthalmia. Simple inflammation of the conjunctiva. Cathartic. Purgative. Cellular Tissue. The fine net- like membrane enveloping or connecting most of the structures of the human body. Cephalalgia. Headache. 552 slossary. Cephalic. Pertaining to the head Cerebral. Appertaining to the bruin. Cervical Belonging to the neck. Cessatio Mensium. Discontinuance of the menstrual flux. Chlorosis. Green sickness. Cholera. See article thereon. Choli kine. A modified species of cholera. Chronic. Long continued, in con- tradistinction to acute. Cicatrix, plur. Cicatrices. A scar left after the healing of a wound, &c. Clavi Pedis. Corns. Clonic M-asm. A spasm which is not of long duration. It is op- posed to tonic spasm, which see. Com.ula. Clots of blood Coagi lable Lymph. The term [liven to the fluid which is slowly effused into wounds, and afier- wards forms the uniting medium or cicatrice. Colic. Griping in the intestines. Cm.lapse. Failing of vitality. Colliquative. Excessive discharge of any secretiou. Co\ia. Drowsiness. Coma Somnolentia. Drowsiness, with relapse thereunto on being roused. /Comatose. Drowsy. Compress. Soft lint, linen, &c. folded together so as to form a pad, for the purpose of being placed, and secured by means of a bandage, on parts which require pressure. Congestio ad Caput. Determina- tion of blood to the head. Congestio ad Pectus. Determina- tion of blood to the chest. Congestion. Overfulness of the blood-vessels of some particular OlgaU. Conglobate Glands. Glauds of a globular form, composed of a texture of lymphatic vessels. They have no excretory duct. Conjunctiva. The membrane lining I the eyelids, and extending over the forepart of the eye-balls. ' Contagion. Propagation of a dis- ease by contact Cornea. The anterior transparent portion of the eye. It is of a horny consistence. Coryza. Cold in the head. Coxagra. Inflammation of the hip-joint. Literally, seizure or pain in the. Coxalgia. Literally, pain in the hip ; inflammation of the hip- joint Cranium. The skull. Crepitation. Grating sensation, or noise, such as is caused by pressing the finger upon a part affected with emphysema; by the ends of a fractured bone when moved ; or by certain salts during calcination. Crepitant Rhonchus. or Rale. The fine crackling noise heard in consequence of the passage of air through a viscid fluid. It ia heard in the first stage of inflam- mation of the lungs. Crepitus. Crackling or grating. Cutaneous. Appertaining to the skin. Cuticle. The outer or scarf skin. Cysticis. Inflammation of the bladder. Debile Low. Defecation. Alvine evacuation. Deglutition. The act of swallow- ing. Delirium. Derangement of the brain, raving. Depletion. Abstraction of the fluids ; generally applied to vene- section. Desiccation. A drying up. Desquamation. Falling off of the epidermis iu form of scales. Diaphragmiti8. Inflammation of the diaphragm (muscular parti- tion between the thorax and ab- domen). Diagnosis.—Distinction of maladies. Diarrhea. Looseness of the bow- els. Diarrhea neonatorum. The same as the above, in infante. GLOSS.* Diathesib. Constitutional ten- dency. Dietetic. Relating to diet. Diplopia. Affection of the eyes, in which objects appear double or increased in number. Diuretic. Medicines which in- crease the secretion of urine. Dorsal. Appertaining to the back. Drastic. Powerful purgatives. Duodenum. The first intestine after the stomach, so called from its length ; the twelve-inch gut. Dyscrasia. A morbid condition of the system ; adj. Dyscrastic. Dysecoia. Deafness. Dysmenorrhea. Painful menstru- ation. Dyspepsia. Indigestion; literally, difficulty of appetite. Dyspnea. Difficulty of respiration. Shortness of breath. Dysuria. Difficulty in passing urine. Effusion. A pouring out or escape of lymph or other secretion. Emaciation. A falling off in the flesh. Emetic. Provoking vomiting. Emphysema. Windy swelling. A swelling caused by the diffusion of air in the cellular tissue, ren- dering it tense, elastic, and crep. itating. It is divided into the traumatic when the air has been introduced through a wound; idiopathic, or spontaneous, when the gas is developed within the cells, which is, however, of rare occurrence. Encephalitis. Inflammation of the brain aud membranes. Endemic. Peculiar to a particular locality. Endocarditis. Inflammation of the internal parts of the heart. Enema. A clyster. Engorgement. Swelling up of. Enteralgia. Colic Enteritis. Inflammation of the intestines. Ephemeral. Of a day's duration. Ephialtes. Night-mare. 24 ARY. 553 Epidemic. Diseases arising from general causes. Epigastrium. The region of the stomach. Epilepsy. Epilepsia. Falling sick. ness. Epistaxis. Bleeding from the nose. Epithelium. The cuticle. Erysipelas. St. Anthony's fire. Rose. A disease of the skin. Erysipelas Phlegmonodes. Phleg- monous erysipelas. Erysipelas (Edematodes. (Ede- matous erysipelas. Erysipelas Erraticum. Wander. ing erysipelas. Erysipelas Gangrenosum. Gan- grenous erysipelas. Erysipelas Neonatorum. Indura- tion of the cellular tissue in in- fants. Exacerbation. Aggravation of fever, &c Exanthema, plur. Exanthemata. Eruption terminating in exfoli- ation. Expectoration. Discharge of any matter; phlegm; pus from the chest. Exudation. Discharge of fluid from the skin, &c. Faeces. Alvine excrement. False Joint. When the two frag. ments of a broken bone do not be. come united by an osseus bond of union, the limb continues in a state of preternatural mobility, and, if not remedied, is converted into a false joint, admitting of flexion in various directions, with- out pain. Fascia. In anatomy, the tendin- ous expansion of muscles which bind parts together are called fascia. Fauces. The throat. Favus Convertus. Pustular ring- worm, or ringworm of the scalp. Febris, plur. Febres. Fever. Febris Nervosa. Nervous Fever, or typhus. Femur. The bone of the thigh. Fetor. Stench. 554 r, L08PARV First Intention. See t'nion by thr. Fistula. An obstinate tube-like sore, with a narrow orifice ; adj. Fistulous. j Fistula Lachrymalib. An ulcer- i ated opening in the lachrymal sac. I Flatus. Wind in the intestines. Flatulency- Fetus. Tlie infant in the womb. Fomentation. The application of j flannel wet with warm water. Fontanel, plur. Fontanejla. The mould. Functional Dise\ses. Those in I which there is supposed to be only , derangement of action. Furunculus. A boil. Furunculus Malign\ns. Carbun- cle. Gangrene. Incipient mortification ; ' adj Gangrenous. Gastralgia. Pain in the stomach. Gastric. Belonging to the stomach. I Gastritis. Inflammation of the i stomach. Gastrodynia. Vide Ciirilinlgia. Gestation. Pregnancy. Gland. A small body met with in many parts of the body, and ] consisting of various tissues, blood- vessels, nerves, &c. Glossitis. Inflammation of the tongue. Glottis. Opening of the wind- ! pipe. The superior opening of the larynx. Granulation. See Incarnation. H.«mateme8is, or Hematemesis.— Vomiting of blood. Hemoptysis, or Hemoptysis. Dis- charge of blood from the lungs. Spitting of blood. Hemorrhage, or Hemorrhage. Dis. charge of blood. Hemorrhoids, or Hemorrhoids. Piles. Hectic Fever. Habitual or pro- I traded fever. ! Helminthiasis. Worm disease. Hemiplegia. Paralysis of one side I of the body longitudinally. Hepatitis. Inflammation of the liver. Hepatization. Structural derange- ment of the lungs, the result of inflammation; changing them into a substance resembling the liver, hence its name. Hernia. Rupture. Hernia Congenita. Congenital hernia. Literally, hernia from birth. Herpes Circinnatus. Ringworm. Hordeolum. Stye. Hydrocephalus. Water in the head. Hydrophobiasymptomatica. Symp- toms resembling those arising from hydrophobic virus, appearing during the course of other dis- eases. Hypertrophy. A morbid increase of any organ, arising from exces- sive nutrition. Hypocratic. Sunken and corpse- like. Hypochondrium. Region of the abdomen, contained under tho cartilage of tho false ribs. Hypochondriasis. Spleen disease ; great depression of spirits, with general functional derangement ; adj. Hypochondriacal. Hypogastrium. The lower ante- rior portion of the abdomen. Hysteria. Nervous affection ; al- most peculiar to females. Ichor. A thin watery discharge secreted from wounds, ulcers, &c.; adj. Ichorous. Icterus. Jaundice. Icterus Neonatorum. Jaundice of infants. Idiopathic. Original or primary disease. Idiosyncrasy. Individual peculi- arity. Ilium. The haunch-bone. It, to- gether with the pubis, sacrum, and ischium, contributes to form the pelvis. Ileus Miserere. A form of colic, a twisting pain in the region of the navel. GLOSSARY. Incarcerated. Strangulated or constricted; a term applied to rupture. Incarnation. The process by which abscesses or ulcers are healed; this takes place by means of little grain-like fleshy bodies, denominated granulations, which form on the surface of ulcers or suppurating wounds, &c., and serve the double pur- pose of filling up the cavities and bringing closely together and uniting their sides. Incubus. The nightmare. Infection. Propagation of disease by effluvia. Infiltration. Diffusion of fluids into the cellular tissue. Infra Orbitart Nerve. A twig of the second branch of the fifth pair of nerves. It passes out of a small hole immediately below the orbit, (the foramen infra orbi- tarium,) and is distributed upon the cheek, under eyelid, upper side of the nose, and joins with the portio dura of the seventh pair. Ingesta. Food; aliment. Inspissated. Thickened. Integuments. The coverings of any part of the body. The skin with the adherent fat and cellular membrane form the common in- teguments. Intention. See Union by the first. Intumescence. Swelling; puffmess. Invermination. The term given to the morbid states occasioned by the existence of worms in the intestines (intestinal canal). Ischias. Pain in the hip. Ischium. Hip-bone. Ischuria. Suppression of urine. Lachrymal Sac. Lachrymation. Tear shedding. Lactation. Suckling; also the process of the secretion of milk. Lacteal. Appertaining to the pro- cess of the secretion of milk. Lactiferous. Conducting or con- 555 Belonging to the la- Laryngeal. rynx. Laryngismus Stridulus. Asthma of Millar. Laryngitis. Inflammation of the larynx. Larynx. Upper part of the wind- pipe. Lesions. Injuries inflicted by vio- lence, etc. Lesion, Organic. Structural de- rangement, or injury. Leuco-phlegmatic. Torpid or slug- gish ; mostly applied to a temper- ament characterized by want of tension of fibre ; with light hair, and general inertness of the phy- sical aud mental powers. Leucorrhea. Female sexual weak- ness ; vulg. Whites. Lochia. Discharge from the womb after delivery. Lumbago. Rheumatism in the loins. Lumbar. Appertaining to the loins. Lumbricus, plur. Lumbrici. The round or long worm. Luxation. Dislocation. Lymph. A colourless liquid, circula- ting in the lymphatics. Lymphatic. As applied to tempera- ment ; same as Leucophlegmatic. Lymphatics. Absorbent vessels with glands and valves distributed over the body. Lymphatic Glands. Conglobate Glands. These are composed of a texture of absorbents, or lym- phatic vessels, connected together by a cellular membrane. Mamma. The breast in the female; adj. Mammillary. Mania. Insanity; madness. Marasmus. A wasting away of the body. Materia Medica Pura. The title of that splendid work of the immor- tal Hahnemann, in which the true properties of medicaments are given, as determined by exper- iment upon the healthy body. Maxillary Appertaining to the jaws. The superior and inferior 556 GLOSSARY. maxillary bones form the upper and lower jaws. Meatus Aiditorius Externus.— The external passage of the car. Meconium. The excrementitious matter discharged from the intes- tines of a newly-born infant. Megrim. A pain affecting only one side of the head. Meibomian Glands. Small glands within the inner membrane of the eyelids. Menochesia. Feeble menstruation. Menorrhagia. Excessive discharge of blood from the uterus. Menstrual Flux. The monthly period. Meningitis Spinalis. Inflammation of the spinal membranes. Metastasis. The passing of a dis- ease from one part to another. Meteorismus. Extreme inflation of the intestines. Metrorrhagia. Discharge of blood from the womb. Miasm, or Miasma [Marsh). Pe- culiar effluvia or emanations from swampy grounds. Mhturition. Urination. Miliaria. Eruption of minute transparent vesicles of the size of millet seeds; miliary eruption. Miliaria Purpura. Scarlet rash. Minim. The sixtieth part of a fluid drachm. Morbus Coxarius. Disease of the hip; hip-disease. Mucous Membrane. The mem- brane which lines the sides of cavities which communicate with the external air, such as that which lines the mouth, stomach, etc. Mucus. One of the primary animal fluids ; secretion from the nostrils. Myelitis. Inflammation of the spi- nal marrow. Myopia. Short sight ; near-sighted ness. Narcotic. Having the property of inducing sleep. N asal. Belonging to the nose. Nasal Cartilages. The cartilage* of the nose. Nates. The buttocks. Nephritis. Inflammation of the kidneys. Neuralgia Facialis. Face-ache. Nodosities. Swellings ; nodes, a swelling of the bone or thickening of the periosteum. Notalgia. Pains in the loins. Obstructio Alvi. Constipation. Obstructio Alvi Neonatorum. Constipation in infants. Occiput. The posterior part of the head. Octana. An intermittent fever which returns every eighth day. Odontalgia. Tooth-acho. CEdema Swelling ; dropsical swell- ing ; adj, (Edematous. Olfaction Tho act of smelling Omentum. The caul. The viscus consists of folds of the peritone- um connected together by cellular tissue ; it is attached to the sto- mach, lying on the anterior sur- face of the bowels. Ophthalmia. By this term is now usually understood simple inflam- mation of the conjunctiva. (Ca- tarrhal Ophthalmia.) Ophthalmic Nerve. The first branch given off from the Gasse- rian ganglion of the fifth pair of nerves; it divides into the lachry- mal, frontal, and nasal nerves. Ophthalmitis. Inflammation of the entire ball of the eye Organic Disease. In pathology, diseases in which there is derange- ment or alteration of structure are termed organic. Os Uteri. The mouth or opening of the womb. Ossa Spongiosa. The spongy bones. They consist of a spongy lamella or plate in each nostril, which they contribute to form. Ossicula Auditoria. The small bones of the ear. They are sit- uated in the cavity of the tympa- num, and are four in number: GLOSSARY. 557 termed—the malleus, incus, stapes, and os-orbiculare. Otalgia Ear-ache Otitis Inflammation of the ear. Otorrhea A discharge, or running from the ear Ozena. An ulcer situated in the nose. See Ozana Palate Bones These are placed at the back part of the roof of the mouth,between the superior max- illary and sphenoid bones, and ex- tend from thence to the floor of the orbit. Palpebre The eyelids. Palpitatis Cordis. Palpitation of the heart. Panaris. Whitlow; panaritium; paronychia. Pancreas. A gland situated trans- versely behind the stomach. Paralysis. Palsy. Paralysis Paraplegica. Paralysis affecting one half of the body transversely. Parenchyma. The. connecting medium of the substance of the lungs. Paronychia. Vide Panaris. Parotitis. Inflammation of the parotid gland ; the mumps. Paroxysm. A periodical fit of a disease. Parturition. The act of bringing forth. Pathogenetic. The producing or creating of abnormal phenomena. Pathognomonic. Characteristic of and peculiar to any disease. ; Pathology. The investigation of the nature of disease. Pectoral. Appertaining to the chest, j Pectus. The chest. Pediculi. Lice. Pelvis. The basin-shaped cavity below the abdomen, containing j the bladder and rectum; and womb in woman. Percussion. The act of striking upon the chest, &c. in order to j elicit sounds to ascertain the state j of the subjacent parts. j Pericarditis. Inflammation of the *24 Pericardium (sac containing the heart). Perineum. The space between the anus and the external sexual or- gans. Periosteum. The membrane which envelopes the bones. Peritoneum. The serous mem- brane which lines the cavity of the abdomen, and envelopes the viscera-contained therein. Peritonitis. Inflammation of the peritoneum. Perniones. Chilblains. Pertussis. Hooping-cough. Petechie. Spots of a red or purple hue, resembling a flea-bite. Phagedenic. A term applied to any sores which eat away the parts as it were. Pharynx. The throat, or upper part of the gullet. Phases. Appearances, or changes exhibited by any body, or by dis- ease. Phlebitis. Inflammation of the veins. Phlegmatic. Vide Leuco-phleg- matic. Phlegmon. An inflammation of that nature which is otherwise termed healthy inflammation. Phrenitis. Inflammation of the brain. Phthisis. (Pulmonalis) Consump- tion, abscess of the lung3. Physiology. The branch of medi- cine which treats of the functions of the human body. Plethora. An excessive fulness of the blood-vessels. Pleura. The serous membrane which lines the cavity of the tho- rax or chest. Pleuritis or Pleurisy. Inflam- mation of the pleura. Pleurodynia. Pain or stitch in the side. Pneumonia, Pneumonitis, Peri- pneumonia. Inflammation of the parenchyma of the lung. Polypus. A tumour most frequently met with in the nose, uterus, or vagina. 558 GLOSSARY. Porrigo Scutulata. Ringworm of the scalp. Porrigo Cervalis. Milk-crust; milk-scab. Posterior Nares. Thejiosterior nos- trils which open into tho fauces. Poupart's Ligament. The tendin- ous portion of the external oblique muscle. It is stretched across from the anterior superior spinous pro- cess of the bone ilium to the pubis. Precordial Region. The fore-part of the chest. Prime Vie. The stomach, and in- testinal tube. (The first passages.) Proctalgia. A sevore pain in the anus. Prognosis. The faculty of predict- ing what will take place in dis- eases. Prolapsus A.m. Protrusion of the intestines. Pino hylaxis. plur. Pruplii/liixes. Means or remedies used as pre- servatives against disease. Prosopalgia. Face-ache. Prurigo. Itching of the skin. Psoas Mlsclus. The names of two muscles situate in the loins. Phoitis. Inflammation of the psoas muscle. Ptisans. Domestic decoctions, such as of pearl barley, &.c. Pirns. The pubic or share bone. Puerperal Fever. Appertaining to childbed. Piriform. Pus-like, resembling pus. Purulent. Of the character of pus. Pus. Matter. A whitish, bland, cream-like fluid, found in absces- ses, or on the surface of sores. Pustule. An elevation of the scarf- skin, containing pus or lymph, and having an inflamed base. P\ 1106IS. Heart-burn ; water-brash. tji insy. Inflammatory sore throat. Qioiidian. Intermittent, about twenty-four hours intervening be- tween the attacks. Rabies. Madness arising from the bite of a rabid animal, generally applied to the disease showing it. self in the brute creation. i Rachitis. The rickets. j Rale, Rattles. Sound in the chest, &c. on auscultation, &C. Raucitas. Hoarseness. Rectum. The last of tho large in- testines, terminating in the anus. Remittent. A torin applied to fevers with marked remissions, and generally subsequent exacer- bation. The yellow fever of tro- pical countries. Re percussed. Driven in. Resolution. A termination of in- flammatory affections without ab- scess, mortification, &c. The term is also applied to the disper- sion of swellings, indurations, &,c Rheumatic Ophthalmia. Inflam- mation of the tunica albuginea, and of tho sclerotica. Rhonchus. A wheezing or rattling sound. In auscultation, tho term is applied to morbid sounds ac- companying respiration, occasion- ed either by the passage of air through fluids in the bronchia or air-cells, or through partially con- tracted bronchial tubes. Rigors. Coldness, attended more or less by shivering. Risus Sardonicus. Involuntary spasmodic laughter. Rose. A term applied to erysipelas, from its colour. Rubeola. Measles. Sacrum. The bone which forms the base of the vertebral column. Saliva. The fluid secreted by the salivary glands into the cavity of the mouth. Saturnine. Preparations containing Sanguineous. Consisting of blood. Sanies. A thin greenish discharge of fetid matter, from sores, fistu- lae, &c. Scabies. Psora. Itch. Scapula. The shoulder-blade. Sciatica. A rheumatic affection of the hip-joint. Sciatic Nerve. A branch of a nerve of the lower extremity. Sciatic, or Ibchiatic Notch. This GLOSSARY. 559 name is given to a notch in the os innominatum, which latter is formed of three bones termed the ischium, ilium, and pubis. Scirrhus. Indolent, glandular tu- mour, generally preceding cancer in an ulcerated form. Sclerotica. The hard membrane of the eye ; it is situated imme- diately under the conjunctiva. Scrobiculus. Pit of the stomach. Scorbutus. Scurvy. Scrofulous Ophthalmia. Inflam- mation of the conjunctiva, with slight redness, but great intoler- ance of light, and the formation of pimples, or small pustules. Secretory Vessels, or Organs. Parts of the animal economy, which separate or secrete the va- rious fluids of the body. Semi-Lateral Limited to one side. Sequela, plur. Sequela. Sinus. A cavity or depression Slough. The part that separates from a foul ulcer. Solidification. Vide Hepatization. Somnolence. Disposition to sleep. Sordes. The viscid, fetid, brown- ish, red-coloured matter discharg- ed from ulcers. The matter which forms round the teeth in fever, &.c has likewise received this appellation. Specific A remedy possessing a peculiar curative action in cer- tain diseases. Spleen. A spongy viscous organ, of a livid colour, placed on the pos- terior part of the left hypochon- drium. Splenitis. Inflammation of the spleen. Splints. Long, thin pieces of wood, tin, or strong pasteboard, used for preventing the extremities of fractured bones from moving so as to interrupt the process by which they are united. Sputa. Expectoration of different kinds. Sputum Cruentum. Spitting of Sternutation. Sneezing. Stertorous. Snoring. Stomacace Canker or scurvy of the mouth. Strabismus. Squinting. Strangury. Painful discharge of urine. Sternum. The breast-bone. Stethoscope. An instrument to assist the ear in examining the morbid sounds of the chest. Stricture. A constriction of a tube or duct of some part of the body. Struma. Scrofula. The king's evil; adj. Strumous. Stye. An inflammatory small tumour on the eyelid. Sub-Maxillary. Under the jaw. Sub-Maxillary Glands. Glands on the inner side of the lower jaw. Sub-Mucous Tissue. Placed un- der the mucous membrane. Sudorifics. Medicines which pro- duce sweating. Sugillation. A bruise, or extrava- sated blood. Suppuration. The morbid action by which pus is deposited, in in- flammatory tumour, etc. Subsultus Tendinum. Twitchings ; sudden starts of the tendons; weak convulsive movements which are often too feeble to ele- vate the limb itself, but sufficient- ly strong to be readily seen or felt in the muscles and their ten- dons. They are most frequently met with in states of extreme debility, particularly in low, ner- vous, or typhoid fevers, and are, in such cases, usually to be dread- ed as prognostications of ap- proaching dissolution. Syncope. Fainting or swooning. Synocha. Continued inflammatory fever. Synovia. A peculiar, unctuous fluid secreted within the joints, which it lubricates, and thereby serves to facilitate their motions. Synovial Membrane., The mem- brane which lines the cavities of 560 GLOSSARY. the joints, and secretes the syno- via. T.f.nia. Tape-worm. Tartar. A concretion encrusting the teeth. Temporal. Appertaining to the temples. Tendon. The white and shining extremity of a muscle. Tenesmus. Painful and constant urging to alvine evacuations, without a discharge. Tetanus, adj. Tetanic. A spas- modic rigidity of the parts affect- ed. Therapeutics. That branch of medicine which describes the action of the different means em- ployed for the curing of diseases, and of the application of those means. Thorax. The chest, or that part of the body situated between the neck and the abdomen. Thrush. Numerous small white vesicles in the mouth. See Thrush. Tic Douloureux. Face-ache. Tinea Annularis. Tinea Capitis. Ringworm of the scalp. Tinea Faciei. Milk-crust; milk- scab. Tinnitus Aurium. Ringing in the ears. Titillation. Tickling. Tonic. Medicines which are said to increase the tone of the mus- cular fibre when debilitated and relaxed. Tonsils. The oblong, sub-oval glands placed between the arches of the palate. Tonsillitis. Inflammation of the tonsils. Topical. Remedies applied to a particular part. Tourniquet. An instrument for stopping the flow of blood until some more permanent method of arresting the hemorrhage has been adopted, or until some oper- ation has been performed. Trachea. The windpipe. Tracheotomy. An operation by opening the windpipe. Traumatic. Appertaining to wounds; arising from wounds. Tremor. Trembling. Trephine. A surgical instrument used for sawing a circular portion of bone out of the cranium. Trismus. Lock-jaw. Trituration. The reduction of a substance to minute division, by means of long-continued rubbing. Trochanter Major. One of the processes of the thigh-bone. Trm.RCLE. A small, round, erup- tive swelling, anatomically speak- ing. In pathology, the name is applied to a peculiar morbid pro- duct occurring in various organs or textures, in the form of small, round, isolated masses of a dull whitish yellow, or yellowish gray colour, opaque, unorganized, and varying in shape and consistence according to their stage of deve- lopment and the texture of part in which they are engendered. Tumefaction. Swelling. Tumefied. Swollen. Tumid. Vide Tiiniefu-it. Tunica Albuginea. The anterior part of the sclerotica, strengthen- ed by the tendinous expansions of the muscles of the eye. Tunica Adnata. That portion of the tunica conjunctiva which covers the sclerotic coat has been thus designated. Tussio Convulsiva. Hooping- cough. Tympanites. Tympany. Drum- belly. An elastic distention of the abdomen, sounding like a drum when struck with the hand. It is attended with costiveness, but no fluctuation ; and is dis- tinguished into—Tympanitis in- testinalis, flatulent obstruction, or lodgment of wind in the intes- tines, recognised by the emission of wind affording relief:—Tym- panitis abdominalis, when the wind is in the cavity of the abdo- GLOSSi Typhoid. Applied to diseases of a low character. Umbilical Cord. The navel string. Umbilicus. The navel. Union by the first intention. The healing of wounds by adhe- sion ; the growing together of the opposite surfaces of a wound when brought into close approximation, without suppuration or granula- tion. The latter process of heal- ing is sometimes designated the second intention. Urethra. The urinary canal. Urticaria. Nettle-rash. Uterus. The womb. Varicella. Pimples, quickly form- ing pustules, seldom passing into suppuration, but bursting at the point and drying into scabs. Chicken-pock. Variola. Smallpox. Variola Spuria. (Varicella.) Chicken-pock. Varix, plur. Varices. Swelling or enlargement of the veins. ARY. 561 Venesection. The abstraction of blood by opening a vein. Vesiccations. An eruptive eleva- tion of the cuticle, containing a clear serous fluid. Vertigo. Giddiness, with a sensa- tion as if falling. Vesicle. A small bladder-like eruption; an elevation of the cuticle containing a transparent watery fluid. Vicarious. Acting as a substitute. Virus. Contagion or poison. Viscid. Glutinous and gelatinous. Viscus, plur. Viscera. Any organ of the system. A bowl. Vomer. A slender thin bone of the nose, forming the partition be- tween the nostrils, and so called from its resemblance to a plough- share. Vomica. An abscess of the lungs. Zygomatic Process. A thin nar- row projection of bone, defining the squamous portion of the tem- poral bone at its base. INDEX. Abdominal Deformity . PAGE 542 Alidomen, pendulous ib. Abortus .... r> i h Abscess .... 288 Absceseus Nucleatus 283 Acidity, see Dyspepsia . 95 Flatulence, &.c. in infant* 462 Administration of Medicines 9 iEgylops .... 330 After-pains .... 534 Agrypnia ■ . 354 Ague .... 39 Air and Exercise . 505 Ambustiones 417 Amenorrho?a 498 Angina, see Sore Throat 81 Cmgrenosa 89 Maligna ib. Membranacea 210 Parotidea . 9.1 Perniciosa 210 Angyleps ... 330 Anor'»xia .... 101 Anthrax .... 285 Anti-mercurial remedies 341 Aphthous Sore Throat . 81 Aphtha? ••.. 466 Apparent Death, Asphyxia 422 , 4 13 from a Fall . 422 Drowning 423 Frost 425 Hanging 423 Hunger . 42-2 Lightning 423 Noxious Vapours 426 Suffocation 423 Apepsia 101 Appetite, Want of 101 Apoplexia 266 Apoplexy 266 Arthritis 307 Asiatic Cholera 152 Asphyxia, Apparent Death . 422 in Infants 443 Asthma 395 Spasmodic in Children 463 Asthma of Millar . 486 Atrophia 493 Atrophy 493 Aversion of the Infant to the Breast 545 Bastard Pleurisy . 251 Bilious complaints PAOI 95 Birth, Treatment after 442 Black Water 119 Bladder Inflammation of 180 Blearedness . 333 Blepharitis .... 333 Bleeding of the Nose 337 Blood, Spitting of 252 Blood-shot Eye 330 Boil .... 283 Bowels, Looseness of 137 Inflammation of 168 Bowel complaint of Children 468 Brain Fever 271 Brain, Inflammation of the . ib. Concussion of the 403 Breasts, Inflammation of 547 Preparation of during Pregnancy . 524 Breath, offensive . 348 Breathing, Difficulty of, see Asthma .... 395 Bronchial Tubes, Inflamma- tion of 225 Bronchitis .... ib. Bronchocele, see Goitre 352 Bruises .... 403 Bunions .... 412 Burns and Scalds 417 Bursa?, Injuries and Diseases of the .... 412 Cancer nasi 341 Cancer iu the face 331 Cancer in the lips 331 Cancer of the Mouth 343 Cancrum oris ib. Carbuncle .... 285 Cardialgia .... 112 Carditis .... 313 Caries of the Bones 341 Carrying of Infants 456 Cataract .... 329 Catarrh .... 187 Catarrh bronchiorum, or Oc- culta 239 Catarrhal Ophthalmia 328 Cephalalgia 370 Arthritica . ib. Nervosa ib. Cephalaea ih. Chest, Determination of blood to 221 Cold in . 225 INDEX. 563 . PAGE Chicken-pox . . .71 Chilblains .... 285 Children, suckling of . 549 Chin-cough, see Hooping- cough . . . .204 Chlorosis .... 495 Cholera .... 149 Cholerine . . . .155 Chronic Laryngitis . . 193 Clavi Pedis . . 287 Clavus Hystericus . . 370 Cleansings, see Lochia . 540 Clothing . . . .506 and Habits , . 4 Coffee, Derangements from the Use of 355 Cold, Common . . . 187 in the head . 193, 459 in the Chest . . 225 Colic.....133 Concussion .... 403 Confinement, Duration of . 535 Congestio ad Pectus . .221 Caput . . 260 Congestive Pneumonia . 240 Conglobate Glands, Diseases of.....288 Constipation . . 123, 513 in Children . 467 Consumption, pulmonary . 259 Consumption, see Phthysis in- cipiens .... 241 Consumption of the Wind- pipe, see Phthysis Laryn- gea .... 193 Contagious Fever, (Typhus) 37 Contusions, see Bruises . 403 Convulsions . • .531 in Children . . 480 Cornea, Ulceration of the . 329 Opacity of, or Specks on the . • ib. Corns ...•• 287 Coryza, Cold in the Head 193, 459 Costiveness . . .123 Cough • • -196 after Measles . • 63 Cough after Smallpox . . 70 ' Hooping . • -204 Coup de Soleil . . -275 Coxalgia Coxagra Cramps and Convulsions ib. 531 PAGE Critical Age, see Dysmenor- rhea . . . .501 Cr°up • . . .210 Crusta Lactea . , . 464 Crying and Wakefulness of New-born Children . . 460 Cynanche, see Sore Throat . 81 Laryngea . . .210 Maligna ... 89 Tonsillaris, see Quinsy 81 Tracheitis . .210 Cynanche Parotidea . . 95 Cystitis . . . .180 Death, Apparent . . 422, 443 Deafness .... 336 Decubitis .... 241 Deficiency in the Secretion of Milk . . . .548 Delivery, Treatment after . 532 Weakness after . 544 Delirium Tremens . . 391 Derangement of the Stomach, Fever from . . .107 Derangement of Stomach . ib. during Teething 478 Dentition . . . . ib. Determination of Blood to the Chest . . . .221 „ Head . 260 Abdomen 323 Deterioration and Discolora- tion of Milk . . .549 Diarrhcea . . . .137 in Lying-in Women 541 during Pregnancy . 513 in Children . . 468 Diet.....508 Diet, Rules ... 14 in Fever ... 20 during Nursing . . 458 Difficulty in Breathing, see Asthma . . . 395 Difficult Menstruation, see Dysmenorrhoea and Chlo- rosis .... 501 Discharge, Irregularities of the lochial . . . 540 Disinclination of the Infant to Suck . . . .545 Dislocations and Fractures 403, 414, 415 Dispepsia, see Dyspepsia. Dose, on the Repetition of the 9 rowning, apparent Death from .... 423 564 INDEX. PAGE Duration of Suckling and Weaning . • 451 Confinement . . 535 Dyscrasia, Morbid Condition 336 Dysenteria . • • 141 l>\sentery • • .lb. Dysmenorrhcea . • .501 Dyspnoea, see Asthma • 395 Dyspepsia .... 95 Ear-ache .... 333 Emansio Mensium • • 495 Emotions, .Mental . 438, 509 Employment of the Mind du- ring Pregnancy ■ 508 Emprosthotonos . . .2*6 Encephalitis . . .271 Enteritis .... 168 Enteralgia . . . 133, 168 Ephialtes .... 357 Epilepsia .... 394 Epilepny ib. Epiphoria .... 330 E|nstaxis .... 337 Kmctations .... 107 Eruptive Fevers . . 48 Erysipelas . . • 280 Neonatorum . 475 Excoriation of the Nipples 546 in Children . 474 see Decubitus . 241 Exercise .... 505 iu the case of Children 455 Expulsion of Meconium . 445 External injuries . . 403 Eyes, Blearedness of . . 333 Hemorrhage from . 330 Inflammation of . 324 Bloodshot . . 330 Eyelids, Inflammation of . 333 Catarrhal Inflammation of the ib. Face, Swelling of . . 516 Face-ache .... 349 Face Ague . . . ib. Scirrhus in the . .331 Warts on the . . 332 Fainting .... 367 Fainting and Hysteric Fits 513 False Pains . . .526 Fall, Apparent Death from a 422 Falling down of the Womb, see Prolapsus , , . 543 Fatigue .... 419 Favus Confertus . . ,297 Feet, Sweating of the . 353 levers, or Febros . . 17 PACE Fever, Brain . • .271 Contagious (Typhus) 37 Eruptive ... 48 Infantile Remittent 488 Inflammatory • 22 Intermittent . . 39 Miliary ... 72 Milk . • .538 Nervous . . 24 Putrid ... 35 'Scarlet ... 48 Simple or Ephemeral 20 Typhus . . • 24 Contagiosus . 37 Putridus ' . 35 Fistula in Ano . • . 306 Lachrymalis . . 330 Fits, see Epilepsy and Con- vulsions . . • 394 Flatus . . . .110 Flatulency . . . ib. in Infants . . 462 Fontanels, retarded closing of the .... 444 Fractures and Dislocations 414, 415 Frozen Persons . . . 425 Fungus Hrematodes . . 306 Oculi . 329 Furunculus . . .283 Malignans . 285 Galling, Excoriation . . 241 Gangrenous Sore-throat . 89 Gangrene . . . .411 Oris . . .343 Gastralgia . . . .112 Gastrodynia . . . ib. Gastric or Bilious Fever, see Dyspepsia ... 95 Gastritis . . . .165 Glands, Conglobate, disease of the . . . . 288 Glossitis .... 346 Goitre . . . .352 Gonorrhoeal Ophthalmia . 329 Gout . . . .307 Gravel or Stone . . .181 Gripes, see Colic . .131 Gumboil .... 346 Gun-shot Wounds . . 413 Habits during Pregnancy . 508 Hair, falling of . . . 543 Head, Determination of Blood to.....26Q Swelling of, in Infants 444 Cold in . 193.459 INDEX. 565 313 ib. 119 181 119 370 128 2.32 252 ib. 540 . 407 . 156 . 160 . 361 . 296 . 502 . 458 . 318 318, 320 . 191 . 204 . 332 411 Head, Water in the Headache .... Heart, Palpitation of the Inflammation of, see Carditis Endocarditis Heartburn Helminthiasis Ha?matemesis Hemicrania (Megrim) Hemorrhoids Hemoptysis Hemorrhagia Pulmonum Hemorrhage from the Lungs after Delivery see Wounds Hepatitis .... Chronica . Hernia .... Herpes Circinnatus Hiccough .... in Infants Hip-gout Hip-disease Hoarseness Hooping-cough Hordeolum Housemaid's Knee Hunger, apparent death from 422 Hydrocephalus . . • 484 Hydrophobia . • .426 Hysteria .... 501 Hysterics . • • 501, 513 Icterus • • .161,474 Incubus .... 357 Indigestion ... 95 Induration of the Cellular Tis- sue • Infants, Treatment of Suckling of Infants, Supplementary Diet of . ' ■ Infantile, Remittent Fever . Inflammation, Acute, of the Liver • • • • Inflammation of the Bladder . Brain Bowels . Breast Bronchial Tubes 225 Ears . • 333 Eyes • • 3~4 Eyes in new- hnm Tnfants 458 Inflammation of the Heart Kidneys . Larynx . Liver Lung PAGE 313 177 193 156 234 475 442 446 449 488 156 180 271 168 547 Margins of the Eye-lids . 333 Peritoneum . 175 Psoas Muscle . 315 Pleura . . 242 Spinal Cord, etc. 358 Spleen . .162 Stomach . 165 Tongue . . 346 Inflammatory Fever . . 22 Influence of External Objects upon the unborn Infant . 509 Influenza . . • 219 Injuries external . . . 403 Insects, Stings of . . . 420 Intermittent Fevers . • 39 Intestine, Protrusion of the . 132 Introduction ... 1 Invermination . . 181 Irregularities of the Lochial Discharge . • .510 Irritation of the Skin . • 294 Iritis . . . 327, 328 Arthritica . • • 329 Ischias . . • • 3's Itching of the Skin . . 291 hch .... 291 Jaundice . • 161,474 Joints, Injuries of the . . 470 Kidneys, Inflammation of . 177 ^ Knee-joint, Diseases of the . 322 Labour .... 528 Labour, complicated . • 528 remedies before . • 525 tedious . • • 528 Lacerations ■ • • 407 Laryngismus Stridulus . . 486 Laryngitis Chronica . • 193 Larynx, chronic inflammation of the • • .193 Legs, cramp in the . . 35~. Leucorrhcea • • • 54J Lightning, apparent death from 423 Lips, Swelling of . . • 331 Scirrhus of the . . ib. Lippitudo, Bleareduess . . 333 Liver Complaint . 155,160 Acute Inflammation of 156 Chronic Inflammation of 160 566 INDEX. Lochia .... Lochial Discharge, etc. Lock-jaw .... of Iufants . Loins, Pains in tin- Loos-ness of the Bowels Lumbago, Rheumatism in the Loins .... Lumbo-sacral Pains Lung-. Inflammation of the . Hemorrhage from the Luxations . . Lymphatic Tumours . Malignant Quinsy Measles .... Meconium, Expulsion of Medical Terms, Glossary of . Medicines, Administration of Megrim, Headache Meningitis Spinalis Mental F1110I10118 . 438. affecting the Milk Meiiochasia Menorrhagia Menstruation . . 499, Scanty Menstruatio Nunia Miliaris Hahnemanni (Purpura > Ml Maris Purpurea .Miliaria, Miliary Fever Milk, excessive Secretion of Deficiency in the Secre- tion of Deterioration and Dis coloration of Fever Mental Emotions affect ing Regurgitation of Suppressed . 536 Miscarriage Mind, employment of during Pregnancy Milkcrust Milkscab Modified Smallpox Morning Sickness Morbus Coxarius Mothers not suckling their Chil iren Mumps Mouth, Canker of the Scurvy in the Moulds, Retarded closine of the . "* PAGE PAUE 540 Mvopia 331 540 Myelitis 358 276 Navel, Rupture of 414 476 Nearsightedness . 331 391 Nephritis 177 137 Nervous Fever 21 Nettle Rash 74 314 Neuralgia Facialis 349 518 Nipples, Excoriation of 546 234 Nightmare 357 252 Notalgia 314 391 414 Nose, Bleeding of the . 337 288 Swelling of the 310 8!) ('ancer in 341 59 Coppery redness of 341 445 Nurse, the Choice of 448 550 Nursing, Diet during . ib 9 Obstipation 123 370 Obstructio alvi 123 358 Obstructio alvi Neonatorum . 467 .509 Occulta 239 518 Odontalgia 77 499 Offensive Breath 348 ib. Ophthalmia 324 ,511 Opisthotonos 276 498 Otalgia 333 499 Otitis ib. ) 55 Otorrhcea . . . 335 ib Ozaena 341 72 Pains in the Back during Preg- 536 nancy 518 False 525 548 Puins in the Loins, Lum jago 314 391 549 Spasmodic, during La- 538 bour 531 in the Hips, Sciatica 548 316-318 462 Palsy 361 , 548 Palpitation of the Heart 351 518 Panaris 293 Paralysis 361 508 Parotitis 93 464 Paronychia . 293 ib. Parol is, see Gumboil 346 70 Parturition . 528 512 Passio_ Hysterica 501 320 Pentwind, see Asthma and Flatulency 110 395 549 Peripneumonia 234 93 Peripneumonia Notha . 239 343 (See also Bronchitis CI ronjpa) 345 Peritonitis 175 Peritoneum, Inflammation of lb. 442 Perniones 285 INDEX. 567 PAGE Pertussis .... 204 Perspiration after Delivery . 537 Suppressed . . ib. Phthysis Laryngea . .193 Incipiens . . . 241 Pulmonalis . . 259 Phrenitis . . . .271 Piles.....128 PleuraTInflammation of . 242 Pleurisy .... 242 Pleuritis . . . . ib. Muscularus, see Pseu- dopleuritis Pleurodynia Pleurosthotonos Pneumonitis Pneumonia Notha, Occulta Typhoid or Congestive Poison Mineral Vegetable Animal Polypus Porrigo Scutulata Lupin os a Furfurans Favosa Deealvans Larvalis Potencies of Medicaments Pregnancy, Observations on During Prolapsus Ani Uteri Prosopalgia Protrusion of the Intestine 132 Prurigo . . . • Prunella, see Sore Throat . Pseudo-pleuritis . Psora . . • • Psoitis .... Purpura Rubra . . • Miliaris . Pustula Nigra Putrid Fever Sore Throat Pyrosis . . . • Quinsy . . • ■ Malignant Rachitis . . • • Rickets . Raucitas . . • • 251 ib. 276 234 ib. 239 240 434 435 436 437 343 297 300 ib. ib. 301 464 5 503 511 132 542 349 349 294 81 251 291 315 55 ib. 285 35 89 119 81 89 488 ib. 191 PAGE Regurgitation of Milk, Acid- ity, Flatulence, &c. . 4f>2 Regimen ... 1 Remedies before Labour . 525 Rheumatism . . .310 in the Loins, Lumbago 314 Hip-joint, Scia- tica . 316,318 Rheumatic Ophthalmia . 329 Ringworm, Herpetic or Vesi. cular . . .296 Pustular . . 297 of the Scalp . ib Rose . . • .280 Rubeola . . . . 59 Rules of Diet ... 14 Rupture (Hernia) . . 361 Navel, in Infants . 444 Scalds and Burns . .417 Scabies . . . .291 Scarlatina . ... 48 Anginosa . • 49 Miliaris . 53, 55 Maligna,seeUlcerated 49 Sore Throat Sequela? of Dropsical Swellings after Scarlet Fever Rash Scalled Head, see Porrigo Scutulata Sciatica Scirrhus, Cancer Scrofula, see Glands Scrofulous Ophthalmia Scorbutus Scurvy • • in the Month Sea Sickness Shortsightedness Sleeplessness in Children Smallpdx Sore Throat Ulcerated Sores, see Ulcers . Spasm of the Stomach in the Chest in Children Spasmodic Pains Spleen, Inflammation of Splenitis Spitting of blood Sprains or Strains Sprains ib. 53 53 48 55 297 . 316 331 288 329 345 ib. 343 420 331 354 452 63 81 89 301 112 463 531 162 ib. 252 403 406 56? INDEX. PAGE 25 1 Spurious Pleurisy Sputum Cruentum S(| nniing, see Strabismus Strains Strabismus Stints of Insects . St. Anthonys Fire Stoniacii. Derangement of Inflammation of Stomacace Stone or (Jravel Struma, see Clauds Stye Suckling Suck. l>i-inelination luu.nl to ... Sudor Miliaris Suffocation, apparent Death from .... Supplementary Diet of Infants Suppressio Mensium Snppie»eil Dysentery Secretion of Milk 536, 5 18 Swelled Face . . .516 >welling of the head in Infants 444 Lips . . 331 Nose . . 340 Veins . . 517 Sweating at the Feet . 353 Siv......in- . . . 367 !\\ ucope . . . ib. S\cosic Ophthalmia . . 329 Swiocha ... 22 Ss novi.il Membranes. Injuries of 411 330 406 330 420 2-0 107 165 . 343 . 181 . 288 . 332 446,451,549 of tho . 545 423 4 19 198 148 Syphilitic Ophthalmia Ulcers Ozama Tea. Derangement from the Kifeelsof Teeihiiig . tetanus . Thrush . Tic Douloureux . Tinea Capitis Auularis . Faciei Tongue, Inflammation of Toothache iu Pregnant Female Tonsillitis Maligna '1 on-illitig, see Sore T hroat 329 306 342 356 478 276 466 3 li) 297 ib. 464 346 77 515 89 81 Treatment of Infants . after Birth Treatment after Delivery Trismus Trismus Nascentium ■ Tumours . . .28 TtlKsis Tussis Convulsiva T\ mpaniiis Intestinalis, see Flatulency Typhoid or Congestive Pneu monia Typhus Fever Coniagiosus PiiIikIiis Ulcerated Sore Throat . Ulcers Urine, Suppression of, see Cystitis, Nephritis 17 Urine, Freipient, painful, or obstructed lOmissiou of See, also Cystitis and Ne- phritis . Urticaria Uterine Swelling and Prolap bus .... Vaccination . Varices, or Swelled Veins Variola Spuria, Varicella Veins, Swelled Vomiting in Infants of Blood Walk, Teaching Children to Slo.vness in learning to Warts on the Face Nose Water-bra-Ii Water in the, Head Watery Eye Weakness after Delivery Weaning Weeping Eye Whitlow W orms Wounds Contused Incised Liberated . 40 Punctured PAGE 4 12 4 12 532 276 476 , 332 196 204 '23 ushot . '