II UVIBI1 IVNOIIVN 3NIDI03W JO AIVIII1 IVNOIIVN 1NI3I01W JO AIVIIM 1 l»RY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF ft = s/g&h I ^k^ = Sri uvian ivnoiivn inoioiw jo Aivam ivnoiivn indioin jo aiviiii i lARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF t Villi IVNOIIVN INI3IQ1W JO AIVIIII IVNOIIVN INDIOIN JO AIVIIII T f , v- ARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF M E NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATIO NATIONAL LIBRARY OF MEDICINE N A T I O N A I LI B R A R Y O F M E D I C I N E NATII HOMEOPATHIC DOMESTIC MEDICINE J. LAURIE, M. D., MEMBER OF THE ROYAL COLLEGE OF SURGEONS, EDINBURGH. SENIOR PHYSICIAN TO THE WESTMINSTER AND LAMBETH HOMCEOFATIIIC MEDICAL INSTITUTION AND DISPENSARY. ARRANGED AS A PRACTICAkMRK FOR STUDEX1S,___ i •*--, • . - i • ' .- ■■...■ i _..*><.. .'-. j *>•-■.•. e vi\ vl.....;-Lb Jr r k,F CONTAINING A GLOSSARY OF l^EDICAL TERMS. * l' '''" i lUliizr. FOURTH AMERICAN EDITION, ENLARGED AND IMPROVED,. A. GERALD HULL, M. D. NEW-YORK: WILLIAM RADDE, 322 BROADWAY PHILADELPHIA : C. L. Rademacher. BOSTON: Otis Clapp. ST. LOUIS : Franksen & Wbsselh(eft. 1848. * i Kvn;i!Ei>, according lo Act of Congress, in the year 1847, by WILLIAM RADDE, In the Cluik's Office of the District Court for the Southern District of New-York. 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 disease in prefer- ence to those set down in the text. For example, where Aconite, Belladonna, or Chamomilla of the 24th or 30th attenuation ore prescribed by Dr. Laurie, the editor would put one drop of the tincture of either of these remedies in a tumbler full of .vater 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 and second dilutions, when used in water, a9 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 medicine 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 in- dicated. 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 pro- per to make the intervals much shorter than the author prescribes. It is quite probable that the water solutions can be repeated at shorter intervals, cceteris paribus, than the pellets or powders ; and for this reason physicians often dissolve the pellets themselves in water, and re- peat the spoonful doses twice or thrice as frequently as they would give them dry. The editor's mode of using this work in acute diseases then, is to put one drop of the tincture, or two drops of a first or second dilution, into a tumbler of water, and to administer of this solution a table- spoonful to an adult and a teaspoonful to a child as a dose. Or, again, when a trituration (a dry powder) is preferred, to stir one-third of an iv PREFACE TO THE AMERICAN EDITION. ordinary penknife blade full (about equal to one grain in weight) of it in a tumbler of water, and use the same doses. And finally, when the pellets are good, and are preferred by the prescriber. the editor recommends that five or six of them be dissolved 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 American editor (as, indeed, with all the foreign works edited by him), where he has not specified his own experience or given the authorities, he wishes to be understood to have compiled the same from the best practical re- sults of the school at large, without formal signs of quotation. New-York, December, 1847. * PREFACE TO THE THIRD EDITION. Prom 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 satisfac- tory indications that the work had been found sufficiently co- pious 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 commencing to make a practical inquiry into the homozopathic 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 additional 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 hae de- rived considerable aid from Jahr's ' Manual' (Nouveau Manuel de Medecine Homoeopathique), and Hartmann's ' Therapie akuter Krankheitsformen,' 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 of Hahnemann,—a work which every stu- dent, who wishes to acquire a proper knowledge of Homoeo- pathy ought to possess, and make a constant habit of care- fully studying and consulting, if he wish to avoid falling into an indolent and unsafe method of practice. J. L. 12 Loicer Berkeley Street, Portman Square, October, 1845. A2 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 po- tencies prescribed, and more explicit directions given for the administration and repetition 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 dis- ease; he has also given the book a more medical character by the addition of the diagnosis of disease, causes, &c, and the employment of medical terms; but in order not to interfere with the utility of the work, a glossary has been added for the non-professional reader. The non-medical public who confine themselves to their proper sphere, viz. the treatment of slight and ordinary ail- ments, will still find this Treati.se useful as a Domestic Med- icine ; in such cases the globules at medium and high poten- cies 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 many years. PREFACE. Vll At the request of several friends, directions have been given 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 principle are, the present paucity* of homoeo- pathic practitioners; the refutation, by a plain statement of the treatment of acute disease, of the too prevalent idea, that Homoeopathy is available only in Clironic affections ; and the hope that this work may, under proper restrictions, prove of service in cases of ordinary derangement, or where the ad- vice of a homoeopathic physician is unattainable; and by assisting in the selection of the proper remedy, save many from having recourse to allopathic modes of relief, such as aperients, &c, which are so calculated to undermine the strongest constitution, and convert trifling affections into per- manent maladies. From the first-mentioned motive, (the present want of homoeopathic 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 va- riety of cases, and in almost all so far obviate immediate dan- ger, and place the malady in such a position as to give time, when imperatively necessary, for seeking suitable advice. * I have sincere gratification in remarking, that even since the first pub- lication of this work, this want has been, to some extent, diminished, by the great number of medical converts who are daily joining our ranks, and whose extensive practice, wherever they have settled, holds out most cheering prospects for the future. Still,' in many of the great lowns and densely-populated districts of this empire, as well as in our posses- sions abroad, a homoeopathic practioner would be eagerly welcomed Much has been, but more remains lo be done.—Author- ♦ Vlll PREFACE. In cases that require prompt and decided measures, such as i; Convulsions," "Croup," &c, the treatment has been pretty fully gone into. In others, such as " Inflammation of the Brain and Lungs," the course to be pursued to ward off all immediate danger, has been briefly, but it is to be hoped, clearly pointed out. Other acute or dangerous maladies, such as "Puerperal Fever," "Phlegmasia Alba Dolens," (puer- peral tumid leg,) "Epilepsy," "Cancer," &c, have been slightly glanced at, or wholly omitted; convinced, that to do justice to their several treatments, would carry the work far beyond its intended limits and purpose, and that an imper- fect 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 pre- vious education of the physician fully to comprehend, and his practical experience properly to apply. To the Student, still at the threshold of ourscience—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 harmonious uniformity of the homoeopathic system, conjoined with its invariable rule of administering only one medicinal substance at a time, have misled many into the 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, although wholly destitute of other physiological or pathological knowledge, imagine them- selves qualified to prescribe for every variety of ailments, and their presumption is generally in exact ratio with their igno- rance. No doubt, from the inherent excellence of the system some of these zealous individuals have cured diseases that have defied the allopathic mode: but generally, from the ab- sence of a medical education, and of a perfect knowledge of the Materia Medica, by a circuitous route; whereas the prac- tised mind of the physician, frequently detecting the exact 4 PREFACE. IX nature of the disease, and at all times carefully discriminating the primary from the purely sympathetic, or secondary symp- toms, is thereby enabled to make a more ready selection of a specif c remedy, and save the patient from a course of needless suffering. If such be the case in Chronic, how much more so in severe and complicated Acute diseases; such, it is evident, no indi- vidual, not fully competent, should take upon himself the serious responsibility of treating, unless coerced by an impe- rious 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, *he administration of the latter will be always marked with decided benefit. In conclusion, it may be observed, that from the unfair impressions of the science, that have been so industriously propagated, Homoeopathy has been too frequently treated as a species of charlatanism, 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 Homceopathist has effected: prehaps again seeking his assistance when the mis- chief has been rendered irremediable by their own fatuity. Others, who have seen members of their families (whose diseases were beyond the power of medicine) die during 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 casP6 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 suc- cess in thousands of cases, in which every other mode.has signally failed—upon the firm and irrefragable basis of a mul- titude of unimpeachable and incontrovertible proofs. WILLIAM RADDE, 3 2 2 BROADWAY, NEW-YORK, Respectfully informs the Homciopathic Physicians, and the friends of the System, that he is the tble Agent for the Leipzig Central Homoeopathic Pharmacy, and that he has always on hand a pood assortment of the best II myopathic Medicines, in complete sets or by single vials, in Tinctures, Dilution*, ami Triturations; also Pocket '"•;'£* of .Medicines ; Physicians' and Fami/ii Medicine Chests to iMurie's Domestic (MJ Remedies)—EPP'S (54 Remedies)- HERING'S (58 II.niedies).— Small Pocket cases at 33, with Family Guide and 'S. Remedies.—Cases containing 415 Vials with fine- tunes and Triturations, for Physicians.—Case* with .'III Vials of Tmc'.uies and Tritura- tions to Jahr's New Manual.—POCKET-CASES wiihi.li Vials of Tincture* and Tritu- rations.— Cases from i>()0 to 400 Vials with low and high dilutions of .Mi dicated Pellets.— Cases from 50 to 80 Vials of low and high Dilutions, &c &<•. lloimiopathio Chocolate. Relined Sugar of Milk, pure Globules, &c. Jtrnica Tincture, the U--1 specific remedy for bruises, sprains, wounds, etc. Arnica Piaster, fir (urns. etc. t'rtica t'rent, for Bums; Iluma-npathic Tooth-Potriler: as well'as Hooks, Pamphlets, and Stan- dard Works on the System, in the English, French, and German languages. HOMOEOPATHIC BOOKS. JAHR'S NEW M NUAL; originally published under the name of Symftome;.- Cor>r;\ (Digest of Symptoms). This work is intended to facilitate the comparisons of the practitioner, to discover the characteristic Symptoms of each drug, and to determine with easo and correctness what remedy is most homoeopathic to the existing gioup of symptoms. Translated by Charles J. Ilempel. M. D.. assisted by James M. Unin, IM. I>. ; with revisions and clinical notes by John F. Gray, M. D., with contiibntions by I»i-. A. Cerald Hull and George W. Cook, M. !)., of New-York, and Drs. C. tiering, J. Jeanes, C. Neulhard, VV. Williamson, and J. Kitchen, of Philadelphia. "Witii a Preface by Dr. Const. Hering. Price for vol. I. $.">. RAU'S ORGANON. Translated by C. J. Hempel.M. D ?1 ->.>. BECKER, M. D. On Consumption. Translated from the'German, 1848. 38 cts. ---------- On Diseases of the E.w. 184-<. 38 cts. ----------On Constipation. I-IH. 38 cts. ---------On Dentition. 1848. :w cents. HKMIT.L'S HOENNINGHAUSEN for Ilom.eopailiic Physicians; to be used at the bedside of the Patient, and in studying the Materia Medi.-a Pura. One octavo volume, mo-t complete edition, including the Com oi.laii.-e-, of llomii-opallin: Remedies. Translated and adapted to the use of the American Pio'e-ion, by C. J. Ilempel. 1^47. Bound. Price 81 50. HARTMANN'S ACUTE DISEASES, Vol.1. By Dr. Charles J. Hempel. 1817. Bonml. Price £l 50. JAHR. G. II. (»., M. D. Short Elementary Treatise upon llomoeopathia and the Manner of its Practice ; with some of the most important effects of ten of the principal Homoeopathic Remedies, for the use of all honest men who desire to convince themselves, by experiment, of the truth of the doctrine. Second French edition, corrected and enlarged, translated by Edward Bayard, M. D. Hound. 37£ el,. HAIINEM-VNN. Dr. S. The Chronic Diseases, iheir -peeilio nature and Homao- pathic Trcatnnnt. Translated and edited by Charles J. llotnpel, M. I)., with a preface by Con-tantine lleriug, M. D., Philadelphia. :-\o, 5 volume. Hound. 1845. $7. HEMPEL'S Homo-opathic Domestic Physician, 18-Hi. Bound, .M) cK. BoENNINGIIAL'.SI-'.VS Essay on the llom.-i/opaihic Treatment of Intermittent Fevers. Translated and edited by Charles Julius Ilempel, VI D. 1845. 38 cts. A TREATISE on tht use of .Irnica in ea-es of Contusions, Wounds, Strains, Sprains, Lacerations of the Solids, Concussions, Paialy-is, Rheumatism, Soreness of the Nipples, etc.. etc ; with a number of cases illustrative oI the use of that drug. Bv Charles Julius Ilempel, M. I). 1845. 18& cts. HAHNEMANN. Dr. S. Materi Medicj I'ut.. Translated and edited by Charles Julius Hempel, M , D. 4 vols. 1*4! HOMOEOPATHIC COOKERi, ond ertWun, with additions by the lady of an American Homoeopathic Physician. Designed chiefly for the use of such persons as are nnder homceopathic treatment. 50 cts. RUECKERT'S THERAPEUTICS : or Successful Homoeopathic Cures, collected from the best homceopathic periodicals. Translated by Charles J. Heinpel, M. D. One large 8vo vol., bound, S3. THE HOMCEOPATHIC EXAMINER. By Drs. Gray and Hempel. 2volomes. New Series. ]84f> and 1847. Bound in two volumes. $ti. TRANSACTIONS OF THE AMERICAN INSTITUTE OF HOMOEOPATHY 1846. Bound. SI 50. ' THE BRITISH JOURNAL OF HOMOEOPATHY. By Drs J J Drvsdale J R. Russell, and Fr. Black. London, 1840 and 1847. 2 vols. *<; ' ' • CONTENTS. PART I. INTRODUCTION. Regimen ...... { Clothing and Habits ..... 4 Potencies of the Medicaments . • . .5 Administration and Repetition of the Medicines . . 9 Pharmaceutical Signs ... 12 Synopsis of the Rules for Diet . • . . 14 20 PART II. ON THE SYMPTOMS, CHARACTER, DISTINCTION, AND TREATMENT, OF DISEASES. FEVERS. General consideration of Fever, &c. Causes .... General Treatment and Diet . Simple or Ephemeral Fever. Febris simplex Inflammatory Fever. Synocha Nervous Fever. Febris nervosa. Typhus . Congestive Fever .... Putrid Fever, or Typhus. Typhus putridus Contagious Fever, or Typhus. Typhus contagiosus Accessory Treatment (during typhus). Prophylaxes, &c Intermittent Fevers. Ague. Febres intermittentes 17 19 20 20 22 24 26 36 37 38 39 «• ERUPTIVE FEVERS. Scarlet Fever. Scarlatina . . . . .48 Purpura rubra ..... 55 Scarlatina Miliaris ..... ib Scarlet Rash ...... jh Measles. Rubeola ..... 59 Smallpox. Variola .... 63 Chicken-pox. Variola spuria, Varicella . . 71 Miliary Fever. Miliaria ... 72 Nettlerash. Urticaria .... 75 DISEASES OF ORGANS CONNECTED WITH THE DIGESTIVE SYSTEM. Toothache. . ~- - Sore Throat, or Quinsy. Angina . 31 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 . Spasm of the Stomach. Gastrodynia, Cardialgia Heartburn. Pyrosis Vomiting of Blood. Hematemesis . Constipation. Obstructio AIci Piles. Hemorrhoids Protrusion of the Intestine. Prolapsus Ani Colic. Entcralgia Looseness of the Bowels. Diarrhoea . Dysentery. Dysentcria . Suppressed Dysentery. Cholera ------Asiatic Cholerine 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 . DISEASES OF ORGANS CONNECTED WITH THE RESPIRATORY SYSTEM. Catarrh, or Common Cold ..... 187 Hoarseness. Raucitas ..... 191 Chronic Laryngitis. Laryngitis chronica . . 193 Cold in the Head ..... ib. Cough . . . . . .196 Hooping-cough. Tussis convulsiva . . 204 Croup. Angina membranacea .... 210 Influenza ...... 219 Determination of Blood to the CJiest. Congestio ad Pectus . 221 Inflammation of the Mucous Membrane of the Bronchial Tubes. Bronchitis ... . 225 ------Broncliitis Chronica ..... 232 Inflammation of the Lunga. Pneumonia, Peripneumonia, Pneu- monitis ...... 231 CONTENTS. Xlil Pneumonia Notha Occulta Typhoid, or Congestive Pneumonia Consumption, or Incipient Phthisis Inflammation of the Pleura. Pleurisy, Pleuritis Pleurodynia. Pseudo- Pleuritis Spitting of Blood." Hcemoplysis DERANGEMENTS OF THE CEREBRAL SYSTEM. "^ Determination of the Blood to the Head. Congestio ad Caput . 260 " Apoplexy. Apoplexia ..... 266 Inflammation of the Brain and its Tissues. Brain Fever. Phre- nitis Encephalitis . . - . .271 Tetanus . . . . . . .276 CUTANEOUS DISEASES. St. Anthony's Fire. Rose. Erysipelas . . . 280 Boil. Furunculus . 283 Carbuncle. Anthrax. Furunculus malignans. Pustula nigra . 285 Chilblains. Perniones ..... ib. Corns. Clavi pedis ...... 287 Abscess ...... 288 Itch. Scabies . . . . ■ .291 Whitlow. Panaris. Paronychia . 293 Irritation of the Skin . . . • .294 Ringworm. Herpes circinnatus .... 296 Ringworm of the Scalp ..... 297 Ulcers ...... 301 GENERAL DERANGEMENT OF THE SYSTEM. Gout. Arthritis . . . . .307 Rheumatism. Rheumatismus .... 310 Lumbago . . . . , . . . 314 Inflammation of the Psoas Muscle. Psoitis . 315 Sciatica ....... 316 Pain in the Hip. Coxalgia, coxagra . . • 318 Hip-disease. Morbus coxarius .... 320 Determination of Blood to the Abdomen. Congestio viscerum ' abdominis, congestio ad abdomen .... 323 Acute Inflammation of the Eyes. Ophthalmitis .. . 324 Short Sight. Myopia . . ■ ■ • 331 Swelling of the Lip ib. Scirrhus . . . . . ib. Warts on the Face ..... 332 Hordeolum, Stye . . • . . ib. Inflammation of the Ears, and Earache. Otitis, otalgia . 333 Bleeding of the Nose. Epistaxes .... 337 Swelling of the Nose ..... 340 Canker of the Mouth. Cancrumoris . . • 343 Scurvy. Scorbutus . 345 B 239 . 240 241 . 242 251 . 252 XIV ieONTKNT3. Inflammation of the Tongue. Glossitis Offensive Breath .... Faceachc. Neuralgia 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 M'jelit,,- • Palsy. Paralysis .... Rupture. Hernia ..... Fainting. Swooning. Synco])e Headache. Cephalalgia .... Pains in the Loins. Notalgia Delirium Tremens Potatorum .... Epilepsy. Epilepsia .... Asthma ...... 346 34 ^ 349 :r>i 352 ib. 353 354 357 358 361 ib. 367 370 391 ib. 394 395 CASUALTIES. Concussion, Bruises, Sprains, and Wounds, &c, Burns and Scalds Fatigue ..... Stings of Insects Sea-sickness .... Apparent Death. Asphyxia Hydrophobia .... Poisons .... Mental Emotions .... 403 417 419 420 420 422 426 434 438 PART III. TREATMENT 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 444 . 445 446 . ib. 447 . 448 450 . ib. 451 . 453 454 • 457 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 aim neonatorum Bowel Complaints. Diarrhoea neonatorum . Excoriation. Excoriationes neonatorum Jaundice. Icterus neonatorum Induration of the Cellular Tissue. Erysipelas neonatorum Lockjaw of Infants. Trismus nascentium . Derangement during Teething . . Convulsions in Children .... Water in the Head. Hydrocephalus Asthma of Millar ^he Rickets. Rachitis .... 4j|fantile Remittent Fever Atrophy. Atrophia ..... Vaccination ..... PART IV. TREATMENT OF FEMALES AND THEIR PECULIAR AFFECTIONS, Chlorosis. Emansio mensium Amenorrhoea. Suppressio mensium Menorrhagia ..... Dysmenorrhoea ..... Hysterics. Hysteria . . . OBSERVATIONS ON PREGNANCY. Introductory remarks .... Air and Exercise ..... Clothing ...... Diet ....... Employment of the Mind and Habits . Influence of External Objects upon the unborn Infant Mental Emotions ..... DERANGEMENTS DURING PREGNANCY. Menstruation ..... Morning Sickness ..... Constipation . Diarrhoea ...... Fainting and Hysteric Fits .... XVI Toothache ... Swelled Face .... Swelled Wins. Varices . Pains in the Back .... Miscarriage. Abortus ... treatment defore parturition. Preparation of the Breasts Remedies before Labour . False Pains . Parturition . Serious or complicated Labours Spasmodic Pains, Cramps, and Convulsions treatment after delivery. Introductory remarks After-Pains .... Duration of Confinement diseases following parturition, Suppressed Secretion of Milk Excessive Secretion of Milk Perspiration after Delivery Milk Fever Irregularities of the Lochial Discharge . Diarrhoea in Lying-in Women Abdominal Deformity Falling off of 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 not Suckling their Children Glossary ..... Index . .... -.15 516 517 518 ib. 524 525 ib. 527 528 531 532 533 535 535. 536* 5$i 539 539 541 ib. 542 ib. 543 ib. 544 ib. 546 547 548 ib. ib. 550 562 Erratum.—P. 286. First line of Note by Editor, for Croutplaster read Courlplatter TABULAR INDEX OF THE MEDICINES, THEIR SYNONYMS, AND ANTIDOTES. Acidum Hydrocyanicum. Prussic acid. Ammon. carb. Camph. Ipecac. Cqff. Opium. Acidum Muriaticum. Muriatis Acidum, s. Hydrochloricum. Muriatic acid. Camph. Bryonia. Aconitum Napellus. Aconite. Monk's Hood. Camph. Nux vom. Wine, Vinegar, Paris. Acidum Sulphuricum, s. Sulphuris Acidum vitrioli. Sulphuric acid, Vitriolic acid, Oil of vitriol. Pulsatilla. Alumina. Argilla Pura. Aluminum oxydatum. Alumine. Bryonia. Camph. Chamom. Ipecac. Ammonium Carbonicum. Carbonas (sub) ammonii. Sal volatile. Car- bonate of Ammonia. Arnica. Camph. Hepar sulph. Ammonium Causticum. Caustic Ammonia. Dilute Vinegar. Ammonium Muriaticum. Murias, s. Hydrochloras Ammonii, Sal Am- moniacum. Muriate of Ammonia, Hydrochlorate of Ammonia, Sal Ammoniac. Camph. Hepar sulph. Antimonium Crudum. Stibium Sulfuretum Nigrum. Antimonii Sul- furetum. Crude Antimony. Sulphuret of Antimony. Hepar sulph. Mercur. Arnica Montana. Arnica. Leopard's Bane. Camph. Ignatia. Ipecac. Arsenicum Album. Acidum Arseniosum. Sesqilioxide Arsenic—White Arsenic. China. Ferrum met. Graph. Hepar. Ipecac. Kali carb. Nux vom. Samb. Verat. Aurum Foliatum. Leaf Gold. Bellad. China. Cuprum met. Mercur. Baryta Carbonica. Carbonas (sub) Baryta?. Carbonate of Baryta. Camph. Belladonna. Atropa Belladonna. Deadly Nightshade. Caffea. Hyosc. Hepar. Pulsat. Bovista. Lycoperdon Bovista. Puff-ball. Camph. Brominium. Bromine. Coffea. Opium. Camph. Bryonia Alba. White Bryony. Aeon. Chamom. Ignat. Nux vom. Calcarea Carbonica. Calcis Carbonas, Carbonate of Lime. Camph. Nitr. ac. Nitr. spir. Sulph. Cannabis Sativa. Hemp. Camph. Cantharis. Cantharis Vesicatoria, Meloe Vesicatorius. Cantharides. Lytta Vesicatoria. Spanish Blistering Fly. Camph. Will TABULAR INDEX. Capsicum Annum. Cayenne, Capsicum, or Guinea Pepper. Camph. Cahbo Animalis. Animal Charcoal. Camph. Cahbo Vegetabilis. Carbo Ligni. Wood Charcoal. Arscn. Camph. Cqffea. Lach. Causticlm. (Tinctura acris sine kali.) Caustic. Coffea. Colocyn. Nitr. spir. Nux. vom. Chamomilla. Matricaria Chamomilla. Wild Chamomile. Aeon. Coccul. Cqffea. Ignat. Nux vom. Pulsat. China. Cinchona Officinalis. China; Cortex. Quinquina. Yellow Bark. Amt'ca. Arsen. Bellad. Calcar. Carb. veg. Ipecac. Sulph. Cicuta Virosa. Water Hemlock. Arnica. Tabacum. Cina. Artemisia Santonica. Worm. Seed. Ipecac. Cocculus. Menispermum Cocculus, Cocculus Indicus, Cocculus Tu- bcrosus. Indian Berries. Camph. Nux vom. Coffea Cruda. Coffea Arabica. Mocha Coffee Berries. Aeon. Cham. Nux com. Colchicum. Colchicum Autumnale. Meadow Saffron. Nux vom. Coccul. Pulsat. Colocynthis. Cucumis Colocynthis. Bitter Cucumber, Colocynth. Camph. Caust. Cqffea. Cliamom. Conium. Conium Maculatum. Hemlock. Coffea. Nitr. spir. Crocus. Crocus Sativus. Saffron. Opium. Cuprum Mf.tallicum. Copper. Bellad. China. Ipecac. Mercur. Nux. vom. Cuprum Aceticum. Acetas Cupri. Acetate of Copper. Bellad. Calc. carb. China. Coccul. Ipecac. Mercur. Nux vom. Digitalis. Digitalis Purpurea. Common Foxglove. Nux vom. Opium. Droseha. Drosera Rotundifolia. Round-leaved Sun Dew. Camph. Dulcamara. Solanum Dulcamara. Bitter Sweet, Woody Nightshade. Camph. Ipecac. Mercur. Euphrasia. Euphrasia Officinalis. Eye-bright. Pulsatilla. Feiirum. Ferrum Metallicum. Pure Iron. Arnica. Arsen. Bellad. Ipecac. Mercur. Pulsat. Ferrum Aceticum. Ferri Acetas. Acetate of Iron. Arsen. Bellad. Mercur. Nux vom. Graphites. Plumbago. Pure Black Lead. Arsen. Nux vom. Vinum. Helleborus Niger. Black Hellebore, Christmas Rose. Camph. China. Hepar Sulphueis. Hepar Sulphuretum. Sulfuretum Calcis. Liver of Sulphur, Sulphuret of Lime. Acetum. Bellad. Hyoscyamus. Hyoscyamus Niger. Henbane. Bellad. Camph. China. Hypericum Pehfoliatum. Mesmerism. TABULAR index. XIX Ignatia Amaha. Strychnos Ignatia. Faba *Ignatia. St. Ignatius' Bean. Pulsat. Chamom. Coccul. Arnica. Camph. Vinegar.. Iodium. Iodine. Arsen. Camph. Coffea. Phosphor. Sulph. Ipecacuanha. Cephaelis Ipecacuanha, Ipecacuanha Root. Arnica. Arsen. China. Jalappa. Convolvulus s. Ipomcea Jalappa, Ipomcea Macrorrhiza. Jalap. Camph. Kali Bichromatum. Bichromate of Potash. Lachesis. Trigoncephalus Lachesis. Lance-Headed Serpent (poison of the). Alum Arsen. Bellad. Nux vom. Rhus tox. Ledum Palustre. Rosmarinus Sylvestris. Wild Rosemary, Marsh Tea. Camph. Lycopodium. Lycopodium Clavatum. Lycopodii Pollen. Club Moss. Wolf's Claw. Camph. Pulsat. Magnesia Carbonica. Carbonas (sub) Magnesiae. Carbonate of Mag- nesia. Camph. Mercurius Solubilis. Mercurius Hahnemanni. Black Oxide of Mer- cury. Arnica. Bellad. Camph. Hep. sulph. Iod. Laches. Sulph. Mercurius Vivus. Hydrargyrum. Quicksilver. Vide Mercurius Solubilis. Mezereum. Daphne Mezereum. Mezereon. Camph. Mercur. Moschus. Moschus Moschiferus. Musk. Camph. Nux mosch. Natrum Carbonicum. Carbonas (sub) Sodae. Carbonate of Soda. Arsen. Camph. Natrum Muriaticum. Murias Sodae. Hydrochlorate of Soda. Arsen. Camph. Nitr. spir. Nitri Acidum. Acidum Nitricum. Nitric acid. Calc. Carb. Conium. Camph. Hep. sulph. Sulph. Nux Vomica. Strychnos Nux Vomica. Nux Vomica. Aeon. Camph. Coffea. Pulsat. Opium. Papaver Somniferum. Opium. White Poppy. Camph. Calc. carb. Hep. sulph. Mezer. Sulph. Petroleum. Rock Oil. Aeon. Nux vom. Plumbum Metallicum. Lead. Alum. Bellad. Hyosc. Opium. Phosphorus. Phosphorus. Camph. Coffea. Nux vom. Phospori Acidum. Acidum Phosphoricum. Phosphoric Acid. Camph. Cqffea. Platina. Platinum. Pulsat. Pulsatilla. Anemone Pratensis. Meadow Anemone. Pasque Flower. Cham. Coffea. Ignat. Nux vom. Rhabarbarum. Rheum. Rhubarb. Camph. Cham. Nux vom. Rhus Toxicodendron. Sumach. Poison Oak. Bellad. Bryon. Camph. Coffea. Sulph. S.X TABULAll INDEX. Sabadilla. Veratrum Sabadilla. Caustic Barley. < 'amph. Pulsat. Saein-a.. Juniperus Sabinn. Savine. Camph. Sambucus. Sanibucus Niger. Elder. Arsen. Camph. Squill.v. Scilla Maritima. Siiujll. Camph. Secale. Secale Cornutum. Ergot of Rye. Camph. Opium. Senega. Sencka. 'Snake Root. Arnica. Bellad. Bryon. Camph. Senna. Cassia Senna. Senna. Chamom. Sepia. Sepia Succus. Inky juice of the Scuttle Fish. Aeon. Ni'.spir. Vinegar. Silicea. Silex. Siliceous Earth. Camph. Hepar. sulph. Spigelia. Spigelia Anthelmintica. Indian Pink. Camph. Aurun. Spongia. Spongia Usti. Spongia Marina Tasta. Burnt Sponge. Camph. Stannum. Pure Tin. Cqffea. Pulsat. Staphysagria. Delphinium Staphysagria. Stavesacre. Ambra, Camph. Stramonium. Datura Stramonium. Thorn Apple. Bellad. Nux vom. Sulphur. Aeon. Camph. Mercur. Nux vom. Pulsat. Sulphuris Tinctuea. Spirit us vini Sulphuratus. Tincture of Sulphur. Vide Sulphur. Theridion Curassavicum. Black Spider of Curacoa. Camph. Tartarus Emeticus s. Stibiatus, Antimonium Tartaricum. Tartras Potassii et Antimonii. Tartrate of Antimony and Potassa, Tartarized Antimony. Tartar Emetic. Coccul. Ipecac. Pulsat. Thuja Occidentals. Thuja, Arbor vitae. Tree of Life. Camph. Pulsat. Valeriana Officinalis. Valerian. Bellad. Camph. Cqffea. Mercur. Veratrum Album. Helleborus Albus. White Hellebore. Aeon. Arsen. ac. Camph. Cqffea. China. Mercur, Viola Tricolor. Jacea. Pansea. Hearts'-ease. Camph. Verbascum Thapsus. Mullein. Camph. Zincum. Zincum Mctallicum. Zinc. Camph. Hep. sulph. Ii-nat. Note. In the selection of THE remedy, it is not necessary that all the symptoms noted should be present ; at the same time, care must be taken, that there arc no symp- tom* of any consequence not covered by the medicine, or more strongly indicative of another. When symptoms are met with, not covered by a remedy, which nevertheless appears in- dicated, the tabular index may, with advantage, be availed of, in order that it may be ascertained if the symptom required to complete the group, is given under the medica- ment in any other part of the work. In other cases, where different medicines are pointed ont as useful in an affection, the table may be made use of, for, by carefully noting the symptoms given nndcr them elsewhere, the reader may thereby be enabled to select the remedy most clearly indicated. HOMOEOPATHIC DOMESTIC MEDICINE. PART I. INTRODUCTION. The principal points we hare to notice in this part are, the Regimen to be observed under treatment—Clothing, and Habits—the Administration and Repetition of the Medicines —and the Potencies in general use. REGIMEN. The excellence of the homceopathic rules on regimen has wrested approbation even from our own opponents, although at the same time they disingenuously make use of it as a handle against the science itself, and ascribe the cures effect- ed to its observance, rather than to the efficacy of the medi- cines employed. To individuals unacquainted with Homoeopathy, the regimen is represented as extremely rigid : to that assertion a plain statement of the course to be pursued in general cases will prove the best refutation ; and it mny jilso be observed, that at the first sight the self-denial imposed seems more stringent than it would prove on being carried into effect, and that many individuals in the Author's own experience have pursued the 2 INTRODUCTION. same system of diet, after they have had no further occasion for medical assistance, thus continuing from choice what they had begun from necessity. The homoeopathic vegimen consists merely of the avoidance of medicinal and indigestible substances during treatment, both as calculated to interfere with the actions of the medicines and the proper functions of the alimentary system. Conse- quently, among liquids, the articles generally proscribed are green tea or strong black tea, coffee, malt liquors, wine, spirits, and stimulants of every description ; lemonade, or other acid or alkaline drinks, and natural or artificial mineral waters ; cocoa, unspiced chocolate, toast-, rice- or barley-water, oatmeal gruel sweetened with a little sugar, or raspberry or strawberry syrup, if desired, whey, milk and water, or pure milk not too recentfrom the cow, boiled milk, and in some instances butter- milk, or in fact any non-medicinal beverage, is allowable." In animal food, pork, 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 oleaginous species, such as eels, salmon, &c, or shellfish, as oysters, lobsters, &c. Eggs, raw, or soft boiled ; butter, if free from rancid or unusual taste ; cream, plain unseasoned custards, and curds. Stimulating soups and made dishes are so evidently opposed to homoeopathic regimen, as scarcely to require further notice. * 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 partak- ing 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 taken into account in the selection of the remedies. REGIMEN. 3 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. Among vegetables, all of a pungent, aromatic, medicinal, or indigestible description, or greened with copper, are pro- hibited ; such as onions, garlic, eschalots, asparagus, radishes, horseradish, 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, cauliflower, spinach, seakale, etc., may be used with the need- ful precaution 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, bitter almonds, peach leaves or kernels, fennel, aniseed, mar- joram, 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, partic- ularly by the dyspeptic. Salt and sugar in moderation are admissible. 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 good butter ; or light puddings, such as bread-, rice-, sago-, semalino-, with- out wines, spices, or rich sauces, are admissible : but coloured confectionery, 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 4 INTRODUCTION. of course be kept upon a low regimen : gruel, barley-water, etc.; and at the commencement of convalescence alight pud- ding, with a little weak beef-tea or mutton or chicken broth, should form the whole of the nourishment given. Nature, however, is our best guide, and when she takes away appe- tite, thereby intimates the necessity of not taxing the digestive functions. CLOTHING AND HABITS. Upon the first point it were scarcely worth while entering into any observations, were it not simply to remark upon the impropriety of wearing garments impervious to air, and fitting closely to the shape, and the custom of exposing the extremi- ties and chests 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 under 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 POTENCIES OF THE MEDICAMENTS. 5 wet towel, with cold or scarcely tepid water, and the use of thu flesh-brush, are by no means objectionable, and frequently indeed strongly to be recommended. 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 administration 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 leuco-phlegmatic temperament; they require generally low potencies and frequent repetition—such cases are not without their parallel in allopathic practice. Also, in disease, we find 6 INTRODUCTION. some persons who appear to enjoy a peculiar exemption from infectious and even contagious influence. To this rule, how- ever, of giving the low potencies in such cases, there are ex- 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 vice versd. 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 poten- cies are generally called for, although we frequently find bene- fit in resorting to the lower. Third class. Those in whom no marked or a scarcely perceptible medicinal action declares itself, but a well-marked re-action ; in such cases we must be guided by other indi- cations 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 obtain the greatest possible benefit without materially in- creasing the sufferings of the patient. We generally find a particular susceptibility to medicinal influence, at any potency, in persons dwelling in the country, of robust frame, simple habits, and regular lives, who are not subject 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 de- pending upon the individual's employment, habits, and pur- suits, it is difficult to give any fixed rule. Age. In infancy and early childhood, we find a marked receptivity to medicinal influence, a decided action and speedy re-action, consequently the higher potencies are the most ap- plicable in their diseases, and they rarely require so frequent a repetition ; however, in acute diseases of any of the more the medicaments. 7 noble organs, we may exhibit lower potencies, particularly of some of the less energetic medicines, for example, Sambucus, Ferrum, Ipecacuanha, Chamomilla, etc., a globule constituting the maximum 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 generally most suitable ; to this rule, however, there are many exceptions, particularly in those who are engaged in laborious employments. 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, some- times without an equivalent re-action : here we should be cautious in administering, and generally use the higher poten- cies. In the Bilious, there is generally but little susceptibil- ity, but the re-action, when roused, is powerful and prolonged ; hence a necessity 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 repeated 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; this rule should, of course, be modified according to the remedy itself, the disease, and the individuality of the patient. 8 INTRODUCTION. The Nature of the Remedy. Medicaments which in their crude state possess little or no appreciable medicinal properly, but whose virtues have been developed by trituration and segregation of particles, such as Lycopodium, Natrum muriaticum, Calcarea carbonica, Sepia, Carlo vegctabilis, Sil'.cea, 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 nilricum, Arsenicum, etc. On the contrary, some which have a short-lived, but well-marked action, may be used in some cases in the origi- nal substance ; for example, Moschus, Valerian, and Camphor, but in exceedingly small doses. Others again have been found nost useful at the first, second, or third potency, such as Tartarus emeticus, Ferrum, Ipecacuanha, Hepar sulphuris, Stannum, Rhus toxicodendron, Opium, and in many cases Cinchona. 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 practition- ers 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 suf- fering as possible, and when the physician succeeds in effect- ing this, he may rest satisfied with himself, even although it was by the assistance 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 ADMINISTRATION. 9 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 atten- tive observation are necessary to make a good homoeopathist. For my own part, I consider the whole range, from the first attenuation to the thirtieth, and even upwards* useful, accord- ing to the nature of the case, and the properties of the remedy, and moreover, that a rigid adherence to any particular dilu- tion in all instances, savours rather of the empiric than of the professor of a liberal art. ADxMINISTRATION 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 discrimination of the administrator, and a careful observ- ance 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 assured we have chosen the proper remedy, if no perceptible medicinal aggravation or amelioration declare itself, but the disease seems to gain ground, repeat the medi- cine. In cases of high inflammatory action, Aconite has some- times to be repeated every two hours, hour, or even less. • Hahnemann, in his latter years, was much in favour of an extension of the scale of potencies';~and Gross and other continental homoeopathists 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. 10 INTRODUCTION. If a medicinal aggravation take place, followed by ameliora- tion, we must let the medicine continue Us action, until the amelioration appears to cease, and the disease again make head ; if new symptoms set in, we must then have recourse to the medicine thereby indicated. Should, however, no per- ceptible medicinal aggravation 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 first 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 its 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 comparatively 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, in the selec- tion of which it will be necessary to choose one related to the remedy first prescribed. 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 for- mer, 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 developement of collateral or pathogenetic signs occa- ADMINISTRATION. 11 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 slovvly,wemay gradually increase the dose, or, still better, give at suitable intervals some other remedy or remedies of as nearly analogous medicinal properties to that first administered as possible, and then return to the original remedy, if heedful; if, on the other hand, decided amelioration follows each admi- nistration, we 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 favorably must be recurred to. 12 INTRODUCTION. 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 tho 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 preserve it from decomposition. It maybe 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 %&, means two globules of the thir- tieth 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 constipation 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. LIST OF MEDICINES. 13 Acidum phos. China, Lach., Rhus, Verat., are some- times suitable after Acidum phos. Acidum sulp. Puis, is sometimes useful after Acid, sulph. Aconite. Am., Ars., Bella., Bryon., Cann., Ipec, Spong., Sulp., &c., will frequently be found of use after Aconite, whe- ther 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. Aeon., 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., Stram., Valer., are sometimes the most appropriate medicines after Belladonna. Bryonia. Alum, and Rhus will sometimes be found suit- able after Bryonia. Calcarea carbonica. Lycopodium, Nitr. 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. Cinchona. Arsen., Bella., Puis., Veratr., are sometimes suitable after Cinchona. Cuprum. Calc. and Veratr. are sometimes of service after Cuprum. Hepar sulp. Bella., Merc, Nitr. ac, Spong., Silicea, are sometimes suitable after Hepar sulp. Ipecacuanha. Am., Ars., Chin., Cocc, Ign., Nux, are sometimes suitable after Ipecacuanha. Lachesis. Alum., Ars., Bell., Carb. v., Caust., Con., Dulc, Merc, Nux vom., Phos. acid., are sometimes useful after Lachesis. Lycopodium. Graph, Ledum, Phos., Puis., Silic, are sometimes serviceable after Lycopodium. 2 14 introduction. Mercurius. After Mercurius, Bell, China, Dulc, Hepar, Lach., Nitr. acid., Led., Sulp., are sometimes suitable. Nux vomica Bryon., Puis., and Sulp., will frequently be found efficacious after Nux vomica. Opium. After Opium, Calc, Petr., Puis., will sometimes be found of use. Phosphorus. Petr- and Rhus 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, Pals., and Sulph., are sometimes use- ful after Rhus (ox. Sepia. 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. Aeon., 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. ' SYNOPSIS OF~THE RULES FOR DIET, UNDER HOMCEOPATHIC TREATMENT. ALIMENTS allowed. Soup or broth made from the lean of beef, veal, and mut- ton ; to which may be added, well boiled, sago, tapioca, ver- micelli, rice, semolina, or macaroni, seasoned merely with a little salt. RULES for diet. 15 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 portions 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- lina, fecula of potato, sago, arrow root, rice ; simple cakes composed 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. Beverage. Water, milk, cocoa, chocolate, (unspiced), ar- row-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. Soups. Turtle, mock-turtle, ox-tail, giblet, 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 meats. * 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.—Ed. 16 INTRODUCTION. Fish. Crab, lobster, oysters,* and shell-fish in general ; and almost all other fish not specified in Aliments allowed. Vegetables. Cucumber, celery, onions, artichokes, radish- es, parsley, horse-radish, leeks, thyme, garlic, asparagus ; and every description of pickles, salads, and raw vegetables, or vegetables greened with copper. Pastry of all kinds, whether boiled, baked or fried. Spices, Aromatics, 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 atone 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 in- flammation as synonymous terms, others as mere modifica- tions of the same pathological state of the system. The in- vestigation 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 suffi- cient 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, ex- cept 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, 2* 18 FEVERS. 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 res- pecting fever and inflammation, I cannot but render the trib- ute 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 substan- ces. 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 satisfac- tion to be enabled to trace the connexion more closely, and to show the perfect affinity between medicinal and morbid ac- tion. 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 disease 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 inflammatory 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 present all these different phases. Fevers terminating fortunately and running a regular course may be divided into five stages; the accession, increase cri- sis, decrease, and convalescence. When the result is fatal it may arise from a metastatis, the exhaustation of a vital en- ergy 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 homceopathic 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 homceopathic system than it is where they are treated allopathically, or left to na- ture ; 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 perspira- tion or increase or alteration of other secretions, or by the ap- pearance of an eruption, after which, if salutary, the skin be- comes 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 disease : 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 adherence to the mere nomenclature of disease. Causes of Fever. It cannot be denied but that there exists in certain individuals, a particular predisposition to acute diseases, and, as before remarked, in introduction, the san- guine, nervous, and bilious temperaments possess this suscep- tibility in a far more marked degree than the phlegmatic. 20 FEVERS. The exciting causes are numerous. Miasms, epidemic in- fluences, contagion, powerful mental emotions, derangement of some important organ, external lesions, excess or errors in diet, 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 produce 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 pa- tient'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 consid- ered as her voice calling for fluid. Water is the best diluent; no solid food, broth, or even gruel and the like, should be per- mitted in cases 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, sweet- ened 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 de- gree, the digestive powers. SIMPLE or EPHEMERAL FEVER. Febris Simplex. The disease seldom presents any distinct character, and generally runs its course in twenty-four hours j as, however FEVERS. 21 it frequently forms the initiative of other more serious dis- orders, it deserves attention. Before attacks of scarlatina, measles, small-pox, etc., it is generally present, although oc- casionally 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 cause 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 °-g 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. 22 fevers. INFLAMMATORY FEVER. Synocha. Diagnosis. Shivering or chill (generally considerable) followed 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 ; respiration hurried, in accordance with the pulse ; ameliora- tion of symptoms as the pulse assumes a more normal state. 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 hemor- 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 pathognomonic 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 medicament which has so successfully superseded all the inflammatory fever. 23 antiphlogistic measures of the old school, subduing inflam- mation without lowering the vital energy. No one who com- pares the pathogenetic 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 resemblance which they present to those of pure inflam- matory disease ; and by this powerful auxiliary the author has no hesitation in declaring that disease of the said description is brought so fully under the control of the physician, as to be in a great measure 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, which, unless it threatens to run on to inflammation of the brain, in which case Belladonna 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 Belladonna, Bryonia, &c. Belladonna 3. 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 ; noc- turnal sleeplessness, with furious delirium; eyes red, shining and fiery ; general internal and external heat; burning thirst, and agonizing restlessness. Administration. Six globules of the potency named 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 as the improvement advances. Bryonia 3. This medicament is indicated when, in ad- dition to the usual symptoms of inflammatory fever already given, we find a heavy stupifying headach, with a sensation as if the head would burst at the temples, much aggravated by movement, 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 stomach ; 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 potency above named may be added to an ounce of water, and a dessert- spoonful given every four or six hours ; few cases are so par- ticularly urgent as to require more frequent administration of the remedy ; indeed, when the virulence of the disease has been subdued, a single dose is generally found sufficient, and no further exhibition should take place as long as the patient manifestly continues improving. When inflammatory fever seems to arise from a primary inflammation of some important organ, such as the Head, Lungs, Liver, or Stomach and Bowels, the treatment will be found under 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 nervous or NERVOUS FEVER, OR TYPHUS. 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 diag- nosis, and treat it on its first appearance as an inflammatory attack—or of stimulating the inflammation by what is com- monly denominated an anti-nervous treatment, should the pre- cursory symptoms lead us to consider it typhus, and it after- wards assume 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 vio- lence : we may also meet with spasms and convulsions. All these symptoms, if the disease is allowed to gain ground, in- 3 26 NERVOUS FEVER, crease in malignancy, the evacuations become involuntary, the weakness and lassitude excessive, and the patient sinks down to the bottom of the bed—an evidence of completo prostration of strength, while all endeavours to rouse him arc fruitless, and he is perfectly blind to all around. Tenderness of the abdomen or pain in the region of the caecum is also frequently met with. Some only of the above symptoms may be 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 disturb- ance of the vascular system, great heat, and quick hard pulse, inflammatory typhus : a distinction is also found in the type, as in continuous and intermittent typhus ; in the accidental circumstances 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 symptoms vary according to the organs attacked. It may be remarked, that in most forms of this malady, the course is extremely irregular,—the precursory symptoms may precede the disease only a few days or several weeks, and its dura- tion is also uncertain. Death may take place from exhaustion of the vital ener- gies, paralysis of the whole system, or of the brain, apo- plexy, disorganization of some of the nobler viscera, or a change to the putrid form. Causes. Densely populated neighbourhoods, where a number of individuals are crowded into small apartments, and or typhus. 27 the 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 symptoms set in, such as headach, giddiness, nausea, vomiting, watery, 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 shivering, we may administer— Ipecacuanha £^p 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 appetite, nausea, vomiting of mucus, slimy evacuations, and particularly when the above symptoms occur in phlegmatic subjects, with extreme depres- sion of spirits, and tearfulness. Administration. Two globules of the sixth potency in a little water ever 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. 28 nervous fever, stomach and intestines, particularly the rectum, a frequent cause of the above-mentioned constipation ; painful pressure, 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 abdominal 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, severe headach, 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 distension of the abdomen ; evacua- tions copious, watery, 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, —Mercurius 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, etc. 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 headach, 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 distension of the abdomen ; thin, yellow, watery motions occasionally intermixed with undigested substances ; urine scanty, pale, or dark coloured, and cloudy ; oppression at the 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 de- lirium and carphologia, or spasmodic or convulsive attacks; parched lips, soreness of the corners of the mouth, redness and dryness of the tongne, 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 ; rne- teorismus; and constipation, or watery motions ; scanty and 3* 30 nervous fever, red or amber-coloured urine, rapid respiration, pulso full and accelerated, or quick, hard, and wiry ; parotid glands inflamed and tumid. Stramonium may be given when, in addition to the abovo symptoms, we find twitching of the muscles of tho 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 tho body, and constant delirium ; frequent but ineffectual urging to urinate. Administration. Of the three last mentioned reme- dies, six globules of the third potency may bo 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 improvement 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, &c. will be attended with a desirable result. We will now proceed to the consideration of the two med- icines, 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 me- dicines above mentioned possess many striking points of similarity, but also many of difference ; they may on some occasion be administered alternately with great advantage in the manner below described ; for the several employments the indications are as follows : Bryonia. More particularly when the disorder assumes the character of a Febris nervosa versatilis, or Typhus cere- bralis, with violent stupifying headach, as from a blow, and OR typhus. 31 pain across the temples, as if the head would burst. Aggra- vation 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. Petechia?, irritability irascibi- lity, despair of recovery. Rhus 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 diarrhoea, and congestion to the head and great weakness. The headach 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 NERVOUS FEVER, lity and prostration, almost amounting to paralytic weakness of the different limbs, shooting pains in various parts of tho body, aggravated when at rest or at night, and momentarily relieved by moving the part affected ; pulse .quick and small, or weak and slow. In the morale we may notice, excessive anguish, anxiety, extreme lowness of spirits, and inclination to weep. Petechia?, as in Bryonia, are frequently 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 some 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 important 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 strength, 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 percept- ible, and rapidly sinking, cold perspiration on the face and OR TYPHUS. 33 extremities, involuntary and offensive evacuations, deep red urine, with a cloud floating in it or rising towards the surface. 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 fortunate results. Acidum phosphoricum. 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 Rhus, 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 copious watery diarrhoea ; the motions are generally passed involuntary ; sanguineous evacuations ; frequent, weak, and occasionally an intermitting pulse. Should the debilitating sanguineous evacuations con- tinue, Acid, nitricum should be administered, or Cantharides, 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. 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; carpologia ; 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 be 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. phosp., 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. Phosphorus. 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 gener- ally supervenes of greater or less duration, according to the violence of the attack. In such instances Cinchona flg£, OR TYHPUS. 35 in a little water, repeated in five days, followed by Valerian in about four days to a week, according to the result pro- duced. Of this latter medicine, three or four globules of the third potency may be given in a glass of water, and repeated every two days, if necessary, until the desired result is at- tained.* An alteration of these two medicaments, at intervals of twenty-four hours, has also been found very useful in these cases. When debilitating sweats supervene Cinchona should be administered, followed by Sulphur if required. Should symptoms of deranged digestion remain after the fever has been subdued, Nux vomica and Pulsatilla will be found most serviceable according to the temperament of the individual, and the symptoms present. (See article Indiges- tion.) The other medicaments mentioned under the head referred to, may also be advantageously consulted. Where a peculiar morbid state of the constitution exists, denomi- nated 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 circum- stances, may be administered. 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 Putridus. 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, ment of Arsenicum and Carbo vegetabilis; but consider it ol sufficient importance to be remarked on separately, although of course, except in cases of decided emergency, no indivi- dual 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, pulso 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; colliqua- tive or sanguineous diarrhoea; dark and bloody urine, epis- taxis, petechia;, and other marked tendencies to organic dis- solution. The patient is always found lying on his back, and continually shrinks down to the foot of the bed, a sign of utter helplessness and prostration. Therapeutics. Arsenicum corresponds closely to the foregoing symptoms, and is, therefore, our principal remedy when the disease 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 Acid, phosph., Acid, 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 TYPHUS. 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 teaspoonful of water every three hours, has, in a number of instances, 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 in- * 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, when the vital energies seem 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 certain stages of so-called putrid fever—the attention of the practitioner is therefore particularly called to them in such circumstances. 4 38 CONTAGIOUS FEVER, termission of the pulse, meteorismus, involuntary evacutions, 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 Hyoscyamus or Stramonium administered in the same man- ner, 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. Accessort Treatment—Prophylaxes, &c. We need hardly insist upon what every practitioner knows to be essentially adjuvant in the treatment of this affection, a constant 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 vegetable and animal matter : a plain wholesome diet, with a moderation in the use of fermented liquors or wine, and total abstinence 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 cannot be too strongly reprobated; both these practices weak- en 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 pre- sent a perfect image Of the existent malady, and to choose his remedies accordingly, which should be administered di- rectly on the premonitory symptoms declaring themselves, without waiting for the further development of the dis- ease. 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 fl3fi 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 Intermittentes. We have now to enter upon a class of fevers differing es- sentially from those already considered, in possessing a mark- ed 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 fevers. called the Apyrexia, the patient is generally free from suf- fering. 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-eight, a Tertian, of seventy-two, a Quartan ; even longer intervals have been ob- served between the attacks ; hence the Oetanac 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 disease, 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 peculiarly apt to assume the intermittent form. Nervous or inflammatory fever may change into an inter- mittent, or the latter take upon itself, if it continue, the cha- racter of either of the two former, or become remittent; this frequently happens in hot climates. Ague is rarely dangerous in this country, except when of long continuance, by the weakness it occasions and the inju- ry 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 en- tails an increase of suffering, and the perspiration fails to relieve ; he complains of a sense of weight in the hypochon- dria, particularly the right, with griping pain in the bowels, INTERMITTENT fevers. 41 flatulent distension of the abdomen, diarrhoea, or constipation, and constant thirst; or of headach, 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 ab- sence of perspiration, and the disease passing into continued or remittent 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 treat- ment. Premonitory symptoms. Sense of languor, or general un- easiness ; yawning, headach, 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 headach, at others with coma, stupor, or delirium ; the pain noticed 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 general- ly above the natural standard, while the patient complains of cold. Sometimes the patient feels only a slight degree of cold, 4* ) 42 INTERMITTENT FEVERS. without tremors, but accompanied with symptoms of function- al 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 modifi- ed inflammatory attack, with hot, dry skin, and thirst, oppress sion 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 deli- rium. 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 tofcontjnuous 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 of 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 uneasiness and other symptoms begin to disappear, and the patient, in simple ague, continues free from suffering until the next paroxism. r 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 g^f^y. be administered in the apyrexia or interv^frJ^^]%frjhr?xymm,' «•? Therapeutics. 1fJ| Offlm^^medies have been found misappropriate in oifaSi^fE^J.'tbis^'ffection : Cinchona, Arsenicurhtfpebc%$KMia, Nux vomica, Pulsatilla, Antimonium crudum, Bryonia, "Veratrum album, Cocculus, Sabadilla, Ignatia, and Carbo vegetmbilis. Cinchona. This well-known, but too frequently abused remedy is undoubtedly of the greatest efficacy in tho|e fevers which owe their origin to the influence of marsh miasm, and are peculiarly prevalent at particular seasons of the year. INTERMITTENT FEVERS. 43 It may be given as soon as the precursory symptoms manifest themselves, when we find a degree of fever, with anstety, palpitation of the heart, headach, sneezing, great thirst, Jflili- my, or nausea, and pain in the bowels. It is also^l indicated when the fever has set in by adypsia during the cold stagd— but thirst after the heat and during the sweating. It is contra-indicated when thirst exists during the hot stage. Administration. When properly selected, a single dose of this medicine (three or four globules of the thirdfpdteri.cy) will generally remove the fever ; but in other cases Treqwent 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, ap- pear 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 bum&g.heat, as if molten lead were coursing through the veins, communicating an unpleasant sensation of heat (calor 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, def ire to vomit, retching, and even vomiting; severe'^nd bujrrh^pains in the stomach, and insupportable pains all over the bdfly, especially in the limbs. A marked characteristic of Arsenicum is, that all the suffer- ings of the patient, pains in the limbs, &c, increase in ii*- tensity 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. ' ■ -*ff?| -. Administration. Of this medicament £gA given during'" the apyrexia, will be generally found a sufficient doge ; hoffl 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, two 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 minutes, according to the exigency oi the case. Such cases are happily rare in this country, but I have thought it advisable to touch upon the means to be em- ployed when they do occur ; in such instances also Veratrum (which see) is occasionally 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 performs a cure,—the most marked re- sults have been derived from its Administration with Nux vomica in the following mode: exhibit Ipecacuanha ™- in a little water, and repeat the dose in three hours ; Nux Vo- mica °§- twelve hours after, and if possible, in the evening. Should, however, the apyrexia take place towards evening, lengthen the intervals, giving the Ipecacuanha every five hours, allowing twelve hours to intervene, and administering the Nux vomica in the evening, and if the attack be quotidian, re- peating the latter medicine in the apyrexia preceding it. Either of these remedies is of itself sometimes found suf- ficient to shorten the duration of the disease ; the indications for Ipecacuanha are as follows : much shivering, with but little heat or vice versa; increase of the shivering by external warmth ; oppression at the precordial region ; adypsia, 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 FEVERS. 45 sour eructations, tension of the abdomen, or spasms of the abdominal 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, aching in back and limbs, and dragging pain in abdomen dur- ing the rigors. During the hot fit particularly, headach, buzzing in the ears, heat in head, face, with redness of the cheeks, 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 Antimonium 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 hot stage, 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 5g£ may be given in a dessert-spoonful 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 dose about three hours before the expected attack. Antimonium 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 46 INTERMITTENT FEVERS. dry and hot. It may be exhibited at the samo potency and the same manner as Pulsatilla. Bryonia is indicated by headach and vertigo, with dry heat preceding the attacks of shivering; by the predominance of cold or shivering, with Tedness of the checks, heat in the head, and headach ; or marked heat followed by 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 may be exhibited at the same potency and in the same manner as Nux 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. Administration. 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 ^£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 the stomach and abdomen, such as cramp-like pains at the epigastrium, or constrictive pinching, or tearing, burning, colic-like pains in the hypogastrium. Sabadilla (3) 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, as given under Arsenicum. intermittent fevers. 47 Ignatia (6) 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 attended 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 shiver- ing ; 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. &^- 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 threaten to change into a remit- tent or inflammatory fever, we must have immediate recourse to Aconite, of which we may give ^£, 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 useful 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 treat- ment 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 fe\ i:k* ERUPTIVE FEVERS. Under this head, I intend to treat of those diseases pos- sessing 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, smallpox, chickenpox, milary fever, and nettle-rash. SCARLET FEVER. This disease, in its simple generic character, consists of a contagious fever, with swelling of the face and a scarlet ap- pearance of the skin —(hence its name)—-which is of a bright raspberry 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. How- ever, in the present day, we seldom meet with it in this sim- ple form, but more frequently complicated with severe or ulcer- ated sore throat, delirium, congestive or violent inflammatory symptoms, and often with more or less deviation from the cha- racteristic 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 comes 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 ; and even the angina and redness of the tongue present in most cases of this disease may be considered as an internal 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, lacrymation, the usual precursors of measels. The greatly accelerated pulse, which denotes the approach 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 repeti- tion 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. 5 50 eruptive fevers. tinue ; it is when the disease appears principally to attack the head, throat, thoracic, or abdominal viscera, that it becomes dangerous.* The eruption frequently dose not appear before the third day, and then only in isolated patches : Belladonna should therefore be 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 brigftt-nd appearance, sometimes exco- 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;^ 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, ^^ in a little water, every four or six hours, according to the effect produced, and follow it with Nux vomica fl-gfl, in the same manner, if the former prove inadequate to complete the cure. (Vide Ulcerated sore throat.) * "When scarlatina anginosa occurs in complication with pneumonia, phrenitis, or enteritis, the remedies mentioned under these different heads must be had recourse to. « t See the article on the " Administration of the remedy" in the In- troduction. SCARLET FEVER. $\ 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 jirks or general convulsions, and varying color of the skin from pallor to deep 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 gives 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 (Homceopathic Examiner, new series, p. 133, vol. 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 mucus.—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 repercussed, the result of which is frequent- ly fatal, this medicament may be almost considered specific ; or at least the substance with which the greatest 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. Affections 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, &c, spasmodic affec- tion of the chest, sometimes even eclampsia ; as well as great restlessness, frequent change of position, sopor, delirium, &c. 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 to 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 -$$-, 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. Ill, 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 desqnamatory 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. °-Qg-Q- 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 headachs, stammering, &c.; and may frequently be advantageously alternated with the medicines just men- tioned. Dropsical swellings of the whole body is not an unfrequenl^ 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 tho same : Helleborus, Arsenicum, Belladonna, and, in obstinate cases : Arnica, Bryonia, Phosphoric acid, Digitalis, Baryta rn. 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 hard 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 j?,, in a teaspoonful of water, and with adults, or robust children above ten years of age, B£- 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 tform, that is, SCARLET FEVER. 55 not possessing the clear scarlatina hue, we should alternate this medicine with Aconite (6) one or two globules, accord- ing the age, allowing the Aconite an action of about twelve hours, and afterwards proceeding with the Belladonna as be- fore. While taking these medicaments, the patient must ad- here strictly to the homoeopathic diet, particularly avoiding wine and acids. We must, in administering prophylaxes, care- fully watch their effects, and if a medicinal action set in, dis- continue 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 HAHNEMANNI. 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 dose 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 56 ERUPTIVE FEVERS. of the efflorescence does necessarily add to the danger, as the latter is often greatest, when the efflorescence is scarcely perceptible. 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 the outbreak of the rash, becomes trival 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. Aconitum. 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 (-§—) 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 favorable circumstances, is speedily accomplish- ed by means of these remedies. Wheri, however, this eruptive fever occurs in complication with scarlatina, smallpox, or measles ; or when it breaks out in unfavorable 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 : Ipecacuanha, 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 themselves : Slight, general fever chills, with rapidly 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 ; op- pression at the chest, short cough, sometimes attended with reddish sputa, and followed by a shooting pain under the ribs ; occasional vomiting ; angina pharyngea. In such cases, then, a dose or two of Aconite, at intervals of four hours, will be found of considerable service ; if not sufficient to put a check to the further progress of the affection. Ipecacuanha (3). In many instances, either at the com- mencement 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 eve- ning ; 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 restless- ness 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 (6), is frequently more efficacious than either Coffea or Ipecacuanha in relieving the extreme anxiety, rest- lessness, deep sighing and moaning, which so generally at- tend 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 Cinchona, followed by Phosphorus. Bryonia is further indicated when the accom- panying fever partakes of a nervous character, attended with delirium and other symptoms mentioned under Bryonia in the 58 eruptive fevers. article on Nervous fever — which see. The excessive and continual urging to urinate, which sometimes sets in, in the course of the disease, is often very readily subdued by Bry- onia or by Conium. Belladonna (6). When the disorder is met with during the prevalence of Scarlatina, (as also when symptoms, moro or less characteristic of the latter affection, make their ap- pearance in the course of purpura miliaris,) this remedy is a most efficient auxiliary; it is, moreover, a most important re- medy when symptoms of cerebral disturbance exhibit them- selves ; or when the patient complains of the throat, which, on being examined, is found to be in a state of phlegmonous inflammation. Mercurius may follow Belladonna when the tonsils become much inflamed and tumefied, or ulceration su- pervenes ; in this latter instance, however, Arsenicum or Acid. nitricum may become necessary under particular circum- stances. (Vide Scarlatina, p. 47 ; Sore throat, p. 84 ; and Scarlatina maligna, p. 50.) Phosphorus. 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 (6). 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 Scar- latina with this affection, Dulcamara should be administered. Arsenicum (6), may be 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 paralysed, 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 as- sumed a gangrenous aspect. (See Ulcerated sore throat.) When the disease, in cases of a bad type, takes on a ner- vous or even a putrid character, with extreme offensiveness of all the excretions, and hemorrhage from the nose, mouth, &c. The medicines mentioned under fevers of the said descrip- tion, ( which see, p. 32,) must here also be employed. Cu- prum aceticum 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 disappears 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 sec- ond 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 in- herent disposition to consumption. * Rhus and Sulphur may also be mentioned as having been found useful 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 re- commended as the most usefuL 60 ERUPTIVE FEVER8. Diagnosis. Catarrhal symptoms, such as short dry cough, lacrymation, with redness of the eyes, and a degree of fever, 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 generally 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 gra- dually 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-like desquamation of the epidermis, a distinguish- ing sign of this disease. Aconite 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 distress- ing, dry cough. Administration. ^, 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 ne- cessity of having recourse to another remedy. Pulsatilla is also very efficacious, and even specific in MEASLES. 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.| 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 Ipecacuanha is very useful. Administration. Of Pulsatilla of the third potency 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 derange- ment is present, or when the cough which so generally ac- companies 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 green- ish 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 pain 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 eruptive fevers. ment; also in those cases of measles where no eruption de- clares itself, but simply headach and catarrh, with inflamma- tion of the eyes, which present a glassy appearance, are bloodshot, or streaked, and watery ; finally when evident signs of cerebral irritation, &c. set in. Administration asunder 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 dispncea and diarrhoea with colic and vomiting : When symp- toms of cerebral disturbance supervene, Cuprum aceticum* Belladonna, and Stramonium, or Helleborus 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 remains. (Vide Typhus.) For the treatment of coughs which measles sometimes leave after them, Sulphur, Sepia, Carbo v., Conium, Chamo- milla, Drosera, Dulcamara, Hyoscyamus, Ignatia, Nux v., Bel- ladonna, &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 Diarrhosa. Otitis or Otorrhoea : Pulsatilla, Carbo v., Sulph., Merc, and Hepar sulphuris, chiefly. Parotitis: Arnica, and Phos. Tenderness of the skin: Mercurius. Miliaria alba, chiefly Nux v., Burning, itching, rash, which bleeds after scratching, Arsenicum and Sulphur. As a precautionary measure against the attacks of this dis- ease, when epidemic, we may administer Pulsatilla &g-, in a little water, followed by Aconite ^-, three days after; allow the latter medicine.to act for twenty-four hours, and continue the alternation for a fortnight, renewing it when ne- cessary 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 it virulence, and gives a milder character to the complaint when taken. Diagnosis. This disease is frequently very sudden in its attacks, commencing with dullness and shivering, followed by febrile symptoms, with headach, severe pains in the small of the back and loins, languor, weariness and faintncss ; the patient also complains of headach, 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 afterwards spreads over the whole body. Catarrhal symptoms, as sneezing,' coughing, wheezing, and frequently difficulty of breathing, often accompany this disease. The eruption first appears in the shape of small hard-point- ed red elevations, which become depressed in the centre as they enlarge, and contain a semi-transparent fluid, with in- flamed circular margin; about the sixth or eighth day, the lymph in the pustule becomes converted into pus, and the de- pression 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 commencement of the disease, the seventh from the appear- ance 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 lymph, 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 more severe, the fever runs high, and frequently continues so throughout 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 fre- quently assumes a typhoid character, and sometimes carries off the patient 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 practition- er to ward off a fatal result. Salivation, with soreness of the throat and aphthae, 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 cleanli- ness must also be observed, 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 plaster for the face, of different substances, such as gum, mucilage, calamine, &c. We have, however, in general course of practice, found the specific action of the medicines, 6* 66 ERUPTIVE FEVERS. and the precaution above mentioned, sufficient materially to obviate all evil consequences of this nature. Therapeutics. In the first or febrile stage of the disor- der, Coffea is valuable in allaying the nervous excitability generally present. Administration. %fi 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 startings or convulsions set in prior to the appearance of the eruption : and again during the maturative stage, when the nights of the little patient are much disturbed by a trouble- some 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. Antimonium tartaricum 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 Antimonium tartaricum is given alone, it will be sufficient to repeat the dose every three to six or even twelve hours ac- cording to circumstances. Bryonia is sometimes useful in assisting the natural course of the eruption ; it is also indicated when considerable symp- Loms of gastric derangement are present, such as bitter taste in the mouth, foulness of the tongue, headach, rheumatic pain in the limbs, increased by motion, constipation and irritability if 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, s£ 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 being administered as above ordered, until these symptoms are ibated. 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, headach and delirium; great thirst, nausea, and vomiting: or when there is redness of the tongue at the tip and margins; abdomen tumid and painful, particulaily at the epigastrium, with sensibility on pressure ; prostration 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. Should vomiting set in attended with diarrhoea we may ad- minister Ipecacuanha^, followed by Pulsatilla &£, if the 68 ERUPTIVE FEVERS. symptoms become aggravated towards evening and the patient be of a mild phlegmatic temperament. If Antimonium tartaricum and Ipecacuanha do not succeed in allaying the nausea and vomiting, and the patient complains of excessive thirst and dryness of the mouth; the tongue being at the same time very foul and dark, and the prostration of strength excessive, we may administer Arsenicum ^ 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 symptom 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 (yf) is sometimes useful, when some pustules are already formed, in forwarding the eruption 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 every six hours, until amelioration declares itself. When the fever runs high in confluent smallpox and threatens to continue so, • In some cases, and especially those of a bad type, livid spots or dif- fused ecchymoses are observed on the skin prior to the evolution of the eruption (variola nigra ) Arsenicum is here also of considerable ser rice, 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 Sulphur, when not sufficient of itself to mitigate the ex- , |Cessive febrile action. While the disease is running its course, particularly during the distension 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 Mercurius 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 known : 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 cough which sometimes results from an attack of small- pox, Belladonna, Mercurius, and Arsenicum are three of the most appropriate remedies in most cases, (the particular in- dications for which will be found in the article on Coughs, which see ;) and 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 sulphuris, Euphrasia, Sulphur, Calcarea, Arsenicum, Pulsatilla, Mer- curius, Nux 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 generally assumes, when it attacks those who have been pro- perly vaccinated. We must regulate our treatment according to the symptoms, being guided in the selection of the reme- dies, 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 re- covery it is necessary that the patient abstain for a consider- able time from animal food. It may be remarked that after recovery from an attack of malignant smallpox, the patient's constitution frequently re- * I have given in detail the treatment which has been generally adopt- ed by Homoeopathists, and with great success. But it may here be added, that Vaccinine, given internally, has obtained much repute as an im- portant 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-FOX. 71 tuires a thorough renovation, and that he should be put under course of medicine best calculated to attain that result. CHICKEN-POCK. Variola spuria, Varicella. Diagnosis. A disease bearing a considerable resemblance n its external character to smallpox, but differing in its dura- ;on, and symptomatically, being considerably milder, gene- ally requiring no medical assistance, but merely attention to et, and but rarely becoming dangerous, except when it ex- :nds itself to the lungs or brain. The fever, however, occa- ionally runs high. When this affection a'iacks an individual, and smallpox is pidemic, which is not unfrequently the case, it is often mis- ken for that disorder, but it soon discovers its real character / the rapidity with which the eruption declares itself; the ustules (in many instances closely resembling those of the mallpox) being generally fully matured by the third day, and le whole eruption disappearing at the end of the fourth or fth, without. leaving any mark. Therapeutics. When much fever is present we should heck it by the administration of Acontie -£-, repeated from ime to time as required, or Coffea, -3a, also occasionally re- eated if there be simply extreme restlessness and anxiety. Vhen cerebral symptoms threaten, Belladonna ; for the em- doyment of this medicine, see Inflammation of the Brain. kVhen 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 pus- tules 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 supervene, more closely resembling Smallpox, we may con- sult the remedies mentioned under that disease. 72 eruptive fevers. MILIARY FEVER. Miliaria. 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 be considered as an evidence of some internal constitutional taint; it is also not uncommon with women at the period of confinement arising from the room being kept at too high a temperature —a frequent cause of this malady. This, like other cutaneous affections of the same nature, is generally preceded by febrile symptoms, the eruption appears on the fifth or sixth day ; from the commencement of the fever we frequently find profuse perspiration, with a putrid sour odour ; previous to the vesicles evolving themselves, there is a ting- ling or itching of the skin, occasionally attended with a sen- sation of burning, together with a numbness of the extremi- ties ; the patient complains of a sense of oppression at the chest, sometimes with short dry cough, and stitches in the side, and not unfrequently of severe or fugitive rheumatic pains in the 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 form, 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 (6), when the accelerated circulation is at- MILIARY FEVER. 73 tended with considerable determination of blood to the head, and delirium. Arsenicum (6), when the eruption is accom- panied with excessive anxiety. 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 (3), or should the symptoms which precede the eruption be accom- panied by constipation, or shooting pains in the chest, Bryonia (6) 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, repeated in from four to twelve hours, according to the in- tensity 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. When sympto- matic, it may be recognized 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 7 74 ERUPTIVE FEVERS. 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 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, &c, present themselves, (see Cuprum aceticum, article Scarlet Fever, p. 48.) 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 unfrequently arising from indigestion, caused by the use of improper articles of food. Before the eruption discloses itself, tho patient is affected with restlessness, languor, op- pression, 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 con- stitutional 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- monium crudum, Belladonna, Hepar sulphuris, Rhus toxico- dendron and Bryonia. nettle-rash. 75 Dulcamara (6) when the exciting cause has been cold or damp, when the affections occurs in wet weather, or when we find considerable fever with bitter taste in the mouth, foul tongue, diarrhoea, pains in the limbs, and extreme itching, with a burning sensation after scratching. Aconite (6) when the febrile symptoms are more intense, the pulse high, the skin hot and dry, great restlessness and anxiety present. Nux vomica (6) when there is considerable gastric de- rangement, with constipation, more especially when arising from wine, stimulants, or indigestible substances ; it may, if necessary, follow Aconite in eight or twelve hours after the febrile symptoms are somewhat modified. Pulsatilla (6) deserves a preference under similar circum- stances when the bowels are relaxed, and the patient of a quiet disposition and lymphatic temperament, and the attack has apparently been excited by indigestible food. Antimonium crudum (6) may follow Pulsatilla, should the latter have failed to relieve the affection. Belladonna (6) is indicated when the affection is attended with a severe throbbing headach, with redness of the face. Hepar sulphuris (6), when cold in the head, and particu- larly if affecting only one nostril, is present, has frequently been found useful. Rhus toxicodendron (6) is one of the most useful reme- dies in a great majority of cases of this eruption, and especially when the affection has apparently arisen from some idiosyn- crasy of constitution, in which the eruption has been thrown out by the use of some particular article of food. See article on Diet in Introduction. Administration of the Medicines. In ordinary cases we may dissolve four globules at the potencies above given, in six dessert-spoonfuls of water, and administer one morning and evening, except in the case of Aconite, which maybe more frequently repeated when the febrile symptoms seem to de- mand it.* « Vide note, p. 21. 76 eruptive fevers. In this, as in every other cutaneous eruption, great care ought to be taken against driving in the eruption, by external applications or lotions ; their sudden suppression, as before noted under Scarlatina and Smallpox, being frequently at- tended with fatal consequences. When, however, from im- proper treatment we have reason to dread this having taken place, we should administer Bryonia ^, repeated every four hours until the eruption reappears, which will generally he found sufficient to bring back the rash, and prevent further dangerous consequences. Should, however, marked cerebral symptoms declare themselves, see Scarlet Fever, Repercus- sion of the eruption. Urtica urens has been found useful in some cases. In those of a chronic or extremely obstinate character Calcarea, Lycopodium, Sulphur, Carb. veg., Causticum, Acid, nitric, Conium, Natr. mur., &c.; the latter two, particularly when the eruption is liable to reappear after violent exercise or exertion of any kind ; Calcarea, when exposed to cold fresh air ; and Acid, nitricum on going into the open air, after having kept within doors for a day or two. 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. Among these, Belladonna, Chamomilla, Mercurius, Nux vomica, Pulsatilla, Sulphur, Carbo vegeta- bilis, 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 again, the same remedy may be repeated, provided the symp- toms are of a similar description to what they were before tak- ing the remedy ; if they have altered, select another medicine. Belladonna ^, is particularly indicated when the pains are very severe, of a drawing, tearing, or shooting nature, ex- tending to the face and ears ; 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 affection Nux vomica and Pulsatilla are also valuable when indicated by the symptoms. Rhus and Dulcamara frequently answer best after 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 alto- gether ; as also from very hot or cold drinks, stimulants of every descrip- tion, sweetmeats and acids; they ought farther to refrain from using medicated tooth-powders, particularly if they wish to derive any benefit from homceopathic treatment; the toothpick ought to be cautiously 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 -&-, is 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 infiammation of the gums; noctural perspiration, peevishness and inclination to tears ; it is especially useful in persons who are subject to glandular swellings. Nux vomica %^p 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 or 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. Tho toothache is more liable to come at night or on awaking in the morning, sometimes also after dinner or in the open air. Pulsatilla *$f-, 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 Af. This remedy is particularly valuable in strumous habits, with a tendency to constipation ; 80 digestive system. pain, sometimes attended with swelling of the check and shoot- ing pains in the ears, congestion of blood to the head, and pul- sative headache; the pain is of a tearing, jerking, pulsative description, affecting both carious and sound teeth : aggra- vated in the evening and at night, 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 tho teeth; the gums are swollen, affected with pulsative pains, and bleed easily. Bryonia ^ 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- gation of the teeth, especially during or after eating ; shooting in the ears, with inclination to lie down, pains aggravated by taking anything hot in the mouth, mitigated by lying on the affected side or exacerbated by the contrary position. Carbo vegetabilis 4gf is indicated by toothache, with dragging-tearing, or constrictive and throbbing pains excited by anything hot, cold, 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 -3fl,f, by noctural pain, which extends into the ear, cheek, bones of the face, and temple ; aggravatiem 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 sums. Aconite, Belladonna, Chamomilla, Coffea, and Ignatia, the most useful in affections of this nature with children. SORE THROAT, OR QUINSEY. 81 Aconite ^°4a. 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 described as of a pulsative, throbbing nature. Coffea 4j-05. Against violent pains with great excitability and almost distraction in adults; also when the patient is conscious that the excitement is disproportionate to the pain suffered. 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 §-£. Igmatia -£~ is suitable to those cases presenting similar indications to those of Nux vomica or Pulsatilla, but more particularly applicable to mild or sensitive dispositions with alternation 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, de- noted by swelling and red colour of the back part of the throat, accompanied with difficulty of swallowing, impeded respira- tion, alteration 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 increase of pain on partaking of cold or warm drinks, but temporary re- lief on the external application of heat; also in toothache which returns every spring or autumn during the prevalence of easterly winds, (and then continues 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 shootings into the ear, Rhododendron chrysanthum is a useful remedy, in repeated doses. 82 digestive system. constriction about the throat, with a feeling of soreness, and sometimes of obstruction in the act of swallowing the saliva ; if it runs its course, the difficulty of swallowing and breathing increases, the tongue swells and becomes foul, the tonsils as- sume a redder hue, occasionally a number of small yellow eminences appear at the back of the throat, and particularly on the tonsils ; the patient complains of thirst, and the pulse is hiijh. strong, and frequent; sometimes the cheeks swell and become florid, and the eyes inflamed, and in severe cases delirium is not an unfrequent occurrence. As the local affec- tion progresses, the majority of the foregoing symptoms be- come aggravated, the tonsils tumefied, and suppuration en- sues if resolution be not speedily effected. When suppuration takes place, the pain is instantly re- lieved on the bursting of the abscess ; it sometimes happens, however, that scarcely has the patient been relieved from suf- fering by the latter event, before the state of the other tonsil gives indications that a similar train of symptoms are about to be encountered there. This affection, occasionally, if not properly treated, dangerous in its simple form, becomes par- ticularly critical when it puts on the putrid type. In such instances, the attendant fever generally assumes a typhoid character ; when this takes place, we may always infer a pe- culiar constitutional tendency. Therapeutics. The following are the principal remedies used in the treatment of this affection : — Aconitum, Belladonna, Mercurius, Carbo v., Acidum nilricum, Lachesis—Pulsatilla, Nux v., Arsenicum, Chamomilla, Ignatia, Dulcamara, Hepar sulphuris, Silicea, Sulphur. When this affection is at the commencement attended with considerable fever, thirst, and dry heat, deep redness of the parts affected, painful and diffi- cult deglutition, pricking sensation in the throat, with aggra- vation of the symptoms when speaking, we should have re- course to Aconite. Administration. This must be regulated by the intensity of the inflammation ; in many cases a dose of™, repeated in six hours, if necessary, will be found sufficient, but if the in- flammatory symptoms are very violent, we may add six glo- SORE THROAT, OR QUINSEY. 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 ^ip 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, Mea- sles, &c, is one of the best remedies we possess against phlegmonous inflammation of the throat. When the above symptoms have been subdued by Aconite, or should the fol- lowing symptoms have existed from the commencemeut, we should have immediate 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 ex- amination, the throat presents a bright red colour, with swell- ing of the palate, uvula and tonsils; also accumulation of slimy whitish mucus in the throat and on the tongue, obliging the patient to spit frequently ; swelling of the muscles and glands of the neck, severe headache, chiefly confined to the forehead, sometimes determination of blood to the head, and delirium. (After Belladonna, Mercurius, Lachesis, or Pulsa- tilla 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 subdues 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 Belladonna in troublesome cases, is one of the most valuable remedial agents ; following that medicine, when necessary, to complete 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 ; inflammatory redness and swelling of the affected parts of the throat, burning in the throat, desire to swallow, attended with a sensation of an obstruction existing in the passage ; ac- cumulation of thick and tenacious mucus in the throat, dif- ficult 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 tongue ; occasional swelling of the gums ; unpleasant taste in the mouth, which is filled with saliva more or less inspissated; 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, Hepar sulphuris, Carb. v. or Ac. nit. are often suitable after Merc.) 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 the throat from the slightest external pressure ; — it is moreover an excellent rem- edy in all cases of tonsillitis in which Belladonna or Mercurius have afforded relief, but seem incapable of effecting resolu- tion ; and also in aphthous sore throat with considerable ul- ceration, 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 required 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 healing appearance a few hours after the use of Mercurius. Administration. Six globules of the third potency in an ounce of water, a dessert-spoonful every six then every twelve or twenty-four hours until 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- ducing 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 in- dicated likewise when there are small offensive ulcers of the throat, or considerable debility is present. (Vide Ulcerated Sore Throat, page 89.) Sulphur is frequently useful after Nux vomica. 8 86 digestive system. Administration. ££ in a little water exhibited in the evening when practicable ; in severe cases repented every six hours, until improvement results. Pulsatilla is frequently serviceable after Belladonna, when there is an increased secretion of viscid mucus in tho fauces :—but it is more particularly when the following symp- toms are met with that this remedy is called for : gastric derangement, 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 tho throat, as also, of excoriation and scraping, with dryness of the throat without thirst, shooting pains in the throat when not swallow- ing, 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 individuals of a mild and phlegmatic temperament. Administration. -c° 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 swelling of the throat, deep redness of the parts affected, inabillity to swallow solid food, especially when lying down ; thirst, with dryness 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 hoarseness ; fever towards evening, with alternate heat and shivering, red- ness of one cheek, great excitability and tossing about. Administration. &£■ 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 QUINSEY 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. Dulcamara. An almost specific remedy when sore throat, particularly in the form of tonsillitis, has arisen from ex- posure to wet. It may be followed by Belladonna 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 developes itself. This medicine, if 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 employment in this, as in other diseases, is an extreme over- excitability 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 sulphuris is valuable in bringing the matter to a head, when resolution cannot be effected, and the quinsy has attained to such a height that its bursting is desirable from the painful sensation of suffocation which arises in conse- quence of the tumefied condition of the tonsils. 88 DIGE8TIVE SYSTEM. Administration. One grain of tho trituration, third po- tency, added to an ounce of water. One dessert spoonful every two hours until the quinsy bursts. Silicea. This remedy is in some instances more effica- cious than Hepar in rapidly forwarding the suppurative pro- cess, and causing the ripened abscess to burst. Administration. Six globules of the sixth in an ounce of water, a dessert-spoonful every two hours. Mercurius 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 unfavorably and even fresh abscesses form in suc- cession : Sulphur, Hepar s. and Psoricum, repeated every eight or twelve hours, have chiefly been recommenced in these fortunately rare cases. Sulphur in ordinary cases ; Hepar s. when the patient has been previously subjected to an abuse of Mercury under allopathic treatment, and Psoricum when Sulphur has been taken in excess * Half a grain of the tri- turation to an ounce of water, a tablespoonful every twelve hours. The 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 homceopathic 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 Homazopatky, No. vii. ULCERATED SORE THROAT. 89 ULCERATED SORE THROAT. Malignant Quinsey, Malignant, putrid or gangrenous Sore Throat.—Angina Maligna, Tonsillitis 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 petechia?, break out on various parts of the 8* 90 DIGESTIVE SVSTEM. body, and usually, though not necessarily, add to the danger,— as many are carried off, particularly children or persons ol an advanced age, without any eruption.—when the local symp- toms are severe and the fever high : But tho appearance of livid spots or petechia:, and other indications of so called putrescency, with frequent shivering, weak fluttering or inter- mittent pulse, sunken countenance, severe purging, extreme prostration, and bleedings from the nose, mouth, &c., 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 tho disease, when a gentle sweat breaks out about the third or fifth day, when the sloughs throw off in a favorable manner, leaving a clean florid healthy-looking bottom, and the respiration becomes more gentle and free, the expression of the face more lively, and the pulse stronger and more equal, a salutary 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 type, 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, Mercurius, Acidum nitricum, Pulsatilla, Arsenicum, Lachesis, Nux v., Carbo vegetabilis, Sulphur, r 5U, especially uselul after Pulsatilla and Nux vomica, in removing any symptoms that may remain. Hepar sulphuris, 6, is a valuable rem- edy in some cases of dyspepsia, but particularly in those in which the patient has previously been taking blue-pill, or any other mercurial preparation for a considerable time. Acidum sulphuricum, 3. Dyspepsia arising from excessive study, drinking, or other excesses, with the following symp- toms : great weakness of digestion ; acrid, foul, putrid taste in the mouth, dry tongue, burning and smarting sensation in the throat, sometimes attended with pricking, especially at night, and so troublesome as to prevent sleep (Pyrosis) ; offensive breath, especially in the morning (aphtha) ; renewal or aggra- vation of the symptoms from drinking cold water ; all cold drinks appear to disagree, unless a little brandy or some other ardent spirit is added to them ; accumulation of water ; saliva in the mouth ; flatulence ; bitter risings ; vomiting of a limpid fluid, or of food. It may here be remarked that, in cases where Nux vomica seems indicated, but the disposition is of a morose or hypochondriacal turn, Cocculus ^Tj may be substi- tuted with effect; when the indications for temperament are not sufficiently distinctive, Cocculus, Nux vomica, and Pulsa- tilla may be advantageously alternated. Finally, Carbo vegetabilis T5- will frequently remove any symptoms that may remain after Nux vomica. Cinchona |! is a valuable auxiliary in the treatment of this derangement, when there is imparled appetite with great weakness of digestion, which is more liable to be experienced on partaking of supper ; flatulence ; bitter taste ; langour ; hypochondriacal disposition ; and particularly when we can trace it to debilitating losses of fluids, such as to abstraction or loss of blood, too great a drain upon the resources during lactation, prolonged use of aperient medicines, &c, also dis- orders arising from abuse of tea, or from residing in impure atmospheres, and especially such as are overloaded with the exhalations of decayed vegetable matter. WANT OF APPETITE. 101 Natrum c. may follow Nux. v., Bryonia, or Cinchona, with advantage when a degree of weakness of digestion remains. In chronic cases, this disorder sometimes takes a critical turn vomiting becomes excessive, everything taken is returned from the stomach, the skin is hot and dry, the patient becomes emaciated, and the countenance cadaverous. Here, it need hardly be said the aid of the experienced physician is re- quired,—it will therefore be sufficient to intimate, that Arsen- icum and Lachesis will in such cases tend much to invigorate the sinking energies, and even,—with the occasional aid of Ly- copodium, Veratum, Baryta, Phosphorus, Conium, or some one or other of the above-mentioned remedies, where necessary,— eventually effect a cure, provided the inroads of organic lesions have not already placed the unfortunate sufferer beyond the reach of art. Accessory Treatment and Diet. In no other class of disorders is it more requisite to adhere strictly to dietetic re- gulations than in those where there is derangement in the digestive system, whether functional or organic : the patient so affected should therefore, as closely as possible, regulate his regimen by the rules laid down at the commencement of this treatise, carefully avoiding, moreover, all such articles as he may find disagree with him, even if they appertain to the aliments allowed. He should generally abstain from soups, and everything that has a tendency to distend the stomach, such as taking large quantities of warm liquids ; he should not indulge his appetite to its full extent, avoid late hours, unneces- sary exposure, severe mental exertion or anxiety, take sufficient exercise in the open air, and, as much as possible, keep his mind from dwelling upon his complaint, or on gloomy subjects. WANT OF APPETITE. Apepsia. Anorexia. Want of appetite being a concomitant symptom of many diseases, is treated in this treatise as such when present; but we now propose to look upon it as one of the leading symp- toms of indigestion, and as such, deserving a particular notice. It may, as in the case of dyspepsia, in a great variety of cases 102 DIGESTIVE SYSTEM. be considered as attributable to an ill-regulated regimen, im- perfect mastication of food, sedentary habits, and the neglect of taking sufficient exercise. In many instances, removing tho exciting cause will euro this disorder. Sufferers from this inconvenience should care- fully avoid creating an artificial appetite, or partaking of the smallest quantity of food till a healthy call from nature proves that the former has assimilated ; the habit of taking tea, and even as the expression is, " making a meal of it," within a couple of hours after removing from the dinner table, is a frequent cause of apepsia and dyspepsia. Another cause is the habit of drinking frequently, or very copiously during meals, and thereby attenuating the saliva and gastric juice, and rendering them less fitted for the purpose of digestion. Other causes are the customs of sleeping after dinner, par- taking of heavy suppers, before retiring to rest, and indul- gence in fermented vinous or spirituous liquors, or in tea or coffee, particularly the latter. An alteration in the hours of meals, and avoiding too long fasts between them, will frequently remove this affection. In other cases, early rising, great attention to diet, avoiding rich or highly seasoned food, together with the daily use of pure, cold water,—drinking a tumblerful an hour or so before breakfast, three or four hours after dinner, and again about the hour of retiring to rest,—will suffice to restore the weak- ened digestive functions to a normal condition. When, however, we cannot trace this disorder to any of the above, or some other probable cause, when every attention to regimen, and even an alteration of diet according to individual peculiarities or idiosyncrasy has failed to produce any good effect, we generally find the want of appetite accompanied with other symptoms of derangement of the digestive func- tions, which may prove useful in aiding us to select a proper remedy to restore the natural tone of the stomach ; this will be found among the medicines most useful in Dyspepsia and Cardialgia : namely, Nux vomica, Chamomilla, Pulsatilla, Cinchona, Ipecacuanha, Antimonium crudum, Bryonia, Arnica Hepar sulphuris, Lachesis, Sulphur, and Calcarea. want of appetite. 103 Administration, the same as in Dyspepsia (page 95,) which see. Nux vomica is the principal remedy when the want of appetite can be traced to late hours, the habitual use of wine and coffee, sedentary and studious habits,—also when the following symptoms are present : dryness of mouth, tongue coated white with craks or slimy mucus in the mouth, agustia, pyrosis, or insipidity 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 working or dragging of the tendons in the lower extremities, or cramps, restlessness, and general irritability of disposition,—symptoms aggravated in the morning. 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. 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, sliminess of the mouth, scraping roughness or acidity at the pharynx, bitter eructations, aversion to warm food or to meat, butter, and all rich food ; loss of taste ; distension 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 digestive system. exacerbation of symptoms in tho evening, in contradistinction to Nux vomica, which is generally in the morning. This re- 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 mastication is tho cause of the affection. Finally, in cases where there is a marked aversion to tobacco, even when accustomed to its use. Moreover, this remedy will be frequently found of benefit in some cases where Chamomilla has only temporarily relieved ; but should a considerable degree of nervousness, or even irritability, remain after Pulsatilla, Nux vomica may be had recourse to. Cinchona in anorexia occurring during foggy weather when the air is charged with unwholesome vapours, or in the vicinity of marshy lands. The following are its indications : a sensation of constant satiety with general indifference to food and adypsia ; tongue cracked or loaded with yellow or white coating : sensation of sinking and fluttering in the epigastrium (particularly when this symptom can be traced to the effects of tea) ; eructation after eating ; desire for highly- seasoned food, acids, pepper, and other condiments ; general weakness, with inclination to assume the recumbent posture, and inability to remain long in one position ; uncomfortable feeling of dry heat, or shivering and sensitiveness in the open air : retarded or interrupted sleep: general feeling of uneasi- ness, with moroseness and peevishness. Ipecacuanha is indicated by the following symptoms : Nausea or vomiting, without foulness of the tongue, with dislike to food. Tobacco—even to smokers—has a nauseous taste, and causes vomiting. This remedy is also useful when the impaired appetite has arisen from bolting the food, parti- cularly in the cases of children, and may be followed by Pulsatilla, when only partial relief has been obtained. Antimonium crudum, in cases where a great disposition to nausea and vomiting with foul tongue exists ; anorexia, dryness of the mouth with great thirst, particularly during the night ; accumulation of phlegm in the throat with continual attempts to clear the throat ; frequent rising soon after meals, of WANT OF APPETITE. 105 the food last partaken of: pain or disagreeable fulness at the epigastrium, frequently with sensibility to external pressure. In cases of recent standing with the above symptoms it is very speedily efficacious ; and when relief does not quickly follow, the next mentioned remedy should be had recourse to. Bryonia in recent derangement of the stomach with ano- rexia. When we find thirst more during the day than through the night ; with a sensation of dryness in the throat, extend- ing down the oesophagus ; chilliness ; yellow, dark-brown, or white coated, cracked tongue, with constipation. Arnica. This remedy is valuable when the loss of appetite has arisen from sitting up at night, watching at a sick bed ; from not having devoted a sufficient number of hours to the period of rest; or from intense mental exertion, or from pro- vocation or excitement. When from these causes the nervous system is powerfully affected ; tongue coated yellow ; taste foul, bitter, or sour, or nauseous or chalybeate, with offensive smell from the mouth ; with rising of the food or eructations of the taste or smell of rotten eggs :* aversion to smoking and desire for acids; sensation of fulness in the scrobiculous after meals, with inclination to vomit: distension of the abdomen, with pinching colic, relieved by doubling up the body, and renewed by drinking the smallest quantity of wine : passing off and then coming on, with inclination to evacuate the bow- els : general irritability and impossibility of fixing the mind upon any subject: inclination to remain lying down, which relieves a heavy stupifying headache, which the least motion or even conversation increases. Hepar sulphuris is useful in chronic cases of want of appetite, with indigestion from the slightest cause, even with the most careful observance of diet. It is indicated by de- sire for high-seasoned 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, Sepia, Slannum, also cover the latter symptoms): the practitioner will therefore do well to bear the said remedies in mind when this particular symptom is a prominent one, and does not yield to Arnica. 106 DIGESTIVE SYSTEM. chief antidotes to Mercurius, and consequently one best adpated to those affections arising from long-continued use of Calomel. Administration. One grain of the third trituration in six dessert-spoonfuls of water, one daily, fasting. In other cases, it will be found more beneficial to give a globule or two of the sixth in a little water, and not to repeat the dose until five or ten days.* Lachesis is a valuable remedy to follow Hepar sulphuris in obstinate cases, particularly when long-continued constipa- tion is complained of, and the symptoms have always been aggravated by acid drinks, &c. : in the latter case Arsenicum is also useful, and may sometimes precede Lachesis with advan- tage. Administration. fi&^ in the same manner as Hepar sulphuris. In addition to the two last-mentioned remedies we may observe, that in the same class of cases, Belladonna, Mercurius, Sulphur and Calceirea may be used with considerable advan- tage, when the former remedies have only afforded partial relief. Acidum sulphuricum is a useful remedy in cases of im- paired appetite, with weakness of digestion, arising from habi- tual excess in the use of ardent spirits, or from debilitating loss of fluids, such as blood, &c, or in consequence of exces- sive study,— with the following symptoms : acrid or putrid taste, dry tongue, burning and smarting sensation in the gullet resembling heartburn : offensive breath, especially in the morning (aphthae): disagreeable sensation of pricking in the throat, frequently occurring during the night, and dis- turbing sleep. In other cases, the practitioner or student may consult the subjoined remedies in the Materia Medica with advantage, either as applicable to the treatment of this affection or dyspepsia and cardialgia. Sepia, Colchicum, Fer- rum, Silicea, Ruta, Amon. c, Rhus, Aurum, Baryta c, Acid. nitr., Kali c, Natr. m. and c, Graphitis, Hyoscyamus, Ig- * Vide note, p. 21. DERANGEMENT OF THE STOMACH. 107 natia, Staphysagria,Kreosotum, Petroleum, Anacardium, Caus- ticum, Drosera, N. mosch., Capiscum. DERANGEMENT OF THE STOMACH, ERUCTATIONS, &c. Under this head we intend treating of a disorder which may arise in individuals of a generally unimpaired digestion— the characteristics of eructations will assist to indicate the remedy for persons subject to this unpleasant affection. The ordinary causes of this derangement are : hurried, im- perfect mastication ; an overloaded stomach ; fat, greasy, indigestible or tainted food, flatulent vegetables, ices, stimu- lants, &c, and are so well known that it is hardly necessary here to enter upon them, particularly as they will be more specially noted under the different medicines. Therapeutics. When the symptoms of approaching stomachic derangement declare themselves immediately, or a few hours after a repast, a little strong black coffee is fre- quently a sufficient restorative. Should, however, this fail to relieve, and sick headache and inclination to vomit be present, we should assist nature by tickling the fauces with a feather, and by giving tepid water to drink until the stomach has completely evacuated its con- tents. Should, however, on the following morning symp- toms of deranged digestion continue, such as nausea, in- clination to vomit, or vomiting, and disagreeable or offensive eructations, we should administer Antimonium crudum -|- in a little water, one of our most useful remedies in this affec- tion, and which rarely fails to at least afford some relief. It is also peculiarly indicated when the affection has arisen from drinking sour or impure wine ; or when, in addition to the symptoms of disordered stomach, a degree of fever returns every second day. Ipecacuanha fl§-. When a rash has been thrown out, from the effects of a disordered stomach, attended with anx- iety, oppressed breathing, and sickness, this remedy will, in 10S DIGESTIVE 8TSTEM. most cases, effect speeilv relief; — but should the difficulty of breathing, or a degree of nausea, or other uneasiness continue, Bryonia should be exhibited. Bryonia figft. In addition to the usefulness of this re- medy in the foregoing instance, it is also very serviceable when the following symptoms are present; bitter eructations ; fever, alternately with coldness and shivering ; or redness ot the face, heat in the head, and thirst with coldness and shiv- ering ; also where diarrhoea or constipation and peevishness, or excessive irritability are present. Arsenicum -{P, acrid and bitter eructations with nausea and vomiting ; also dry tongue, excessive thirst, salt taste in the month, and burning or violent pressure in the stomach, with diarrhoea or colic, and griping in the hypogastrium, par- ticularly when arising from the effects of an ice which had been partaken of when warm, or from fruit, stale vegetables, or from acids. It may in many cases be advantageously fol- lowed by Carbo vegetabilis, which see. Nux vomica ^{p, offensive eructations, constipation, and confused headache, particularly if arising from previous in- toxication, or even slight over-indulgence in wine or other stimulants ; when possible, it should be taken the same night, as taken in the morning, although eventually relieving, it fre- quently causes an aggravation for a few hours. Arnica fl§5. Eructations resembling rotten eggs.* Pulsatilla &$&, next to Antimonium crudum, the most important remedy in recent cases of deranged digestion, with eructations of ingesta, tongue foul and covered with mucus : chilliness and lowness of spirits ; and also when a rash has been thrown out in consequence of the derangement. This remedy is, moreover, almost specific when the disturbance has arisen from the effects of rich food, such as pork or pastry, or even tainted meat, or from the effects of ices, cold fruits, or crude vegetables, acid wine, &c. (Arsenicum may follow Pulsatilla, if the latter do not effectually relieve.) Aconite s%^. When the affection owes its origin to par- ♦ See also note, page 105. derangement of the stomach, etc. 109 taking of sour beer, vinegar, or other acids, particularly when we find oppressive pain in the stomach, great heat in the head, nausea, or actual vomiting of mucus, or even of blood. Hepar sulphuris ^o When the digestion is naturally weak, and sour vomiting, attended with burning in the throat, colic, and diarrhoea is liable to ensue from the slightest error of diet, and particularly when anything of an acid quality has been partaken of. (Lachesis is often of great service here in alternation with Hepar sulphuris, at intervals of a week or so.) Carbo vegetabilis q-^, although last mentioned, is not one of the least valuable remedies in this affection, and is often found particularly useful after Pulsatilla, Arsenicum, or Nux vomica, in removing any symptoms that may remain ; it is moreover, particularly useful where great susceptiblity to the influence of the atmosphere, particularly to cold, exists at the same time ; or in sufferings arising from abuse of wine, ices, salt ; further, in derangement of the stomach arising from having partaken of game, or fish which has been too long kept, or meat which has been recooked while in a state of fer- mentation, as is liable to occur in warm weather ;—in the lat- ter instances, Carbo v. is to be preferred to any other medi- cine, and will rarely fail to afford relief; if any disagreeable symptoms remain, Cinchona^, maybe administered in a little water, and followed, if required, by Pulsatilla § in the same maner ;—finally, this remedy is peculiarly valuable in obsti- nate and chronic cases of deranged digestion 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 dissolve four or five globules in eight or ten teaspoon- * A small quantity of finely-powdered charcoal in a little good French brandy will be found an equally efficacious mode of administering this remedy as a corrective against any unpleasant effect arising from hav- ing partaken of tainted meat or fish. 10 110 digestive system. fuls of water, and give one from time to time, according to tho exigency of the case. FLATULENCY. Flatus. This affection, and the 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 frequent indulgence in vegetables and fruits : In corpulent individuals the sufferings arising from this com- plaint, such as difficulty of breathing, palpitation of the heart, trembling of the limbs, confusion of the head, and swelling of the face, especially in hypochondriacal subjects, are most distressing. However, with proper attention to regimen, and suitable medical treatment, it is rarely very difficult to remove. As an accompaniment of deranged digestion, it has also been noticed under Dyspepsia. Against this complaint the most careful preservatives are avoiding cold, exposure in cold damp weather, very cold drinks, or distending the stomach with a large quantity of warm fluid, particularly strong tea or coffee : each patient should also study his own digestion, and carefully refrain from partaking of any species of aliment which experience has found liable to produce flatulency. Sedentary habits also should be avoided, and a proper portion of the day de- voted to exercise in the open air. Therapeutics. In the treatment of this affection, the following medicines have been found most frequently called for: Cinchona, Arsenicum, Nux vomica, Pulsatilla, Carbo vegetabilis, Colchicum, Belladonna, Colocynth, and Tincture of Sulphur. Of these Nux vomica and Pulsatilla are most fre- quently required. Administration. In recent cases, six globules of the third potency may be given, dissolved in an ounce of water, a dessert- spoonful every half hour till relief ensues ; after which a dose of a couple of globules every four or five days or so, to coun- teract the tendency to this affection.* * Vide note, p. 21. FLATULENCE. Ill Cinchona g-. 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 use of purgatives, or to deranged digestion arising from flatulent food, with painful tension and distension of the abdomen, or when, on the occasional 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 s, where the last-mentioned symptom has not been relieved by the foregoing medicine. Nux vomica g-. 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 sensation of pressure as from a stone, particularly when the affection arises from an habitual use of coffee, or sedentary habits. Pulsatilla -g, 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. Colchicum -g, 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 with the hand—without any marked pain, but with heat and difficult of respiration. (This remedy is often peculiarly efficacious when the derangement is attributable to vegetable food.) Belladonna. In cases of flatulent obstruction, in 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 Colo- cynth when the relief obtained is only temporary, or when, from the manner in which the patient traces the course of his 112 digestive system. uncomfortable feelings, there is every reason to conclude that the flatulent distension and obstruction occupy the entire extent of the colon. When the flatulence occurs very frequently, in fact, where a marked predisposition to it exists, we must have recourse to Tincture of Sulphur -^. Although I have pointed out the remedies best suited to the cases of this affection most ordinarily occurring, and have also treated of the same subject under Dyspepsia and Colic, to which the reader is referred, I still think it advisable to add a few medicines which bear particularly upon this disorder, and deserve a careful study. They are : Lycopodium, Coccu- lus, Natrum, Natrum muriaticum, Zincum fvliatum, Magnelis polus arctus, Agnus castus, Ferritin, Graphitis. SPASMS OF THE STOMACH. Gastrodynia, Cardialgia, Gastralgia. Diagnosis. Contractive and spasmodic or gnawing pains at the epigastrium, extending to the chest and back, attended with anxiety, nausea, eructation or vomiting, with faintness and coldness of the extremities : the patient is sometimes re- lieved by emission of ascending flatus, and when complicated with pyrosis, by a discharge of a quantity of limpid fluid ; occasionally headache and constipation are present. In some cases the pain is very slight, but there is always more or less, and a degree of anxiety, with nausea, increased by taking food ; it seems generally to arise from an abnormal state of the nerves of the stomach, and is frequently accompanied by a disease of the liver, spleen, or pancreas, or even by scirrhus of the stomach or duodenum. Although the real seat and nature of this disorder may be somewhat obscure, yet upon one point we may rest perfectly satisfied, that, even where it exists as a primary and idiopathic disease, the digestive function rarely fails to be considerably impaired* during its progress. The disease is a frequent attendant on gout; and it very rarely occurs be- fore the age of puberty. The paroxysms last for a longer or shorter time, and return in many instances periodically, and spasms of the stomach. 113 may be brought on by partaking of improper articles of diet, or in severe cases, by any solid food whatsoever. The chief articles to be avoided by an individual suffering from this malady are—crude, uncooked vegetable substances, such as salads, cheese, new bread, sweetmeats, cherries, nuts, olives, and roasted chesnuts ; and stimulants of all kinds, whether tea, coffee, alcoholic or fermented drinks. The causes are : long fasting between meals, very hot or cold drinks, an habital use of ardent spirits, of indigestible food, worms, and in some instances perhaps, exposure to cold or damp weather. It is a more frequent affection of the female than the male sex, frequently occurring after the cessation of the usual monthly discharge, or from any interruption of its usual course : in such instances it is frequently accompanied with hysteria, syncope, and may pass on to vomiting of blood. Notwithstanding the usually tintractable nature of this affection, it has been treated with marked success by the method about to pointed out. Therapeutics. Nux vomica is the principal, and in most cases, the most appropriate remedy against spasms of the stomach, and particularly in cases where this affection can be attributed to the long-continued use of strong coffee, or to an excessive indulgence in spirituous liquors ; it is, moreover, of essential service in many cases of the same disorder which have arisen after the suppression of chronic or hemorrhoidal discharges, or when the party affected is liable to fits of hysteria or hypochondriasis ; the following are the immediate symptoms which call for the administration of this medicine; Constriction, pressure, squeezing, or spasm in the stomach, accompanied with the sensation as if the clothes were too tight at the waist, or as if flatus were pent up in the hypo- chondria. This sensation, as well as the pains before men- tioned, become generally increased after a meal, or after par- taking of coffee ; in addition to which a feeling of depression or constriction is experienced at the chest, which, in many cases, extends to between the shoulders and the lower part of 10* 114 digestive system. the back. Frequently also nausea, accumulation of clear water in the mouth, or risings of sour bitter fluids, attended with a sensation of burning in the throat and gullet (pyrosis); sour or putrid taste in the mouth, vomiting of ingesta, flatu- lent distension of the bowels, constipation, aching in the forehead, palpitation of the heart, and anxiety. When these symptoms are liable to be excited by a fit of passion, or become aggravated in the morning, or when the patient is occa- sionally awakened out of his sleep by the spasmodic attack, this remedy is still more certainly indicated. Administration. •-£ in a dessert-spoonful of water, and repeated in six hours if necessary ; or in chronic cases with a constant pain, six globules of the same potency may be dissolv- ed in four dessert-spoonfuls of water, and a dose taken every evening until finished.* Of this, as of all the other medicines we may administer a dose from two to four hours before an expected paroxysm, when the Cardialgia returns periodically, or when from some imprudence in diet we have reason to ap- prehend an attack. This precaution, if it fails altogether to check it, will often greatly modify it. Should Nux vomica merely afford a temporary benefit, followed by renewed aggra- vation, and in cases where the disorder returns again after it has been for a time suppressed by Nux, we should repeat that remedy ; and if it then fail to afford relief, Carbo vegetabilis will generally complete the cure. Should this fail, particularly where the affection is traceable to the suppression of some chronic eruption, Tincture of Sulphur ought to be adminis- tered. This medicine, as well as Pulsatilla and Sepia, whose value in such cases we shall notice under there several heads, is particularly useful in gastrodynia in females, arising from any disturbance of the menstrual function. Administration. Of the Carbo vegetabilis we may dis- solve T62 in eight teaspoonfuls of water, and give one morn- ing and evening until finished. Of the Tincture of Sulphur | in the same manner. In some cases also, where no improvement results from the exhibition of Nux vomica the following should be consulted : • Vide note, p. 21. SPASM OF THE STOMACH. 115 Chamomilla, Belladonna, Cocculus, Ipecacuanha, Pulsatilla, Sepia, Ignatia amara, Cinchona, Staphysagria, Stannum, Bryonia, Platina, Senega, Ratanhia, and Arnica montana. Of course, also, a preference should be given from the first to that medicine whose symptoms approach most closely to those under which the patient is suffering. Chamomilla (3.) For the employment of this remedy the principal indications are pressure, as if from a stone in the pit of the stomach, or painful pressure at the precordial region, as if the heart would be crushed, flatulent distension at the same part, as also of the hypochondria and abdomen, with shortness of breath, anxiety, and throbbing headache : Mitigation of the above symptoms on partaking of coffee, a distinguishing mark between the indications of this remedy and those of Nux vomica: On the other hand, as in the case of the latter, it is also indicated when the symptoms, as described, are lia-ble to be brought on by a fit of passion. In obstinate cases, where Chamomilla fails, notwithstanding the apparent similarity of the symptoms, Belladonna (6) ought to be substituted for it: also when we meet gnawing pressure, or spasmodic tension in the pit of the stomach, re- lieved on bending backwards and holding in the breath ; further, spasms of the stomach, which recurs daily during dinner, or else pain of so violent a nature as to deprive the patient of consciousness: Carbo. v. may be preferred to Belladonna, how- ever, when the most prominent symptom remaining, consists of a sense of aching and pressure at the pit of the stomach and the pracordial region, causing a sensation as if the heart were about to be crushed. (See Chamomilla.) Cocculus (6) in many cases of this complaint are particu- larly indicated, when in addition to the usual symptoms there are constipation and constrictive pains over the entire abdo- men, with flatulency and accumulation of water in the mouth, and alleviation of the sufferings on the recurrence of the lat- ter symptoms. Ipecacuanha (3) is also useful in cases of this affection, when the paroxysms are accompanied with nausea, vomiting, dull darting pains in the pit of the stomach, and sensation of excessive uneasiness in the same region. 116 DIGESTIVE SYSTEM. Pulsatilla (6.) In eases with shooting pains in the sto- mach, which are aggravated by movement, and particularly by making a false step. Pulsatilla is also one of the most appro- priate remedies when the attacks are followed by vomiting, or accompanied by violent tension and squeezing, or throbbing and sensation of anxiety about the pit of the stomach, increase of pain after eating, or more particularly a feeling of pressure and pinching after dinner, with a relaxed state of the bowels, or a disposition thereto. Disposition to hysteria or hypochon- driasis. It is, as well as Sulphur and Sepia, called for in cases of this affection, arising from suppressed menstruation. Sepia (12.) Castrodynia arising from suppressed or dif- ficult menstruation, and may in general cases advantageously follow Pulsatilla: it is indicated by most of the sufferings that arise, taking place after a meal, by pressure in the stom- ach as from a stone, and by a burning pain in the epigastrium and scrobiculus : by restoring singly, or in conjunction with Pulsatilla and Sulphur, the menstrual flux, it frequently re- moves the cardialgia and hysteria consequent upon this de- rangement, or at least places the affection in such a position that it is easily cured by some other medicine, closely cor- responding to the remaining symptoms. Ignatia amara (12) is indicated under nearly similar cir- cumstances as Pulsatilla, with the exception of the state of the bowels, the Ignatia being more appropriate to cases attend- ed with costiveness, and where the inclination to vomit is absent, or when the affection has been caused by grief, anxiety, &c, or occurs in hysterical or hypochondriacal in- dividuals. Cinchona (6) is of great service in most cases of spasms of the stomach with general weakness, arising from loss of humours, the result of bloodletting, or repeated hemorrhages, abuse of emetics or aperients, too long continued suckling, &c. ; and is further indicated by great weakness of digestion, disten- sion and uncomfortable weight, pressure, or pains in the sto- mach after eating, so that the patient feels much easier when fasting ; these latter are the more immediate indications for the employment of this medicine. (Nux v. and Carbo v. may follow spasm of the stomach. 117 Cinchona, should the latter not remove all these symp- toms.) Staphysagria (6). This is useful in some cases of this complaint, and is particularly applicable when there is acute pressive tension and squeezing about the pit of the stomach, which sometimes obstruct the breathing, but which is relieved by bending the body forward. When the pain partakes of a marked tensive character, and extends to the region of the navel, with sensibility of the region of the stomach on ex- ternal pressure, shortness of breath, anxiety, and nausea, Stannum (12) will be found more appropriate. Bryonia (12). This medicine is more particularly adapted to the milder cases of cardialgia, with painful 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 relieved by eructation and external pressure. This remedy is moreover still more clearly indicated when the symptoms are generally accom- panied with severe headache or painful compression in vari- ous 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 move- ment ; habitual costiveness. Platina (30). Spasms of the stomach in females, occur- ring particularly at the monthly period, (Chamomilla, Pulsatilla, Nux v., and Cocculus are equally efficacious at such periods 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 long duration. Senega (6) will be found efficacious in cases with painful pressure and burning in the stomach, especially at night. Ratanhia (6.) Spasms of the stomach, or painful constric- tive pain, relieved by eructation, with loss of appetite, hic- cough, distension of the abdomen, costiveness, and frequent micturition. Arnica Montana (6,) in spasms or pains in the stomach, which have originated in the effects of a strain, or from a blow, &c, will be found specific. It is, however, also an 118 digestive system. excellent remedy when there is a sense of pressure as from a stone,or of fulness in the stomach and scrobiculus, constrictive pain in the stomach and in the precordial region, shooting pain in the pit of the stomach, with painful pressure or aching, extending to the back, and tightness of the chest, increased by eating, drinking, and external pressure. Bismuthum. Cardialgia, with tenderness on pressure at the pit of the stomach in hysterical females. This remedy is further often of great service in some of the most obstinate cases, particularly when there is a sensation of great weight or pressure, with indescribable pain and uneasiness in the stomach. Lycopodium (12.) Squeezing or compressive pains pro- ceeding from each extremity of the stomach, with flatulent distension ; want of appetite; pains in the back and loins, (constipation); exacerbation of the symptoms in the open air, after a meal or in the morning. Lachesis (12.) Spasms of the stomach, particularly in persons addicted to excessive indulgence in wine or ardent spirits, relieved by partaking of food ; flatulence, constipation. Sulphur (6.) Frequently an indispensable remedy in chronic cases, attended with heartburn : aggravation of the pains after a meal; constipation, hemorrhoids. Calcarea (18.) In obstinate cases, occurring in individ- uals who are habitually addicted to the abuse of wine or ar- dent spirits, Calcarea will generally be found of great service, especially after the previous employment of Nux v., Lachesis, and Sulphur. It is further a valuable remedy in the cases of plethoric females subject to nasal hemorrhage, or to exces- sively copious menstruation ; and is generally indicated when the paroxysms of pain come on usually at night, or after a meal; in which latter instance vomiting sometimes results, or nausea and acidity, with painful sensibility or pressure at tho epigastric region ; constipation, hemorrhoids, or chronic loosness of the bowels. Ai ministration. In most cases these medicines may be exhibited in the same manner as already noted under Carbo vegetabilis and Sulphur. (See also remarks upon Nux vomica.) VOMITING of blood. 119 In severe cases six globules of the potency named after each medicine may be dissolved 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 orga- nization it may sometimes be needful to give a less number of globules, and to select a higher poteney, the thirtieth.* These are the principal remedies to be employed against the ordinary cases of Cardialgia; in those of a more compli- cated character an experienced homoeopathic medical adviser ought to be consulted.! HEARTBURN. 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 the stomach, sometimes extending upwards. It is frequently accompanied with anxiety, nausea, and vomit- 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, Acid, sulphuricum, Carbo v., Cinchona, or Calcarea, will be found the most appropriate in ordinary cases. (See the aforesaid derangements for particular indications.) VOMITING OF BLOOD. Haematemesis.. 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, &c. ; the quan- tity varies ; blood is also occasionally discharged in coagula by stool. Premonitory Symptoms. Weight, pressure, fulness or ten- sive pain or spasm in the hypogastric or hypochondriacal re- * Vide note p. 21. t Vide Dyspepsia, p. 95. 120 digestive system. gions ; griping and colic ; burning heat in the region of the stomach ; anxiety, particularly on partaking of food or drink, or on pressure on the stomach ; saltish taste in the mouth ; impaired appetite and nausea; giddiness syncope, cold per- Bpiration; sometimes also an intermittent pulsation is per- ceptible at the scrobiculus. Some only of the preceding symptoms may be present previous to the attack, and others during its course when very severe, or frequently renewed. We often find wild delirium or wandering, accompanied with spasms and a gra- dually increasing weakness and remission of pulse with fre- quent syncope. The most frequent causes of this affection are the sudden suppression of any sanguineous discharge, and the consequent determination of blood to the stomach ; it is consequently apt to declare itself after a stoppage of the hemorrhoidal flux, and is a very common affection in females, from the suppression or cessation of the catamenia ; in which case, as before remarked under that affection, it is frequently preceded by Cardialgia. Other causes are scirrhus of the stomach, internal lesions or injury of that organ from swallowing sharp substances, or from worms ; poisons, drastic purgatives, or emetic drugs, external contusion, obstruction of important viscera, or a change in the constituent principles of the blood itself; the direct cause is the bursting of some of the vessels of the stomach. The dangers arising from the use of powerful astringents are, inflammation or subsequent induration of the stomach, or putrid gastric fever. Therapeutics. Although it is unlikely that any one, not properly qualified, would think of treating a sovere case of this affection, unless compelled to do so from the difficulty of ob- taining medical advice, yet it may be advisable to point out such remedies as experience has proved to be most service- able in it as ordinarily met with,—premising, however, that when it arises from any organic disease, of the existence of which the experienced practitioner can alone determine, a different course may be necessary. VOMITING OF BLOOD. 121 When it occurs in females from the non-appearance or sup- pression of the monthly discharge, or from its final cessation, see articles Chlorosis, Amenorrhea, 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 symptom above given declare themselves, and particularly when a considerable de- gree of fever precedes the attack. Administration. Six globules of the 6th in an ounce of 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, pre- vent 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, Cardialgia, and Derangement 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 haematemesis, which has ceased of itself, but still left great weakness. 122 digestive system. Administration. Ag° in about a teaspoonful of water, after which, if a slight aggravation ensue, we must wait quietly until it passes off; and while improvement continues progress- ing, refrain from repeating ; and after forty-eight to seventy- two hours, we may give a second dose ; but if no marked alteration of any kind declare itself, or if the disease advance, we may repeat it from four to six hours, the same dose. Arnica. One of our most important remedies in severe cases, and especially when occurring in individuals of a robust constitution, of a sanguine temperament and choleric disposi- tion. It is further indicated when the patient complains of pains, resembling the results of a contusion, in all the ex- tremities. Administration. Six globules of the third 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 attacks, -6fi in a little water, repeated every 6ix or even every twelve hours, have been found sufficient. Tincture of Sulphur is useful in strumous habits, or when the affection has arisen from suppressed haemorrhoids ; its value, also, in cases of abnormal menstruation will be pointed out in the proper place. Administration, ^f10, in four dessert-spoonfuls of water, one morning and evening for two days, and if no severe symp- toms direct our attention to another remedy, it should be al- lowed to continue its action for a week or fortnight, as long as a gradual improvement is going on; in fact, in such con- stitutions we should take every opportunity between the in- tervals of the attacks, of giving a dose or two of this medicine, should no other better calculated to combat this tendency ap- pear to merit a preference. The following remedies also deserve a careful study : Phos- phorus, Belladonna, Arsenicum, Lycopodium, (may be ranked next to Nux v. in cases arising from abdominal congestion,) and Hyoscyamus, (which, with Belladonna, is particularly useful incases with Spasmodic action:) Lycopodium, Arsenicum, Phosphorus and Secale cornutum (Schirrus.) Finally, Carbo constipation. 123 vegetabilis, Millefolium, Cantharides, Calcarea carbonica, Na- trum muriaticum, Zincum and Causticum, under peculiar cir- cumstances, and as tending to eradicate the predisposition to such affections. The application of dry cupping-glasses to the abdomen and under the rids, or of a cloth which has been dipped in mode- rately cold water, to the lower region of the abdomen, some- times form useful auxiliaries in arresting the hemorrhage. See also Hemorrhage from the Lungs, under Hemoptysis. Diet. The rules already given under Cardialgia, should be observed, but with still greater strictness; no solid food must be partaken of; all drinks should be cold ; animal jel- lies, preparations of milk, light puddings, and broths, merely tepid, may be allowed in cases where the patient may require such nourishment; but nothing more must be taken than is absolutely necessary for that purpose ; immediately after an attack, no food should be given for some hours, and then very cautiously, and in small quantity. It is evident that, in such cases, absolute rest, both mental and bodily, is essentially requisite. CONSTIPATION. Obstructio 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 derangement 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- 124 DIGESTIVE 8Y8TEM. 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 to nature, would have disappeared of itself, leaving no ill con- sequences, has, by an ill-judged administration of aperients, been converted into obstinate Constipation, embittering ex- istence and 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 state 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 the affection. v Many of the principal causes of this disorder, besides that mentioned, are the same with those particularized under Indigestion or Dyspepsia. Therapeutics. In trivial cases it will be found sufficient to pay proper attention to diet, to avoid too dry or indigestible food, masticate properly, to partake of meat only once a day, and to take sufficient exercise in the open air.* Should this course not have the desired effect, we must choose one or more of the following remedies : namely Opium, Alumina, Bryonia, Nux vomica, Pulsatilla, Platina, Natum muriaticum, Plumbum metallicum, or Carbonicum, Sulphur, Lachesis, Ve- ratrum, Lycopodium, Sepia, Veratrum, Silicea. Opium is chiefly to be selected in recent cases when Con- stipation is not habitual, but is also, like Nux v., and other remedies, serviceable in cases of a more chronic character when arising from sedentary habits. In old people, it is gener- ally more useful than Bryonia and Lachesis, although these and the other remedies must be borne in mind and administered when called for by the nature of the symptoms. The more immediate indications for Opium are : want of power to relieve the bowels, with a feeling of constriction in ano ; pulsation * See also the concluding remarks of this Chapter. CONSTIPATION. 125 and sense of weight in the abdomen, dull, heavy pain in the stomach, parched mouth, and want of appetite, determination of blood to the head, with redness of the face and headache. Administration. •Q3fl, in a little water, repeated in twelve hours if no benefit result* Alumina. Constipation from an apparent absence of peristaltic motion; faeces hard, dry, broken, evacuated with considerable exertion of the abdominal muscles and forcing, and sometimes streaked with blood ; constipation from travel- ling. Administration. Same as Nux v. Bryonia is especially useful in constipation occurring in warm weather, and in persons of dark complexion and an irritable 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 at- tended with determination of blood to the head, and headache. Administration. £§, in a little water, repeated in twenty- four hours, even if partial relief ensue. In chronic cases two globules may be taken daily for a week or so until benefit result, or a change ensue which may render the selection of another remedy, appropriate to the modified symptoms, neces- sary. 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- continued 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 lively temper, with determination of blood to the head, and headache, unfitness for exercise, disturbed sleep, and a feeling of general oppression 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 remarked under Dyspepsia, particularly indicated for individuals subject to hemorrhoids. • Vide note, p. 21. 11* 126 digestive system. Administration. *$*, taken in a little water towards evening. In chronic cases ,V in six teaspoonfuls of water, one each night at bed time ; or gs repeated every four to eight days.* Pulsatilla has nearly the same indications as Nux vomica, with the characteristic distinction of temperament before noted under Dyspepsia. In recent cases, it is particularly indicated when the obstruction has arisen from indigestion brought about by rich or greasy food, and when it is accom- panied with moroscness and shivering. Administration. fi§a or T6., in the same manner as Nux v. Platina is a useful remedy when constipation has been brought about by travelling, when Opium has failed, or es- pecially when the constriction is attended with straining. Administration. £§a, /„, in the same manner as Pulsatilla. Plumbum metallicum, or carbonicum. Obstinate con- stipation, with ineffectual efforts : painful retraction and con- striction of the anus ; or evacuation of tenacious, hard, bullet- shaped faeces. Administration. Same as Nux vomica. Natrum muriaticum. (6 or 30.) This remedy will some- times be found efficacious when many others have failed to relieve, particularly in chronic and extremely obstinate cases. Administration. Same as Nux vomica, or, in chronic cases, four globules of the 30th in a teaspoonful of water every four or five days until relief is obtained, or another re- medy called for by an alteration in the symptoms. Sulphur is one of the best remedies in the relief of habitual constipation, and particularly when hemorrhoids are present, or a disposition to them exists ; frequent inclination to go to stool, but without the desired result. Administration. -^ in six dessert-spoonfuls of water. One to be taken morning and evening until finished ; or in the same manner as described under Natrum muriaticum. Veratrum. Constipation, chiefly from inactivity of the rectum, with heat and dryness of skin, determination of blood to the head and lateral headache. •Vide note, p. 21. CONSTIPATION. 127 Administration. Same as Sulphur. Lachesis. Obstinate constipation, after Nux v., in those who habitually take wine rather freely, attended with flatulent distension after meals and ineffectual efforts to eructate. Administration. Same as Nux vomica. Sepia : May frequently be taken with advantage in chronic constipation after Nux and Sulphur; this remedy is, more- over, particularly well adapted for females, in whom there is an irregularity or obstruction of the menstrual flux ; constipa- tion in individuals subject to rheumatism ; hard conglomerate bullet-shaped fasces. Silicea. When constipation is accompanied with colic, impaired appetite, and thirst; and the stools are hard, knotty and passed with great difficulty ; tenesmus. (Conium is oc- casionally useful in completing the cure after Silicea. Administration. See Sulphur. Lycopodium. Chronic constipation with ebullition and determination to the head ; flatulence, sense of weight in the lower part of the bowels. Administration. Same as Sulphur. There are several other remedies useful in obstinate and complicated cases of this affection, the treatment of which however, requires considerable experience and a good knowl- edge of disease, and of the Materia Medica. In all cases of an obstinate or chronic nature, recourse may occasionally be had to an enema or lavement of tepid water, as a temporary mode of belief, 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 violent so as to cause suffering,) will be found useful auxiliaries in promoting a regular action of the bowels. When constipation occurs in '■ We 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 on rising, until the natural habit is restored, when it should be omitted, and only resumed on a repetition of the trouble. 128 digestive system. alternation with diarrhoea, Nux. v., Lachesis, Rhus, Antimo- nium, Ruta, Bryonia, Opium, and Phosphorus have been found useful. PILES. HEMORRHOIDS. Diagnosis. 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 the inner foldings of the same intestine, and with or without bleeding, (open or blind piles,) preceded or accom- panied by pains in the back, sacrum, and abdomen ; sensation of itching, pricking, tickling, burning, or pressing at the rec- tum, sometimes extending to the adjacent parts, with, in gen- eral, constipation and not unfrequently derangements of the urinary functions. The predisposing cause is attributable to a constitutional taint; among the exciting causes are habitual costiveness, severe exertion on horseback, prolapsus, use of drastic medi- cines, stimulating diet, the use of vinous, alcoholic, and fer- mented drinks, and coffee, and suppression of long-continued discharges, sedentary habits, &c. During the treatment of this affection it is of the utmost importance to attend strictly to the homoeopathic rules for diet. Strong or healing drinks, such as wines, coffee, tea, and stimulating or highly-seasoned food of all kinds are par- ticularly to be avoided. Sedentary habits and the use of soft cushions or chairs materially tend to aggravate the affection. The painful practice amongst surgeons of removing the hem- orrhoidal excresences 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 cases it wholly fails, and the disease returns, and sometimes in an aggravated form. Therapeutics. The medicines most used in this affection are Aconitum, Nux vomica, Sulphur, Lycopodium, Arsenicum, hemorrhoids. 129 Belladonna, Hepar sulphuris, Pulsatilla, Platina, Ignatia, Antimonium crudum, and Cinchona. Administration, as follows, except where particularly specified to the contrary : Six globules of the potency marked after each medicine, in six dessert-spoonfuls of water, giving one morning and evening until finished, and in ordinary cases allowing this exhibition to continue its action for a week or ten days.* Aconite, although not specific in its curative action, is use- ful in allaying pain when considerable and distressing inflam- mation exists, and may in such cases precede the administra- tion of each of the folio- ing medicines, which are among the principal remedial agents in this disease. Administration. ^^ 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. Nux vomica %-q, 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 jerk- ing pain, as if from bruises in the lions, rendering it difficult to rise or walk in an erect position, and when they are ac- companied by constipation and sometimes painful and diffi- cult urination, and the other symptoms described under Indi- gestion or Dyspepsia. Sulphur 3^, may follow the administration of Nux vomica, and an alternation at intervals of from a week to ten days of these remedies, frequently effects a cure in cases of long stand- ing. Arsenicum 3-5-. Hemorrhoids accompanied by burning and shooting pains, heat and agitation, and sometimes pros- tration of strength. * Vide note, p. 21. 130 digestive system. Belladonna ^. Moist hemorrhoids, with an insufferable pain in the sacral region, as if the back would break or be rent asunder. Hepar sulphuris may follow Belladonna should that med- % icine fail to, or only partially relieve these symptoms. Administration. Half a grain of the third trituration in six ♦ dessert-spoonfuls of water, one every six hours until finished. Rhus toxicodendron -g. When the violent pain men- tioned under Belladonna still continues severe, and particu- larly if relieved by motion. Capsicum t^. When a burning sensation exists, attended with considerable itching and diarrhoea. Pulsatilla 12. Discharge of blood and mucus during stool, and at other times with painful smarting and sensation of excoriation in the hemorrhoids, pains in the back, pallid countenance and disposition to fainting. Platina g-g, when there is frequent inclination to go to stool, followed by a very scanty and difficult evacuation, suc- ceeded by general shuddering and a feeling of weakness in the abdomen; frequent creeping, itching, and piercing at the anus, particularly in the evening ; violent dull pinching in the lower intestine, and discharge of blood during stool, and at other times. Lycopodium. A most important remedy in chronic he- morrhoidal affections, particularly when there is congestion to the head, with giddiness and headache, flatulent distension of the abdomen, constipation, severe burning, itching, and pricking pains in ano, with painful protrusion of the hemor- rhoids, and sometimes prolapsus ani after a motion ; acrid discharge from the hemorrhoids ; prurient eruption around the anus. Ignatia^. Itching and creeping, also sensation of con- striction and excoriation in the anus, and prickings extending deep into the lower intestine ; discharge of blood or of bloody mucus, and rumbling noise in the abdomen, and protrusion of the lower intestine, accompanied with acute pain. Antimonium crudum t^. Discharge of mucus and of blood at every stool, followed by severe colic and pain in the hemorrhoids. 131 hemorrhoids, with throbbing, itching, and burning at the anus, and discharge of viscous acrid moisture, particularly at night; frequent determination to the head, with bleeding at the nose ; stiffness in the back, shooting pains in the loins, burning and rheumatic pains in the limbs, flatulence, and constipation. Colocynth. In cases of hemorrhoids, attended with ex- cessive, almost insupportable colic, this is a most efficient remedy. Administration. ££> in a teaspoonful of water, repeated every two or three hours, or oftener if necessary, until relief is obtained ; in chronic cases, with less intense pain, it may be taken as described at the commencement of this Chapter p. 128. When the discharge of blood from piles amounts to hemor- rhage, a dose or two of Aconitum may be given in the first place, followed by Ipecacuanha, if improvement do not spee- dily follow ; again, if Ipecacuanha does not arrest or diminish the discharge in a few minutes, Sulphur must be administered, and followed in turn by Aconitum: if, notwithstanding the employment of these remedies, the hemorrhage does not cease, Belladonna should be given, and then Calcarea.* Adminis- tration. A few globules of the third or sixth potency in a teaspoonful of water. When the hemorrhage abates under the action of any of the remedies, the dose must not be re- peated until the improvement ceases, and the bleeding threat- ens to return ; but should the medicine which previously relieved be found to have lost its effect on repetition, the next in rotation must be had recourse to. Cinchona is valuable either as an immediate remedy to sup- port the patient, when there has been much loss of blood, or afterwards against consequent debility. These are the principal remedies to be employed in the treatment of ordinary cases of hemorrhoids; and when judi- ciously selected, will be certain to afford the desired relief, provided the patient is careful to adhere strictly to the rules laid down in the introductory remarks to this affection. In » C. Hering's Hausartzt. 132 digestive system. severe cases of long standing, much patience and perseve- rance are required before the disease can be permanently removed. PROTRUSION OF THE INTESTINES. Prolapsus Ani. By this term is understood the protrusion of a portion of the mucous membrane of the lower intestine : it is of much more frequent occurrence in children than adults, and takes place during straining when at stool, 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. Therapeutics. The principal remedies for removing the tendency to this affection are: Ignatia, Nux vomica, Mercu- rius, and Sulphur. Administration. The same as in hemorrhoids ; in chil- dren under ten years of age, one to two globules, in the quan- tity of water stated. Ignatia y6^, is particularly efficacious in mild or sensitive temperaments, attended with constipation. Nux vomica -£q, is indicated for persons of irritable or lively disposition, and addicted to high and stimulating diet, with a tendency to hemorrhoids and constipation. Mercurius |, is particularly suited for children, in whom the disease is attended with hardness and swelling of the abdomen, and where the straining is excessive. Sulphur is one of the best remedies for the permanent removal of the disease. Administration. |^ repeated in five or six days. Calcarea, Lycopodium, and Sepia may be found necessary in some obstinate cases, after Sulph., administered in a simi- lar manner as described for that remedy. In other cases, Plumbum, Arsenicum, Mezereum, Natrum m., Colchicum, Ruta, Theridion, and Magnes Artificialis 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- erally attended with a painful distension of the abdomen, with spasmodic contraction, and sometimes accompanied with vomiting and costiveness, or diarrhoea. The general exciting causes of this complaint are ; acid' fruits and indigestible substances ; cold from wet feet, drinking cold beverages when heated, constipation, worms, &c. 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. Therapeutics. The principal remedies in its treatment are : Nux vomica. Pulsatilla, Chamomilla, Belladonna, Coc- culus, and Coffea. Administration. Four globules at the potency named, dissolved hi 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. Nux vomica -g, 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, pressive, and forcing-down sensation, compelling the sufferer to bend double ; violent cutting pains in the hypogastrium ; confused head- ache, with occasional lojss of consciousness ; respiration short and difficult; flatulence, aggravation of the pains on the slight- * See Hemorrhoides. 12 134 digetive system. est motion, generally disappearing when at rest; violent pain in the loins, and sensation of internal heat and obstruction ; constipation, coldness and numbness in the hands and feet du- ring the paroxysm ; at the monthly period in females, when 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 thigh ; aching and creeping sensation in the same part when sitting ; painful pressure towards the rectum. . Pulsatilla 3, is more useful in the affection occurring in females, either during the catamenia or at other times, when coming on periodically in the evening during cold, damp weather ; also when there are present a disagreeable tight- ness and distension of the abdomen and the upper part of the waist; pulsation in the pit of the stomach, aggravation of the suffering when at rest or in the evening, attended with shivering, which increases with the pains, and is mitigated by motion ; severe bruising pains in the loins, especially when rising up ; when it has arisen from overloading the stomach, or from rich greasy food, with inclination to vomit, flatulence, diar- rhoea, paleness of the face, livid circle round the eyes, and headache ; also in hemorrhoidal colic, with fulness of the veins of the hands and forehead, restlessness, anxiety, and sleeplessness. Chamomilla 3. Bilious colic ; colic in females during the menstrual flux. The following are the principal indications : sensation as if the intestines were gathered into a ball, and as if the abdomen were empty, with tearing and drawing pains, attended with excessive anxiety and restlessness ; distension under the lower ribs and in the pit of the stomach; incarce- rated flatulency, sometimes nausea, bitter vomiting, followed by desire to relieve the bowels, and bilious diarrhoea; livid circles round the eyes, alternate paleness and redness of the face ; the pains come on particularly at night, at other times early in the morning, or after a meal. This remedy, as before stated, is particularly adapted for children of irritable tempe- raments, and is extremely serviceable in all cases in which a fit of passion has been the exciting cause of the sufferings. It is also useful when colic has arisen from cold in the COLIC 135 feet, or checked perspiration. Although in most instances Chamomilla is of itself sufficient, it has been sometimes found useful to precede it by a dose of Aconite. (Colocynth is often useful after Chamomilla, when the latter has only produced partial relief.) Belladonna g. Flatulent colic when there is protrusion of the transverse section of the great intestine, which becomes distended like a pad, attended with colic-like pain, doubling up of the body, which is relived by pressure on the part : also severe bearing-down pains, aggravated by motion ; at other times there is a sensation as if the above swelling had been removed downwards, deep into the abdomen, with feeling of bearing-down of the 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 intestines. The symptoms are also attended with a liquid or puriform species of diarrhoea, and swelling of the veins of the head ; the pains are sometimes so violent as almost to deprive the patient of reason. Cocculus -g 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 distension of the entire abdomen, with nausea and difficulty of breathing ; also when there is a sensation of emptiness, tearing and burn- ing pains in the intestines, sometimes with squeezing, tearing and pulling pains, excessive anguish and nervous excitement, and constipation. Colocynth ■§. In 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 constrctive 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 distension of the abdomen ; at other times a sense of emptiness is experienced, cramps and shivering, or tearing pains in the legs ; during the continuance of the attack, excessive restlessness, agitation, and tossing about from the violence of the pain : when the pains 136 digestive system. come on, they continue without any apparent intermission ; after their disappearance, a sensation of bruising remains, and the sufferer feels as though the intestines were held together by thin threads, likely to break from the slightest motion. Both this remedy and Chamomilla are particularly efficacious in the so-called bilious colic, being indicated by the diarrhoea and bilious vomiting attending it, and in cases where passion has been the exciting causes. Colocynth is more particularly useful in the case of adults, or where the fit of anger is at- tended with indignation. Sulphur g may follow either Chamomilla or Colocynth in cases of bilious colic where only partial relief has been ob- tained ; or of flatulent colic after Nux v.; Carbo v.; Cocculus, or Chamomilla ; and hemorrhoidal after Nux v. or Carbo v. Arsenicum -g in colic, arising from disordered stomach, with nausea, vomiting ; diarrhoea, with green or yellow evacua- tion, violent gripings, headache, paleness of the face, and blue marks round the eyes. Coffea ^ is valuable when we 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 body and extremi- ties. It is also useful in some kinds of menstrual colic, with a sensation as if the abdomen were being rent asunder ; or with fulness and pressure in the abdomen and violent spasm which extend to the chest. Cutting pains in the intestines as if di- vided by a knife. The pains present so violent, as almost to drive the patient to distraction, and cause him to bend double and draw up his limbs ; violent spasm in all his members. In cases of colic arising suddenly from indigestible food, a cup of black coffee, without milk or sugar, will frequently af- ford relief, by causing the stomach to free itself from the cause of annoyance ; in instances where that article has not been made one of ordinary beverage. When from Constipation, Silicea is an excellent remedy, and sometimes Conium. See Constipation. For colic arising from worms, see Worms. f37 LOOSENESS OF THE BOWELS. Diarrhoea. 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 temperture, the prolonged use of powerful purgatives, which, although still more fre- quently the cause of constipation, nevertheless, by producing irritation of the intestinal canal, also predispose to attacks of this derangement, worms, &c. 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, dose not rashly check its course. Therapeutics. The principal remedies in this affection are Dulcamara, Bryonia, Cinchona, Ferrum aceticum, Chamo- milla, Rheum, Mercurius, Pulsatilla, Nux vomica, Arsenicum, Antimonium crudum, Rhus toxicodendron, Opium, Sulphur, Calcarea, Acidum phosphoricum, and Phosphorus. Administration. In recent cases, six globules of the re- medy, at the potency mentioned, 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 quan- tity, administered in teaspoonfuls. In chronic cases it will generally be sufficient to administer the dose night and morn- ing, or only once a day, and even only once in four or five days or longer, according to the effects produced.* Dulcamara (6) 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. 12* 138 digestive system. when the diarrhoea is attended with colic, or cutting pain, chiefly in the region of the navel ; when the evacuations are liquid, slimy and yellow, generally coming on at night, and attended with nausea or vomiting ; want of appetite and great thirst ; paleness of the countenance and lassitude. Bryonia (6). In cases of diarrhoea arising from the before-mentioned causes, and with many of the symptoms noted under Dulcamara, when this medicine has failed to afford the required relief in six or eight hours, it should be given, particularly if the looseness is liable to be aggravated after a meal, and any portions of undigested food are present in the motion ; looseness after partaking of milk : in diarrhoea oc- curring during hot wether, when we cannot trace the causes to any errors of diet, requiring other remedies ; this medicine is also indicated, and particularly so in the following instances : Diarrhoea from checked perspiration or being overheated ; cold drinks—a chill from remaining in any cold exposed situation, or in draughts —or from biting, easterly winds. When this af- fection has been produced by passion, particularly in individuals of what physiologists denominate a bilious temperment, it is most useful—if any symptoms remain after Chamomilla, which in such cases deserve a preference. It may also be remarked, that the diarrhoea arising from drinking impure water when heated has frequently found relief in this medicine. When the water is strongly impregnated with vegetable substances, it may be advantageously followed by Cinchona. This is a case which seldom occurs, but knowing that it dose occasionally, particularly with sportsmen on moors, and in marshy ground, it has been judged advisable to add these remarks. (Antimo- nium is sometimes required to complete the cure, after the previous exhibition of Bryonia.) Cinchona (6.) Looseness, in consequence of indigestion, particularly if in consequence of partaking of fruit or flatulent food, such as vegetables ; evacuations are very profuse, and sometimes attended with but little pain, and when the dis- charge comes on immediately after partaking of food, or at night, evacuations liquid and brownish, sometimes containing portions of undigested food: it is, in some instances, also in- LOOSENESS OF THE BOWELS. 139 dicated, when considerable spasmodic or colic-like pain is present, with flatulence, want of appetite, thirst, and great weakness ; it is also valuable after improper treatment of this affection, when considerable debility remains. Ferrum aceticum (6) may be advantageously given in al- ternation with Cinchona at intervals of twelve hours, when the evacuations 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 there is pale- ness of the face, weakness of the eyes, pains in the back and anus ; with great weakness of digestion. Chamomilla s, is a remedy, as already stated elsewhere, particularly useful in children, either at the time of teething, or at a more advanced period, when the affection has been excited by checked perspiration ; it is further particularly indicated, when the evacuations are watery, billious,] green, yellow, or sli- my, or of a fetor resembling rotten eggs ; when there axe ful- ness at the pit of the stomach, severe colic or spasm, pain in the abdomen, distension and hardness of the abdomen, bitter taste in the mouth, foul tongue, thirst, want of appetite, bil- ious vomiting and flatulency in infants, attended with restless- ness and screaming, and drawing up of the limbs towards the stomach ; in cases of adults, s^-. Sulphur is frequently use- ful in completing the cure when the pains or colic has been removed by Chamomilla. Rheum (3), when the symptoms, in a great measure, re- semble Chamomilla, but the pain is not so violent, and the evacuations have a sour smell; paleness of the face is also an indication for this medicine. Mercurius (6). When the diarrhoea arises from a chill, and the 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, * See also Arsen., Merc, Bryonia, Phosph., Lachesis. t Diarrhoea biliosa. 140 digestive system. trembling or shivering, and shuddering, great lassitude, and disposition to syncope ; diarrhoea with ingesta. Pulsatilla (6). One of the best remedies in simple loose- ness or diarrhoea arising from errors of diet, such as indulgence in acids, fruits, or rich indigestible food, attended with foul tongue and other dyspeptic symptoms. (See Indiges-tion.) Another remarkable indication for this remedy is one evacua- tion differing from another in colour. Ipecacuanha. Looseness arising from indigestion, particu- larly if caused by imperfect mastication, attended with nausea and vomiting; paleness of the face, (see also Arsen.,) weak- ness, and desire to retain the recumbent posture (in the case of children). When Ipecacuanha does not appear to afford much relief, Pulsatilla ought to be had recourse to in the space of from 12 to 24 hours, afterthelast dose of Ipecacuanha: when, in the case of children, the motions have a very sour smell, Rheum is to be preferred to Pulsatilla, from whatever cause the attack may have arisen. Nux vomica (6). Scanty evacuations or motions, consist- ing of slime and blood, attended with straining and great weakness, flatulency, and violent cutting pains in the region of the navel; for some of the accompanying symptoms the read- er is requested to study the indications given under this reme- dy, in Indigestion. Arsenicum (6). Autumnal diarrhoea, or looseness arising from errors in diet, acids, fruits, cold drinks, ices, or from a chill, &c, the characteristic symptoms for its employment are, watery, slimy, greenish, or brownish corrosive, burning evacua- tions, with violent colic, excessive thirst, emaciation, and great weakness; and when more liable to come on at night or after eating or drinking.—(Vid. the further indications for this im- portant remedy in Part III, under Bowel Complaints in Children.)* Antimonium crudum (6). Also in cases arising from dis- ordered stomach, with white tongue, loss of appetite, eructa- * When Arsenicum does not answer our expectations, Veratrum should be substituted; the latter remedy is, moreover, for the most part to be pre- ferred when the disease appears to have arisen from atmospheric causes. dysentery. 141 tions and nausea ; diarrhoea alternating with constipation. (See article upon this affection. Rhus toxicodendron (6). Lumpy or pap-like diarrhoea, coming on only at night, preceded by colic, which disappears after each evacuation. Opium (3). Diarrhoea arising from fright or from cold, fol- lowed, if required, by Dulcamara in the latter case. For other indications, vide Mental Emotions. Lachesis. Diarrhoea from acid drinks, or sour unripe fruits, with severe griping ; diarrhoea with ingesta. Sulphur (6). Is a most 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 children, when the diarrhoea is attended with excoriation and papular eruptions, it is particularly efficacious ; also in cases where the slightest cold brings on a relapse or an at- tack ; or when milk disagrees and causes a looseness. Calcarea (6). May be had recourse to after Sulphur. Acidum phosphoricum (3). In obstinate cases, with por- tions of undigested food in the evacuations ; or occasional in- voluntary evacuations. Phosphorus (3). In chronic, painless diarrhoea, with gra- dual prostration of strength; diarrhoea with ingesta. Diet. Acids or acidulous wines, beer, coffee, strong tea, and fruits, whether raw or cooked, should be carefully avoid- ed. Solid food proscribed as tending to keep up the intesti- nal irritation ; and gruel, fresh milk in moderation, broths, and light mucilaginous food substituted. DYSENTERY. Dysenteria. Diagnosis. Constant urgency to evacuate the bowels, te- nesmus, 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 ac- celerated pulse, then dull abdominal pains and increased eva- 142 digestive system. cuations ; after a time no faeces are discharged, but white mucus, which may afterwards change to blood (bloody flux) : stools, particularly when fever is present, very frequent and fetid; if not checked in time, the disease may terminate in ulceration or gangrene, or the patient may sink from exhaus- tion. This affection is very frequently complicated with rheumat- ic pains, which will be noticed under the different remedies, as an additional indication for their employment. The excit- ing causes are, checked perspiration, particularly in warm weather; low or marshy situations, local irritations, such as worms, scybala, &c. and suppression of hemorrhoids, metas- tases, and sometimes, in infants, difficult dentition. Therapeutics. The principal remedies found useful in treatment are Aconitum, Chamomilla, 'Pulsatilla, Ipecacuanha, Colocynth, Mercurius vivus, Arsenicum album, Carbo vegetabi- lis, Nux vomica, Cinchona, and Sulphur. Aconitum. This remedy is peculiarly adapted to the fever frequently present, and in young and plethoric patients is ge- nerally required in the commencement or in the course of the disease. It is indicated by full and hard pulse ; severe pains, generally in one spot; abdomen tense and painful when touch- ed, denoting the commencement of inflammation ; also valu- able when we find pains resembling rheumatism in different parts of the body, with shivering, or excessive heat and thirst. Administration. As in Inflmmatory Fever, which see. Chamomilla. If after the administration of Aconite, we still find violent heat and thirst, rheumatic pains in the head, and constant agitation and tossing. This remedy is also use- ful when this disease seems to take for its proximate cause gastric impurities formed in the primae via? ; or when it has arisen from exposure to a cool atmosphere when in a state of perspiration. When we find foul tongue with clammy, bitter taste in the mouth, bilious stools, and before tenesmus declare itself, this evidently points out the remedy as more useful in the first or diarrhoeal stage ; it may be followed by Pulsatilla, when the symptoms given under that remedy present them- selves. DYSENTERY. 143 Administration ^, in a little water, repeated every six hours, until improvement takes place, or indications for an- other remedy present themselves* Pulsatilla, when the gastric symptoms noted under Cha- momilla are present, but the stools consist entirely of mucus striated with blood. (Dysenteria pituitosa.) Administration, same as Chamomilla, but at the sixth po- tency. The three remedies, above mentioned, are also valuable in dysentery, arising from cold, or what is commonly denominated rheumatic catarrhal dysentery, Rheumatismus Intestinorum. Ipecacuanha. This remedy is serviceable when the dy- senteric affection seems fairly established ; when the stool consists of slimy matter containing white flocks, followed by evacuations of sanguinolent mucus. Administration, same as Chamomilla. Colocynth, In cases attended with violent colic and ex- cessive distension of the abdomen, shivering with chills, ap- parently extending from the abdomen over the" whole body, excessive agitation and restlessness, tongue coated white ; sli- my, and sometimes bloody evacuations ; it is sometimes found useful to follow Ipecacuanha, or Mercurius.^ Administration. •§, in six teaspoonsful of water, one every hour until improvement declares itself, when the inter- vals between the doses may be lengthened.! Mercurius vivus in the red dysentery or bloody flux, • Vide note, p. 21. t A successful procedure in our practice has been the alternate admi- nistration of Colocynth 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 twe, three, four or more hours during the day, and Mercury at evening or during the night. In some cases, however, where the griping pains vand tenes- mus were intense, we have alternated the Colocynth and Mercury during the night, at such intervals as the urgency of symptoms demanded. After a favorable impression from these drugs, the disease sometimes remaining stationary, especially during the autumn or prevalence of feb- rile miasms, we have found a dose or two of Colchicum to awaken anew the susceptibility of the system to the above or other indicated remedies.—Ed. t t Vide note, page 21. 144 digestive system. when we find severe tenesmus or straining, with evacuation, merely of a little mucus, sometimes succeeded by or accom- panied with protrusion of a portion of the intestine and in- creased discharge of pure blood, or of putrid, corrosive, green- ish, yellowish, or frothy mucus, intermixed with blood, and sometimes followed by the evacuation of small hard substances (scybala) after much straining ; burning in ano ; severe griping and lancinating pain before, during, and even after the motions; increased 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 effica- cious a remedy, that any remaining symptoms will, in gene- ral, be removed with facility, either by means of Colocynth, Acidum phosphoricum, Acidum nitricum, (the two latter espe- cially in the event of a continuance of the sanguineous stools,) or any of the other remedies which may seem more appro- priate 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 dessert-spoonful every three hours until the symptoms are mitigated, when the intervals may be lengthened. Bryonia is frequently called for in those cases in which it has been found necessary to administer Aconite at the com- mencement of the disease ; but is more particularly indicated when the attack has occurred during the heat of summer from the effects of a chill, and is attended with typhoid fever of the inflammatory form ; with loose evacuations of a brownish co- lour and putrid odour, occasionally containing lumps of coagu- lated mucus resembling undigested substances, or also small hard lumps or balls, (scybalous faecal matter) with griping dur- ing, and burning in ano after the act of evacuating, aching pains in the limbs, aggravated by movement. When the dis- ease has attained an advanced stage, and the accompanying fever is of a low typhoid type, the patient much exhausted and distressed with severe rheumatic or aching pains in the * Mercurius sublimaPus corrosivus is sometimes more speedily effica- cious than Mercurius vivus or Merc, solubulis against the above symp- toms. J * dysentery. 145 loins and extremities when reclining or sitting still, and the stools of a slimy, frothy, white, gelatinous, or sanguineous nature, passed involuntarily at night in bed : Rhus not unfre- quently gives a favorable turn to the disorder. Administration of Bryonia and Rhus. Six globules of the third potency in about half an ounce of water, a teaspoon- ful every two hours until an alteration is effected. Arsenicum. 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- tration exists from the commencement, with burning pain in evacuating the bowels, thirst and aggravations of the suffer- ings after drinking; or, on the contrary, adipsia:—also when the disease threatens to assume the ulcerative or gangrenous character—characterized by previous severe pains, particu- larly burning, which suddenly cease ; hypocralic expression of countenance ; rapid sinking of the vital energies ; pulse small and intermittent; coldness of the extremities ; highly offen- sive, putrid, and cadaverous smelling evacuations, both of fasces and urine ; unconscious passing of stools ; offensive breath and petechiae 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 vegetabilis 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 * Dysenteria putrida. 13 146 digestive system. two remedies has effected benefit—where neither of them might have been singly adequate to the exigency of the case. Administration. Six globules of the sixth or twelfth potency exhibited in the same manner as Arsenicum. Nux vomica. When Arsenicum has diminished these symp- toms and warded off the danger, but we find that the fasces still retain a highly putrid odour; also at any period during the course of the disease, when the following symptoms are pre- sent :—Frequent scanty evacuations of mucus or sanguine- ous mucus, and occasionally small, compact, hard faeces (scy- bala) attended with violent cutting or griping pains in the re- gion of the navel, borborygmus, pains in the loins, tenesmus, burning or sensation of excoriation in the anus, and sometimes protruston of the intestine ; great heat and excessive thirst. Administration. Same as Pulsatilla. Cinchona 3. In cases where the disease has an endemic character, occurring in marshy countries, and in many cases when a state of putridity remains in the faeces after the ad- ministration of the remedies above mentioned. Administration. Same as Pulsatilla. Cantharides. Sanguineous stools mixed with whitish mu- cus or solid substances like false membranes ; strangury.* Administration. Six globules of the third in an ounce of water, a dessert-spoonful every four or six hours. Sulphur. When the more marked symptoms are amelio- rated by the use of the foregoing remedies, but the Dysentery still continues obstinate, and especially when the disease oc- curs in subjects who have previously been long affected with hemorrhoids ; or when it has from time to time been subdued, and afterwards returned with greater or less violence ; or even when the apparently best selected remedial agents have failed to check its course. It will frequently be found most efficacious in all these cases, since when this occurs we may suspect some latent constitutional cause is baffling our efforts. * Colchicum autumnale is preferable to Cantharides when the symp- toms are as described, and the disorder rages epidemical during the a£ tumnal season. ° DYSENTERY. 147 In the instance first noted by its removal, the affection is ter- minated ; in the second the predisposition to a return of the attack is obviated ; and in the third, the constitutional taint alluded to being controlled, the organism becomes susceptible to the specific action of the other medicaments. Administration. ^6a, in a little water, repeated at first every twelve hours until an effect is produced, then discon- tinued for a time and allowed to act. In conclusion it must not be omitted to add that when the disease is of long standing, and has become so to speak habitual, a cure is often effected by means of Phosphorus. Administration. Two globules of the third potency in a little water daily, until a favorable change sets in.* Rules of Conduct and Diet. In this affection it is of great importance to keep up a moderate degree of warmth around the abdomen, which is best obtained by flannel worn outside the 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 the more severe the inflammatory symp- toms, the more strict must be the abstinence. No solids should on any account be given ; but the diet should consist principally 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. Even after convalesence 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 diet 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 ma- jority of cases, the homoeopathic method checks it at its com- mencement, without allowing it to assume the more frightful forms portrayed in the instructions of its treatment; and it * Vide note, p. 21. 148 DIGESTIVE SYSTEM. passes off leaving the patient in sound health: in the most violent cases where it has already made head, and seems ap- proaching a fatal termination, it may almost be said to be the only system which offers a chance of salvation to the sufferer : And in strumous constitutions, where under the old mode of procedure the results are commonly so unfortunate, it gently mitigates the violence of the symptoms, and safely conducts the patient through his perils. Suppressed Dysentery. When the dysenteric evacuations have been suddenly checked by allopathic means, and a violent inflammatory or spasmodic action declare itself, such as severe pains, anxiety, dyspnoea, nausea, and empty retchings, or dis- tension and tenderness of the abdomen ; suppression both of faeces and urine ; coldness of the face, tongue, and extremities ; breath also cold ; with spasms of various kinds in different parts of the body, which are renewed by any exertion, either of speech or movement,—the following remedies will be found useful: Aconitum. Against any inflammatory symptoms that may present themselves, to be repeated according to the rule already given until relief follow.* Cuprum aceticum. When spasms or cold sweats predom- inate. Administration. ■&£, in a little water, repeated in three to six hours, according to the effect produced. Belladonna, against inflammatory colic, or if symptoms of .abdominal inflammation set in, see article Enteritis and also Colic, and administer accordingly. Colocynth. Violent colic and distension of the abdomen, see Colic Veratrum album. Coldness of the body and extremities and retching. Administration. Six globules of the sixth potency in an ounce of water, a dessert-spoonful every two to six hours. Carbo vegetabilis in extreme cases, with scarcely per- ceptible pulse, and cold breath. * Vide note p. 21. cholera. 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. When the patient has escaped the serious consequences above noticed, chronic complaints frequently are the result of Suppressed Dysentery ; the most frequent are Dropsy, Par- alysis, and Rheumatism. CHOLERA. By the term Cholera Morbus was formerly understood a disease attended with nausea, griping, purging, and vomitin°-, generally prevalent towards our summer months, and at the season when fruit was plentiful. But it has now become a generic term, under which are included two varieties__the Cholera Morbus, properly so called, and the Asiatic cholera. Diagnosis. The first named, sometimes called the Spora- dic Cholera, generally commences with a sudden feeling of nausea and griping, followed by purging and vomiting; in severe cases accompanied with coldness of the body particu- larly 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, anxiety, and tenesmus. Causes. 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. Therapeutics. In the treatment of Cholera in its sporadic form, (i. e. when the disease arises from occasional causes, such as cold, fatigue, &c.) the following remedies will be found to be the most efficacious : Chamomilla, ipecacuanha, Veratrum album, Arsenicum album, Cinchona, and Pulsatilla. Chamomilla is almost specific when the attack has been 13* 150 digestive system. excited by a fit of passion or great dread of being attacked during the prevalence of the disease. The following are the symptoms which particularly indicate its employment: acute colic-like pains, or heavy pressure in the region of the navel, sometimes extending to the heart, with excessive anguish ; bilious diarrhoea, cramps in the calves of the legs ; tongue coated yellow, and sometimes vomiting of acid matter. Administration.* A few globules of the third potency to half an ounce of water, a teaspoonful every two to six hours, according to circumstances. Ipecacuanha, may be administered after the above, should the attacks of vomiting become more prominent; or it may be selected from the commencement, should vomiting predominate, or at least assume as marked a character in the complaint as the diarrhoea. Other indications are sensations of weakness, or softness (flaccidity,) coldness in the face and limbs, sense of shivering in the abdomen ; slight cramps in the calves of the legs, and in the fingers and toes. Administration. Same as Chamomilla. Veratrum album. Should the disease increase, notwith- standing the administration of the preceding remedy, and assume the following characteristics, violent vomiting with severe diarrhoea, excessive weakness, and cramps in the calves of the legs; eyes hollow or sunken, countenance pale, and expressive of acute suffering and intense anguish ; coldness of the breath and tongue, excruciating pain in the region of the navel, tencerness of the abdomen when touched ; dragging pains and cramps in the fingers, shrivelled appearance of the skin on the palms of the hands. This is also one of the best remedies in both varieties of this disease. Administration. Six globules of the third potency in a teaspoonful of water, repeated in half an hour or even less, should there be no change of any kind for the better; or one or two drops of the third tincture may be added to an ounce of water, a^lessert-spoonful every half, one, or two hours, • Vide note, p. 21. cholera. 151 according to the severity of the symptoms ; when ameliora- tion has taken place, lengthening the intervals. Arsenicum is useful when this malady assumes a severe character from the beginning, but it is more particularly indi- cated when the disease is attended with rapid prostration of strength,insatiable thirst, excessive anxiety, loss of articulation, with fear of approaching death, burning sensation in the region of the stomach, almost constant discharge from the bowels, or renewal of the discharge on every occasion that the desire for drink is gratified ; suppression of urine or scanty micturi- tion, followed by a burning sensation ; violent and painful vomiting, tongue and lips dry, cracked and blueish, or black; hollow cheeks, pointed nose, pulse almost imperceptible, or small, weak, intermittent, and trembling ; severe spasms in the fingers and toes; clammy perspiration. Administration. Six globules of the sixth potency in a teaspoonful of water to be repeated, in the same manner and under the same conditions as described for veratrum. Cinchona is chiefly most useful against the weakness which remains after cholera, but is also serviceable occasionally dur- ing the course of the disease, particularly when there is vom- iting of ingesta, and frequent watery and brownish evacua- tions containing particles of indigested food ; also when there is oppression at the chest with eructations which afford tem- porary relief; severe pressure in the abdomen, especially after partaking of the smallest portion of food ; great exhaustion, sometimes amounting to fainting. This remedy is particularly marked when the disease has been excited by indigestible substances, such as unripe fruit, &c, or by inhabiting a marshy situation. Administration. ^-, repeated every four, six, or twelve hours according to circumstances, until amelioration result. Pulsatilla, in mild cases, cases where there is mucous diarrhoea and dyspeptic symptoms. It is also useful when the disease has been excited by the use of indigestible articles of diet. (Vide Diarrhoea and Indigestion.) Administration. fi§-, repeated every four hours, until a favorable change takes place. 152 digestive system. Asiatic Cholera. This disease generally commences with vertigo, headache and singing in the ears, a sensation of flatulence in the stomach, griping pains, and a feeling of weight and oppression in the region of the heart. In some, but not all cases of Asiatic Cholera, we find the lips, nails, and sometimes the whole skin of a blue colour, but in almost every instance the frame loses its power of generat- ing heat; the pulse and pulsation of the heart are almost un- felt, circulation of the blood becomes stagnant. Patients who have escaped through the second stage are frequently carried off by a typhoid fever in the third. When the premonitory symptoms of this disease, as above noted, exhibit themselves, its complete developement is fre- quently prevented, by the administration of the saturated solution of Camphor, one part of Camphor to twenty of spirits of wine. Administration. One or two drops of the above every five minutes in a teaspoonful of cold water, until a cessation or amelioration of the symptoms take place, when the inter- vals between the repetition of the dose may be lengthened to every two, then every four or six hours. In many cases also we may succeed in checking the dis- ease at its commencement by the remedies already mentioned under Sporadic Cholera, administering, however, more fre- quently, say every hour at first. But when Cholera sets in in all its frightful forms, we should have immediate recourse to Veratrum. 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 change to spasms and convulsions, with spasmodic constriction of the chest, which obstructs respiration. Cuprum must be had re- course to in the same manner as described for Veratrum. Arsenicum should be alternated with Veratrum, when an in- tense burning sensation is experienced in the stomach and bowels, with extreme prostration of strength, great thirst, etc. (Vid. Indications, page 150.) , Carbo vegetabilis may often be given with advantage CHOLERA. 153 when the patient is reduced to a state of almost complete as- phyxia, with scarcely perceptible pulse ; 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 Carb. v., but the pain, vomiting, cramps, &c, return, Veratrum must again be had recourse to. Phosphorus (followed by.Acidum phosphoricum, should great clamminess of the tongue supervene) is particularly use- ful in cases of diarrhoea, 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. Administration. A few globules of the third every four or six hours. * Phosphorus is further indicated in the course of congestion " in the chest" during the course of the disease ;—finally, it is one of the most serviceable remedies against the obstinate diar- rhoea which sometimes remains after an attack. In conclu- sion, it may be added that a few doses of Cantharides, 3, will be found useful when there is great irritation and pain in the bladder. Rhus, Bryonia, &c, when Typhus Fever re- sults (vide Typhus). Belladonna, followed, if required, by Opium and Lachesis, when there is Congestion of the Brain. Aconite, Phosphorus, Bryonia, Belladonna, Sic, in the event of Congestion to the Chest ; and Aconite, followed by Nux v., Bryonia, or Mercurius, Sic, when the stomach and intes- tines become the seat of congestion (vide Congestion to the Abdomen). Secale cornutum is very useful in cases of colourless diarrhoea, with pains in the extremities remaining on the ces- sation of the vomiting, but is also valuable after Veratrum and Cuprum, when the cramps or convulsions do not yield to these remedies. Cinchona against the weakness,—and Sulphur and Phosphorus are two of the most important remedies against irritation or weakness in the alimentary canal, characterized • Vide note, page 21. 154 digestive system. by frequent attacks of or nearly continual looseness occurring after cholera. The foregoing, then, are the principal reme- dies employed by homoeopathists in cholera, and when the treatment is had recourse to from the commencement, it gene- rally yields without difficulty ; the disease rarely passing into the second stage, and almost never into the third- The best preservatives against infection are Veratrum, Cu- prum, and Camphor ; an occasional dose of the preparation mentioned under the latter medicine, at page 152, has fre- quently been found sufficient to .ward off an attack ; it is more particularly during the first stage of the disease itself, however, under whatever form it sets in, that the greatest reliance is to be placed on this remedy. Veratrum and Cuprum are the prophylactics which have been employed with the greatest succss. One drop of the tincture at the third dilution, or a few globules of the same potency of each medicine may be taken alternately every third day in a little water, fasting ; avoiding, moreover, excesses of all kinds, late hours, exposure to night air, and melancholy thoughts, or fear, which are all strongly predisposing causes to attacks of this malady. When the disease happens to break out, notwithstanding these pre- cautions, it is almost invariably in the mildest form. It may also be remarked, that during the prevalence of this affection the clothing should be sufficient to preserve the body at an equable temperature, and care taken to avoid chills or check- ed perspiration, or cold and wet feet: those who are affected with considerable perspiration in their feet should change their stockings at least once daily ; a flannel bandage worn round the abdomen is also a useful precaution, and it should not be hastily laid aside when the danger seems to have pass- ed away ; also constant exercise should be taken during the day in the open air. Adherence to the homoeopathic rules is a sufficient dietetic guide ; raw vegetables and cold fruits, for example melons, should be carefully abstained from, and even the more wholesome varieties and all cooked vegetables, ex- cept potatoes, be used in extreme moderation ; pure beer and non-acid wines are not objectionable for individuals not at- tacked with the same limitation. It may appear almost super- cholera. 155 erogatory to observe that purity of air and thorough ventila- tion is highly necessary. Accessory Treatment. The patient should be kept in a room of a warm temperature, the bed should be heated by ar- tificial means, and bottles of hot water applied to the feet if necessary. The observance of this rule greatly facilitates the action of the medicine employed ; anything which might disturb the equanimity of the sufferer, such as noise or con- tradiction, should be carefully avoided, and his spirits should be sustained as much as possible. Cold water is the best drink, but the patient should not be allowed to take too much at a time ; the occasional administration of a small piece of ice, if possible, is often attended with benefit; and injections of iced water are sometimes serviceable in relieving the colic and cramps in the intestines. During the convalescence fol- lowing this disease we must be careful not to indulge the pa- tient to the full extent of his appetite. Remarks. When this disease is raging as an epidemy,we not unfrequently find individuals suffering under many symp- toms bearing a marked resemblance to those of cholera, but with constipation instead of diarrhoea, and retching in place of vomiting ; this affection being closely analogous to Suppressed Dysentery, the reader will find the treatment under that head, article Dysentery. CHOLERINE. This affection being merely diarrhoea, occurring during the prevalence of cholera without any of the more severe symp- toms of the disease, consult that article for its treatment. LIVER COMPLAINT. This disease is divided into the Acute and Chronic ; the latter generally goes by the name of Liver Complaint, although a careful diagnosis will generally discover that the real dis- ease is in the stomach and intestines ; however, in many cases the liver itself becomes much affected from this cause, and in itself deserves considerable attention. 156 digestive system. When the diseasehas been for a long time unchecked, and the inflammation becomes deeply seated in the substance of the liver, an abscess frequently forms, bursting either exter- nally or internally; in the latter case not unseldom proving critical, or bringing on hectic fever. ACUTE INFLAMMATION OF THE LIVER. Hepatitis. This disease is much more common in tropical climes than with us. There, a high mode of living, exposure to heavy dews or damps in the evening, and the powerful rays of the sun by day, are among its principal exciting causes ; but it may also arise from violent mental emotions, the use of stimu- lating or alcoholic drinks, suddenly suppressed evacuations, strong emetics or purgatives, the use of mereury, gall-stones, external lesions, or injury of the brain. Diagnosis. This differs according to the seat of the in- flammation, when on the outer surface or convex side the symptoms closely resemble those of pleuritis ; there is gene- rally a violent pain in the right hypochondrium, sometimes re- sembling stitches, at others burning—shooting to the sternum, the right scapula, and point of the shoulder, and even affect- ing the right foot, with sensation of numbness or tingling in the arm of the same side, the pain increased by inspiration ; a short dry cough, and the symptoms of inflammatory fever; bowels irregular, generally constipated, and evacuations in most instances of an unnatural colour. In this form the patient can only lie on the left side. When the seat of inflammation is on the inner or concave side 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 affected. The eyes and countenance become yellow, and sometimes complete jaundice declares itself ; the urine is orange coloured, the evac- uations mostly hard and generally of a whitish or gray co- lour. We also find bitter taste in the mouth, vomiting, and considerable distress—the patient can only lie on the right side. Inflammatory fever is also present in this form, and in acute inflammation of the liver. 157 both,"the right hypochondrium, on examination, will usually be found hot, tumefied, and painful on pressure. Inflammation of the liver, unless well treated, is apt to as- sume the chronic form; it may also end in suppuration exter- nally, or internally by a communication either with the lungs or intestinal canal, or by a vomica in the substance of the or- gan itself; in indurations or other alterations of structure, in gangrene, or in the formation of adhesions. The disease may terminate by resolution, critical metastases, hemorrhoids, diarrhoea, epistaxes, or cutaneous, particularly erysipelatous eruptions. Therapeutics. The following remedies are those most required in its treatment: Aconitum, Belladonna, Mercurius, Lachesis, Bryonia alba, Chamomilla, Nux vomica, Pulsatilla, and Sulphur. Aconite is especially indicated in the commencement of the attack, and may always precede the other remedies, when there is violent inflammatory fever, attended with insupport- able shooting pains in the region of the liver, with tossing, restlessness, and great anxiety and anguish. Administation. Six globules of the third potency in an ounce of water, a dessert-spoonful every three hours.* Belladonna may be advantageously administered after Aconite has subdued the preceding symptoms, or from the commencement, when the following indications present them- selves : oppressive pains in the region of the liver, which ex- tend to the chest and shoulders, distension of the pit of the stomach, sometimes extending across the epigastrium, pro- ducing a sensation of tension, with difficult and anxious re- spiration ; determination of blood to the head, with cloudiness and giddiness, sometimes causing faintness ; great thirst, toss- ing 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 • Vide note, p. 21. 14 158 digestive system. t~- .- marked medicinal action declare itself to allow it to pass off before repeating the medicine, and also to lengthen the inter- vals according to the amelioration produced. . When Belladonna fails to remove the whole of these symp- toms, we frequently find that xMercurius will have the de- sired effect; this medicament is too well known as an allo- pathic remedy in the cure of this disease, and the consequences produced by its abuse are frequently so great, as to render the disease almost incurable. It is generally administered, even when not indicated, until its marked pathogenetic symptoms declare themselves, and consequently the patient, in addition to the original malady, has frequently to contend with a medicinal disease. The following are some of the principal indications for its employment : Painful sensations in the region of the liver, with shooting, burning, or oppressive pains, not allowing the patient to lie long on the right side ; sometimes augmented by movement of the body or part affected ; bitter taste in the mouth, want of appetite, thirst, and continual shivering, sometimes followed by sweating, but without relief, with well marked yellow co- lour of the skin and eyes ; also when there are enlargement and induration of the liver, or where we have reason to sup- pose the formation of matter. Administration. A grain of the third trituration to an ounce of water, a dessert-spoonful every three to six hours, according to results, and with the precaution specified under Belladonna. Lachesis. In subacute cases, or in those in which Bella- donna or Mercurius have merely afforded partial relief, Lache- sis is often of great service. It may also be administered with advantage alternately with the said remedies in obstinate cases occurring in drunkards. Bryonia, when the pains in the region of the liver are mostly shooting, o# consist of an obtuse pressure, with tension and burning, increased by touch, coughing, or respi- ration, and especially during inspiration ; also much exacer- bated by movement; also when the symptoms are attended with violent spasmodic oppression of the chest; rapid and acute inflammation of the liver. 159 anxious respiration, bitter taste in the mouth, tongue coated yellow ; constipation present. Administration. Same as Belladonna. Chamomilla, when there are pressive pains, pressure in the stomach, oppression of the chest, and a sensation of tight- ness under the ribs ; yellow colour of the skin, pains not ag- gravated by motion, Sic. ; tongue foul and yellow, bitter taste in the mouth ; paroxysms of great anxiety. Chamomilla is also almost a specific when the above symptoms have been brought on by a fit of passion. Administration. Same as Bryonia. Nux vomica is particularly indicated when the pains are shooting and 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 ; also when enlargement and induration occur ; and in the chronic form, when there are marked symptoms of gastric derangement. (Vide Nux vomica, art. Indigestion.) Administration. Same as Bryonia. Pulsatilla. Sensation of tension in the region of the liver, and pressure or dull pain in the epigastric region ; op- pression at the chest, bitter taste, yellow tongue, nausea ; loose, greenish, and slimy stools ; excessive anxiety, espe- cially towards evening or during the night. Administration. Six globules of the sixth in an ounce of water, a dessert-spoonful every six hours. Sulphur is valuable 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 after Nux vomica, to combat the sequelae of the disease. Administration. When to assist the action of the medi- cines, a single dose -G2 in a teaspoonful of water, may be given, and followed by the remedy judged most appropriate to the case in the space of six or twelve hours, according to cir- cumstances ; when employed to combat the sequelae of the disease, four globules at the same potency may be dissolved in four dessert-spoonfuls of water, and one exhibited morning 160 DIGESTIVE SYSTEM, and evening, and so on until relief is obtained, or another re- medy is called for by an alteration in the symptoms. Diet. The same as under Fevers, modified according to J.he violence of the disease. LIVER COMPLAINT, or CHRONIC INFLAMMATION OF THE LIVER. Hepatitis Chronica. In this form of the disease we find many of the foregoing symptoms, but in a modified degree ; further, a continued pain or uneasiness in the right side seldom leaves the patient, who gradually falls off in flesh and loses strength; and there is not unfrequently present an occasional cough with expectora- tion ; sometimes considerable perceptible enlargement of the liver, either continual or returning periodically, with a number of dyspeptic symptoms ; high coloured or red urine, yellow tinge of the skin and eyes, occasional febrile symptoms ; the pulse, except during these attacks, generally quick but regular. Nux vomica 3-^ and Sulphur 3-^ are two of the principal remedies in this affection, which, however, frequently re- quires a careful discriminative treatment, and all the acumen of the practised physician to conduct it to a happy issue. For the indications of these remedies, see Acute Inflam- mation of the Liver. Administration. As in Indigestion, which see ; under which also will be found directions for the regulation of Diet. Carduus marianus. This remedy is indicated by most of the symptoms which have been described under Bryonia and Nux v. in the preceding chapter, but it is more particu- larly called for when there is bitter taste, with dull pain or occasional shooting or pricking in the right hypochondrium, increased by inspiration, yellow hue of the skin ; short dry cough, or cough with expectoration of mucus streaked with blood ; slight feverishness. Aurum, Hepar s., Lycopodium, Magn. m., Natrum, Silex, Cinchona, Almina, and Calcarea, have also been found useful in particular cases. 161 JAUNDICE. Icterus. Diagnosis. Yellow colour, varying in shade from a pale saffron to a dark-brown yellow, first in the eyes, then extend- ing over the surface of the whole body ; hard whitish faeces ; orange-coloured urine; symptoms of deranged digestion, sometimes tensive pain or pressure in the region of the liver. In severe cases even the perspiration will impart a yellow hue to the patient's linen. The disease frequently declares itself without being plainly referrible to any exciting cause ; the principal are affections of the liver, indigestion, poisonous substances, taking cold, powerful mental emotions, emetics, or drastic purgatires 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 as- sumes the intermittent type. Jaundice is not of itself to be considered as a dangerous disorder, but rather as an indication of some internal derange- ment, which, if neglected, may entail serious consequences, for example, dropsy, hectic fever, or general atrophy. Mercurius and 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, es- pecially when we can trace the disease to have arisen from partaking of indigestible substances, or where it appears in an intermittent form. 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 Nux vomica, should the bowels be confined, or alternately confined and relaxed. Nux vomica is also indicated when sedentary habits, over study, or indulgence in spirituous liquors appear to be the predisposing, or partly the exciting causes. 14* 162 digestive system. Pulsatilla. Lassitude, great weakness and anxiety, es- pecially towards evening, obtuse pressure, but sometimes also pricking or shooting pain in the region of the liver, extending occasionally upwards towards the right shoulder; whitish stools. Digitalis. A most important remedy in many cases of this disease ; the following are the principal indications for its employment; nausea, retching, or vomiting ; tongue clean, or coated white ; pressure at the pit of the stomach and region of the liver; sluggish state of the bowels, with white, grey, ox clay-coloured evacuations, alternate heat and chills. (Icterus Spasmod. s. Spast.) Aurum is frequently an excellent remedy in obstinate cases after Pulsatilla, when the disorder occurs in young females. Administration.* In general cases, four globules at the sixth potency, in four dessert-spoonfuls of water, one exhib- ited morning and evening; in cases of very young children we may substitute one for four globules in the same quantity of water. (See remarks upon this subject in Introduction to Part III.) Should Jaundice be accompanied with symptoms of in- flammation, and pain and pressure in the hepatic region, see Acute Inflammation of the Liver; and that accordingly in the majority of such cases Aconite, followed if needful by Belladonna, Mercurius, or Chamomilla, as best indicated, will be found of essential service. In very obstinate icterus the alternation of Sulphur, Hepar sulphuris, Lachesis, and Acid, nilricum has been found suc- cessful ; but as these cases frequently arise from obstructions, atony, or a spasmodic or irritable state, they require consid- erable skill and discrimination in their treatment. INFLAMMATION OF THE SPLEEN. Splenitis. Diagnosis. Sharp pressing or shooting pains in the region of the spleen ; in most cases a high degree of fever, with * Vide note, p. 21. inflammation of the spleen. 163 general derangement; sometimes enlargement and tumefac- tion ; and when very severe, hematemesis. It is a rare disease in this country, but sometimes declares itself in hot seasons, when it is not unfrequently mistaken for other affections. It may, however, arise in individuals of delicate constitutions, or in children when exposed to the in- fluence of marsh miasms, particularly when to that cause has been added insufficient clothing, want of exercise, of proper nutriment, and long-continued mental disquietude. The value of Cinchona in this malady and the power it dis- plays of developing an affection closely similar, affords a beautiful exemplification of the truth of the homceopathic law. From our very imperfect knowledge of the physiology of this viscus and its relation to the other organs, this disease, except when it presents itself in the tangible form above men- tioned, is extremely difficult to diagnose. Its best character- istics are tenderness or sensibility on pressure in the splenic region, with general debility ; paleness of the complexion, bloodless appearance of the conjunctiva, languid circulation, and tendency of the extremities to become cold. Therapeutics. The chief remedies in this affection are Cinchona and Arsenicum, which are useful not only in its treatment, but against the tendency to dropsy, which not un- frequently develops itself; this can but rarely occur, however, where the proceedings of the physician are guided by the ho- moeopathic law, inasmuch as the very remedies employed to combat the disease itself, are the surest preventives against such a result. The other medicines most frequently required are Aconitum, Arnica montana, Nux vomica, and Bryonia alba. Aconitum. Against the fever generally present, if severe. Administration.* Six globules at the third potency to an ounce of water, administering one dessert-spoonful every half- hour, hour, or four hours, according to the exigency of the case. Cinchona. When the inflammatory symptoms have abat- • Vide note, page 21, 164 DIGESTIVE SYSTEM. ed, or if no fever of any moment existed from the commence- ment, particularly if the disease owes its origin to marsh miasm, or if the accompanying fever present an intermittent type, in which case it should be administered during the Apy- rexia. Moreover, if impaired appetite and general derange- ment be present, see this medicine under Apepsia. Also, if the patient have been weakened by hematemesis or diarrhoea, (see these articles.) Administration. In general cases we may dissolve &&Q-& in four dessert-spoonfuls of water, and give a dose morning and evening, and so on until improvement results. Arsenicum, also useful where the disease assumes an in- termittent character, or is complicated with that affection, (see Cinchona, and this remedy, art. Intermittent Fever.) And further, when the patient complains of a violent burning pain in the region of the spleen, and a constant pulsation at the scrobiculus, attended with great anxiety ; also watery or san- guineous diarrhoea, and burning at the anus ; excessive weak- ness, and oedema of the feet. A dministration, same as Cinchona. In some cases it has been found advantageous to alternate these two remedies, giv- ing a dose of the medicine selected morning and evening, al- lowing an action of one, two, or three days, according lo cir- cumstances, and then exhibiting the other in the same manner. Arnica, indicated by pressing pain in the left hypochon- drium, causing dyspnoea, and when the vomiting of blood is very severe. Administration. ^a, in a teaspoonful of water, repeated in six hours, if necessary, but when the last-mentioned symp- toms is present, exhibit as under Hematemesis. Nux vomica is chiefly indicated by the symptoms of de- ranged digestion, constipation, &c, which remain after the more threatening symptoms are removed. Administration. &$a, in a little water at night, repeated every twenty-four hours while necessary. Bryonia is found useful in milder cases, where an aching, shooting pain is in the splenetic region, which is much aggra- vated by the slightest movement, or when the patient com- INFLAMMATION OF THE STOMACH. 165 plains of a constant stitch in the side, or the left hypochon- driac region, and general gastric derangement with constipa- tion exists. Administration. ££, 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 spleen re- quire a long and judicious course of treatment for removal, or even amelioration. I shall, therefore, briefly direct the atten- tion of the reader to those remedies which have proved most successful in these instances—namely, Sulphur, Calcarea car- bonica, and Baryta carbonica (particularly when the mesenteric glands have become affected), and further, Lycopodium, Carbo vegetabilis, Plumbum, Mezereum, Stannum,. INFLAMMATION OF THE STOMACH. Gastritis. 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 membrane of the stomach, which frequently involves the sub- mucous tissue, and sometimes the muscular coat. Diagnosis. 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 vomit, retching, vomiting, great thirst, increased or brought on by the smallest quantity of food or drink ; some- times with hydrophobic symptoms (hydrophobia symptomatica); soreness of the throat, with inflammation of the fauces ; hic- cough, sobbing, great restlessness, anxiety, and prostration of strength; 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, and remittent pulse ; sunken features, with expressions 166 digestive system. of anxiety, constipation, but frequently diarrhoea or alternations of these two states. Death may ensue from gangrene, in which case the pains suddenly cease, the coldness of the extremities increases, and the pulse becomes scarcely perceptible and remittent; or from paralysis of the nervous system during the attacks of the spasms or syncope. When this disease has been improperly treated if the patient has the good fortune to escape with life, it may pass into chronic inflammation, scirrhus, or ulceration of the stomach. Causes. One of the most frequent is partaking of cold drinks or ice-water, when heated or during hot weather, and also acid or poisonous substances taken into the stomach; le- sion from any rough-pointed body swallowed, external contu- sion, ardent spirits, suddenly checked secretions or evacua- tions, abuse of emetics, metastases. Therapeutics. The remedies which have been found the most useful in the homceopathic treatment of Gastritis, are ; Aconitum napellus, Ipecacuanha, Nux vomica, Antimonium crudum, Pulsatilla, Bryonia, Ranunculus bulbosus, Euphor- bium, Cantharides, Hyoscyamus, Belladonna, Arsenicum. Aconite is requisite in those cases in which synochal fever is developed,—and must be repeated until relief is obtained or an alteration in the symptoms calls for the selection of another remedy.* Ipecacuanha is useful when the vomiting is excessive, the epigastric region considerably distended, and the patient af- fected with great anxiety, restlessness and difficulty of breath- ing. Antimonium crudum may follow the former remedy, or be given in preference thereto, if the tongue be much loaded. Bryonia may be administered after any of the foregoing reme- dies should they have afforded only partial relief, and particu- larly if the disorder has been excited by a chill from cold drinks when overheated. Nux vomica is one of the most important remedies in Gas- tritis mucosa of drunkards, and in the same affection when occurring as a metastasis from suppressed haemorrhoids: • Vide note, page 21. inflammation of the stomach. 167 finally, Nux vomica has been found efficacious after the pre- vious administration of Aconitum, Bryonia, Ipecacuanha, and Arsenicum, when the disorder has been caused by a chill from drinking iced water when overheated. Lachesis and Arsenicum may, in some instances, be advantageously administered in al- ternation with Nux v., in the idiopathic gastritis mucosa of drunkards.* Pulsatilla has been recommended in the subacute form of gastritis, arising from the sudden suppression of some secre- tion, such as the menstrual flux, etc. ; and also in cases pro- ceeding from a chill in the stomach from ice, particularly after the previous employment of Ipecacuanha or Arsenicum. Ra- nunculus bulbosus, Euphorbium, and Cantharides have been recommended in the 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 the said symptom, there is excessive prostration of strength ; thirst with violent vomiting immediately after drinking ; small, quick, and occasionally intermittent, pulse ; anxiety, restlessness, and apparent sinking of the vital energies,—Arsenicum must at once be had recourse to, whether the disease may have arisen from a chill in the stomach or any other cause, (excepting, of course, poisoning by that remedy, in which case the treatment to be followed will be found under the head of Poisons). The alternate administration of Aconitum with Arsenicum has been found useful in some cases; in others, Veratrum and Arsenicum: The former, at an earlier stage of the disorder, with accom- panying inflammatory fever, and the latter where the extremi- ties have become cold, the pulse small, features sunk and expressive of great anxiety ; hiccough, thirst, vomiting on partaking 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 be directed to the following : Belladonna,—Inflamma- tion of the fauces with redness of the tongue at the tip and margins ; hydrophobia symptomatica. Hyocyamus,—Stupor, • Opium also may be included with advantage here. 168 DIGESTIVE SYSTEM. or confusion of ideas with incoherent speech ; convulsions, symptomatic hydrophobia. Lachesis, Stramonium and Can- tharides may likewise prove useful in cases in which the latter symptom is present (see Hvdrophobia.) Finally, Co- locynth, Mercurius vivus, Sulphur, and Chamomilla may be mentioned as likely to prove serviceable auxiliary remedies in some instances. Arnica should be borne in mind, if the at- tack can be traced to lesion of the stomach from any rough or pointed substances having been swallowed, or also if from external contusion. When the disease has passed into the chronic form, Natrum m., Lachesis, and Nux v. may be administered in alternation with great advantage : followed, if required, by Lycopodium, Colchicum, Sulphur, and Phosphorus, Sic. Vide also Car- dialgia (which chronic gastritis nearly resembles) and Dys- pepsia. INFLAMMATION OF THE BOWELS. Enteritis. Diagnosis. This disease is comparatively of rare occur- rence in the idiopathic form, and appears much more fre- quently as a symptomatic affection, particularly in the course of some fevers—such as low Nervous Fevers, Scarlet Fever, Measles, Sic. ; also in all diseases attended with hectic fever. It much more frequently occurs in the sub-acute or chronic than in the acute form. In the acute form of the disease, involving the submucous tissue and peritoneal coat, as well as the mucous membrane, the symptoms are usually as follows : Intense burning or pungent pain, generally in one spot of the abdomen, especially in the region of the navel, increased by the slightest pressure and by movement, with tightness, heat, and distension of the abdomen; sobbing, anxiety, and violent thirst, with aggravation of suffering from cold drinks ; obsti- nate constipation ; violent vomiting, first of slime and bile, and sometimes even of excrements (Ileus miserere) ; small and contracted pulse, inflammatory fever, flatulence, and fre- quently obstruction of urine. In the subacute form of the disease, or in simple enteritis inflammation of the bowels. 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 over the abdomen, which is commonly, 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 and margins, however foul the centre may be. Loss of appetite, indigestion with nausea and vomiting, more or less prominent, according to the portion of the intestinal tube affected ; being greater the nearer the seat of the inflammation is to the stomach. When the inferior parts are implicated (as is indicated by pain or soreness in the iliac regions and in the course of the colon), there is usually diarrhoea, the stools being frequently slimy and mixed with blood, in sever cases consisting of pure blood, particularly when the rectum is involved, in which case there is more- over, considerable straining. The pulse is quick, the thirst sometimes excessive, with a greater or less degree of fever and extreme languor. Unless resolution take place, it may terminate in induration of the intestines—laying the foundation of chronic constipa- tion—suppuration, or gangrene. The 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 are cold in the feet and abdomen, suppressed discharges, cathartics, worms, metastases, partu- rition, indigestible or highly stimulating food, prolonged use of acids, sour wine or beer, &c. The state of the atmosphere appears to have some share in producing it, from the circum- stance that the disorder sometimes prevails almost as an epidemic. Therapeutics. Arsenicum, and where required Veratrum, are the principal remedies in the first described variety of this disease, as well as in the severest forms of gastritis to which letter, indeed, it bears a strong resemblance ; but the treatment must necessarily be commenced with Aconite when the accom- 15 170 digestive system. panying fever is intense, and the skin hot and parched. For the selection and administration of these two remedies, see Gastritis. Opium and Plumbum are the principal remedies against Ileus Miserere, as noticed in the Diagnosis. In the subacute form of the complaint, a few doses of Aco- nite are often serviceable ;—but as soon as the marked in- flammatory symptoms have been subdued, one or more of the following remedies must be selected to complete the cure : Belladonna, Mercurius, Acid nitricum, Bryonia, Colocynth, Chamomilla, Nux v., Pulsatilla, China, Opium, Cantharides, Colchicum, Rhus, Phosphorus, Sulph., Silex. Belladonna.* Tongue red and smooth, or coated white, or yellowish brown in the centre with intense redness of the tip and margins, and inflammatory redness of the papillae ; skin hot and dry, intense thirst, with occasional delirium, especially at night ; sensation of soreness or of excoriation in the entire abdomen, with tenderness on pressure, and sometimes consider- able distension, particularly in the region of the arch or trans- verse section of the colon. Nux vomica. Redness of the margins of the tongue, with yellow or whitish coating in the centre ; sensation of soreness, with burning heat in the abdomen ; loss of appetite ; indiges- tion, with vomiting after partaking of food, and aggravation of the abdominal pain after drinking; flatulence, constipation, or constipation and looseness alternately ; scanty watery stools, or stools consisting of a small quantity of mucus, sometimes tinged with blood, and attended with straning. This remedy is especially useful when the above symptoms have been caused by the sudden suppression of an hemorrhoidal flux, or from indigestible food, &c. Sulphur is frequently of great value in completing the cure after Nux v. Mercurius is a most important remedy in this disease, even in the most serious cases, and especially after Aconite and Belladonna, or Arsenicum, should that remedy have been cal- led for. The following are its principal indications : tongue * The alternation of this remedy with Mercurius, the indication per- mitting, cannot be too strongly urged in this dangerous disease, especi- ally when the symptoms are fearfully prominent__Ed. INFLAMMATION OF THE BOWELS. 171 very foul, coated white or dark brown ; it is sometimes dry, but more frequently covered with thick mucus ; excessive thirst; abdomen hard, tense, distended, and very tender to the touch; copious watery, bilious, and highly-offensive stools ; but more frequently there is constant urging to stool, followed after severe straining, by the evacuation of a small quantity of mu- cus tinged with blood ; at other times of pure blood in con- siderable quantity ; extreme prostration of strength, chilliness and shivering, with tendency to sweating at night, which, however, brings little or no relief. Acidum nitricum. The indications for this remedy are much the same as those described under the foregoing; it is therefore of great service in completing the cure when Mer- curius has only produced partial relief. It is an invaluable medicine in chronic cases, attended with abdominal tender- ness and tenesmus, and especially when the disorder occurs in individuals who have been previously subjected to an abuse of Mercury under allopathic treatment. Bryonia. After the previous employment of Aconite, Bry- onia is occasionally a useful remedy here, when the patient complains of severe headache, with constipation, and pain in the abdomen after meals ; it is also indicated, however, when, after Aconite, there remains dark redness of the tongue, or whitish or yellow coated tongue, with parched mouth and considerable thirst; loose offensive evacuations, particularly after partaking of food or drink; nausea and vomiting after eating. Pulsatilla. When the acute inflammatory symptoms of enteritis, arising from the sudden suppression of some ha- bitual discharge, such as the catemenia, or the hemorrhoidal flux, or occurring as a sequela of measles, have been subdued by Aconite, and the following symptoms remain; tongue loaded with a thick white, grayish, or yellow coating ; adipsia, or, on the contrary, excessive thirst, deranged digestion, loss of appetite, with nausea and vomiting after partaking of a little nutriment ; sensibility of the abdomen on pressure, or on every movement; flatulence. 172 digestive system. Colocynth. In cases where the large intestines are the seat of the inflammation, attended with tympanitic distension of the abdomen, soreness and sensibility to the touch ; tormina and diarrhoea, with increase of pain followed by urgent desire to go to stool after eating or drinking ; nausea, or vomiting of bilious matter ; frequent discharge of flatus. Chamomilla. Is peculiarly well adapted to the treatment of the disorder as it is likely to occur in children, or in highly nervous and excitable females, who are extremely sensitive to pain, and complain loudly from trivial suffering ; it is indi- cated, moreover, by a sensation of soreness in the abdomen, as if arising from internal excoriation or ulceration, accompanied with painful tenderness on slight pressure, and slimy, whitish, watery, or greenish, or yellowish diarrhoea of an offensive odour. Cinchona. Is frequently useful after Aconite or any of the foregoing remedies, when there is a tympanitic distension of the abdomen ; diarrhoea, aggravated after a meal, with undi- gested food in the evacuations ; thirst, extreme weakness of digestion, and great debility. Cantharis. In very serious cases, with discharge of pure blood at stool, and strangury ; or in an advanced stage of the disorder, with evacuations of mucus and solid substances, like shreds of membrane, this remedy will frequently be found of considerable service. Colchicum. Will also be found useful occasionally in ad- vanced stages of the disorder, with tympanitic distension of the abdomen, diarrhoea, the stools consisting of white or transpa- rent gelatinous mucus, or of blood mixed with substances re- sembling false membrane. Rhus. When eruptions break out about the mouth, and there is redness of the tongue, with pain as if from soreness or ulceration in the abdomen, and tenderness on pressure ; watery, slimy, frothy, or sanguineous stools ; low fever, with noctur- nal delirium. Rhus is chiefly used in symptomatic enteritis, such as frequently occurs in low Nervous Fever, which see. The chronic stage of the complaint, which is chiefly char- acterized by fixed pain, fulness, or uneasiness and oppression INFLAMMATION OF THE BOWELS. 173 in the lower part of the abdomen, increased after meals or after cold drinks ; appetite impaired or capricious ; thirst, particu- larly after dinner or at night; bowels constantly relaxed, or there is constipation alternately with diarrhoea ; fetid and dis- coulored evacuations ; skin hot, 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 elevated papillae, especially at the root; emaciation, weakness, and languor. Here the foregoing remedies described for the acute and subacute variety, but more particularly Belladonna, Nux v., Bryonia, and Rhus, together with Acidum nitricum, Phosphorus, Sulphur, Silicea, and Arsenicum, will in most in- stances be found among the most serviceable. Acidum nitricum. Is particularly indicated when there is thirst, attended with pains in the bowels or other uneasiness after drinking ; impaired appetite, tenderness of the abdomen, fetid diarrhoea and tenesfnus ; greenish stools, with ingesta ; skin dry and harsh during the day, sometimes with nocturnal sweats. Phosphorus. Soreness in the abdomen, with tenderness on pressure, and distressing distension after meals ; obstinate diarrhoea, or constipation and diarrhoea alternately; stools containing ingesta; pulse rather quick and hard; weakness and emaciation. Sulphur. This remedy is one of the most useful in ente- ritis, arising from the suppression of some accustomed dis- charge, such as the hemorrhoidal, Sic.; as also in cases arising from the driving inward of a tetter, or sudden healing up of an ulcer ; tongue red, or loaded ; thirst; pain, as from excori- ation, in the abdomen, with tenderness on pressure ; or fulness and uneasiness in the abdomen, increased by cold drinks or after meals ; diminished or fastidious appetite, with aversion to meat; fetid diarrhoea, frequently containing ingesta; consti- pation, or constipation alternately with diarrhoea ; flatulence ; skin yellow or otherwise unhealthy looking, or dry and peal- ing, but often covered with perspiration at night, or towards morning ; pulse quick and hard ; emaciation, with considera- ble debility. 15* 174 DIGESTIVE SYSTEM. Silicea. When the disorder has been excited by the sud- den suppression of the perspiration of the feet, or the rapid healing up of a chronic ulcer, Silicea is one of the most impor- tant remedies. The following symptoms are some of the more immediate indications for its selection : dryness of the mouth, loaded tongue, great thirst, with diminished appetite, and sometimes disgust at meat, or cooked and hot food, with de- sire for cold food and drinks ; abdomen hard, hot and tense, and painful to the touch ; constipation, or extremely fetid watery stools ; borborygmus, especially on movement; skin dry and parched during the day, and covered with sweat towards morning ; pulse quick and hard. Arsenicum. Has already been noticed as the principal re- medy in acute cases of a violent character ; it is, moreover, a remedy of considerable service in some of the chronic varieties of enteritis, with a sensation as from excoriation, or of burning heat in the abdomen, attended with nausea, want of appetite, and great thirst; increase of pain after cold drink ; borboryg- mus ; diarrhoea, sometimes with ingesta ; fetid, discoloured stools ; skin parched, hard, and of a yellowish, unhealthy- looking hue ; emaciation, with extreme debility. Lachesis, Lycopodium, Natrum muriaticum, Secale cornutum, Hepar sulphuris, Sepia, Calcarea, Graphites, Carbo vegetabilis, Causticum, Antimonium crudum, and Ipecacuanha, may also be of considerable service in some cases—the two last named have occasionally been used with advantage after Aconite against the vomiting in acute cases. When we have reason to suspect worms as the cause of this affection, the patient must be treated accordingly. See Invermination, p. 181. Administration of the Remedies. In the acute form of the disease, a few globules of the third potency of the remedy indicated may be added to an ounce of water, and a dessert- spoonful of the liquid given every three hours, lengthening the intervals as soon as improvement sets in. In the sub- acute and chronic form, the sixth, and in some cases the thir- tieth, potency may be substituted for the third, and the doses INFLAMMATION OF THE PERITONEUM. 175 administered at intervals of from six to twelve hours and upwards.* Diet. In acute cases of inflammation, either of the stomach or bowels, the regimen must be placed under the same restric- tions as described at page 17 (Fever;) and in sub-acute and chronic cases the food should be very light, and given in small quantities ; raw fruit, green vegetables, and sometimes pota- toes, must be strictly prohibited ; the drink should consist solely of toast-water or barley-water, or the like. INFLAMMATION OF THE PERITONEUM. Peritonitis. Diagnosis. Painful tension and tumefaction of the abdo- men with a sensibility to the touch even more acute than that in Enteritis ; so much so that the patient cannot bear the pressure even of a sheet upon the abdomen ; frequently con- stipation or ischuria, and the symptoms of enteritis, Causes. General causes of inflammation, and moreover external injury, parturition, chill of the abodmen, and me- tastases. Therapeutics. In the first place it will generally be found beneficial to administer three or four doses of Aconitum at the third potency, exhibited at intervals of time varying according to the exigency of the case, until the fever and in- flammation lower : this remedy has been found in many cases sufficient of itself to remove the affection, and in all it mate- rially modifies its violence. When the cause is external lesion, we should administer Arnica ^, and repeat it in twelve hours, and at the same time apply bandages wetted with a diluted tincture, as given under External Injuries in cases of contusion. Sometimes vomiting and othersymptoms closely resembling those of enteritis are present, and frequently constipation and * Vide note, p. 21. 176 digestive system. ischuria ; and other times merely the marked sensibility of the abdomen and tumefaction with gastric derangement; but, physiologically considered, these symptoms arising from the intensity and extent of the inflammation, and the sympathy of the other organs, our chief care must be to lower the in- flammation, which being in a great measure brought under control by the medicine above noted, we will find considerable benefit from the employment of Nux vomica and Mercurius to combat any remaining symptoms. Nux vomica. When there is distension of the abdomen with tendency to the predominance of gastric symptoms and ischuria. Administration. &cft, repeated every six to twelve hours, according to the severity of the symptoms. Mercurius is more particularly suited to the advanced stages of the disease, with weak, quick pulse, nocturnal sweats, and great weakness. When the inflammation extends to the pleura and the breathing becomes affected with acute shooting pain, we should have recourse to Bryonia (3), as described for Aconite. (See also Pleuritis.) When the peritoneal coat, or upper portions of the alimen- tary tube or of the stomach itself, becomes affected, evidenced by an increase in the intensity of the disease, the pain extend- ing higher—vomiting, generally a rare symptom, becoming severe and continual—collapse of the features, small pulse, and a rapid sinking of the vital energies, closely resembling gastritis—we should have recourse to Arsenicum. Administration. ^, in a little water every four to six hours, until relief is obtained. In cases where there are evidences of the brain being af- fected, Belladonna may be had recourse to. (See Phrenitis.) In other instances Cantharides, Chamomilla, Bryonia, Rhus Lycopodium, Colocynth, etc., may be found necessary. As this is a disease whose care devolves more particularly upon the experienced professional man, I have contented my- self with stating the remedies most likely to be called for in ordinary cases : in many instances the symptoms are so close- inflammation of the kidneys. 177 ly analogous to those who are met with in Gastritis, that most of the remedies which have been described applicable to the treatment of that disease will generally be found equally useful here.* INFLAMMATION OF THE KIDNEYS. Nephritis. Diagnosis. Pressing, pungent pain in the renal region, shooting along the urethra to the bladder, dysuria, strangury, and ischuria (when both kidneys are affected), hot and high- coloured or red urine ; drawing up, swelling, and pain of the testis on the affected side ; numbness and spasms of the foot on same side ; nausea, vomiting, colic, and tenesmus : lying on the part affected and motion aggravate the pains. Causes. Excessive use of stimulants ; shocks of the body, falls, or strains, external injuries; long lying on the back, abuse of diuretics or cantharides, suppressed hemorrhoids or menstruation, metastases or calculi. Therapeutics. The principal remedies in this affection are, Aconitum, Cantharides, Nux vomica, Pulsatilla, Belladon- na, Hepar sulphuris, Cannabis, Mercurius, Arnica montana. Aconite. In the inflammatory stage of this affection, this remedy should be administered in repeated doses, in the same manner as in Inflammatory Fever ; after which, in the majority of cases,— Cantharides will be found most efficacious in the further treatment, and more particularly when the urine passes off in drops or is tinged with blood, or when micturition is exceed- ingly painful, with burning pain in the urethra, and when the general symptoms of shooting, cutting, and tearing pains in the loins and region of the kidneys are present, or even in cases of complete strangury. * In Peritonitis Puerpuralis, Aconitum, Ipecacuanha, Bryonia, Ar- senicum, Veratrum, Chomomilla, and Pulsatilla are the remedies which have chiefly been used; but some of the others which have been men- tioned in the treatment of Gastritis may be found serviceable in parti- cular cases. 178 digestive system. Administration. Six or eight globules of third or sixth potency to an ounce of water, a dessert-spoonful every one, two, or three hours till benefit result.* The proved value of this medicine, when used homoeopa- thically, in the cure of this painful disorder, is another of the many beautiful exemplifications of the truth of the homoeopa- thic law, and its power of causing diseases of the urinary or- gans, even when applied in the form of blister is so well known, that in all medical works it has been noted as an ex- citing cause of this affection. Nux vomica. When the affection can be traced to a sup- pression of a hemorrhoidal discharge, determination of blood to the abdomen, excess in wine or stimulants, and sedentary habits, and where we find constipation, feeling of faintnesSj nausea, vomiting, distension of abdomen, drawing up of the testis and of the spermatic cord. Pulsatilla. In females of phlegmatic temperament, when arising from irregular or suppressed menstruation. Administration. -«£, of the last-mentioned remedies, re- peated every twelve hours, while necessary, t Belladonna. When shooting pains in the kidneys are present, extending to the bladder,—this medicine is further indicated when nephritis is accompanied with colic and car- dialgia, heat and distension in the region of the kidneys, scan- ty micturition of an orange yellow, or sometimes of a bright red, depositing red or whitish thick sediment; anxiety, rest- lessness, and periodical aggravation — constipation. Administration. Same as Cantharides. Hepar sulphuris is useful when we have reason to appre- hend the formation of an abscess or the commencement of suppuration ; here the diagnosis is difficult, and the profes- sional student must be careful not to mistake the apparent alleviation of suffering for the subjugation of the disease. The following symptoms may serve as a guide in these cases ; ces- sation of the acute pain, a sensation of throbbing and a sense of weight in the region of the kidneys ; alternate chills and slight flushes of heat and copious perspiration. * Vide note, p. 21. t Ibid. INFLAMMATION of the kidneys. 179 Administration. A grain of the third trituration to an ounce of water, a dessert-spoonful every three or four hours, lengthening the intervals according to results. Mercurius is also valuable in this stage, but more particu- larly when diarrhoea and tenesmus are present. Administration. Same as Hepar sulphuris, at intervals of from six to twelve hours. Cannabis. When a dragging pain or sensation as if from excoriation is experienced, extending from the region of the kidneys down towards the groin. Administration. Same as Cantharides, but at somewhat longer intervals. Colchicum. When in addition to the usual symptoms of this disease there is excessive nausea with tympanitic disten- sion of the abdomen, and painful and scanty emission of bright red urine. Administration. Same as Cantharides. When the disease has assumed a chrcnic form, and indura- tion of the kidneys has taken place, Mercurius -§-, in a tea- spoonful of water, will often be found useful, a dose once a week for three or four weeks, followed by Aurum -fa, a dose once a week, unless some marked indication call for the em- ployment of another medicine. In Nephritis arising from contusions or violent concussions of the body, Arnica is the principal remedy. Administration. -6-, repeated in twelve hours, and a lo- tion applied externally. (See External Injuries.) In cases arising from the abuse of Cantharides in blistering, an occasional 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. Observation. This disease sometimes arises from the presence of calculi in the kidneys ; in which case the symp- toms of fever do not occur until a considerable time after se- vere pain has been experienced ; further, a numbness of the thigh, and a retraction of the testicle of the affected side, are considered as distinguishing marks of the existence of a cal- culus in the kidney or ureter :—Here the use of Nociatiana 180 digestive system. rustica has repeatedly been found an useful palliative, admin- istered at a low potency (3) every half hour. In conclusion, the following remedies, whose utility in various forms of ne- phritis or nephralgia, clinical observation has confirmed, may be pointed out as meriting the attention of the professional student: Calcarea carbonica, Lycopodium, Cannabis, Phospho- rus, Sepia, Uva ursi, Sarsaparilla, Kali carbonicum, and Gra- phics. Patients suffering from Nephritis should strictly avoid wine, malt liquor, and spirits. INFLAMMATION OF THE BLADDER. Cystitis. Burning pain in the region of the vesica, with tension, heat, pain when touched, and external tumefaction; frequent and painful discharge of urine, or suppression, and generally tenesmus ; fever, and sometimes vomiting, as in Nephritis. The causes closely resemble those of Nephritis, but it also occurs more frequently in parturition than the former affection. Therapeutics. "We should have recourse to Aconitum, as in Nephritis, when a considerable degree of inflammatory fever is present, followed by— Cantharides, which here, as in the above-mentioned dis- ease, is the leading remedy. Nux vomica. When attributable to an indulgence in wine or spirituous liquors, this remedy, timeously administered, will in many instances check its further progress ; also, when it results from suppressed hemorrhoids or dyspeptic de- rangements :—Nuxv- may be followed if required, by Sulphur and Calcarea. The two last named are well adapted to the treatment of the chronic form of the complaint. Pulsatilla. Valuable in checking the development of the affection when arising from suppressed menstruation.* * Pulsatilla is, moreover, servicable in all cases, from whatever cause arising, when occurring in individuals of phlegmatic temperament, with the following symptoms : frequent desire to urinate, painful and scanty emission of slimy or sanguinolent urine, which deposits a purulent look- ing sediment; burning and cutting pains in the hypogastrium, with ex- ternal heat and tumefaction; suppression of urine. WORMS. 181 Hyoscyamus. When difficult urination is present, but the disease is not far advanced, particularly when we have reason to suspect that this symptom arises from spasmodic constric- tion 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. Arsenicum and Carb v. have been found very serviceable in allaying the burning in the urethra during urination. When Sulphur, Calcarea, or any of the foregoing remedies have not succeeded in arresting it. Administration of the first-named remedies, the same as in Nephritis ; Hyoscyamus, Digitalis, Sulphur, Calcarea, Ar- senicum and Carbo v., in the same manner as Nux v., and Pulsatilla. When this disease has arisen from the applica- tion of Cantharides as a blister in allopathic practice, Camphor must be administered as ascribed under Nephritis. And when it arises from the presence of stone or gravel, the same remedies as those mentioned at the termination of the pre- ceding chapter are the most useful. INVERMINATION. WORMS. Helminthiasis. The existence of worms in the intestinal canal, in the ma- jority of cases, evidently arises from a peculiar constitutional taint, inducing a certain diseased state of the mucous or lining membrane, and thereby giving rise to the formation of these parasites ; and although no 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 nutrition at that age. Weakness of the digestive function, accumulation 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, lumbricus, and taenia or tape-worm ; of the latter there are two varieties,—the solitary tape-worm, composed of long and slender articulations, which has been 16 182 DIGESTIVE system. known to exceed the length of thirty feet; and the common tape-worm, which varies from three to ten feet, seldom comes away entire, but in joints, which are considerably broader and thicker than those of the variety first mentioned. The presence of worms, unless when passed, is not always easy of detection, since subacute inflammation of the mucous membrane from other causes will frequently present nearly the same range of symptoms ; but here, (as in the treatment of many of the most serious acute diseases,) Homoeopathy pre- sent two manifest advantages over the old system. In the first place, if acting upon the certainty of tho existence of worms, we administer a remedy specific to the affection : in the next, when we are uncertain as to the true character of the complaint, and select a medicament distinctly indicated by the united symptoms, it will be found applicable to the affection, from whatever cause it arises ; and a careful observance of the known pathogenetic powers of the remedies selected, will materially assist us in tracing the disease to its proper source. Diagnosis. Pallor and sickly appearance of the countenance, and sometimes flushing, livid circles round the eyes, dilated pupils, headache or vertigo, irregularity of appetite, fcetidity of breath, acrid eructations, occasional nausea and vomiting, foul tongue, tensive fulness of abdomen, with a sensation of gnawing and burning at particular parts of the intestines ; hard and tumid belly ; great thirst ; discharge of mucus from the rectum, bladder, (and vagina ;) heat and itching at the anus ; slight febrile symptoms, and nocturnal wakefulness, with low spirits or irritability of temper, and gradual emacia- tion ; we also generally notice an inflammatory redness of the nostrils, with great disposition to picking or boring at the nose, especially in children, with sudden screaming when waking, and grinding of teeth. In addition to the above ge- neral symptoms of this affection, we frequently meet with severe colic-like pains, with slimy and bloody evacuations ; involuntary discharge of saliva, especially when asleep ; con- vulsions in children, and epileptic attacks, combined with cerebral affections in adults ; inflammation of the bowels. WORMS. 183 In tenia, in addition to the above, we find a sensation as of something rising into the left side of the throat, and then fall- ing back ; or a feeling of a lump on either side, with an un- dulatory motion; feeling of suggilation in the abdomen, creeping torpor and numbness in the fingers and toes. Therapeutics. Aconitum, Ignatia amara, Sulphur, Cal- carea carbonica, Ferrum metallicum, Cina, Nux vomica, Mer- curius, Spigelia, Sabadilla, Silicea, Cicuta virosa, and Filix mas. Aconitum. When 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. Administration.* ££, to an infant T% in a little water, repeated in six hours if necessary ; when it has lowered the fever we must have recourse to some other remedy. In most cases Ignatia amara, which is also particularly indicated by spasmodic twitchings in one of the extremities or in individ- ual muscles. Administration. &%3- in fonr dessert-spoonfuls of water, one twice a day ; for an infant ^ in four teaspoonfuls, one night and morning. Sulphur, in case the annoyance still continues after the lapse of two or three days. Administration. | in .an ounce of water, a teaspoonful morning and evening until finished; for infants £§ in the same manner. Calcarea carbonica and Silicea may be administered in like manner, should no marked amelioration ensue ; allowing an interval of about a week or ten days to elapse between the different remedies. Ferrum metallicum may advantageously follow the above, after a similar interval. Administration. A grain of the third trituration to an ounce of water, a teaspoonful once a day ; for infants sg- in the same manner. •Vide note, p. 21, 184 DIGESTIVE SYSTEM. This course of treatment persevered in for a short time has often proved successful in most obstinate cases, by purifying the constitution and restoring the mucous membrane to a healthy state. When excessive irritation is present, and does not appear to diminish readily under the .action of the pre- ceding remedy, we may give a drop of the tincture of Urtica urens, in a little water, or on a piece of loaf sugar, every night or morning for several successive days, and should this not relieve the annoyance, we may administer an enema of a dessert-spoonful of salt to a pint of water, of which from two to six fluid ounces, according to age, may be injected ; if this act as a laxative, a mixture of vinegar and water in the pro- portion of one-fourth part of the former may be used.* After this palliative course of treatment, the course above mentioned may again be resumed should it appear necessary. Cina. This is'an eminently useful medicine in the case of worms, and is generally indicated where the following symp- toms are met with: Frequent boring at the nose, great per- verseness of temper, heat and irritation, constant inquietude and restlessness, with, in children, a desire for things which are rejected when offered ; fits of crying when touched, pale- ness of face, with livid circle round the eyes ; constant crav- ing for food even after a meal, griping, distension, and hard- ness in the abdomen, with discharge of thread and round worms, and loose evacuations ; occasionally, convulsive move- ments in the limbs, weakness and lassitude. This medicine is particularly indicated for Colic produced by worms. Administration. Same as Ignatia. Nux vomica is a valuable adjunct in cases of worms, in which considerable derangement of the digestive function is present, with irritability of temper and constipation. Administration. ^ in a teaspoonful of water at bedtime, repeated in three or four days if called for. Mercurius. When we find diarrhoea, distension of the abdomen, and hardness in the umbilical region, with increas- ed secretion of saliva. * Hering's Hausartz. WORMS. 185 Administration. As Ignatia. Spigelia in extreme cases, with colic, voracity, diarrhoea, and chilliness. Administration. As Ignatia. Belladonna. Great nervous excitement; nocturnal deli- rium, with startings during sleep ; tendency to be startled or frightened at the most trivial cause ; also colic, headache, thirst, quick pulse, hot, dry skin : should these symptoms not yield to Belladonna recourse must be had to Lachesis, or to Silicea should the febrile symptoms continue, and the patient affected be of a scrofulous diathesis. Administration. Two globules of the sixth potency in a teaspoonful of water, until the febrile action is subdued. Cicuta virosa. Worm colic with convulsions. Administration. -^, in a little water, repeated in a few hours, if necessary. In severe cases, a drop of the third, in four dessert-spoonfuls of water, once every half hour. The treatment of taenia, although similar to the above, has some modifications. In most cases we may give Aconitum, followed by Cina, after which considerable relief is often ex- perienced ; and then have recourse to Filix mas, a drop of the third potency to an ounce of water : a teaspooful twice a day, until finished :— In chronic cases the following treatment has proved suc- cessful : Nux vomica, Mercurius, and Sulphur, each -^a, a sin- gle dose, alternated at intervals of from six to eight days. When any improvement takes place after the administration of any one of these remedies in particular, it will be well to repeated that medicine at the stated intervals, as long as it ap- pears to do good, instead of going on to the next remedy in rotation.* Moreover, in this course of treatment, Calcarea carbonica, &fi, may advantageously follow Sulphur, in scrofu- lous habits, at an interval of ten days. Natrum muriaticum, Lycopodium, Graphites, Baryta, or Phosphorus have been found necessary to complete the cure in particular cases. Regimen. The food ought to be wholesome and nutritious ; meat, such as roast or boiled beef or mutton, once a day, in' • Vide note, p. 21. 16* 186 DIGESTIVE SYSTEM. moderate quantity, and occasionally a light pudding ; green fruits or vegetables must be strictly prohibited, and the utmost care should be taken to prevent children from eating raw herbs, roots, etc., which they are so prone to pick up in their rambles when not looked after. Plenty of exercise in the open air is of essential service, and must on no account be neglected. DISEASES OF THE ORGANS CONNECTED WITH THE RESPIRATORY SYSTEM. CATARRH, or COMMON COLD. This term is given to an affection which consists of a mild degree of inflammation of the lining membrane of the nostrils, windpipe, and occasionally also of the ramifications of the latter ; induced by exposure to sudden changes of tempera- ture, or to a damp or chilly atmosphere with insufficient clothing, particularly as regards children. This com- plaint is characterized by slight fever, impaired appetite, ob- struction of the nose, sneezing, unusual languor, pains in the head or in the back and extremities, and subsequently hoarse- ness or cough, generally preceded by transitory chills or shi- verings ; 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 a cold in the head ; of which latter af- fection, and moreover Hoarseness and Cough, I shall treat separately. Therapeutics. In 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 warm de- mulcent fluid, such as gruel; bathing the feet and legs in warm water, at the temperature of about 98-100 degrees of 188 RESPIRATORY SYSTEM. Fahrenheit, is also a useful auxiliary mode of restoring per- spiation, but the patient should go to bed immediately after- wards. Very robust persons who are accustomed to be in the open air in all weathers, but who have caught cold after having overheated themselves, will frequently prevent any bad effects by drinking one or two glasses of cold water on going to bed ; when however, they have learned by experience that little benefit is to be derived therefrom, a few globules of Carb. v. or Silicea should be taken instead. A moderate degree of ab- stinence should, at the same time, be observed ; veal or chicken broth, bread, sago, or semolino pudding, and such like, in- stead of the ordinary diet. The drink may consist of water- gruel, 'barley-water or toast-water. All strong liquors must be abstained from. The following are the principal medicines to be employed in the majority of cases, when called for : Nux vomica, Chamomilla, Coffea cruda, Belladonna, Bryonia, China, Dulcamara, Arnica montana, Mercurius, Acidum phosphoricum, Sulphur, Calcarea, Ipecacuanha, Ar- senicum, Selicea, Camphora, and Aconitum. Administration. Each medicine in a little water, at the dose specified ; repeated in twelve hours, if required.* Nux vomica, ^ when the symptoms of common cold de- clare themselves, will often check the attack. It is also in- dicated by external pains in the head, from the same cause. When convenient, it is preferable to administer this remedy towards evening. Chamomilla #. In the treatment of chidren this medicine is generally preferable to Nux vomica in arresting the attack. It is (like Belladonna, Bryonia, China, Dulcamara, Sulphur, and Silicea) extremely valuable in restoring the suppressed perspiration, and removing the following symptoms : colic with pains in the head, ears, and teeth, thirst, ill humour, and impatience. Coffea cruda &%&. This remedy is indicated where there is excessive sensibility, fretfulness, and sleeplessness, with general pains especially in young persons. • Vide note, p. 21, COMMON COLD. 189 Belladonna $£, when there is throbbing, bursting head- ache, attended with determination of blood to the head, in- crease of the pain from movement or exposure to cold air. Bryonia. Headache, particularly at the temples, with aching pains in the limbs, much increased by the slightest movement. Cinchona. Aching pains in the shoulderblades, and in the extremities, increased by the slightest pressure on the affected parts, with great restlessness and constant desire to change the position of the limbs. Dulcamara ^, 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 ears, and obtuseness of hearing ; pains in the 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 cold; or when the affection has arisen from a wetting, or in damp weather. Arnica Montana ^-, when aching pains, or pains as if arising from a bruise are felt in the limbs after exposure to cold, causing excessive restlessness and constant disposition to change the position of the affected parts, and increase of pain from the slightest touch or movement. Mercurius -6a, when the pains in the limbs and joints are accompanied with profuse sweating, which affords no relief; followed by Dulcamara should the sweat continue, and be of an offensive odour. Acidum phosphoricum °^. Aching pains, relieved by movement. Silicea. Pains in the limbs, colic and general derange- ment arising from suppressed perspiration, particularly in those who are subject to sweating at the feet. Sulphur s6b, 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 days. Ipecacuanha ^. Nausea and inclination to vomit, or Dyspnoea, almost amounting to suffocation, arising'from having taken cold, followed by— 190 respiratory system. Arsenicum ^, should no amelioration declare itself in six or eight hours. Pulsatilla. Useful in cold in the head with loss of taste and smell resulting from a chill, followed or preceded by Bel- ladonna, should there be an uncomfortable sensation of heat in the eyes and head, and heat and smarting in the nose. Or by Nux v., should there be complete stuffing or dryness of tho nose. (See Coryza.) Rhus toxicodendron, general indisposition from exposure to a thorough wetting when in a state of perspiration : followed by Bryonia in a few hours, if no improvement is experienced. Camphora,* when there is unusual weariness, heaviness, and general uneasiness, attended with shivering, and dryness or coldness of the skin, will generally succeed in preventing the development of an attack either of common cold or of influenza. Administration. A drop of weak spirits of Camphor every two or three hours, until relief is obtained. Aconitum is usually called for in febrile attacks, provoked by cold,—when hot, dry skin is present, —and, when timely administered, will frequently prevent the affection from as- suming a more serious form. The remedies for any other effects, arising from cold, will be found under the different heads, such as Sore-Throat, Diarrhoea, Cough, etc. Some individuals, particularly amongst those of the fair sex, are tormented with an extreme degree of susceptibility to cold; the best corrective to which is, to rub the throat, chest, and indeed the whole body every morning with a wet towel, until a glow of heat is produced,—drying one part be- fore another is commenced,—also to acquire a habit of going • The happiest effects will speedily follow the administration of Cam- phor in incipient colds or influenzas, when, in addition to the indications recorded above, there are: tearful eyes, snuffling nose, hoarseness and rough and sore sensation in the throat. It seems also to predispose the system to accept more readily the impression of other remedies that may be subsequently required. Our rule has been to administer a tablespoonful of weak Camphor- water, twice or thrice, at intervals of three four, or six hours.—Ed. HOARSENESS. 191 out every day, provided there is no inherent predisposition to pulmonary consumption ; all extremes, either of heat or cold, should at the same time be avoided, and care taken, when the body is heated, to 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 find Silicea, Carb. v., and 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 remedies must be had recourse to :—Bryonia, Bel- ladonna, Dulcamara, Nux v., China, Mercurius, Rhus, Chamo. milla, Arsenicum, Lachesis, Rhododendron, according to the character of the sufferings which are experienced after each exposure to the influence of the atmosphere. HOARSENESS. Raucitas. The seat of this affection 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 frequent ac- companiment of this disorder. The remedies mentioned under Catarrh and Cough are those which are generally found most useful in this complaint. Amongst these, in cases of recent origin, the following de- serve particular notice : namely, Pulsatilla, Mercurius, Nux vomica, Capsicum, Rhus toxicodendron, Sambucus nigra, Cha- momilla, Carbo vegetabilis, Drosera, Sulphur, and Hepar sul- phuris. The indications for the employment of these medicines are as follow : Pulsatilla (6.) Almost complete aphonia, particularly when accompanied with loose cough, or thick yellow coryza. Mercurius (6.). This remedy will be found useful in re- moving any symptoms 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 Mercurius, namely, a disposition to profuse sweating, especially at night. 192 respiratory system. Nux vomica (6.) Hoarseness, accompanied with a dry, fatiguing cough, worse in the early hours of the morning, with dry obstruction of the nose. Capsicum (6). Hoarseness, and dry obstruction in the nose, attended with an unpleasant sensation of crawling and tickling in the nose ; with a severe cough, worso towards evening; with pains in other parts of the body, such as the head and abdomen. It is also better suited than Nux vomica for individuals of a lymphatic temperament. Rhus toxicodendron (6). Hoarseness, accompanied with sensation of excoriation in the chest; oppressed breath- ing, with frequent and violent sneezing, unaccompanied by coryza, but occasionally by a great discharge of mucus from the nose during the attacks of sternutation. Sambucus nigra (3). Hoarseness, with deep, hollow cough ; oppression at the chest; frequent yawning ; restless- ness, and thirst. Chamomilla (3). Hoarseness, with accumulation of mucus in the throat; cough worse at night, continuing even during sleep, and frequently with a degree of fever towards evening, and great irritability of temper. This remedy is frequently found specific in cases of children. Drosera (30). Hoarseness, with very low, or deep and hollow voice. Carbo vegetabilis (30). Chronic hoarseness, worse in the morning and towards evening, with aggravation after talk- ing. Sulphur (30). Hoarseness, attended with roughness and scraping in the throat; and of great value in obstinate cases, where the voice is low, and nearly extinct; particularly in cold damp weather. (Sulphur is especially useful after Puis.) Hepar sulphuris (3). An admirable remedy in chronic hoarseness, particularly in individuals who have taken large quantities of mercurial preparations ; otherwise Causticum is equally useful.* * Sulph. calcarea and Silicea are most useful remedies in obstinate hoarseness attended with coryza. HOARSENESS. • 193 Administration of the Remedies* Dissolve four glo- bules, at the potencies mentioned, in four dessert-spoonfuls of water, and exhibit one, morning and evening, for two days; or, in some cases, continue for three ; being guided by the re- sult. Of Hepar sulphuris, half a grain, in the same manner. When we find individuals in whom this affection occurs frequently at different seasons, or on the slightest exposure to cold or damp, we may naturally infer that there is a constitu- tional predisposition to chronic laryngitis, a malady requiring a judicious treatment by an experienced practitioner, as, if neglected, it may eventually end in Chronic Laryngitis. Phthisis Laryngea. This is a comparatively rare disease, and, when present, there is gene- rally a degree of ulceration. The following are its principal contents : pain in the larynx, and round the glottis ; pain and difficulty in swallowing'; hoarseness, and difficulty of respira- tion ; frequent attacks of severe cough, with scanty and oc- casionally 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 sulphuris, Lachesis, Phosphorus, Carbo vegetabilis, Causticum, Acidum nitricum, Calcarea carbonica, Arsenicum, and Spongia. Aconite with Spongia, and Hepar sulphuris, and frequently also Lachesis, are the most useful remedies in this disease in the acute form. (See also Croup.) 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. Diagnosis. This affection is a very general attendant upon Catarrh. Therapeutics. When it is the leading symptom, or ex- * See note, p. 21. 17 194 RESPIRATORY SYSTEM. ists independently of those already mentioned, the best me- dicines for expediting its removal are Nux vomica, Euphrasia, Pulsatilla, Chamomilla, Mercurius, Hepar sulphuris, Belladon- na, Ammonium, Natrum, and Arsenicum, Lachesis, Silicea, tyc. Administration. Three globules of the potencies named, to be dissolved in four teaspoonfuls of water, one to be taken morning and evening, unless otherwise specified.* Nux vomica. Dry obstruction, especially, during night only, with pressive heaviness in the forehead, and confusion in the head ; heat in the face, increasing towards evening. If in combination with other catarrhal symptoms, see the indica- tions already given for its exhibition under the several heads of Catarrh, Hoarseness, and Cough. This direction equally applies to the other medicaments here quoted. Administration. Two globules of the sixth potency, to be dissolved in a teaspoonful of water, and taken towards bed- time ; to be repeated the second day following ; but should an alteration in the symptoms have taken place without any cor- responding improvement, another remedy must be selected. Lycopodium (12) will often be found efficacious after Nux v., in obstinate cases of stuffing of the nose, particularly at night, rendering it necessary to sleep with the mouth open, which causes a disagreeable dryness without much thirst, confusion in the head, and burning pain in the forehead. This remedy is frequently more or less useful in colds in the head of all kinds. Administration, same as Nux v. Pulsatilla (6). The discharge thick, fetid, greenish yel- low, or mixed with clots of blood; loss of taste and smell, head- aches, sneezing, chill, especially towards evening ; disposition to weep, lowness of spirits, heaviness or confusion of the head in a warm room. Chamomilla (6). The affection having risen from checked perspiration, acrid discharge from the nose, causing redness of the nostrils, and excoriation or soreness under the nose ; chapped lips ; shivering, with thirst. Mercurius (6). Dryness of the nose, with obstruction ; • Vide note p. 21. COLD IN THE HEAD. J 95 profuse discharge, producing excoriation, swelling or redness of the nose, pains in the head and face. This is a valuable re- medy in the generality of ordinary cases of cold in the head, and particularly when the complaint is, as it were, epidemic* Hepar sulphuris (6). Chiefly when only one nostril is affected, or when headache is experienced, or the complaint renewed on each exposure to cold air; further, in most cases in which Mercurius, though apparently indicated, has pro- duced little or no improvement. Belladonna (6) may follow the above, if required, but especially when the sense of smelling becomes variously af- fected, being at one time too acute, and another too dull. Ammonium. Stuffing at the nose, especially at night; swelling and painful sensibility of the nostrils ; dryness of the nose. Natrum. Cold in the head, renewed by the slightest chill, or exposure to a current of air; stuffing of the nose every sec- ond day. « Lachesis. Swelling and soreness of the nose and nostrils, with copious watery secretion. Arsenicum (6). Obstruction of the nose, with, at the same time, discharge of thin, acrid, excoriating mucus, and burning heat in the nostrils, &c. Suffering relieved by heat; pain in the back, feeling of general debility, or prostration of strength. Dulcamara 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. Silicea is often an excellent remedy in all cases which are of frequent recurrence, and always of a most obstinate char- acter. Camphor. In the premonitory stage of the complaint, with shivering and headache, the attack may frequently be checked by a drop or two of spirits of weak camphor. Sulphur, Calcarea, Graphitis, Silicea, Natrum, and Pulsatilla are the best remedies for removing extreme susceptibility to * When the secretion from the nose is excessive, and there is at the same time, confusion in the head with redness and soreness of the eyes and eyelids and copious acrid or scalding lachrymation, Euphrasia should be prescribed. 196 respiratory system. colds in the head.* Against the effects of a suddenly sup- pressed catarrh, the following are the most important remedies : Aconite against headache, followed by Pulsatilla, and then Cinchona, if the secretion does not return ; difficulty of breath- ing, Ipecacuanha, followed if required, by Bryonia and Sul- phur ; against hoarseness, cough, or disease in the respiratory organs, arising from a similar cause, see the remedies men- tioned under these different heads. COUGH. Diagnosis. Forced and audible respiration without fever ; or a symptom in acute diseases, such as fever, pneumonia, or phthisis ; either dry or accompanied with expectoration. Cough, although not dangerous of itself, may become so, or form an important feature of other diseases. As a precursor of phthisis it is too often neglected. It may arise from an'irritation of the air-passages or lungs ; from cold or other causes, or from disease of the same organs, or be merely sympathetic or the consequence of derangements or other important viscera. Therapeutics. The following are the medicines most use- ful in this affection : Aconitum, Dulcamara, Belladonna, Nux vomica, Pulsatilla, Ammonium carbonicum, Ammonium muri- aticum, Chamomilla, Hepar sulphuris, Ignatia, Ipecacuanha, Mercurius, Carbo vegetabilis, Capsicum, Bryonia, Rhus toxi- codendron, Arsenicum album, Drosera, Silicea, Lachesis, Caus- ticum, Sulphur, Calcarea carbonica, Euphrasia, Sepia, Slan- num, Verbascum, Arnica montana, and Squilla, Sic. Aconitum. Violent short cough, with quick hard pulse and feverish heat; pricking in the chest when coughing, or during inspiration. • In other cases this desirable result may be attained by the adminis- tration of Mercurius, Hepar s. and Belladonna, on each successive attack (when the symptoms resemble those which have been described under these remedies)—and failing these, Silicea, Sulphur, and Calcarea ; and the other remedies mentioned above as useful in removing this suscepti- bility must be had recourse to. COUGH. 197 Dulcamara ^. The following are indications for the selection of this remedy : moist cough after exposure to wet or cough with expectoration of hright-coloured blood ; aggra- vation of the cough on movement or when out of doors ; alle- viation in the recumbent posture or when within doors. Belladonna °£°. Short, dry, barking, (spasmodic catar- rhal, or nervous) cough at night in bed, and also during sleep, renewed by the slightest movement; dry cough day and night, with irritation or tickling in the 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 al- lows time for respiration. Finally, this medicine is sometimes useful in cough with rattling of mucus in the chest, pricking in the sternum or in the hypochondria, and expectoration of thick white mucus, coming on especially after meals ; hoarse- ness, redness of the face, headache, sneezing after coughing, and pain in the nape of the neck.* Nux vomica ^-§-. This is a valuable remedy in many cases either of catarrhal or nervous character, and is particu- larly efficacious w'here there is a dry, hoarse, fatiguing, and sometimes spasmodic cough, which occurs in an aggravated form in the morning, and occasionally also towards evening, and attacks more or less during the day, but relaxes again at night. When, however, it is occasionally supplanted by op- pression at the chest, on lying down or 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 little mucus which is detached with great difficulty. The cough is generally excited by a disagreeable tickling or scraping, with a feeling of roughness or rawness in the throat, sometimes attended with hoarseness and feeling of roughness in the chest, but more frequently with severe headache, or pain as if from a blow or bruise in the epigastrium and hypochondria; it is frequently aggravated after meals, or by movement, not un- " Hyoscyamus frequently answers when Belladonna has only afforded partial relief, and may be preferred to the latter, when the nocturnal cough is mitigated for the time by sitting up in bed ; also when there is mucus rattling in the throat. 17* 198 respiratory system. frequently also by reading or meditation, and is occasionally followed by vomiting. Pulsatilla fl^. Severe shaking, catarrhal or nervous spasmodic cough, worse towards evening and at night, fre- quently followed by vomiting ; sensation of suffocation, as if from the vapour of sulphur; increase of cough when in the recumbent posture ; cough which is at first dry, then followed by copious expectoration of yellowish or whitish mucus, some- times of a salt or bitter taste ; or expectoration of mucus streaked with blood ; wheezing or rattling of mucus in tho chest; the paroxysms of coughing are frequently accompanied with soreness in the abdomen, as if from a bruise or blow, or painful shocks in the arms, shoulders, or back, and some- times followed by a sensation as if the stomach became in- verted from the violence of the cough ; involuntary emission of urine when coughing ; loose cough, with aching in the chest, hoarseness, cold in the head ; excited by a sensation of scraping or of erosion in the throat; shivering. Ammonium carbonicum a££. Dry, tickling cough, some times with fever, occurring during the prevalence of a cold, stormy, bleak state of the atmosphere, and attended with a sensation of heat or burning behind the sternum, resembling that which is occasioned by drinking spirits ; roughness of the voice. Ammonium muriaticum s-^s-. This remedy is sometimes serviceable after the former when the cough sounds looser, yet is unattended with expectoration. Chamomilla. Dry cough, excited by continual tickling or irritation in the larynx and chest, and increased by talking ; the cough is most troublesome during the night, but also occurs during the day, particularly in the mOrning and towards even- ing ; accumulation of tenacious mucus in the throat ; wheez- ing in the chest; cough during sleep, sometimes accompanied with paroxysms, as of threatening suffocation ; cough with scanty expectoration of tenacious bitter mucus. This medi- cine is well adapted to the treatment of coughs in children ac- companied with more or less of the symptoms above describ- ed, or with hoarseness, cold in the head, dryness in the throat COUGH. 199 and thirst; great fretfulness ; fever towards evening ; parox- ysms of coughing after crying, or after a fit of passion. Hepar sulphuris s^3-. Obstinate cases of violent dry hoarse cough, sometimes attended with a dread of suffocation, and ending in lachrymation. The attacks are frequently ex- cited or aggravated on any part of the body being exposed or becoming cold from the bed-clothes slipping off, and are gen- erally worse at night; also dry deep cough excited by a feel- ing of tightness in the chest, or by talking, stooping, or as- cending stairs ; hoarseness. Ignatia -f^. Shaking spasmodic cough, or short hacking cough, as if arising from the presence of dust or feather-down in the throat, which becomes aggravated the longer the pa- roxysms of coughing continues ; dry cough with coryza, oc- curring both day and night. This remedy is further particu- larly efficacious when the attacks of coughing become aggra- vated after eating, or on lying down at night, or on rising in the mornings and when the sufferer is of a mild and placid temper, or subject to alternations of high and low spirits. Ipecacuanha ™-. 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 dry cough, arising from tickling in the throat; or severe, shaking, spasmodic cough, with oppressed breathing, almost amounting to suffocation. In the case of children this remedy is frequently valuable when they appear to be threatened with suffocation from the accumulation of mucus, or where the paroxysm is so severe as scarcely to afford time for respiration, causing the face to assume a livid hue, and the frame to become quite rigid. (Calc. is often useful after Ipec.) Mercurius -$-. Catarrhal cough, with hoarseness, watery coryza, or with diarrhoea ; or dry cough, 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 sneezing ; excited or increased by talking; cough in children with discharge of blood from the nose, which coagulates as it 200 respiratory system. flows, vomiturition, and headache ; dry spasmodic cough, with retching after the paroxysms, and expectoration of blood. Carbo vegetabilis b^l. Hollow cough excited by irri- tation, or a troublesome sensation of crawling in the throat, and attended with burning pain, and sensation as if from exco- riation in the chest: catarrhal or nervous spasmodic cough, frequently followed by inclination to vomit or vomiting, occur- ring in paroxysms throughout the day : cough with hoarseness, especially towards evening, or morning and evening, increas- ed by speaking. Chronic cough with expectoration of green- ish mucus, or even of yellowish pus—or with expectoration of blood and burning sensations in the chest (a characteristic indication for this remedy as well as Arsenicum.) Capsicum s-^. This remedy is frequently very efficacious in cases of cough occurring in individuals of the lymphatic temperament. It is particularly indicated when the paroxysms are more severe towards evening and at night, frequently at- tended with unsettled pains in various parts of the body, and bursting headache; also painful pressure and aching in the throat and ears ; cough with offensive breath, and disagree- able taste in the mouth. Bryonia sg8-. Catarrhal cough occurring in winter during the prevalence of frost and cold easterly winds, with aggra- vation of the fits of coughing on coming from the opon air into a warm room. The following are the general indications for * its employment: Dry cough excited by constant irritation in the throat, or as if caused by vapour in the larynx and wind- pipe, with greatly accelerated respiration, as if it were impos- sible to obtain sufficient air ; spasmodic, suffocating cough, after partaking of food or drinks, and also after midnight; cough with prickings in the chest, and violent bursting head- ache, especially at the temples, also with prickings in the pit of the stomach, or in the side : further, in loose cough with yellowish expectoration or slight spitting of blood, this remedy will frequently be found of great service; dry ner- vous cough. Rhus toxicodendron £§&. Short, dry cough, worse to- wards evening and before midnight, excited by tickling in the cough. 201 chest, attended with anxiety and shortness of breath; cough on waking in the morning, or short cough with bitter taste in the mouth, on lying down at night and on waking in the morn- ing. Cough with expectoration of bright blood, with sensa- tion of insipidity or exhaustion in the chest, or shooting pains in the chest and sides. Arsenicum ^, cough with oppression at the chest, and tenacious mucus in the larynx and chest; cough excited by a sensation of dryness and burning in the larynx. Dry cough, chiefly in the evening after lying down, often with difficult res- piration and fear of suffocation, as if arising from inhaling the vapour of sulphur; dry cough, excited by eating or drinking, or by ascending stairs, or cough which arises as soon as the open air is encountered ; thin acrid coryza ; sneezing ; periodic dry cough —nocturnal cough with general burning heat; cough with expectoration of sanguineous mucus. Drosera £££, in many cases of chronic cough with hoarse- ness ; or deep, hollow cough, with pain in the chest and under the ribs, alleviated by pressing the hand on the side, excited or aggravated by laughing ; cough on lying down in the even- ing and during the night. Matutinal cough, with bitter and nauseous expectoration; dry, spasmodic cough, aggravated at night, or towards evening, and frequently followed by vomiting of ingesta, or bleeding from the nose and mouth. Silicea $f. Cough with oppressed breathing on lying on the back, or cough attended with tightness and oppression at the chest as if something stopped the respiration while speak- ing or coughing. Fatiguing, or deep hollow cough, day and night, aggravated by movement or speaking, and sometimes attended with aching and pain as if from a bruise in the chest; cough with copious expectoration of transparent mucus, or of pus, sometimes streaked with blood ; cough with asthmatic breathing and emaciation, with dread of suffocation at night. Lachesis ^. Fatiguing cough excited by dryness or con- tinual tickling in the larynx or chest ; or by pain or tickling in the pit of the stomach or the epigastrium ; also by the slightest pressure on the exterior of the throat; cough excited by talking, laughing, or reading aloud, or anything which may 202 respiratory system. tend to increase the dryness or irritation in the throat; short, dry, suffocating cough, as if caused by the presence of a crumb of bread sticking in the throat, with ineffectual efforts to ex- pectorate. Cough on rising from the recumbent posture, or attacks of cough always after sleeping, or on lying down to sleep; cough also during the day, or also at night during sleep, so that the patient is unconscious of it; continual hoarseness, with a sensation as if something were in the throat which could not be detached. Causticum -§". Dry, hollow cough, which even awakes one from sleep ; short cough excited by tickling, crawling, or a feeling as if the throat were excoriated, or by talking and cold, attended at times with burning or a sensation of soreness in the chest, and rattling of mucus ; pain in the hip, and oc- casionally involuntary discharge of urine when coughing. Sulphur fiffi. In some cases of chronic coughs, and par- ticularly in dry cough, which disturbs the patient at night as well as during the day ; the cough is frequently excited after partaking of food, or during a deep inspiration, and is gener- ally attended with a sensation of spasmodic constriction in the chest, sometimes followed by inclination to vomit, or involun- tary escape of urine, or pain as if from excoriation, or prick- ing pains in the chest; headache, pains in the chest, the ab- domen, loins and hips ; also cough, with expectoration of thick, whitish or yellowish mucus, or of a greenish yellow, fetid mucus, or pus, of a salt or sweetish taste ; feverish cough with spitting of blood. Calcarea carbonica-^. Dry cough, aggravated towards evening, or at night, excited by tickling in the throat, or by a sensation as if there were a feather down in the throat ; also, loose cough, with rattling of mucus in the chest, and expec- toration of offensive thick, yellow mucus; anxiety. Euphrasia fi^a. Cough, with violent coryza and lachry- mation ; diurnal cough, with difficult expectoration of mucus ; or matutinal cough, with copious expectoration, and oppressed breathing. Sepia-&■. Cough, with copious expectoration of mucus of a saltish taste, of a yellow or greenish colour ; also dry COUGH. 203 spasmodic 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 constitutional taint, such as the scrofulous, scorbutic, Sic; in chronic coughs, with thick, yel- lowish, greenish, or even puriform expectoration, with a putrid taste, it is a valuable remedy. Stannum ^fa. Cough, with copious expectoration of a greenish yellow, of a sweetish or saltish taste, attended with great weakness and disposition to sweats; or dry shaking cough, worse at nignt or towards morning, excited, or aggra- vated by speaking or laughing, and occasionally followed by vomiting of ingesta. Cinchona. Paroxysms of cough as if excited by the va- pour 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. Verbascum flfa. This remedy is frequently of great ser- vice in children, though less frequently so than Chamomilla. Indications : dry, hoarse cough, worse towards evening and at night: occurring during sleep. Iodium (3). Cough in plethoric children, with copious ac- cumulation of mucus in the bronchi, and ineffectual efforts to expectorate. Phosphorus. 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 excoriation; cough with hoarseness, fever and depression of spirits, sometimes with apprehensions of death ; dry sounding cough, followed by expectoration of viscous or sanguineous mucus. Arnica ^g^ is of great value in coughs, attended with bleeding from the nose and mouth : headache, pricking in the chest (pleurodynia), rheumatic pains in the loins and extremi- ties, and soreness or pain, as from a bruise in the chest and abdomen. 204 RESPIRATORY SYSTEM. Squilla. In short dry cough, excited by a full inspiration, or chronic cough, or catarrh with copious secretion of whit- ish viscous mucus, which is alternately expectorated with ease and difficulty, this remedy is useful. Administration of the remedies. The dose mentioned after each medicine in a teaspoonful of water, repeated in from twenty-four to forty-eight hours, as required ; in severe cases, six or eight globules in an ounce of water, a dessert- spoonful every three or four hours.* These are the principal remedies to be had recourse to in this disordor ; but in complicated cases we may have to call in the aid of other medicaments. In some obstinate, nervous coughs, occurring in highly irritable, nervous, and hysterical habits, which are generally dry, or attended with scanty and difficult expectoration, consisting of a little clear mucus, change of air will frequently readily effect a cure. For cough arising from Worms, see the remedies mentioned under that heading ; or from teething, see Dentition. Stomach coughs, or coughs occurring in women during the last months of preg- nancy, are to be relieved by the remedies mentioned under Dyspepsia, Unmedicated jujubes, or sugar candy may be allowed occasionally, to moisten the throat or mouth, in cases 0f dry irritating coughs. HOOPING-COUGH. Tussis Convulsiva. Pertussis. This is almost peculiarly a disease of childhood, and one which few individuals escape during that period ; it generally appears as an epidemic ; and is, by the majority of physiologists, acknowledged to be communicable by contagion ; we seldom find an instance of a person suffering a second time from its attacks. Over many the affection passes lightly, but in the majority of cases it proves a distressing, and in some a fatal malady baffling all the ill-directed efforts of the allopathic physician to conduct it to a favorable termination. Under the old practice, not only was a great deal of valuable * Vide note, page 21. hooping-cough. 205 time lost in endeavouring to subdue inflammation by antiphlo- gistic measures, but the patient's vital energies were weakened and rendered less capable of contending with the disease, when it assumed the spasmodic type. On the contrary, we have it in our power, by the adminis- tration of remedies specific to the affection, to check the in- flammation at its outset, subdue the other distressing attendant symptoms, and shorten the duration of the complaint, without allowing it to leave after it any of those evil consequences, such as debility and emaciation, which oblige the patient to endure a tedious and protracted period of convalescence. Diagnosis. Paroxysms of violent and convulsive expira- tions, in rapid succession, interrupted by long whistling in- spirations, and in young subjects a loud shrill whoop, termi- nate^ by the expectoration of a quantity of mucus, or a fit of vomiting, after which the attack ceases for some time. If the case is severe, the features swell and become livid ; blood escapes from the nose, mouth, and even from the ears. A com- plete cessation of respiration and almost suffocation takes place as if from spasm of the lungs, which lasts for minutes. The at- tacks return every three or four hours, more frequently in severe cases ; the least excitement brings them on ; they are more frequent and violent at night. Respiration is free during the intervals, and the patient in every respect healthy, except being weak. Pathologists generally consider this disease under three stages ; the distinction between the second and third is, how- ever, not often very clearly marked. The first or febrile stage commences with the symptoms of an ordinary catarrh, attended with slight fever, which gra- dually increases, the breathing becomes more difficult, and is accompanied with irritative cough and pains in the chest. In the second or convulsive stage* the febrile activity dis- appears, and the characteristic cough and other symptoms of the disease develop themselves. In the third or nervous stage there are longer intermissions * The congestive and nervous of some authors. 18 206 RESPIRATORY SYSTEM. between the paroxysms, but increased weakness from the du- ration of the cough. Therapeutics. In the incipient, febrile, irritative, or ca- tarrhal stage of the cough, the most appropriate remedies arc to be found amongst those we have already pointed out in the treatment of Common Cough, and must be selected according to the indications there given, and administered in the same manner unless otherwise specified. By a careful selection of these remedies it is frequently possible to check the disorder in the first stage. Accordingly the most suitable medicaments for this purpose are Dulcamara, Pulsatilla, Mercurius, Bella- donna, Hepar sulphuris, Chamomilla, Nux vomica, Arnica, Ipecacuanha, Aconite, Bryonia, and Phosphorus. Administration. See Cough, page 204. Dulcamara s^3-. When the attack has apparently been excited by exposure to wet (a thorough wetting,) the cough loose, with copious and easy expectoration. Pulsatilla Aga. Cough loose, and accompanied with la- chrymation, weakness of the eyes, sneezing, thick discoloured coryza and slight hoarseness, and inclination to vomit after coughing ; occasional diarrhoea, especially at night. Mercurius q^3-. Hoarseness, watery coryza, with sore- ness of the nostrils : dry fatiguing cough, generally occurring in two successive fits. Belladonna ^§£, is one of the most important remedies in the catarrhal stage of hooping-cough, when there is dry, hol- low, or harsh and barking cough occasionally at night, or which becomes materially aggravated at that period. This medicine is also particularly well adapted to the angina or sore throat, which is not unfrequently concomitant at the com- mencement of the affection. Hepar sulphuris. Cough worse at night, but looser than that indicating Belladonna. This medicine is also useful in forwarding the secretory process. Administration. Half a grain of the trituration, at the third potency, to half an ounce of water, a dessert-spoonful twice a day. hooping-cough. 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. The paroxysms of coughing are excited by an almost incessant irritation of the larynx, and in the upper part of the chest. Nux vomica £§£, is of greater service when the cough ap- proaches the second stage. It is indicated by the following symptoms : Dry, fatiguing cough, attended with vomiting, and occurring particularly from about midnight until morning, the paroxysms so protracted and violent as to produce appa- rent danger of suffocation, with blueness of the face, and oc- casionally bleeding from the mouth and nose. (Arnica is better adapted to this latter symptom when it occurs with a copious discharge of blood.) Ipecacuanha &%& is, like the former, of great value when the cough is attended with danger of suffocation, and each in- spiration appears to excite a fresh fit of coughing. It is fur- ther indicated when the fits are attended with spasmodic stiff- ness of the body, and blueness of the face, great anxiety, and accumulation of mucus in the chest. Aconite £g° may be had recourse to from time to time, when marked febrile or inflammatory symptoms are present, bearing in mind that its action is of short duration, and may be followed in a few hours by any other of the remedies which appear more particularly indicated. The last mentioned remedy, Bryonia and Phosphorus, are chiefly called for when the cough threatens to become associ- ated with inflammatory action in the lungs, &c. Second or Convulsve Stage.—Therapeutics. Drosera, Veratrum album, Cuprum aceticum, Arnica, Ferrum metalli- cum, and Coniummaculatum* Drosera is one of the principal remedies in the treatment of the disease when it has reached this stage ; and in cases • Acidum hydrocyanicum. In some cases we have had satisfactory results from the use of this acid. It is most indicated when the cough ia violent, concussive, attended by rattling of mucus, suffocating respira- tion and ejection of blood from the mouth and nose.—Ed. 208 respiratory system. where the constitution has not been enfeebled by the transmis- sion of hereditary weakness or other causes, it will speedily declare its beneficial effects, and materially shorten this trying and painful period of the disorder. The particular indications for the use of this medicine are, violent paroxysms of cough, occurring in such rapid succession, as to threaten suffocation, and attended with the characteristic shrill sound during in- spiration, and sometimes fever ; after each fit of coughing, vomiting of food, or of stringy mucus ; relief on moving about. Administration. —<£", in six teaspoonfuls of water, a teaspoonful after each severe paroxysm of coughing.* Veratrum album is indicated when the child has become reduced in strength and emaciated; or when it suffers from cold sweats, particularly on the forehead, with excessive thirst, in- voluntary emission of urine, vomiting, and other symptoms com- mon to this stage ; also pain in chest and inguinal region ; slow fever.f Administration. The same as Drosera. Cuprum aceticum. This has been found most useful in the nervous stage, particularly when convulsions with loss of consciousness ensue after each paroxysm. Also when we find vomiting after the attacks, and rattling of mucus in the chest, and wheezing at all times. In almost all cases a marked benefit has followed the employment of this remedy ; some- times it has been found sufficient of itself to cut short the dis- ease, and in others, has so far modified it that other remedies which had before seemed to fail, have after its exhibition acted with the most marked effect, and completed the cure.| Administration. According to the formula already given in Scarlet Fever, a dessert-spoonful after each paroxysm. ' Vide note, p. 21. t Carbo. vegetabilis is frequently useful in bringing this stage of the affection to an early and successful termination after the previous use of Veratrum or Drosera, or both of these important remedies ; particularly when, notwithstanding the decrease of cough, the tendency to vomit still remains. (See also Ferrum.) X Cina is also a useful remedy when there are convulsions, or tetanic rigidity of the whole body daring or immediately after the fits of cough- ing particularly in children affected with worms. hooping-cough. 209 Arnica is useful as an intermediate medicine when the epistaxis or hemorrhage from the mouth is considerable ; and also in the affection itself when each paroxysm is succeeded by crying. (Hepar s. is also useful when the latter symptom follow a hoarse dry cough.) Administration. In cases of hemorrhage a drop of the tincture, at the second potency, and repeated after the next paroxysm if necessary. When indicated by the nature of the attack B-S^s-, in six teaspoonfuls of water, one after each par- oxysm. Ferrum metallicum. This remedy will be found very useful as an intermediate when there is invariably vomiting of food on coughing soon after a meal. Administration. A small quantity, say about a quarter of a grain of the third trituration in a dessert-spoonful of water once in twenty-four hours. Conium. When the paroxysms occur particularly at night, and with great severity. Administration. A globule of any potency, from the ninth to the thirtieth, in a teaspoonful of water, night and morning. Third or Nervous Stage.—Therapeutics. The same medicines as have already been given according to the indi- cations that present themselves. On the suppression of all the more serious symptoms, the remedies which have been recommended in the first stage are also useful in removing any catarrhal cough which may remain behind. Change of air is likwise beneficial.* Diet. The diet must be light and of easy digestion ; bread- pudding, semolino, and other light puddings of this description, provided the fever be not high, in which case, weak gruel, barley-water, and the like, must alone be allowed; when the more serious symptoms have been subdued, or in all mild cases, a little chicken-broth, or beef-tea, may be given ; and so on, gradually increasing the amount of nutriment as the disease declines. The drinks to consist of toast-water or barley water. * In neglect or obstinate cases occurring in delicate constitutions, Sulphuris Tinctura and Sepia have been found useful. See also the re- medies for coughs of a bad character under the head of cough. 18* 210 RESPIRATORY SYSTEM. CROUP. Angina Membranacea. Angina perniciosa. Cynanche laryngea. Cynanche tracheitis. s. trachealis, eye. a dessert-spoonful every six, twelve, or twenty-four hours, ac- cording to the emergency of the case. In some cases Cinchona, Rhus toxicodendron, Pulsatilla* and Silicea may be found serviceable in completing the cure after Arsenicum. CHILBLAINS. Perniones. This affection is too well known to require any particular description; the exciting cause is exposure to transitions of •Vide note, p. 21. 286 CUTANEOUS DISEASES. temperature, from cold to heat, and vice versa, but their origin is more deeply seated ; the feet are the part most generally attacked, 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 consti- tutional 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 following medicines will be found valuable : Nux vomica, Pulsatilla, Belladonna, Arnica, Chamomilla, Arsenicum and Sulphur. Nux vomica -g is particularly indicated when the inflam- mation is of a bright red colour, with swelling, attended with itching, 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 suffering comes on, or is exacerbated in the evening or towards midnight. (Sulphur is often very useful after Pulsatilla.) Belladonna -j-j, 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 z* when the swelling is hard, shining, and painful, attended with itching. Chamomilla 7, when with the inflammation and itching, a burning sensation is present, followed by Arsenicum T5, when the pains are excessively violent, at- tended with severe liuming, or when the chilblain bursts, and becomes converted into an irritable sore, with a tendency to fester. Arsenicum may in some such cases be advantageously alternated with Carbo vegetabilis ^r. * The Homceopathic or Arnica Crout plaster, of sufficient size to cover the ahilblain, is frequently of great service in mitigating the suffering.—Ed. corns. 287 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 globules at the potency given after each medicine, repeated every three days, if necessary, until benefit results, or some other remedy becomes indicated. 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 cornutum. 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 be- ing 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 Chil- blains,) Phosphorus* Rhus, Bryonia, and Ammonium Carboni- cum, Lycopodium, Petroleum, Sepia, Acidum phosphoricum, and Sulphur, will be found useful. Great alleviation of suf- fering has, however, been found to result from bathing the feet in warm water, and then applying a very weak Arnica\ lotion (a drop or two of the tincture to an ounce of water,) after hav- ing 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 envelope the affected parts in a pieee of linen which has been dipped in the lotion t The Arnica plaster may be applied to corns as to chilblains, and will often afford the greatest relief to those corns yclept soft.—Ed. 288 cutaneous diseases. While upon this subject it may be remarked that Nux vomica has been found serviceable in cases of 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 TUMORS AND DISEASE OF THE CONGLOBATE GLANDS. 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 rigors 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 cuta- neous surface ; over this spot the skin assumes a redish 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 •welling. 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 into 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 unmedicated fomentations, and forward the suppurative process by the administration of Hepar sul. 2, 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- quently 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 blueish 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 * Carbo 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 as induration, even after the opening of the abscess. 25 290 CUTANEOUS DISEASES. treatment is generally more easily conducted, and the healing of the cavity more speedily effected, when the matter has been evacuated by the aid of the appropriate medicine, instead of the lancet. In chronic abscesses, it has usually been found most benefi- cial to make an outlet for the matter as early as possible, to 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 the bursting of the abscess. The opening should he 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 tho 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 Conolobate Glands situate in the neck, under the chin, and behind the ears, such as is usually met with in scrofulous habits,—Mercurius and Dulcamara are two of the most important remedies.•(■ When * Graphites, Silicea, Hspar s., and Sulphur, Causticum, Baryta c, Carbo v.. Acidum nitricum, Lath-sis, 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, Caibo. a. et v., Hepar s., Sulphur, (Jr/l- careei, and S licea ; as also Kali c, Lycoporlium, Indium, Aculum nitri- cum, Bovista,or Belladonna, etc. are remedies of great utility, and musl be selected according to the general features of the case, when Mercurius and Dulcamara are found insufficient to discuss the swelling, etc. ITCH. 291 suppuration or ulceration ensues, Hepar sulphuris, Lachesis, and Silicea are more useful. These latter particularly Hepar sul. and Silicea, together with Sulphur and Calcarea, 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 are 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, and we are hence, fre- quently under the necessity of having recourse to Mercurius, 292 CUTANEOUS DISEASES. Carbo v., Hepar s., Causticum, Sepia, Veratrum, Lycopod., etc. as follows : Mercurius. when the eruption is accompanied by intolerable itching, especially on becoming warm in bed ; looks dry and cracking, but consists of minute vesicles re- sembling papillae, when not narrowly examined, which are slightly inflamed and bleed easily when scratched (scabies papulifurmis.) These little' elevations or vesicles are some- times intermixed with pustules, which on breaking form scabs. It is sometimes necessary to administer Sulphur in alternation with Mercurius, in this form of the complaint, at intervals of four or five days until an improvement or change in the symp- toms results :— 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 papuhn-looking form, and Mercurius alone has previously been administered, Hepar 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, however, 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 the pustular or humid variety (scabies purulent a), 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 axilla?, and near the knee- and elbow-joints,—Sulphur, as has been already stated, is the principal remedy ; considerable benefit will neverthe- less be obtained by giving Lycopejdium 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, Ca-sticurn must be exhibited at short inter- vals for three or four successive times, lengthening the inter- vals 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 blueish colour, Lachesis 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, Creosote 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 pow- erful external applications. WHITLOW. Paronychia. "'Panaris- By this term is understood an abscess more or less deep- ly 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 : Mercurius, Hepar Sulphuris, Rhus, Sulphur, and Silicea. Therapeutics. We may generally commence the treat- ment by Mercurius. 25* 294 CUTANEOUS DISEASES. Administration -0A, 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 Hepar s* Rhus is more particularly indicated when there is a consi- derable degree of erysipelatous inflammation. Administration -3'-, in the same manner as Mercurius. Lachesis. In cases where the affected part is of a dark red or blueish 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 sore form on the affected finger.t But we must have recourse to the alternate administration of Sulphur jj{}, and Silicea £§, at intervals of eight days each, in cases where a constant tendency to a recurrence of the complaint exists.:(: These remedies, particularly tho 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. The 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 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 in 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, and evacuation is not speedily obtained, the lancet must be em- ployed. t Hering's Hausarzt. t 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, Nux vomica, or Arsenicum album. 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 Pulsatilla proves insufficient; also in cases when the parts affected bleed readily after scratching. (Sul- phur is sometimes useful every four or five days, in alternation with Mercurius, in such cases.) Rhus toxicodendron. 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, Sic may be called for in particular cases. Opium is often useful in the case of old people. In Prurigo scroti, Sulphur, Acidum nitricum, Dulcamara, and Rhododendron have chiefly been recommended.—Prurigo pudendi: Sulphur, Sepia, Conium, Calcarea, Natrum m., and Sulphur.__P. ani : Sepia, Acidum nitricum, Thuja, Mercurius, Sulphur, as also Kali c, Baryta c, and Zincum. Administration 4&a, in four dessert-spoonfuls of water, 296 CUTANEOUS DISEA8ES. one daily ; to be repeated, if necessary.* Of Mercurius and Rhus toxicodendron we may substitute the sixth for the thir- tieth potency. RINGWORM (HERPETIC OR VESICULAR.) Herpes circinnatus. This affection generally occurs in children. It has been considered contagious from the circumstance of several chil- dren of one family, or at the same school, being sometimes attacked at the same time ; but there is every reason to be- lieve that this opinion is erroneous, from the circumstance of none of the other species of herpes being communicable by contact. When not complicated with another disease, it is not attended with any general constitutional derangement. The disorder is characterized by an eruption of small rings or circular bands, the vesicles only occupying the circumfer- ence ; 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 discharge, when little brown- ish scabs form over them. The portions of skin within the circlets are usually healthy at first; but for the most part sub- sequently 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 the 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 eruptioni or should there be any indications of the formation of fresh rings. •Vide note, 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. Favus 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 continuance,—indeed there are a 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 extremi- ties ; when confined to the trunk, it proves by no means so obstinate 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. 298 CUTANEOUS DI8EASES. adjacent patches, and assume an extensive and irregular ap- pearance, but commonly retain a somewhat circular shape. These incrustations become thick and hard by accumulation, and are detached from time to time in small pieces which bear a close resemblance to crumbling mortar. W hen the scabs are removed, the surface is left red and glossy, but studded with slightly elevated pimples, in some of which minute glo- bules of matter 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 scabbing is repeated, it is thrown out by the roots, and finally there remains only a narrow chaplet of hair round the head. If the hair follicles are destroyed, the baldness remains per- manent. Causes. The disease appears to originate spontaneously in children of scrofulous, flabby, or feeble and emaciated habit, if they be ill-fed, ill-lodged, uncleanly, and not suffici- ently exercised ; but it is chiefly propagated by contagion. Thkrapkutics. It cannot be denied that, even under homoeopathic treatment, the disease frequently proves ex- tremely obstinate ; but in many cases the difficulty experienced in effecting a cure arises from the previous treatment which the patient has undergone, or from the culpable conduct on the part of the parents or others in having allowed the disorder to pursue its course for a lengthened period, unchecked and utterly neglected, ere proper assistance is sought. The following are the principal remedies employed in the homceopathic treatment. Rhus, Arsenicum, Staphysagria, Hepar s., Lycopodium, Dul- camara, Bryonia, Phosphorus, Graphites, Baryta c, Calcarea, Oleander, Sulphur, Sic. 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 favorable prog- ress is made, or if, on the contrary, the affection becomes rather worse, and the exudation takes on an acrimonious char- acter, 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 exter- nally also with good effect, by dissolving a few globules of the remedy used in 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 following 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 DISEASES. tion and tenderness of the said glands ,) after which Staphy- sagria 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 Olmndtr must be ad- ministered according to circumstances. In some cases, 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 humidor moist-looking eruption: Staphysagria, Rhus, Arsenicum, Lycopodium, Sul- phur, Sepia, and also : Baryta c, Calcarea c, Graphites, Ci- cuta v.rosa, and Oleander- In the other varieties of scald-head, such as the Porrigo lupinosa* Porrigo furfurans,] Porrigo J(tiu>su,\ Sic, 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 the 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 laminated crusts, or scale-like exfoliations. This affection is confined to the scalp, and is attended with considerable itching and soreness, although there is but slight excoriation ; the hair partially falls off, and occasion- ally becomes subsequently somewhat lighter in colour. i Distinguished by the eruption of large, soft, straw coloured pustules, generally somewhat flattened, 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 much itching. On breaking, these pustules discharge a viscid matter, which hardens into semitransparcnt, greenish-yellow scales The disease ex- tends to the face, and eventually the ulceration spreads over the entire head, and from the continued discharge the hair and moist scabs become malted together. Pediculi are generated in large numbers, and aggra- vate the excessive irritation. The incrustations thicken into irregular masses, bearing some resemblance to honeycomb. The acrid exudation from the ulcerated patches on the scalp exhales an offensive and pungent vapour. ULCERS. 301 class of remedies are required as above enumerated; whilst against Porrigo decalvans (characterized chiefly by patches of baldness,) Graphites, Phosphorus, Baryta, Lycopodium, and Zincum have been found the most serviceable ; but Sulphur, Calcarea, Silicea, Sic, 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 favorably, 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, notwithstand- ing the exhibition of two or three doses of a particular reme- dy, 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 medi- cine is repeated, or another remedy substituted. Undeviating attention to cleanliness must be observed throughout the entire course of the complaint, and the ho- mceopathic 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 in the skin. Sometimes there is at the commencement a 26 302 CUTANEOU8 DISEASES. single small excavation ; at others, several contiguous ulce- rated spots are observed, which speedily become blended together, and form a sore of considerable magnitude. When no effort at cicatrization or healing is taking place, the ulcer always presents an excavation or hollow, tho 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 blueish 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, Mercurius, Sulphur, Silicea, Sepia, Lyco- podium. 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- ULCERS. 303 posed to extend rapidly, or when it is surrounded by numer- 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. Mercurius 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, Assafuelida may be admin- istered, provided Arsenicum, or some other remedy does not merit a preference. 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 infe- rior extremities. Silicea is another remedy of nearly equal importance to Sulphur in the treatment of chronic ulcers. It is accordingly of the utmost service in many cases when administered in alternation with that remedy, and in those of a very obstinate character, with Sepia 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. 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 tiucture 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.* • Vide note, page 81, 301 CUTANEOUS DISEASES, When the ulcer is inflamed or extremely painful, a soothing effect is often derived from the application of linen dipped in warm water; and if the ulcer be seated in the leg, the af- fected limb should be kept at rest, and not allowed to remain in a depending position. In others, and a still larger number of cases, the application of lint dipped in, and kept constantly wet with cold water, is more efficacious, especially when the ulcer presents a sharp, jagged, and undermined appearance, with no distinct formation of granulations, but exhibits a sur- face consisting 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 surround- ing 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 dress- ings 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 mariner, 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 fre- quently met with in elderly persons, the treatment ought to be exclusively internal at the commencement, and the doses administered at intervals of a week 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 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. Phagedenic Arsenicum, Silicea, Mezereum, Hepar s., Sulphur; also Conium, Acid, nitricum, and Ranunculus. Scrofulous. Sulphur, Silicea, Calcarea, Lycopod, Carbo v., Arsenicum, Acid, muriaticum, Baryta acetica, and Belladonna. Putrid Ulcers, or those occurring in Cachectic, Scorbutic subjects. Sulphur, Silicea, Arsenicum, Carbo v., Hepar s., Acidum muriaticum, Pulsatilla, and, in some instances, Amman, c. et. m. Gangrenous Ulcers. Arsenicum, Lachesis, Cinchona, Silicea, Belladonna, and Conium; also Rhus toxicodendron, Secale cornutum, and Squilla. 26* 306 CUTANEOUS DISEASES. Carcinomatous. Arsenicum, Lachesis, Conium, Sulphur, Silicea, Diadema aranea, Mercurius; also Aurum, Staphysa- gria, and Hepar s. Fistulous. Sulphur, Silicea, Calcarea, Lycopodium, Pul- satilla, and Antimon* Mi:hcurial. Hepar s., Acidum nitricum., Acidum phos- phoricum, Aurum, Carbo vegetabilis, Sulphur, Silicea, Bella- donna, Thuja, and Sursaparilla. Svphilitic. Mercurius chiefly, but also Acid, nitricum. to promote healthy granulation when the former is insufficient, or to combat mercurial complication when the patient has previ- ously been subjected to injurious doses of that remedy. In other cases, Lachesis and Thuja 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 Svcosis. In some cases of this affection, however, Mercurius and Sulphur alternately, or one or more of the following re- medies : Acidum phosphoricum, Cinnabar, Lycopodium, Eu- phrasia, Staphysagria, and Sabina will be found requisite. ♦ In fistula in ano: Sulph., Calc, Silez, Ca.us., and Puis, have chiefly been employed wilh success. In fungous ulcers .• Sulphur, Silicea, Cal- carea, Graphites, Sepia, Staphysagria, Petroleum, Antimonium, Iodum, Thuja, and Acid, nitric; and in fungus hematodes : T-hosphorus, Thuja and 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 genera] 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- 308 GENERAL DERANGEMENT. rally with a feeling of dislocation in the joints of the feet, and burning or severe scalding pain in the part attacked, more or less intense ; after a time these sensations disappear, leaving 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 exciting causes of gout may be numbered the following: a luxurious mode of life; stimulating diet or drinks ; sudden check of perspiration ; mental emotions; sedulous application to studious pursuits, and neglect of taking proper exercise in the open air ; and a use of aperient medi- cines and tonics. In plethoric habits, the gout shows a con- siderable inclination to shift its seat to the head, and in dys- peptic individuals to the stomach and intestines. Therapeutics. In general cases of this affection, the principal medicaments are Aconite, Pulsatilla, Nux vomica, and Bryonia. Aconite in plethoric or corpulent habits, when there is considerable inflammatory fever, with hard and quick pulse. Administration. 5g- in a little water, repeated in six hours if necessary ; in very severe cases exhibited as in In- flammatory Fever. Pulsatilla, where the pains are of a shifting nature, exa- cerbated towards evening or in bed, with paralytic or torpid sensation in the part affected, and more particularly when the dyspeptic symptoms given under this medicine (see Indiges- tion or Dyspepsia) 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 af- fording relief. Pains worse at night, with restlessness and constant necessity to change the position of the extremities ; pale and anxious or haggard countenance, are generally re- lieved by Ferrum, or Ferrum and Rhus in alternation ; and in other cases by Cinchona, especially when there is sensibility to the touch, and aggravation of the sufferings from the most trivial pressure or blow. GOUT. 309 Administration. ^ repeated in from six to twenty-fom hours, according to results.* Nux vomica, when the pains are worse towards the morn- ing; a paralytic and torpid sensation, with cramps and throb- bings in the muscles ; and moreover, when in addition to other 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 ferment- ed 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 before alluded to. Administration. Same as Pulsatilla. 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 medica- ment. In chronic cases, the applicability of the following medi- cines should be consulted : Lycopodium, Aurum, Sulphur, Calcarea carbonica, Colocynth, Hepar sulphuris, Colchicum, Phosphorus, Conium maculatum, Daphne, Causticum, Guaja- cum, Todum, Rhododendron, and Manganum. Also, as inter- mediate remedies,—Arnica, Ledum palustre, and Sabina. In Arthritis vaga the following remedies have been re- commended in addition to Pulsatilla : Nux v., Arnica, Man- ganum, Nux moschata: and also Rhododendron, Plumbum, Daphne, and Assafoetida. Arthritic Nodosities. Causticum, Lycopodium, Aurum, Ledum, Graphites, Rhododendron, Calcarea, Sepia, Staphy- sagria. As also, Agnus, Antimonium,' Bryonia, Phosphorus, Sabina, Zincum. Arthritic contractions are sometimes benefitted by Sulphur, Causticum, Bryonia, Rhus, Guajacum : —or, Colocynth, Silicea, Calcarea, etc. Arthritis occurring in individuals whose occupations compel them to work in the water, is chiefly to be relieved by Calcarea, Pulsatilla, Sar- saparilla, and Sulphur.—And in some cases by Arsenicum, * Vide note, p. 21. 310 general derangement. Dulcamara, Antimonium, Nux muschata and Rhus. — Nux v. is one of the most important remedies against the precursory symptoms of gout; and Belladonna against recent metastasis. RHEUMATISM. Rheumatismus. 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 disease is of two kinds, the Acute and Chronic; the 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 affect- ed ; 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 com- monly less perceptible ; 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. Therapeutics. 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, Sic. 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. ^ in a little water, repeated every six hours, until the fever is lowered : in very severe cases exhib- ited 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. Administration. ^ 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 changing 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 ^6°, 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, page 21. 312 general derangement. and chest, aggravated by cold; gastric derangement; consti- pation ; irritability of temper. Administration. Same as Belladonna. Mercurius is indicated in cases where the pains are in- creased by the warmth of the bed, or exposure to damp or cold air, aggravated at night, and especially towards morning ; also where there is considerable puffy swelling of the parts affect- ed. This medicine is particularly useful when the pains seem seated in the bones or joints ; profuse perspiration with- out alleviation of suffering, is also a good indication for its employment. (Lachesis is often efficacious when Mercurius fails to relieve the foregoing symptoms.) Administration. Same as Belladonna. Pulsatilla %%, is useful in shifting rheumatic pains, par- ticularly if attended with a sense of torpor or paralysis, reliev- ed by exposure to cool air, worse at night or in the evening. Administration. Same as Belladonna. Rhus toxicodendron ag", 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 medicament may sometimes follow Bryonia with considerable advantage. Fer- rum 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. Hepar sulphuris and La- rheumatism. 313 chesis alternately have 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,) Belladonna 3, in repeated doses, is a useful remedy if timely administered 5 and may in some cases be advantageously employed in alternation with Aconi- tum, and followed by Spigelia 1-3 and Digitalis 1-3. 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., Phosph., Veratr., Clem. When the pains are aggravated or excited by the slightest chill, — Aconite, Calc, Bry., Dulc, Merc, Sulp., Acid, phosph., will generally be found the best from which to select a remedy. When the attacks are excited by unfavorable weather,—Calc, Rhus, Dulc, Rhod., Verat., or Lycop., Carb. v., Lach., Hepar, Mang., 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., Dulc. Carb. v. Rheumatism with paralytic weakness,—Arnica, Ferrum, China, Sic Against unsettled or shifting or rheumatic pains, in addition to Pulsatilla : Arnica, Bryonia, Nux m., and in some instances Rhodo., Daphne, Mang., Plumb., Assa. Rheumatism from congelation,—Arsenicum, Bryonia, Nux moschata chiefly. 27 314 general derangement. LUMBAGO. Diagnosis. Violent pain of a rheumatic character in the lumbar region, either periodical or permanent, frequently ac- companied with a considerable degree of fever. Therapeutics. The medicines most valuable in its treat- ment are : Aconite, Bryonia, Nux vomica, Rhus toxicodendron, Belladonna, Pulsatilla, and Mercurius. Administration and Potencies of the remedies. Same as in Rheumatism, which see. Aconite may be given at 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 : also when they are much increased by motion 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. Rh,us toxicodendron may be exhibited when the same indications as those given under the preceding medicine are present, with the distinction of the pains being aggravated by rest. It is also a useful remedy in chronic cases. 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 Nux vomica, are moreover attended with sensation of constriction ; it is particularly indicated, as remarked in other INFLAMMATION OK THE PSOAS MUSCLE. 315 parts of this work, for females, or individuals of mild, sensi- tive, 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. INFLAMMATION OF THE PSOAS MUSCLE. Psoitis. Diagnosis. Pain in the renal region, hip, and downwards to the leg. The limb can neither be stretched or 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, perinaeum, or thighs : it may also produce caries. Therapeutics. The remedies given under Lumbago and Rheumatism (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 -£, repeated in from twelve to twenty- four hours, according to circumstances * • Vide note, p. 21. 316 GENERAL DERANGEMENT. When shiverings or rigors are 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 Staphysagria in repeated doses, followed by Silicea or Hepar, to bring the abscess to a head as quickly as possible, and thereby relieve the sufferings of the patient. In by far the greater number of cases of Psoas or Lumbar abscess, however, we have no premonitory symptoms which might lead us to anticipate such a disease, and are but too often unaware of the existence of the disorder until an exter- nal tumour is formed. (See Chronic Abscess.) 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. Staphysagria may follow the above when a discharge of a peculiarly offensive sanies takes place. Aurum, Assafcetida, Argentum, 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 are Aconitum, Arsenicum, Chamomilla, Ignatia, Nux vomica, Pulsatilla, Colocynth and Rhus toxicodendron. Aconitum. When considerable constitutional disturbance attended with fiver is present. Administration. -n0A 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. ^> 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. -3a, 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 oc- curring 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 eve- ning, and during the night, or when seated, but somewhat re- lieved in the open air; this remedy is best adapted for an in- dividual of mild disposition and leuco-phlegmatic tempera- ment. Administration. Same as Arsenicum. Colocynth is an important remedy in this distressing disease. It has been found of the greatest service in cases where the right leg was affected, and the pains liable to be excited, or much aggravated by a fit of anger or indignation. Veratrum, Staphysagria, Manganum, Mezereum, Hepar s.f Sepia, Phosphorus, Ruta, Kali c, Conium, etc., may also be • Vide note, p. 21. 27* 318 GENERAL DERANGEMENT. found useful in particular cases of this complaint, or Neuralgia generally. (See also the remedies described for the treatment of rheumatic pains, art. Rheumatism.) Rhus. This medicament is more peculiarly indicated when the pains are aggravated by rest, relieved by motion, or by warmth; with disposition to melancholy or an unaccountable feeling of dread. Administration. Same as Chamomilla. PAIN IN THE HIP. HIP-GOUT. RHEUMATISM IN THE HIP. Coxalgia, Coxagra. Ischias. Diagnosis. A pain in the hip-joint dependent upon a true gouty inflammation, almost universally of an acute descrip- tion, the pain is extremely violent, and extends from the hip- joint to the neighboring aponeurosis, the periosteum, and the adjacent ligaments ; consequently, sometimes reaches up- wards to the back or downwards to the thigh, rendering mo- tion excessively painful, either in walking, rising up, sitting down, or turning in bed. When the pain is not deeply seated, there is generally absence of either swelling or redness. This species of gout usually assumes the irritable charac- ter, runs its course quickly, and forms an active local inflam- mation, which very rapidly terminates in suppuration when unchecked. It occurs more frequently in the male than in the female subject. When suppuration supervenes, the pain becomes more ob- tuse, pressing and throbbing; the inflammatory fever assumes the suppurative character (febris suppuratoria), indicated by shivering and shuddering, alternating with heat, to which a number of other sufferings become united, such as swelling, pains in the knee, limping, luxatio spontanea, &c. Therapeutics. The following remedies have been found most effective in the treatment : 'Mercurius, Rhus toxicoden- hip diseases. 319 dron, Aconitum, Belladonna, Pulsatilla, Hepar sulphuris, Colo- cynth, etc. Mercurius is a useful remedy when the disease is attended with halting in the gait, and sharp, cutting, tearing, and burn- ing pains, which are materially aggravated at night and during every movement, and are usually attended with profuse noc- turnal sweating ; also where exudation threatens or is present. Administration. A grain of the third trituration in an ounce of water, a dessert-spoonful exhibited morning and evening, and continued as long as advantage appears to result from its employment.* Rhus toxicodendron. When darting, tearing, or drag- ging pains are experienced in the hip-joint, attended with tension and stiffness in the muscles, aggravated or chiefly present during rest. Also painful sensibility of the joint when arising from the sitting posture. Administration %, in six dessert-spoonfuls of water, one every twelve hours until relief is experienced. Aconitum. When the affection is attended with marked febrile symptoms, or considerable inflammation of the joint itself exists from the commencement. Administration £, in six dessert-spoonfuls of water, one every two, four, or six hours, until the above symptoms are relieved. Belladonna is particularly indicated in the inflammatory stage when attended with a marked redness of the skin, and considerable pain on the slightest movement, with lameness ; in such instances it may advantageously precede Mercurius. Administration £, in the same manner as Rhus toxico- dendron. Pulsatilla is occasionally found serviceable in mild cases of this disorder, partaking of a rheumatic character, when the patient complains of wrenching pains in the hip-joint, which are aggravated towards night, and even when in a state of rest. (Acid. nitr. is sometimes useful after Puis.) Administration -£, in six teaspoonfuls of water, one daily. * Vide note p. 21. 320 general derangement. Hepar sulphuris is chiefly useful in case of exudation, and may in such instances follow Mercurius with some ad- vantage. 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 sub-acute or chronic cases, when the pain is constant, and of a squeezing descrip- tion, accompanied by a sensation as if the 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. The following remedies have also been found useful in many cases: Sulphur, Silicea, Graphites, Bryonia alba, Calcarea carbonica, Digitalis, Argentum, Arsenicum, Acidum nitricum, Creosotum, Assafoelida, Aurumfohatum, Cantharides, Lachesis, Chamomilla, Staphysagria, Nux vomica, Acidum phosphoricum, Sepia, and Calcarea phosphorata. (See also the following article on Hip-disease, and that on Rheumatism where indi- cations for some of the above mentioned will be found.) HIP-DISEASE. Morbus Coxarius. Diagnosis. Chronic inflammation of the bones composing the hip joint (particularly the acetabulum), frequently com- mencing only with pain or uneasiness in the knee of the limb attacked, or a slight weakness of the part affected, attended with limping; afterwards emaciation, and elongation of the limb itself takes place, and as the complaint progresses a severe fixed pain is felt behind the trochanter major, increased by pressure on the front of the acetabulum, extending down to the knee, ankle, and foot, which is accompanied with feverish symptoms, restlessness, and flattening of that part of the nates which is generally fullest and roundest, depression of the crest of the ileum, and distortion of the spine. This complaint is most frequently met with in children, but no age, sex, or condition of life, is exempt from its attacks ; HIP DISEASES. 321 it is peculiarly insidious in its approach, the pain and uneasi- ness in the knee above mentioned being frequently the first symptoms denoting its presence ; hence it is not unfrequently mistaken for some complaint of that joint, by inattentive or inexperienced practitioners ; a most deplorable oversight since it is only in the incipient period of the disease that a favorable prognosis can be given; if no appropriate relief be timely administered, matter forms within the joint, the acetabulum and sometimes the head of the femur become destroyed by caries, luxation upwards and outwards takes place, and the limb, which had previously been preternaturally elongated now becomes contracted and shortened ; the sufferer is then either destroyed by excessive constitutional irritation, or recovers with an anchylosed joint. Causes. An inherent constitutional taint, such as scrofula, is no doubt the principal predisposing cause ; but it is gene- rally attributed to external violence, or exposure to damp or cold, lying down upon damp grass in summer, or some other exposure to cold or damp. Therapeutics. Mercurius and Belladonna are our prin- cipal remedial agents, but we may also find occasion to have recourse, in some cases, to the following, namely : Rhus toxicodendron, Colocynth, Sulphur, Silicea, Calcarea phospho- rata, Pulsatilla, Sepia, and Staphysagria. Mercurius. This remedy is of itself sometimes found to act as a specific in the early and curable stage of the disease ; it is more particularly indicated when the patient is of a scrofulous diathesis and sallow complexion, and when no pain is complained of, but the disease is insidiously advancing. Administration. A grain of the trituration at the third potency to an ounce of water; a dessert-spoonful night and morning, carefully watching the effect,^and discontinuing the medicine when any alteration in the symptoms becomes per- ceptible ; afterwards either returning to its exhibition, or selecting another medicament according to the result. 322 general derangement. Belladonna is more especially called for in the inflamma- tory stage, when the patient evidences considerable pain. Administration. A drop of the tincture at the sixth po- tency to an ounce of water, exhibited in the same manner as Mercurius. In some cases it may be found advantageous to alternate these remedies according to the symptoms that present them selves. Rhus toxicodendron. Darting or dragging or tearing pains in the hip-joint, accompanied with tension or stiffness of the muscles, most painful when in a state of rest ; and severe pain on arising from a sitting posture. Administration. A drop of the tincture at the third po- tency, exhibited in the same manner as Belladonna. Colocynth has been found of much value in this disorder either after Belladonna and Mercurius, or in preference to these medicines when, from the commencement, the hip-joint is described to feel as if firmly and painfully bound by an iron clasp, with pain extending down the limb, and stiffness in the knee joint. Sulphur is generally found called for in chronic cases, particularly when arising from a scrofulous or psoric metas- tasis. Administration %, in six dessert-spoonfuls of water daily In cases of abscess or caries in this disease, Silicea and Calcarea phosphorata may be pointed out to the attention of the practitioner. The following remedies are likewise deserving of attention in the treatment of this serious malady : Calcarea, Bryonia, Hepar s., Acidum phosphoricum, and Lachesis. In affections of the Knee-joint, Silicea forms one of the most important remedies, particularly when the disease begins in the synovial membrane. Acid, nitricum, Aurum, Ac. phos- phoricum, Lycopodium, Lachesis, Sulphur, or Calcarea have, in addition to Silicea, been found useful in inflammation of the synovial membrane of the joints, in consequence of the effects of Mercury ; and Rhus, Bryonia, Lycopodium, Nux v., China, or Sulphur, when as a result of gout or rheumatism DETERMINATION OF BLOOD TO THE ABDOMEN. 323 Sulphur and Calcarea have chiefly been recommended in lymphatic or scrofulous enlargement of the knee ; but also the following in some cases. Silicea, Lycopodium, Arsenicum, Iodium, and Arnica. In the event of suppuration : Silicea, Mercurius, Hepar s.; and in that of serous infiltration : Silicea and Sulphur ; or Calcarea, Mercurius, Iodium. DETERMINATION OF BLOOD TO THE ABDOMEN. Congestio viscerum abdominis. Congestio ad abdomen. This derangement is characterized by a disagreeable or painful 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 weak- ness or prostration, rendering it difficult or almost impossible to walk about; constipation, with pain in the loins, spirits oppressed and irritable. Administration. ^^, in a teaspoonful ofwater, 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 indications ; dull pains, and disagreeable sensation of disten- sion in the abdomen, constipation, tendency to obstinate he- morrhoidal attacks, extreme dejection. Administration. ™0-, 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 the two preceding remedies. 324 general derangement. Administration. ^, in three dessert-spoonfuls of water; a dessert-spoonful daily ; repeated in the same manner four or five days after. Arsenicum will also be found useful, especially when there is a disposition to diarrhopa with extreme weakness : or— Capsicum, when these symptoms occur in individuals of a lymphatic temperament. The two latter remedies may be administered in the same manner as is described under Carbo vegetabilis. Sepia is often of much utility in the case of females, par- ticularly when the symptoms are 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 the open air, together with a careful at- tention to regimen, must be observed by those who are af- flicted with this affection. ACUTE INFLAMMATION OF THE EYES. Ophthalmia. Diagnosis. Superficial bright scarlet redness, pain, and heat 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 cephalalgia, febrile symptoms, and increased intolerance of light, particularly when the entire eyeball (Ophthalmitis) or the sclerotic coat is affected (Sclerotitis,) in which latter case, moreover, the redness presents a pink appearance. This affection may arise from a variety of causes, such as exposure to extreme light, the strong heat of a fire, particu- larly after coming out of an extremely cold atmosphere, ex- ternal injuries, or cold. inflammation of the eves. 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, Belladonna, 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 fever. Administration ^, repeated in from six to twelve hours, until the inflammation is lowered. Belladonna, if great sensibility to light remains. Also in Acute, Arthritic, Rheumatic, and even Scrofulous ophthalmia, when the following symptoms presents themselves: redness in the conjunctiva, margin of the eyelids, and corner of the eyes, with a swollen and tumid appearance ; or redness of the sclerotica, 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 orbits and head with aggravation on moving the eyes; flashes of light, sparks, or darkness before the eyes, with extreme dim- ness of vision towards evening ; objects appearing reversed or double; moreover, when there are the following catarrhal symp- toms : severe cold in the head, with acrid discharge, causing ex- coriation, and sometimes an eruption of pimples under the nose, and on or 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 affection.* Nux vomica. In catarrhal, arthritic, or rheumatic in- flammation of the eye, when there are burning, pressive, or aching pains, feeling as of sand in the eye, with stiffness, • Vide note, p. 21. 28 326 general derangement. smarting, tickling, and itching ; foul tongue, and other symp- toms of disordered stomach ; slight fever in the morning and towards evening ; irritable temper ; pressure on the eyes and eyeballs on attempting to open them ; redness of the canthi; the eye streaked, blood-shot, and swollen, with adhesion of the eyelids ; sensibility to light; briny lachrymation ; affec- tion worse towards morning. Nux v. and Pulsatilla are two of the most useful remedies in simple inflammation of the conjunctiva, particularly at the commencement of the attack ; but Sulphur is often required to complete the cure. Administration. ^, in a little water, repeated in twenty- four hours, or sooner if required.* Cinchona. W'hen the inflammation is less intense, but the motion of the eye painful, and the sensation before noted as of sand in the eye, with the distinction of the affection, exacerbation towards evening ; when the pains are of a burn- ing or pressive nature, with headache in the forehead, as if arising from a suppression of the nasal discharge. Administration. Same as Nux vomica. Arsenicum chiefly in catarrhal and scrofulous ophthalmia, when there exists a violent burning pain or pains of so severe a description as almost to drive the patient distracted ; specks and ulcers on the cornea. Administration. Same as Nux vomica. 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 (Sclerotitis;) painful pressure and smarting in the eyes ; profuse and acrid flow of tears, excited or increased by exposure to cold ; copious secretion of mucus, sometimes sanguinolent; or bright redness of the conjunctiva, with distension of the veins ; minute pustules on different parts of the conjunctiva ; white opaque specks on the cornea ; excessive intolerance of light (scrofulous inflammation of the conjunctiva ;) severe cold in the head with profuse fluent na- sal discharge ; violent headache, and aggravation of the symp- toms towards evening. • Vide note, p. 21. 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 agglutina- tion ; photophobia ; swelling of the lids ; aggravation of the symptoms towards evening; sensitiveness with disposition to weep. (Ferrum is occasionally very serviceable after Pulsa- tilla, especially in scrofulous ophthalmy ; at other times Sul- phur is preferable.) Administration. Same as Nux v. Mercurius. In many cases of catarrhal, rheumatic, and scrofulous ophthalmia, as also in iritis, this medicine is fre- quently to be employed with advantage. Its ordinary indi- cations are : lancinating pains, or painful and irritating pres- sure as if from sand, especially on reading, or otherwise fatiguing the eyes, but also when at rest in bed ; prickingand itching in the eyes, particularly in the open air ; rose-coloured redness of the eye (sclerotitis,) with injection of the veins ; profuse lachrymation ; great sensibility to light, but especi- ally that of the fir^or candle ; vesicles and pustules on the selerotica : ulcers on the cornea ; pustules 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.) 328 general derangement. 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 following symptoms : pressure, smarting, and burning as if from sand ; itching in the eyes or eyelids; dimness of sight, with dusky appearance of specks, vesicles or pustules and ulcers on cornea ; pustules or granular elevations in the eyelids, and scabs round the orbits ; inflam- mation of the iris, with irregularity of the pupil ; copious la- chrymation, and excessive photophobia, and aggravation or suffering on moving the eyes ; painful dryness of the eyes? especially within doors ; contraction of the eyelids ; imper- fect 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, Sepia, Spigelia, Acidum sulphuricum, Petroleum, Lachesis, Acidum nitricum, Ferrum metallicum, Colocynth, etc. If the inflammation arise fronr 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 q^, 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 ap- pear better indicated. Finally, the follolring may be pointed out as being eminently useful, or worthy of attention in the varieties of ophthalmia enumerated. For Catarrhal Ophthalmia, in addition to those above mentioned : Chamomilla, Hepar sulphuris, Lycopodium. inflammation of the eyes. 329 Rheumatic (Sclerotitis:) Bryonia, Chamomilla, Rhus, and Veratrum; Lycopodium, Spigelia, in addition to those de- scribed under the heading of Inflammation of the Eye. Scrofulous : Arsenicum, Conium, Hepar s., Sulpur, and Calcarea; also Dulcamara, Causticum, Ferrum, Graphites, Sepia, Petroleum ; or Aurum, Baryta c et. m., Lycopodium, Cannabis, Chamomilla, Digitalis, Iodium, 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 perhaps Aurum. Sycosic : Thuja, Acidum nitricum, and sometimes Mer- cu rius. Gonorrheal : Pulsatilla chiefly. Abuse of Mercury under previous allopathic treatment: Hepar sulphuris, Acid, nitricum, Sulphur, Pulsatilla, and in some cases Belladonna, Lachesis, Staphysagria, Lycopodium, Thuja, or Cinchona. Fungus H^ematodes : Thuja, Carbo a., and Phosphorus* Iritis Arthritica : Cocculus, Staphysagria, Conium, Ly- copodium, Calcarea, Nux v., Bryonia- Iritis Mercurialis : Hepar s-, Acidum nitricum, La- chesis. In Ulceration of the Cornea, the following remedies have hitherto been employed with the most satisfactory re- sults : Arsenicum, Euphrasia, Sulphur, Lachesis, Calcarea, Belladonna, Mercurius, Hepar sulphuris, Silicea, and Na- trum m. Specks on the Cornea, or Opacity of the same: Bella- donna, Euphrasia, Sulphur, Calcarea, Hepar sulphuris, Pul- satilla : as also Arsenicum, Acid, nitricum, Cannabis, Mag- nesia, Aurum, Lycopodium, Silicea, Sepia. Cataract. The remedies which have chiefly been des- cribed as efficacious in this affection of the eye are : Sulphur, • For the description of the cure of an interesting case of fungus nematodes of the eye, vide Brit. Journ. of Homeopathy, No. 2. 28* 330 general derangement. Silicea, Cannabis, Causticum, Conium, Magnesia, Phosphorus, etc. Strabismus: In addition to the ordinary simple mechanical remedies, great assistance has been derived from, and in other instances the cure solely effected by, Belladonna and Hyos- cyamus, when the affection was not of too long standing. Fistula Lachrymalis. The following remedies have been employed with success in this affection : Silicea, Stan- num, Calcarea, Pulsatilla, and Sulphur. Weeping or Watery Eye (involuntary flow of tears.) When this affection proceeds from an obstruction of the la- chrymal duct, it must be treated by the remedies above enu- merated ; but when it merely consists in a relaxed condition of the glandular apparatus of the eye, with a superabundant secretion of tears (epiphora,) the subjoined remedies have been found successful : Euphrasia, Spigelia, Paris. In other cases, a selection may be made from amongst the following: Puis., Sulph., Euphorb., Clematis, Sepia, Merc, Ferrum, Le- dum, Graphites, Phosph., Lycopod., Silicea, Acid, sulph., Thuja, Veratrum, Petrol, Rhus, Verat., Sabad., Digitalis, Nux v., etc. Blood-shot Eye. This derangement may arise from a blow or fall, the act of retching, vomiting, or violent cough- ing, crying, etc. It presents a bright scarlet appearance in most instances at the commencement, but usually assumes a livid hue at a subsequent period. The affection generally disappears of itself; but as it is liable to prove exceedingly obstinate occasionally, absorption is materially facilitated, and the unsightliness removed by the internal and external em- ployment of Arnica. (See External Injuries.) Belladon- na, Lachesis, Nux v., or Chamomilla may be required in cer- tain cases. DISEASES OF THE EYE AND LIP, ETC. SHORT SIGHT. NEAR-SIGHTEDNESS. Myopia. The medicines which have been employed with the great- est effect in this affection are : Pulsatilla, Sulphur, Carbo v., Acid, phosph., Phosphorus, Conium, Acidum nitricum, Ammo- nium c, Anacardium and Petroleum. Of which Pulsatilla and Sulphur have proved the most serviceable when the af- fection occurred as a sequel of ophthalmia ;—Acidum phosph., when resulting from typhus, or from debilitating loss of fluids, —and Carb v., Acidum nitricum, and Sulphur when attribu- table to the effects of mercurial action. Against sudden attacks of blindness : Aconitum, followed by Mercurius, Sulphur, and Silicea. Against blindness towards evening, Belladonna is the principal remedy ; in other cases, Veratrum will answer better. Should neither of these effect much improvement, Hyoscyamus may be administered. Swelling of the Lips (scrofulous:) Belladonna and Mer- curius are two of the most useful remedies in this affection when there is simultaneous retraction of the lip. If ulcera- tion and incrustations accompany the disorder, Belladonna, Mercurius, Hepar, Sulphur, Staphysagria, Silicea, and Sepia, If there be tumefaction simply, Aurum, Mercurius, Bryonia, Belladonna, Hepar, Lachesis, Sulpur, and Calcarea. Scirrhus. Against indurations of this serious character, either in the face or lips: Belladonna, Conium, Sulphur, Sili- cea, Carbo a. et v., Phosphorus, Staphysagria, and Magnesia m. are chiefly to be recommended; and the following against carcinomatous ulcerations (both internally and externally.) 332 diseases of the eye, etc. Arsenicum, Lachesis, Clematis, Conium, Sulphur, Sthcea, Acidum nitricum, Aranea, etc. Warts on the face. Causticum, and, in some cases, Kali, Sepia, Dulcamara, Thuja, Acidum nitricum, and Sulphur are most useful. The employment of the knife or of caustic in such cases is highly improper, and often attended with the worst effects. Against these excrescences on the other parts of the body, such as the hands, etc., Sulphur and Calcarea form two of the best remedies in cases of long standing ; Causticum, when large and painful ; Lycopodium, when large, and intersected with deep clefts ; when moist: Thuja, Acid. nit. and Sabina (externally and internally,)—Dulcamara, Na- trum, Sepia, and Rhus have also proved useful in some cases. HORDEOLUM. Stye. Diagnosis. This is a little hard tumour appearing like a small dark-red boil, generally in the corner of the eye, or upon the eyelids, attended with severe inflammation, and fre- quently causing fever, considerable pain and suffering. It suppurates slowly and imperfectly, and has no tendency to burst spontaneously. Therapeutics. The two most valuable medicines in the treatment of this affection are Pulsatilla and Aconitum. Pulsatilla will, in most cases, suffice to remove the stye, if given on its first appearance. Administration s%-, in four teaspoonfuls of water, one morning and evening. This medicine may be again exhibited whenever an attack threatens. Aconitum. When inflammation runs high, attended with great pain, fever, and restlessness. Administration e$a, in four teaspoonfuls of water, one every six hours, until the inflammation is reduced, or, in some instances, Staphysagria may be found useful to complete a cure, particularly when the swelling degenerates into a hard white tumour; and in some scrofulous habits, in addition, Arsenicum, Sulphur, Lycopodium, etc. inflammation of the ears and earache. 333 Lippitudo (blearedness) : Aconitum, Euphrasia, Mercurius, Pulsatilla chiefly. Against Blepharitis (inflammation of the eyelids) : Aconi- tum, Belladonna, Hepar, Pulsatilla, Nux v., Chamomilla, and Euphrasia have chiefly been employed with the most success in the acute form of the complaint; and Arsenicum, Sulphur, Calcarea, Antimonium, Cinchona, etc. in the chronic variety. In Inflammation of the Margins of the Eyelids, or Meibomian Glands (ophthalmia tarsi): Belladonna, Mercurius, Hepar, Euphrasia, Nux v., Pulsatilla, Chamomilla, etc. Catarrhal Inflammation of the Eyelids (inflammation of the conjunctiva palpebrarum) : Arsenicum, Mercurius, Hepar chiefly. When the external surface of the eyelid is inflamed, Aconi- tum, Belladonna, Hepar sulphuris, and Sulphur are more par- ticularly called for. INFLAMMATION OF THE EARS AND EARACHE. Otitis. Otalgia. Otitis. Diagnosis. Violent, frequently insupportable pain in the ear, with sensibility, and even inflammation of the meatus auditorius externus, and greater or less fever. The pain, when excessive, communicating with the whole head, may bring on delirium, or even inflammation of the brain. Otalgia may exist either as the effect of otitis again, or, if neglected, may pass on to inflammation ; in many cases again, it may arise by sympathy from toothache, or declare itself as a purely neuralgic affection. Therapeutics. The medicaments applicable to the majo- rity of cases of these troublesome and painful disorders are Mercurius, Pulsatilla, Belladonna, Nux vomica, Arnica, Dul- camara, and Chamomilla, Hepar, Cinchona, Sulphur, etc. Administration. Six globules at the potency specified under each medicine, in an ounce of water, a dessert-spoonful 334 DISEASES OF THE EYE, STO. every half hour to six hours and upwards, according to results, carefully watching the effect of each exhibition. (Seo remarks upon this important point in Intkoduction, article Adminis- tration and Repetition of the Medicines.) Mercurius b. When the pain is attended with a sensation of coldness in the ears, and exacerbation of suffering in the warmth of the bed ; shooting or tensive pains in the internal ear, extending to the cheeks and teeth ; inflammation and in- duration of the ear, with soreness of the orifice, and dis- charge ; swelling of the glands. When Mercurius affords only partial relief, a dose of Hepar s. will often subdue the remaining symptoms ; but if a purulent discharge continue, accompanied by humming in the ear, and pricking pains, Sulphur will generally be found requisite. Pulsatilla z, is a most valuable remedy in this affection. It is particularly indicated when the external ear is much af- fected, and appears inflamed and swollen ; with heat, shoot- ing and tensive excoriating pain internally; moisture in the ear, or somewhat copious discharge. This medicament is particularly useful in cases of females, and in individuals of chilly habit. Belladonna ■$, when determination of blood to the head, with redness of the face, exists ; with digging, boring, tearing or shooting pains extending to the throat, and extreme sensibility to the slightest noise; when the pains are more severe inter- nally ; also when the brain partakes of the inflammation, and delirium is present. (Hepar is sometimes required after Bel- ladonna to complete the cure in obstinate cases.) Nux vomica £. When the pains are of a tearing, shooting nature, extending to the forehead, temples, and bones of the face, worse towards morning ; dryness of the ear ; and partic- ularly when the affection occurs in persons of a lively, cho- leric disposition. Arnica 5, in individuals of nervous, excitable temperament, subject to be attacked from slight causes ; also, when great sensibility to noise is present. (Cinchona is often useful after Armca, especially when the pains are aggravated by lying on, or touching the affected ear. In other cases, Sulphur will be INFLAMMATION of the ears and earache. 335 found more efficacious, particularly when the sensibility is excessive. Dulcamara ^, when the 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. Chamomiilla 5, when there are stabbing pains in the ear, as from knives ; great sensibility to noise, or even to music, extreme sensitiveness, susceptibility, and irritability. Against humming or buzzing in the ears, Nux v. will be found serviceable in recent cases, when the annoyance is worse in the morning ; Pulsatilla when in the evening ; Dul- camara when at night, or Mercurius when accompanied by sweating. China, Carbo v., and Acidum nitricum when the affection occurs in individuals who have taken mercury in large quantities. In chronic cases Aurum, Petroleum, and Causticum, etc. have been found useful; the last-named rem- edy, particularly when there is great sensibility to cold, and tendency to suffer from rheumatic pains in the limbs. Otorrhoea. When this disorder results from acute inflam- mation of the ear ; Pulsatilla, Sulphur, and Mercurius are the principal remedies. Catarrhal or Mucous Otorrhcsa. Belladonna, Mercu- rius, Pulsatilla, and Sulphur chiefly. Purulent Otorrhea. Mercurius, Pulsatilla, Sulphur, Belladonna, and Hepar,—or, Silicea, Calcarea, Causticum, Acid, nitricum, Causticum, Assafoetida, Lachesis, Petroleum, etc. When the discharge is offensive, Causticum, Hepar, Aurum, Carbo v-, Sulphur, and Silicea. Sanguineous Otorrhea. Mercurius, Pulsatilla, and Si- licea,—also Lachesis and Cicuta, etc. When the disorder has arisen from the abuse of mercury : Hepar s., Acid, nitricum, Aurum, Assafoetida, 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, and Natrum m. are the reme- dies from which we may hope to obtain the most assistance. Against the effects of suppressed otorrhoea : Belladonna, 336 diseases of the eye, etc Pulsatilla, and Mercurius; and, in some cases, Nux v., Bryonia or Dulcamara may be selected, according to circum- stances. Belladonna and Bryonia chiefly when there is fever, headache, or unequivocal signs of cerebral irritation ; Mercu- rius, Belladonna, arm* Pulsatilla, followed, if required, by Sulphur, Calcarea and Hepar, when the glands of the neck or the parotids become tumefied. When orchitis results: Pulsatilla and Nux v or Mercurius. In Dvsecoia 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, Hyoscyamus, Sulphur, Silicea, Mercurius, Graphites, Phosphorus, etc. have more particularly been recommended. Nervous do. : Causticum, Petroleum, Phosphorus, Acid. phosphoric, etc. Catarrhal, or Rheumatic do. : Mercurius, Pulsatilla, Arsenicum, Belladonna, Ledum ;—or, Sulphur, Calcarea, He- par, Lachesis, Acid, nitricum, Chamomilla, and Coffea. Deafness from the repercussion of chronic eruptions : Sulphur and Antimonium;—or, Causticum, Graphites, etc. When deafness results as a signal 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 nitricum, Staphysagria, Assafoetida, or Aurum ; Hepar s., Sulphuris, Petroleum or Sulphur. When the disorder is attributable to hypertrophy of the amygdala? : Aurum, Mercurius, Acid, 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, Veratrum, 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 generally been found the most appropriate. [ 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- tana, Belladonna, Bryonia, Cinchona, Pulsatilla, Mercurius, Rhus toxicodendron, Secale cornutum; or, Carbo vegetabilis, Graphites, Causticum, Magnes artificialis, Ammonium muria- ticum, Ferrum, Kali, Sepia, Sulphur, Calcarea, Acidum nitri- cum, Baryta, Bovista, Crocus, Conium, Cina, etc. When the bleeding is excessive, Aeon., Am., Bellad., Cin., Merc, Puis., Rhus., or Sec are the most useful. When the hemorrhage arises from congestion in the head, a preference may be given to Aeon., Bellad., Cin., Crocus, Con., or to Graph., Rhus, Chamom., Alum., etc. When from being overheated, or in consequence of in- dulging to excess in spirituous liquors, etc., Nux vomica, or Aeon., Bellad., Bryonia, Thuja. Epistaxis in females who have too scanty catamenia: Puis., Graph., Caustic, Sep., or Sec In those, on the contrary, who have too copious a menstrual discharge : Aeon., Calc, Croc, Sabina. In debilitated subjects, or those who have previously been exhausted by loss of humours, Chin, chiefly, or Sec. and Ac. nitr. In consequence of physical exertion, Rhus, or Arnica prin- cipally. In consequence of a blow or contusion, Arnica. 29 338 general derangement. Bleeding from the nose in children, arising from worms Cino or Merc. At every attack of coryza : Pulsatilla, or Arsenicum. When nasal hemorrhage is liable to occur from the most trivial cause : Sulphur, Silicea, Sepia, Calcarea, and Carbo. v., and, in some cases, Graphites and Lycopodium are the best remedies to eradicate the constitutional tendency. The following are characteristic indications for some of the 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 the vessels of the head. Belladonna. 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 awakens the patient from sleep, and sometimes returns in the morning ; bleeding from the nose from being overheated. (See Bryonia and Rhus.) Bryonia. Bleeding from the nose, chiefly in the morning, or at night during sleep, causing the patient to awake ; epis- taxis 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 the 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 bleeding from the nose several times a day, particularly after stooping, or after every exertion, preceded and followed by great paleness of the face. (See 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 and Causticum.) BLEEDING OF THE NOSE, 339 Pulsatilla. Hemorrhage from the nose every afternoon, evening, or before midnight, especially in females with sup- pressed 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, particular- ly in the afternoon, preceded by aching and weight or pressure at the forehead; protracted bleeding after blowing the nose. Arnica. 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, spitting, etc., or nasal hemorrhage, which becomes aggravated or re- newed on stooping, or during the night. Ferrum. Nasal hemorrhage in debilitated subjects, with excessive paleness of the face. (Especially after China.) Sepia. Frequent attacks of hemorrhage from the nose, with pale or sallow complexion, especially in females with ob- strupted 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 over-heating, 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 : Dis- charge of dark coloured, thick or viscous blood from the nose, particularly in females who menstruate too copiously, some- times followed by fainting. Moschus. Frequently serviceable when the nasal hemor- rhage occurs in nervous, hysterical females. 340 GENERAL DERANGEMENT. Ammonium c. Bleeding from the nose after a meal. Silicea. Nasal hemorrhage in scrofulous subjects. When the hemorrhage is of an active kind, tho patient should be placed in the erect posture, and kept cool and quiet for some time afterwards. The diet in all cases must bo low, and 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 reme- dies, the anterior and posterior outlets from the nose may be plugged ; 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 dipping the head into a pail of iced water, or salt and water, are amongst the best of the popular means, or occa- sional auxiliary modes of stopping an excessive or prolonged discharge of blood from the nose. With regard to the administration of the remedies, the re- petition 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 cases. (See also what has been said on this matter in the Intro- duction.) 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 Assafattida; or Sulphur, followed by Calcarea; or Bella- 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 most efficacious. When attributable to the habitu- al use of spirituous liquors : Calcarea, Arsenicum., Nux v., Pulsatilla, Sulphur; or Lachesis, Bellad., Merc, Hepar s. Finally, Bellad., Merc, and Hepar have been found most serviceable in cases where the tumefaction was red and very painful; in similar cases of an obstinate character : Bryonia, Sulphur, Calcarea and Rhus have proved efficacious. When black spots in the nose are met with at the same time, Sulphur and Graphites 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 animalis, or Rhus toxi- codendron. Coppery redness, Arsenicmm 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), Teucrium 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, Assafoetida, Acid, phosp., and Silicea, etc. may in some cases become necessary, particularly when the system generally has become impaired by the cause da question. Oz^ena. This disorder consists of an ulcer having its site in the nose, from which a fetid purulent matter is discharged. 29* 342 GENERAL DERANGEMENT. It usually commences with slight inflammation and tume- faction about the alae nasi, accompanied with sneezing, in- creased flow of mucus, with which the nostril becomes ob- structed, and sometimes slight hemorrhage. The ulceration soon spreads from the schneiderian membrane to the nasal cartilages, the mucus gradually assumes the naturo of pus, and if the disease be not checked, the bones become impli- cated, and caries results ; a thin, acrid, offensive matter or sanies is then constantly 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 : Teucrium marum verum, Pulsatilla, Sulphur ; or Magncs 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 tho bones ; followed, if required, in Oz.ena scrofulosa, by Sul- phur, Silicea, Acidum nitricum, Phosphorus, Conium, or Po- tasses bich. In Syphilitic Oz,ena, Mercurius forms the prin- cipal 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„ Assafoetida, Lachesis, Conium, or Thuja. In disease in the Antrum Highmorianum, the following have been recommended : Teucrium marum verum, Arsenicum, Lycopodium, Sulphur, Silex, Aurum, Mercurius, Hepar s., Mezereum, Staphysagria, Curb, v., Antimonium c, Kali hydr., Phosphorus ; and Spigelia, Nux, China, Phosphorus, as pallia- tives when the pains are very severe* * Goullon considers Arsen+im and Lycopodium as almost specific in this disease. He recommends Arsenicum to be given when the pains are excessively severe, of a throbbing and splitting, or bursting description when at their height. Lycopodium when there is a thick and yellow discharge. A. H. Z. 2,24. canker of the mouth. 343 Polypus : Teucrium, Staphysagria, Phosphorus, Sulphur, Sepia, and Silicea have chiefly been recommended. Cancer Nasi : Arsenicum, Carbo v., Aurum, Sepia, Silicea, Sulphur, and Calcarea are the remedies which have princi- pally been pointed out as the most appropriate to combat this serious and frightful malady. CANKER OF THE MOUTH. SCURVY IN THE MOUTH. Cancrum Oris. Gangrenu Oris. Stomacace. This affection consists of a fetor in the mouthewith 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. Sometimes there is also glandular swellings, salivation, or ptyalism ; and usually looseness of the teeth, impeded masti- cation and deglutition, 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 Staphysagria, 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 • Constafltine Hering recommends a drop of Spiritus alheris nilrosi once or twice a day, in the event of Carbo v- or Arsenicum failing to bring about a favorable action in such cases. 344 GENERAL DER ANG EM EXT. during mastication ; the teeth loose, mouth hot, tongue much excoriated, and with difficulty to be moved. Alter 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 complcxioned subjects, of bilious temperament and choleric disposition, who lead a sedentary life ; the gums presenting a putrid aspect, and so much swollen as completely to cover the teeth; countenance pale and sunken. 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 are 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, Sulphur may be pre- scribed, and followed or alternated with Acidum sulphuricum, Sepia, or any of the other medicines already treated of, if re- quired by the bent of the succeeding changes in trft features of the case, etc. Silicea, Sub-boras Sodce, Helleb., and Iodi- um may also prove useful in some cases. scurvy. 345 Lemon-juice, which is well known as a most valuable re- medy in scurvy, is equally useful as a domestic remedy in stomacace. Sage is 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 proportion of vegetables, must be enjoined in order to expedite the cure. SCURVY. (Scrobutus.) This disorder is characterized by excessive debility, pale and bloated countenance ; cedematous swelling of the in- rior extremities ; hemorrhages ; livid spots on the skin, or foul ulcers ; offensive urine and extremely fetid stools. The gums spongy, or otherwise diseased, as described in the pre- ceding article. It chiefly affects sailors, or others who from circumstances are deprived of fresh provisions and an adequate quantity of ascescent food, and are exposed to cold and moisture together with fatigue. Intemperance, want of exercise, impure air, uncleanliness, with depressing emotions, further tend to pre- dispose 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 placebo 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 ace- tous fermentation ; cider, spruce beer, and the like, as also vinegar, have, moreover, been recommended. The homceopathic medicines which maybe prescribed with the most advantage against the ulcers and diseased gums are : Carbo v., Nux v., Arsenicum, Mercurius, Staphysagria, and 346 GENERAL DERANGEMENT. Sulphur; or also, Acid, nitr., Cistus, Nut. m., Ammonium c. et m., Causticum, Dulcamara, Kreasotum, Acid, mur., Sepia, etc. (See the preceding article, and also that on Ulcers.) The use of lemon or wine-juice and other acids must be discontinued during the employment of tho homoeopathic remedies. Gumboil. Silicea, Staphysagria and Calcarea, but parti- cularly the former, are the principal remedies against this affection. When there is much inflammation, and consider- able swelling, Belladonna may be prescribed, followed by Mercurius and Hepar 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 unskil- ful abstraction of a tooth, Silicea is the most important remedy. 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 montana, Urtica urens, Mercu- rius, Aconitum, Belladonna, Pulsatilla, Lachesis, and Arse- nicum. Arnica, in cases of lesion of the tongue from the points of decayed teeth, &c, or of burns or scalds. (Acid phosph., is occasionally required after, or may, in severe cases, be given in preference to Arnica: in other instances, Silicea and 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 Arnica 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 reme- dy, should the inflammation be very intense. Administration ^a ; if needful, repeated in two hours, followed by Mercurius in from three to six hours. Belladonna. When the affection does not speedily yield to Mercurius, 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 potency, 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 extreme cases of this nature, where the disease having 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, ^, internally ; and in the form of lotion, in the proportion of four minims of the mother- tincture to a hundred of water, materially diminish the risk of this taking place. Such cases will, however, rarely, if ever, occur to the ho- mceopathic practitioner, if the disease be taken in time, and his remedies judiciously selected. OFFENSIVE BREATH. Tho most frequent causes of this unpleasant affection are : uncleanliness, leaving particles of food in the teetfi ; an accu- mulation of tartar ; or carious teeth ; a diseased state of the gums ; aphtha? 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 head- ings ought to be had recourse to. When, on the other hand, no apparent cause of the derange- ment can be assigned or detected, benefit will often be deriv- ed from one or more of the following medicines : Nux v., Silicea, Pulsatilla, Sulphur, and Chamomilla; or Arnica, 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, Nux v., succeeded by Chamomilla and Sulphur. If in the evening, or during the night, Pulsatilla or Sulphur. face-ache. 349 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, or1 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 intervals, for several days or weeks in succession, and when at their height, are frequently accompanied with spasmodic twitchings 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 homceopathic 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 ; twiches in the eyelid, or violent shooting and tearing and dragging pains in the ball of the eye ; convulsive jerking in the facial muscles, and distortion of the mouth ; heat and redness of the face. The pain is generally 30 350 general derangement. preceded by itching and creeping in the affected side of the face, and at times becomes so severe as to bo almost insup- portable. Platina. 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 aggravation 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 exception of the torpor and creeping, but particularly when the right side of the face is the part affected. Colocynth. 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 espe- cially 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 prostration, with desire for the recumbent posture ; sensation of coldness in the affected parts ; ex- acerbation 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 slightest touch ; sensation of torpor and paralytic weakness in the affected part ; great loquacity, with ill-humour, paleness of the face, frequently 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, face 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 open 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. arc, Manganum, Merc, Rhus, Ignatia, Arnica, Capsicum, Causticum, Staphysagria, Coffea, etc. may be found useful. When the malady is symptomatic of derangement of the digestive functions,—Nux v., Pulsatilla, Bryonia, Chamomilla, or Lycopodium will usually be found the most serviceable. In Rheumatic Face-ache, or prosopalgia,—Aconitum, Bryonia, Rhus, Causticum, Mercurius, Phosphorus, Pulsatilla, Mezereum, 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, Aconi- tum, Belladonna, and Nux v. will be found the most appro- priate remedies, followed by Sulphur. Should the affection prove obstinate, Arsenicum and Veratrum alternately are some- times useful after Sulphur, when the palpitation has resulted especially in consequence of the suppression of an eruption, or the sudden liealing up of an old sore,— Causticum andXa- chesis are also occasionally useful in the latter case. 352 general derangement. When it results after debilitating losses, such as hemor- rhage, etc., China is the principal remedy, but may require to be followed by Acid, phosph., Sulphur, Calcarea, or Nux v. Palpitation of the heart from a fright usually yields readily to Opium ; from fear or anguish to Veratrum ; after sudden joy to Coffea ; and if from contradiction, or a fit of passion, Aeon., Cham., or Nux v., and Ignatia. When the derange- ment occurs in nervous individuals, and particularly hysteri- cal females, Pulsatilla, Coffea, Cocculus, Veratrum, Lachesis, Chamomilla, and Assafoetida will generally be found the best adapted to afford relief. In other cases, Aurum, Cocculus, Phosphorus, Spigelia, Ferrum, or Acid, nitr., etc. will be re- quired. CRAMP IN THE LEGS. Veratrum, Nux vomica, Sulphur, Calcarea, Lycopodium, Acidum nitricum, Sepia, Camphora, Argilla, 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 Colocynth, 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 Acid. nitr. when it occurs chiefly in walking. Sulphur, after Nux v. or Rhus, when the attacks occur chiefly during the night. Calcarea when stretching out the limb brings on the cramp. Argilla 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. 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, Iodium, Ammonium c, Causticum, and Natrum c et. m. 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 homceopathic 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 30* 354 GENERAL DERANGEMENT. had recourse to in the same manner- After Silicea, Rhus may again be resorted to, if required. These two remedies arc also the most appropriate to be administered against the dele- terious consequences of a suddenly checked foot-sweat. Other remedies may be required in obstinate cases of this complaint, or in those where derangement of the system gen- erally, coexists. The following may therefore be pointed out as worthy of being referred to in such cases : Mercurius, Baryta, c, Graphites, 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 indispensible 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 idiotcy,—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 conformably. SLEEPLESSNESS. 355 Intense mental application, continued up to the period of going to rest; sedentary habits; trfe 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 Bellad. 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 in such cases. 356 GENERAL DERANGEMENT. Stannum 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 some bodily ailment which ought 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.) Coldness of the feet is a frequent cause of retarded or dis- turbed sleep. Daily exercise in the open air is here-, as in most other cases, to be recommended ; also gentle and general friction, when there is at the same time, chilliness or stiffness of the limbs. The application of a vessel containing hot water to the feet is the only mode of obtaining any refresh- ing sleep in some cases, when coldness of tho feet is the dis- turbing cause :— This languid state of the circulation is often capable of being permanently removed by means of homoeopathic reme- dies, combined with appropriate exercise. Ammonium m. and Carbo v. el a.; as also Graphites, Kali c, Nux v., or Sulphur, etc. will generally be found the best adapted to the attainment of this. When, on the other hand, sleep is prevented or retarded by burning heat in the feet,—Lachesis, and, in other cases, Pul- satilla, Acid, phosphoricum, Stannum, Lycopodium, Kali c, Sepia, or Secale c, etc. must be selected. Sleeplessness from a harsh, dry, and imperspirable state of the skin, may be remedied after the removal of the said cause, when not impracticable from too long continuance, etc., by means of Graphites, Natrum c, Silicea, Sepia, Acid, nitr., or Calcarea, etc. (The warm bath forms a useful palliative, oc- casionally.) Sleeplessness and other derangements resulting from tea, require the employment of the antidotes to that drug for their removal. Of these, Cinchona will usually prove the best ; ' A. H. Z. No. 12. Band 28. inflammation of the eyes. 357 should it not be adequate to effect the purpose required, Ferrum will often succeed. (Coffea is to be preferred in recent cases of indisposition from green tea ; but it must be followed by the exhibition of Cinchona, if relief is not soon obtained.) When from coffee, Nux v., as has been already remarked, is the principal remedy ; on other occasions Chamomilla will be required, particularly when sleeplessness and other sufferings, such as headache, colic, etc. occur in nervous, highly excitable, and irritable subjects, who are extremely impatient under sufferings even of a description that would be deemed trivial by ordinary people. Ignatia, particularly in the case of mild, sensitive, or changeable dispositions. Cocculus, in nearly similar circumstances as described under Chamomilla with the distinction of a sensation of emptiness or lightness in the head. NIGHT-MARE. Incubus. Ephialtes. When this well-known and distressing disturbance occurs very frequently in an aggravated form, it becomes necessary to prescribe for it. The homceopathic remedies which have chiefly been employed against it to the best advantage are Aconitum, Nux v., and Opium. Aconitum. When there is considerable febrile excitement, with quickness of pulse, thirst, palpitation of the heart, op- pression at the chest, anxiety, and agitation. Nux v. When night-mare is occasioned by sedentary habits the habitual indulgence in spirituous, or malt liquors, etc. Pulsatilla. When there is derangement in the digestive functions, arising from gross living, heavy suppers, etc. Opium is a remedy of importance in all cases of a severe character : but particularly when, during the attack, the re- spiration is nearly suspended, or stertorous, the eyes only half closed, the mouth open, the countenance expressive of extreme anguish, and bedewed with cold perspiration ; subsultus ten- dinum. When any of the foregoing remedies, but especially Nux v. and Pulsatilla, are insufficient to effect a cure,—Sul- phur or Silicea may be restored to in repeated doses. In other cases, one or more of the following may prove useful : Phosphorus, Ruta, Valerian, Ammonium c, and Hepar. Any 358 GENERAL derangement. apparent exciting causes of the attacks must at the same time be avoided ; the diet should be light and wholesome ; suppers altogether abstained from, and a glass of cold water partaken of instead, on retiring to rest. Daily exercise in the open air, the shower-bath, or sponging with cold water every evening, are useful preventives, or auxiliaries during treatment. ACUTE INFLAMMATION OF THE SPINAL CORD AND ITS MEMBRANES. Myelitis. Meningitis spinalis. This affection is indicated by pain, more or less severe, in some cases of an intermittent character, either confined to the lumbar, dorsal, or cervical region, or embracing the entire length of the spine. The pain is aggravated by the slightest movement, and an exalted sensibility of various parts of the cutaneous surface is often perceptible in the dread and shrink- ing which the patient exhibits at tho slightest touch. Sharp pain at the epigastrium, sometimes spreading over the whole of the abdominal region, and increased on pressure ; palpita- tion of the heart; sensation of constriction and weight in the fore part of the chest, with oppressed respiration ; small, quick, hard pulse,—are symptoms which are generally encountered in the course of the disorder. When the inflammation occupies only a part of the cord, the symptoms vary according to its locality. Thus, when the commencement, or the cervical portion is principally affected : spasm of the pharynx, trismus with loss of voice ; spasm or other abnormal conditions in the muscles of the neck, chest, and superior extremities ; with general clonic con- vulsions, declare themselves. When the dorsal portion of the cord is the seat of the inflammation, opisthotonos usually results. And when that of the lumbar region is seized : re- tention of urine, or paralytic or spasmodic affections of the pelvic viscera generally, are met with. In each of the latter cases, the inferior extremities are commonly either convulsed or paralysed. ACUTE INFLAMMATION OF THE SPINAL CORD. 359 When the membranes of the cord are principally or solely effected, the sensibility of the surface is said to be always in- creased, and the spasms more frequently general, and of a tonic character. While in inflammation confined to the sub- stance of the cord the sensibility is usually lessened, the muscles of the extremities affected with clonic spasm or paralysis, and only those of the back in a state of tonic con- traction. In the former, moreover, the bowels are for the most part constipated,—while in the latter, diarrhoea has almost uniformly been found to predominate. Finally, ac- cording as the interior or posterior columns of the spinal cord happen to be the seat of the inflammation, so, it may be concluded, will the power of motion or the sensibility be ab- normally altered. Causes. Exposure to cold and damp, and external injuries appear to form the leading causes of this inflammation. Chronic Inflammation of the spinal cord and its cover- ings is generally accompanied with a trivial degree of local pain, and its prominent features chiefly consist in derange- ment of the functions of the viscera, deprivation or diminution of the sense of feeling, paralysis, cramp, and emaciation. The chronic variety is even more dangerous than the acute. The disease, when confined to the substance of the cord, may terminate in softening (ramollissement;) induration ; sup- puration ; gangrene. And in effusions of serum, pus, or blood ; or in thickening of their structure, when the membranes have been the seat of the inflammation. Therapeutics. Aconitum must be prescribed in repeated doses, in all cases where the accompanying fever is intense : and on the completion of its beneficial action, recourse must be had to Belladonna, Dulcamara, Arsenicum, Digitalis, Pul- satilla, Bryonia, Nux. v., Cocculus, Rhus, Ignatia, Opium, Veratrum,—according to the portion of the cord which is evidently attacked. Belladonna is the most important remedy when the upper part is the seat of the disorder. If, from the invasion of de- 360 general derangement. lirium, etc., there is some reason to apprehend an extension of the inflammation to the brain, this remedy will still be the most appropriate, and that on which we must rest our chiel hope in so serious a complication of a malady already suffi- ciently dangerous. Hyoscyamus, Stramonium, Bryonia, and in some instances Sulphur, may be found necessary however, and prove useful in warding off a fatal result. (Vide Phre- nitis.) Dulcamara may follow Aconitum and Belladonna, when the more acute symptoms of spinitis have been removed, and particularly when the disease has been excited by expo- sure to cold and wet. Arsenicum, Pulsatilla, and Digitalis have been recommended as useful auxiliary remedies when the thoracic viscera are prominently affected, evidenced by labo- rious and anxious respiration, palpitation of the heart, etc. ; and Veratrum, Nux v., Cocculus, and Ignatia, when the abdominal viscera are seized with coldness and spasms. Should opisthotonos result from inflammation of the dorsal division of the cord : Belladonna, Rhus, Ignatia, and Opium are chiefly to be recommended. Again, when the inflamma- tion is restricted to the lumbar portion of the cord : Nux v., Cocculus, Digitalis, and Bryonia ; or Pulsatilla, Rhus, Vera- trum, and Sulphur. In general tonic spasms resulting from inflammation of the entire cord, or rather its enveloping mem- branes,—Belladonna, Lachesis, Hyoscyamus, Opium, Natrum m., and Ignatia are the remedies from which, in general cases, we may expect to derive the greatest benefit. Arnica, Hyoscyamus, and Opium may claim a preference in myelitis arising from external injury; but we must be guided in our selection by the nature of the symptoms, and not hesitate to have recourse to one or more of the above-mentioned medi- cines if called for. (Vide Hydrophobia and Tetanus.) In the chronic form of the malady, the medicines from which the most benefit may be looked for when the disease has not reached an irremediable stage are, in addition to most of those required in the acute variety,—Sulphur, Silicea, Lachesis, Baryta c, Stannum, Causticum, etc. 361 PALSY. Paralysis. This affection consists in the abolition or diminution of the power of voluntary motion. It usually comes on suddenly, but in some instances it is preceded by numbness, coldness, paleness, and slight convulsive jerking or twitching in the parts. The treatment must be regulated according to the originating cause. When it results from apoplexy, see that article. When occurring as a sequel of rheumatism : Arnica, Ferrum, Rata,—as also Bryonia, Rhus, Lycopodium, Sulphur, and Causticum. When in consequence of debility from loss of fluids ; China, Ferrum, Baryta c and Sulphur. From the sudden suppression of an eruption, or of a wonted discharge : Sulphur and Causticum. And when it is attributable to ex- posure to the fumes of lead, or the constant handling of white- lead : Opium and Belladonna; or, Plalina, Alumina, Pulsatilla, and Nux v. (These remedies are equally useful in Lead Colic, colica pictonum.) With reference to the parts which are affected with the disorder: Belladonna, Graphites, and Causticum are chiefly recommended in paralysis of the facial muscles. Belladonna, Opium, Hyoscyamus, Stramonium, Lachesis, Graphites, and Causticum in that of the tongue. Belladonna, Nux v., Coccu- lus, Lycopodium, Calcarea, Silicea, Opium, Zincum, Ruta, etc., in paralysis of the upper extremities. And in that of the inferior extremities : Cocculus, Nux v., Opium, Sulphur, Sili- cea, Stannum, and Oleander principally. Electricity or galvanism, in moderation, is frequently of considerable service in facilitating the cure, or at all events, in promoting improvement in obstinate cases. RUPTURE. Hernia. By this term is understood a swelling occasioned by the protrusion of some of the viscera from the cavity of the abdo- men. In most cases, the displaced intestines are included or 31 362 general derangement. contained in a bag, derived from the peritoneum, which they push before them in their descent. The situations in which the swelling most commonly makes its appearance are the groin, the navel, the scrotum, the labia pudendi, and the upper and interior part of the thigh. It also occurs in the vagina, perinaeum, foramen ovale, and sciatic notch, and occasionally at every point of the fore part of the abdomen. The viscera which are most frequently protruded arc the omentum, and the small and large intestines, or a portion both of omentum and intestine. But the stomach, liver, spleen, bladder, uterus, and ovaria, etc., have been known to enter into the formation of hernial tumours. In consequence of the tumour escaping at the above-mentioned different situations, it has received the appellations of inguinal* umbilical,'] scrotal.% prudcndal.^ cru- ral or femoral, vaginal, perineal, thyroideal,^ ischiatic and ven- tral, etc. Further, from containing different kinds of viscera, it has been designated epiplocele, when its contents consist of a piece of the omentum only ; enterocele, when of a fold or portion of intestine ; and cntero-epiplocele if both intestine and omentum contribute to form the swelling. A hernia or rupture, for the most part, appears suddenly after some vio- lent corporal exertion, and presents an indolent, usually soft and elastic tumour, at some of the points or situations al- ready referred to, but most frequently at the lower and lateral part of the abdomen (the groin ;) or towards the inner part of the bend of the thigh, or at the navel (descending from the abdominal ring in the first mentioned instance ; from below Poupart's ligament in the second ; and out of the umbilicus or navel in the third.) The swilling is subject to a change of size, being smaller, or quite imperceptible, when in the recumbent position; larger or only apparent on as- suming the erect posture, and particularly when taking a full breath, coughing or sneezing, also on walking or standing long after a hearty meal. It is frequently diminished, or caused to recede completely when pressed, but returns as soon • Or a bubonocele. t Or an exomphalos. Omphalocele. X Or an oscheocele. II Or a bubonocele. § Or hernia foraminis ovalis. rupture. 363 as the pressure is removed. Vomiting, constipation, colic, and other signs of a deranged state of the stomach and intes- tines, are frequent concomitants of rupture, arising from the abnormal situation of the viscera. The nature of the contents of the hernial tumour are gene- rally known by the following distinctions : if the case be an enterocele, the swelling is smooth, elastic, rendered tense by coughing, or by holding the breath ; is in general very easily returnable, and is usually attended with a gurgling noise when ascending. An epiplocele, or omental hernia, is, on the other hand, of a more uneven and doughy or flabby feel ; it is neither made tense, nor receives any impulse from coughing ; is more compressible, and, if large, or in the scrotum, is more oblong and heavier than enterocele ; it recedes very gradually, and its reduction is unaccompanied by any gurgling noise. An entero-epiplocele, or a hernia composed both of intes- tine and omentum, has the characteristic marks less clear than either of the preceding cases ; when reducible, in pressing back the contents, it is known by the gurgling noise which attends the ascent of the intestinal portion, while that of the omentum is reduced without noise, and with greater difficulty ; otherwise, the feeling communicated to the touch is sufficient to render this variety distinguishable from the others. Causes. The predisposing causes of hernia are : general relaxation, or unusual largeness of the naturnal openings of the abdomen. When any such proclivity exists, particularly in children and the aged, the viscera are occasionally protruded by trivial circumstances, such as crying, coughing, sneezing, or even by the act of a somewhat full inspiration ; but in other cases, or where there is no marked predisposition, the protrusion only takes place under great bodily exertion. When rupture ensues in consequence of predisposition, or seems to take place spontaneously, its formation is very gradual ; but when it results from extreme corporal exertion, it appears very suddenly, and if the opening through which the bowel protrudes be small, as is generally the case in such instances, there is much danger of strangulation. 364 GENERAL DERANGEMENT. Hernia is termed reducible when it can at any time be readily- returned into the abdomen, and when, in an unreduced state, it is productive of no pain, or hinderance to the performance of the intestinal functions ; irreducible, when it cannot be re- placed in consequence of its 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 bowels, 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, the patient suddenly becomes relieved from pain, the 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 rigors and convulsive twitching in the tendons supervene, and death soon terminates the scene. Therapeutics. When the disease has not been neglected, or is not of long standing, it may be cured by the action of internal 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 a 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 of inguinal 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, t 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 ex- cessive sensibility to the touch ; violent burning pain in the abdomen ; bitter, bilious vomiting ; agonizing restlessness, and cold perspiration. A secoud 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. t Hering's Hausarzt. 31* 366 GENERAL DERANGEMENT. nilum, under the circumstances mentioned; but when no change for the better resulted after the third exhibition, or when the bilious eructations and vomiting become converted into an acid character, Sulphur must be prescribed, and if the patient fall asleep thereafter, he should be allowed to re- pose quietly. When the tumour is not so painful or tender to the touch 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., Nux v. is to be preferred, and may be repeated every two hours or so.* If no change results in about two hours after the second dose 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 distension of the abdomen, putrid eructations, 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 favorable 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 the remedies indicated ; but the latter should always be tried first, as no bad conseq'uen- • Vido note, p. 21. fainting. 367 ces 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 faintino' 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 sudden transitions from cold to heat; breathing vitiated atmospheres ; great fatigue ; loss of blood ; long fasting; grief, fear, and other mental emotions. When fainting occurs, let the patient be immediately re- moved to where a stream of pure fresh air can be obtained, and let all tight clothing about the neck, chest, and abdomen be loosened ; the patient should at the same time be placed in a comfortable position, with the head low. If the foregoing prove insufficient to effect restoration, sprinkle cold fresh water on the face and neck, and, if necessary, on the pit of the stomach. Should there still be no marked benefit produ- ced, or if the patient becomes cold, a little spirits of camphor may be applied to the nose. When the fainting has arisen from fright, the best medicines for the consequences are Aco- nite or Opium, and sometimes Colocynth. (See Mental Emo- tions.) After great depletion, or other debilitating causes,— Cinchona, and, in some instances, Nux v., Carb. v., and Ve- ratrum ; also a little wine in very small quantities at a time, or a little bread or biscuit, soaked in wine, and sometimes a little strong soup may be administered. Should the fainting arise from mental emotions, Ignatia and Chamomilla are the remedies in general cases. (See Mental Emotions.) When slight pain causes fainting, Hepar sulph. Fainting from vio- lent pain, Aconite, Chamomilla, or Cocculus. If liable to re- sult from even the most trivial degree of fatigue, Veratrum. From excessive mental application, or in those who have been addicted to the use of ardent spirits, Nux vomica. 368 GENERAL DERANGEMENT. In other cases, the following remedies have been recom- mended where the symptoms met with are as described. Aconitum. When there is palpitation of the heart, with determination to the head, humming in the ears ; or when the paroxysms come on usually on assuming the erect posture, and are accompanied with shivering and flushing of the face, suc- ceeded by deadly paleness. Coffea may be prescribed after Aconitum in highly excita- ble or nervous subjects, when the fainting fit has arisen from fright, and the last-named medicine has not relieved much. Hepar sulphuris, when the fits generally come on towards evening, and are preceded by vertigo. Lachesis. When the fainting fits are either preceded, ac- companied, or followed by asthmatic symptoms, vertigo, pale- ness of the face, nausea, vomiting, convulsions, spasms of the jaw. rigidity of the body ; bloated appearance of the face epistaxis ; aching pain or stitches in the fore part of the chest; cold perspirations. (Sec Veratrum.) Moschus. Fainting fits, attended with spasms in the chest, or succeeded by headache, and occurring towards evening, during the night, or in the open air. Veratrum when the attacks are excited by the slightest fatigue ; or when they are often preceded by a feeling of ex- treme anguish and excessive dejection, or despair, and ac- companied by spasmodic clenching of the teeth, and convul- sive movements of the eyes and their lids. When the fits takes place particularly in the morning, after a meal, or after taking exercise ; and there is nausea, with paleness of the face ; also, when the patient complains, on re- covery, of pain in the stomach, sparks before the eyes, or dim- ness of sight, together with a feeling of anxiety; and is, fur- ther, affected with anxiety, trembling, and congestion in the head, or oppression at the chest, — Nux v. is a beneficial remedy. Acidum phosphoricum has been found useful after Nux v., when that remedy has not removed or diminished the tendency to suffer from fainting fits after a meal. When, as is frequently the case, the fits of swooning or fainting. 369 fainting take place in hysterical females, the remedies which W'ill commonly be found the most appropriate are : Ignatia, Nux moschata, Cocculus, Chamomilla, Nux v., Natrum m., or Arsenicum, etc. In conclusion, it may be added, that Caladium, in addition to Aeon., is useful in cases that are liable to come on after assuming the erect posture. Kreasotum and Spigelia, when occurring from the heat of the room. Lycopodium and Sili- cea, when in the recumbent posture. Caladium, when engaged in meditation. Carb. v., Natrum m., Kreasotum, in addition to Nux v., when in the morning. When writing, Caladium. If the attacks are attended with asthmatic symptoms, Kre- asotum and Berberis, in addition to iYuac v. When accompa- nied with headache, Lycopodium, Moschus, Graphites, Natrum m., Stram. ; loss of consciousness, Lycopodium, Oleander, Arnica, etc. Creeping or crawling in the limbs, Nux v., Borax. Humming, buzzing or tingling in the ears, Aconitum, Nux v., Petroleum, etc. Paleness of the face, Berberis, Natrum m., Pulsatilla, etc., in addition to Nux v. Copious perspira- tion or sweating, Calcarea. Pain in the heart, Lachesis, etc Benumbed limbs, Natr. m. Coldness or shivering, Aconitum, Calcarea, Colycynth, etc. Vertigo, Sulphur, Arsenicum, Ber- beris, Lachesis, etc. Vomiting, Lachesis, Nux v., Pulsatilla^ Kali c, etc. Those who are subject to fits of fainting or swooning should, if possible, strictly avoid those frequent causes of fainting fits which have been alluded to at the commencement of this chapter ; as also, where practicable, any other cause known by experience to be productive of the attacks ; otherwise the cure will be rendered difficult, or even hopeless. Administration of the remedies. The dose may gene- rally be repeated in from five to ten minutes, or if after the second or third dose no effect is produced, another remedy must be selected.* • Vide note, p. 21. 370 HEADACHE. Cephalalgia. Cephaleea. Cephalalgia Arthritica. Cephalalgia Nervosa. Hemicrania (megrim). Glavus Hystericus. Headache is often but symptomatic of disease, and in such cases is only to be cured by the removal of the primary affec- tion. When, therefore, it arises from derangement of the stomach, or dyspepsia, constipation, cold in the head, mental emotions, congestion of blood in the vessels of the head, etc. the remedies most appropriate to the treatment of these differ- ent disorders must be had recourse to. In the treatment of nervous headaches, hemicrania or me- grim, the following remedies have generally been found the most useful : Nux v., Veratrum, Colocynth, Pulsatilla, Sepia, Ignatia, Bryonia, Rhus, Ipecacuanha, Chamomilla, Coffea, Hepar, China, Cicuta, Belladonna, Arsenicum, Arnica, Acid. nitr., Petroleum, Sulphur, Silicea, Platina, Causticum, Gra- phites, Natrum m., Phosphorus, Zincum, etc. Rheumatic headaches : Aconitum, Chamomilla, Mercurius, Nux v., Pul- satilla, Lycopodium, Spigelia, Sulphur, Bryonia, Belladonna, China, Ignatia, Phosphorus, etc. Arthritic : Bryonia, Nux v., Belladonna, Colocynthis, Sepia, Ignatia, Veratrum, etc. Hys- terical : Ignatia, Moschus, Platina, Veratrum, Valerian, Se- pia, Aurum, Acid, nitricum, Magnesia, c. et. m., Cocculus, Phosphorus, etc. Against headaches occurring in extremely sensitive individuals : Aconitum, Ignatia, Chamomilla, Coffea, Spigelia, Veratrum, Cina, or Ipecacuanha have usually proved the most appropriate. Headaches arising from the habitual use of Coffee are generally curable by means of Nux v., Cha- momilla, or Ignatia. Those from long-continued, excessive mental application : Nux v., Opium, and Sulphur chiefly ; but also, Lachesis, Pulsatilla, Calcarea, Aurum, Natrum m., Silicea, Lycopodium, etc. If, from sitting up late, or prolonged watching at the bed- side of a sick person : Cocculus, Nux. v., or Pulsatilla. When headache is always excited by exposure to a current of air, Aconitum, Belladonna, Colocynth, Nux v., or Cinchona have headache. 371 often been found successful either in removing the said sus- ceptibility, or in shortening the attacks, and rendering them of a much more bearable character. And when cold, damp, or boisterous weather is generally productive of headache ; Bryonia, Nux v., and Carbo v. : these last named medicines, « together with Silicea, are frequently equally useful, if head- ache is always experienced during hot, sultry weather,—the air being overcharged with elictricity. Against headaches arising from the effects of mercury in large doses : Carbo v., Pulsatilla, Cinchona ; or Hepar sulphuris, Acidum nitricum, Aurum, or Sulphur. Headache after drinking cold or iced water, etc. Aconitum, Arsenicum, Opium, Belladonna, Pulsa- tilla, Sulphur, and Natrum. In general cases, the subjoined remedies will prove useful, and may be selected according to the indications given. Belladonna. When headache is periodic, or nearly con- stant, and the pain is increased by the slightest movement either of the head or body, and particularly on stooping, or by moving the eyes ; or when a bright light, or the most trivial noise tends to aggravate the pain, which consists of a dull pressure at the vertex, or is of a lancinating description, and occupies either the entire head (cephulaea,) or merely one side (hemicrania,) extending from the occiput into the orbit and root of the nose, and is then described as a violent, screw- ing, piercing, bursting or tearing pain, sometimes attended with great heat at the vertex ; or the seat of the pain is in the forehead, and is of a dull, aching, or cutting description, at- tended with a sense of fulness or a feeling as if the brain would be forced through the forehead in stooping. At times these pains become so violently increased as almost to deprive the patient of consciousness whilst they last; or the headache attended with extreme restlessness, sleeplessness and delir- ium ; falling off of the hair in consequence of the headaches. Platina answers well, in some cases, after Belladonna, when the pain is chiefly lateral, and of the same description ; or when there is, at the same time, coldness of the one half of the face, etc, with humming or buzzing in the head. Mer- curius and Hepar s., and in very obstinate cases, Sepia and Silicea, are frequently very useful after Belladonna. 372 general derangement. Bryonia. Aching, piercing, or digging, tearing pain, at a small fixed spot (clavus hystericus;) or piercing, aching pain in the forehead daily after a meal, or coming on in the morn- ing, and afterwards becoming lancinating ; or pain coining on in the morning, disappearing in the afternoon, and returning again in the evening with great violence, when it is attended with a sensation as if the head were pressed together ; burn- ins, tearing pain over the entire head ; shootings in one side of the head. The pains are increased by movement, and are attended with irascibility, and disposition to chilliness or shiv- ering ; they are sometimes relieved or terminated by a fit of vomiting. Nux v., and Rhus often serve to complete the cure of the foregoing symptoms, or, at all events, to curtail or remove each attack after the previous administration of Bryonia. Rhus. Shooting and rending pains, extending to the ears and root of the nose ; burning or pulsative pains ; headache after a meal, with desire to assume the 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 sensa- tion 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. Periodic cephalalgia, aggravated by mental emo- tion, particularly in hysterical subjects ; the pain is either of a lancinating description, and 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. Sepia 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 is especially useful where a sensation is experienced as if the brain were about to protrude through the forehead or orbits; or pain so severe as if the head would split; or semi-lateral, 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 tenden- cy to frequent sweating of the head, or when there is fre- quently great tendernes of the scalp, Silicea is further indi- cated ; as also in cases where the parties affected are sub- ject to the formation of small tubercles on the head. Hepar sulphuris is also a good remedy to follow Bella- donna 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 painful tubercles on the head. The pains chiefly piercing, generally aggravated at night, and frequently limited to a small fixed spot, with a sensation as if a nail were being driven into the 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 coldness at the part which is subsequently affected ; suc- ceeded by throbbing, and then an intestine shooting, piercing, rending, or stunning pain confined to a small space, which can frequently be covered with the point of the finger, and is extremely sensitive to the touch ; or the pain causes a sen- sation as if a nail were driven into the head; at other times, the pain extends 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 place, which can frequently be covered 32 374 oenerl derangement. with the point of the finger ; or rending, aching pain, affect- ing only one side of the head, sometimes combiuod or alter- nating with shootings ; the pain becomes heightened to such 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 tho scalp. The pains are aggravated by movement, such as walk- ing or stooping, or by reflection; also after eating, or on go- ing into the open air, and are frequently attended with consid- erable giddiness or confusion in the head ; the headache is generally attended with extreme irascibility, and is renewed or aggravated after partaking of coffee, the constant habit of drinking which is not an unfrequent 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 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 driven into the brain ; nausea ; dimness of the sight, and sensibility of the eyes to light; paleness of the face, and temporary alleviation from change of posture ; aggravation from noise or strong odours or after partaking of coffee. Ignatia is sometimes service- able in completing the cure after the previous administration of Nux v., or Pulsatilla. It is especially applicable to ner- vous, hysterical females of a mild and sensitive disposition. Coffea. In cases of megrim, brought on by meditation, vexation, or exposure to cold, attended with irritability, sensibility to noise, great anxiety ; and chilliness, and a sen- sation 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. Megrim, characterized by rending or shoot- ing pains, with heaviness of the head, dimness of the sighti sensibility to light; or buzzing or singing in the ears, and ear- * Compare with Belladonna and Arsenicum. 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- ticulary when sitting ; melioration in the open air. Disposi- tion mild ; temperament phlegmatic. China. 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. 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, sometimes attended with a sensation of constriction or tight- ness in the throat ; feeling of coldness at the crown of the head, as if ice were placed upon it; or sensation both of cold- ness and heat on the exterior of the head, with deep-seated or internal burning 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 stom- ach, or painful stiffness of the neck, headache with extreme ^weakness and melancholy ; painful sensibility of the hair to the touch ; chilliness, with general cold perspiration. Arsen- icum and Acid. phos. are sometimes useful after Veratrum, Lachesis. 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 the head ; excessive nocturnal aggravation of the headaches, often accompanied by profuse sweating. 376 GENERAL DERANGEMENT. Colocvnth. Nervous headaches attended with smarting in the eyes ; excruciating lateral action ; rending, dragging pains; nausea and vomiting; feeling of compression in the forehead increased by stooping or lying on the back ; head- ache every afternoon or evening, with great 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. 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 the head (hemicrania) 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 is further occasionally very useful after the pre- vious administration of Coffea when not called for from the com- mencement. Or in hemicrania attended with extreme excita- bility arising from the daily use of black coffee, but which is generally relieved for the time by partaking of a cup of coffee, will generally be materially relieved, if not cured, by Chamo- milla ; sometimes a subsequent dose or two of Nux is re- quired to complete the cure. Sulphur. Chronic headache ; headaches occurring daily, or every eight days, worse in the morning, or during the night, and 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 movement; extreme tenderness of the scalp to the touch ; falling off of the hair. Calcarea. Chronic headaches frequently attended wilh a sensation of extreme coldness, either interiorly or on the 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, con- fusion of ideas, with aggravation from intellectual employ- ment, 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 dispair, occurring periodically and aggravated 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 some- times nausea and vomiting which produce exacerbation ; aching pains in the entire head at night (cephalaea) with burn- ing 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 discription, it is only pos- sible 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 exces- sively 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, Sic, considerably longer intervals must be observed between the doses, when * Vide note p. 21. 32* 378 GENERAL DERANGEMENT. 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 re- quires distinct consideration. Although it is generally asso- ciated with or dependent on other maladies, it so often pre- dominates 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 suffer- ing. It may also depend on accidental causes ; still the re- medy while antidotal to them must carefully embrace all the existing symptoms. Again, it may occur perfectly indepen- dent of any assignable cause, and thus render the following arrangement of the remedies essential to the successful selec- tion of the therapeutical agent. Congestive Headaches or those attended with pressure of blood to the head. Examine carefully the symptoms of Congestive Headache under the following remedies : Aconite, Arnica, Belladonna, Bryonia, Coffea, Ignatia, Mercurius, Nux vomica, and Pulsatilla. Catarrhal Headache. Examine Aconite, Belladonna, Mercurius, Nux vomica, and Pulsatilla. Rheumatic Headache. Aconite, Belladonna, Bryonia, Chamomilla, Mercurius, Nux vomica, and Pulsatilla. Nervous Headache. Aconite, Arnica, Belladonna, Bryo- nia, Chamomilla, Coffea, Ignatia, Nux vomica, and Pulsatilla. Digestive or Gastric Headache. Antimonium crudum, Bryonia, Nux vomica, and Pulsatilla. * In the British edition of Laurie, from which the third American was reprinted, no article on Headache was inserted. We supplied the omis- sion at the time, and, although Dr. Laurie has furnished a chapter lor his last edition, we do not find it sufficiently complete to obviate, in all respects, the repetition of our own paper. We consulted Hahnemann, He ring, Jahr, and other best authorities of our school in its composition. -Ed. HEADACHE. g^g Headache from Heat. Aconite, and Bryonia. Headaches from Changeable Weather, Currents of Air, Cold, Cold Drinks, and Bathing. Aconite, An- timonium crudum, Belladonna, Bryonia, Chamomilla, Nux vomica, and Pulsatilla. ^ Headache from Tobacco. Aconite, Antimonium cru- dum, and Ignatia. 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, and Pulsatilla. Headache from Coffee. Chamomilla, and Nux vomica. Headache from Anger. Chamomilla, Ignatia, 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 for 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, ex- cessive sensibility to the least noise or movement, and, some- times, 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 tumbler- fuls 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 nose, buzzing in the ears, colic, frequent chilli- 380 GENERAL DERANGEMENT. ness, alternating with feverishness, occasional cough ; amelio- ration of the symptoms in the morning, and in the open air ; aggravation in the evening, and from speaking and exercise. The 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 the neck and shoulders, are attended with activefever, dry and hot skin, 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, are throbbing, darting, and sting- ing, producing by their intensity, lamentations, inconsolable anguish, fear of death, and, at times, temporary insensibility, and are attended by thirst, flushed cheeks, small, quick, weak, and occasionally, intermittent pulse, and intolerance of touch, light and sound. Headache from exposure to Heat usually assumes the characteristics of the Congestive, 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, mark- ed particularly by sensation of great weight on the vertex and over the eyes, nausea and amelioration in the open air. All the preceding forms of headache to which Aconite is appli- cable, have the distinctive peculiarities of an increase of suf- fering from motion, rising from a recumbent position, speaking and drinking; 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 propor- tion 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 ad- ministration 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 spasmo- dic pressing in the forehead, as if the brain were contrac- ted 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. The headache which follows Mechanical injuries, such as 382 GENERAL DERANGEMENT. blows, falls, or strains, in the same as the Congestive, atten- ded at times, by pressive sore pain in the part injured or over one or other eve, and green vomiting. This remedy is the more appropriate when the sufferings are aggravated at evening or night, after eating, or by mental or physical exercise. Administration. Arnica follows and alternates admirably with Aconite when the febrile action is prominent and may pre- cede the use of Belladonna, Calcarea and Rhus. The rule of repetition is the same as that given for Aconite. Belladonna. Belladonna obtains in headaches, complicated with Con- gestion to the head, Catarrh, Rheumatism, Neuralgia ; and those from Heat, Spirituous drinks, Mechanical injuries, Cold, and Currents of Air. It is especially suitable for females and children. It is apppropriate 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, heavy and full, as if the brain would protrude through the forehead or side of the head, with pale, haggard face, drowsinsss, 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, imper- fect speech, distortion of the face, especially of the mouth, and other symptoms of Apoplexy. The Catarrhal headache is marked by pressive achiw in the forehead and 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. (Hepar sulphuris or Mercury may precede or follow Belladonna for this variety of Catarrhal headache.) Rheumatic headache is attended by violent shooting 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 arteries, 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- sion 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 Congestive, and indicates Belladonna, especially, when the head seems as if it would split open and the suffering is in- creased by walking and mental excitement, and is attended by hot fever, thirst, vomiting, sleepiness, anxiety, tears, lamenta- tion, 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. Administration. Belladonna is frequently preceded by, 384 GENERAL DERANGEMENT. and alternated with Aconite and Mercury. Its rule of repeti- tion and alternation is the same as that directed for Aconite. Bryonia. Bryonia is available in headaches associated with Conges- tion to the head, Derangement 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 is generally worse in the morning. For headaches of the Stomach, see Indigestion. Nervous headache has pressing, burning, rending and shoot- ing pains, as if a tumor were forming under the skin, and as 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 check-bone, shooting and 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 night. Changeable weather frequently excites the Rheumatic headache. Headache from Heat is marked by pressing pain and ful- ness of the entire head, attended by want of appetite, espe- cially in the morning, nausea, vomiting and diarrhoea, thirst, fever, agitation, trembling and apprehension of the future. The Bryonia may be used in alternation with Belladonna, when that remedy is not promptly efficient for headache from heat, as described under Belladonna. HEADACHE. 385 The headaches of Bryonia appear most frequently in the morning and after meals, and are aggravated by motion, walk- ing, stooping, &c, and touch. Administration. Nux vomica may be used after and alter- nated with Bryonia. The repetition and alternation of the dose the same as directed for Aconite. Chamomilla. Chamomilla is useful for Digestive, Nervous, and Rheuma- tic headaches, and those caused by Coffee, Anger, and Cold; and for females, children, and persons excited by the slight- est 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 recognized 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. Chamomilla may be used after Aconite 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 attend- ed by lively exaltation of the mind, heaviness of the head, with occasional violent pain of one side, redness of the eyes and sleeplessness, and is exasperated by speaking. 33 386 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 ; fre- quently caused by Debauch or Spirituous drink, meditation, vex- ation and influenza; attended by extreme sensitiveness to noise and music, by agitation, great anguish, tears, cries, distrac- tion, throwing about, chilliness, aversion to fresh air and dis- taste for coffee. Administration. The Coffea may be repeated frequently, from half an hour to two and three hours, according to tho relief afforded. Ignatia, Nux vomica and Pulsatilla, may precede and Aconite and Chamomilla succeed the use of Coffea. Ignatia. Ignatia relieves Congestive, Hysterical, and Nervous head- aches, those dependent on Grief Anger, and Tobacco, and those of nervous persons and children. Congestive headache is characterized by a painful sensa- tion of fulness and expansion of the head, as if it would burst, especially when conversing, reading 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 tremb- ling of the body, palpitation of heart and great despondence. Hysterical headache is 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 gaiety, 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 the 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 even- ing and rising in the morning. Rule of administration the same as for Aconite. It may be used to advantage after Chamomilla, Pulsatilla and Nux vomica. Mercurius solubilis or vivus. Mercurius solubilis or vivus, is most efficient in head- aches connected with Catarrh, Congestion to the 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 itching and aching pains on pressing the nose, chills or fever, nocturnal perspiration, violent thirst, pains in the limbs, and increased suffering from either heat or cold. (It may precede or alternate with Belladonna in this form of headache.) Congestive headache has a full and crowded 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 and 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 after Belladonna or Bryonia. 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 evening. Nux VOMICA. Nux vomica is a very prominent agent of cure in Catarrhal, Congestive, 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* Catarrhal 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 in the morning and dry in the evening or at night, with parched mouth and absence of thirst ; bruised sensation throughout the body ; burning heat and redness of the cheeks ; heat of the head and entire body, and alterna- tions of chills and fever, especially in the evening; and hard fceces or constipation. Gastric headachej 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 de- sire'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 Nux is most indicated in persons of a lively temperament, red face and full habit, who make a free use of Coffee and Liquors, and especially in 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 tensive 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 crumps and palpitation in the muscles ; shivering and constipation. (It is mainly indicated for Rheumatic head- ache after Aconite, Chamomilla, Ignatia, 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. The Nux may succeed Aconite, or al- ternate 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 by De- bauch, Spirituous drinks, Intellectual labour, Chill, Bathina-, 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 33* 390 general derangement. root of the nose, forehead, or over one rye, or confusion of the head, and is attended by loss of appetite, taste and 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 the 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 pain3 of the body, which pass rapidly from one joint to another, with sensation of torpor in the parts affected, darlings 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 is aggravated or renewed in the evening after lying down, or at night, or in bed in the morn- ing; at rest, especially when sealed; and mitigated in the open air, by movement, walking, external heat and firm pressure. Administration. Pulsatilla follows, and is of great ser- vice 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 treatment must be directed against the disease from whence they originate. Thus as Haemorrhoids, Leucorrhcea, Metritis, Myelitis, etc. are frequent sources of the complaint, the reader is referred 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 heavy weight, or from any sudden twist on turning the body, or throwing up a window, etc. has given rise to the pain, Rhus toxicoden- dron must be had recourse to; followed, if required, by Sulphur and Calcarea. (Vide also Lumbago, Rheumatism, etc., and for pains in the back, or lumbosacral pains, occurring in females during pregnancy, see that Article, Part IV.) 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 ex- haustion caused by excessive depletion ; from the efTects of lead, and also from the prolonged use of opium. The intem- perate 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 drunkards in the state of prostration which ensues when they have in a great measure given up, or been suddently deprived of their accustomed stimulus. The first symptoms of the malady are generally indicated 392 general derangement. by extreme irritability of temper, weakness of memory but constant activity of mind, anxiety, and incontrollable restless- ness with increased muscular mobility. The appetite is often pretty good, but more frequently impaired in consequence of the previous habits, and the tongue sometimes foul and moist. Soon after these premonitory signs, vigilance sets in, and little or no sleep can be 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 is bent upon poisoning him or doing him some other grievous injury, etc., yet he generally dreads being alone. The speech is frequently stuttering and inarticulate ; the countenance quick, wild, and exceedingly variably, 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 relaxed, very rarely above the natural temperature ; the hands are commonly tremulous, and muscular twitchings are often observable. As the disease advances, sleep is com- pletely banished ; loquacity, with perpetual bustling occupa- tion, becomes incessant; 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 is difficult to con- fine him to his bed or apartment ; at the same lime, ex- haustion is liable to come on very rapidly after great exertion, and the patient is prone to drop down from fatigue. Occa- sionally convulsions take place, but though sometimes 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 symptoms 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 efTects of Opium or its alkaloid, in large doses), Aconitum, Belladonna, Lachesis, Hy- oscyamus, Sulphur, and Calc. form our main remedial agents. delirium tremens. 393 Nux v. is particularly useful in the first stage of the dis- order, and may frequently be the means of arresting its further progress when administered at that period. The 3-6 or 12th 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 com- mencement of the attack, we must have recourse to Opium, (potency 3-6,) in frequently repeated doses. The curative properties 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 homceo- 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 pre- scribed in preference to Belladonna, when the patient's insan- ity 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 impoftance in such * Vide note, p. 21. 394 general derangement. cases, but more especially in plethoric habits. Finally, Stra- monium may be mentioned as likely to be useful when Bella- donna, Hyoscyamus, and even Opium fail to do much good, and the spasms or convulsions are very severe. Coffea and Camphora have likewise been named as likely to prove ser- viceable against the vigilance, or the mental and bodily activi- ty, when the remedies already enumerated fail to answer ex- pectation. But it may safely be averred, that there are few instances in which Nux v. and Opium, when timely adminis- tered, will not succeed in subduing the more violent features of the disease; and Sulphur, Opium, Nux v. and Calcarea, in removing any inveterate sequela?. These medicines, together with Arsenicum and 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 dis- ease as ordinarily met with. Delirium tremens arising from exposure to the vapor of lead, chiefly requires : Opium, Bel- ladonna, and Nux v.; and that from poisonous doses of Opi- um ; Nux v. and Belladonna chiefly. (See Poisons.) EPILEPSY. Epilepsia. This well-known and 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, Nux v.. Opium, Ipecacuanha, Camphor, etc In chronic: Sulph., Calcarea, and Silicea : or, Causticum, Cuprum, Stannum, Bel- lademna, Hyoscyamus, Stramonium, Veratrum, Cicuta, Zincum, Lachesis, Hepar, Arsenicum, Agaricus, etc. When the reper- cussion of an eruption, 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 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 come on in the afternoon, or on retiring to rest, but much more frequently during 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 is very various. One attack generally leads to another, and the paroxysms commonly become more and 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, wilh 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 is exceedingly copious ; and hence, the disease has been divi- ded into dry and humid asthma. In the former (Asthma 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; and in some instances entirely wanting. In the latter, (Asthma humidum), 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 (asthma sicca) the remedies which have been employed with the most satisfactory results are : Arsenicum, Cuprum, Ipecacuanha, Nux v., Bryonia, Pulsatilla.— Opium, Tartarus, Sambucus.— Aconitum, Belladonna, Phosphorus.—Sulphur, Lachesis, Sam- bucus.—Ferrum, Veratrum, Moschus, Stannum, Hyoscyamus, Stramonium, Chamomilla, Carbo v., Aurum, Lycopodium, Acidum nitr., Ignatia, Kali, Ambra, Mercurius, Silicea, Calca- rea, Dulcamara, Coffea, Lobelia inflata, Sic. In moist, humid, ASTHMA. 397 pituitous asthma (asthma humida) : Pulsatilla, Dulcamara, Stannum. — Sulphur, Sepia, Tartarus, Cuprum, Sambucus.— Ipecacuanha, Belladonna, Bryonia.—Ferrum, Calcarea, Lache- sis, Graphites, China, Silicea, Hepar, Baryta c, Conium, Cam- phora, Zincum, Mercurius. In flatulent asthma : Nux v., Cin- chona, Carbo v., Lycopodium, Chamomilla, Phosphorus, Sul- phur, Opium, Zincum, <$-c In asthma spasmodica, Pulmo- nary spasm (cramps in the chest) : Cuprum, Nux, Bryonia, Belladonna, Hyoscyamus, Arsenicum, Lachesis, Stramonium, Cocculus, Nux m., Sambucus, Tartarus, Zincum, Sulphur, Kali, Causticum, Sepia, Stannum, Lycopodium, Sic Asthma ari- sing 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 re- commended, 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 metastasicum) : Sulphur, Carbo v., Arsenicum, Bryonia, and Phosphorus are the most appropriate in the majority of cases. If from suppressed catarrh: Ar- ' senicum, Ipecacuanha, Nux v., Sic Where a chill has given rise to an attack of asthmatical breathing, Ipecacuanha and Arsenicum ; or, Dulcamara, Aconitum, Belladonna, Bryonia, Chamomilla. And when mental disturbance has brought on a paroxysm of dyspnoea: Aconitum, Chamomilla, 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 Cuprum, Moschus, Opium, Tartarus, and Sambucus; or Nux v., Bryonia, Chamomilla, Belladonna, Cinchona, Nux 34 398 general derangement. moschata, or Pulsatilla will prove more useful. And those which have principally been recommended to eradicate the tendency to suffer from repeated recurrences of the disorder, where that is practicable from the absence of serious organic disease, &c, are as follows : Sulphur, Calcarea, Arsenicum, Nux v., Antimonium.—Stannum, Sepia, Silicea, Cuprum, La- chesis, Carbo v.-Lycopodium, Causticum, Graphites, Acidum nitricum, Phosphorus, Ammonium c, Ferrum, Zincum, Tussi- lago. In ordinary cases the subjacent remedies will be found serviceable, when the leading symptoms are in accordance with those which are described. Ipecacuanha. 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 redness ; coldness of the feet; anxiety and dread of suffoca- tion ; feeling as if dust were inspired during the act of respi- ration, and caused the suffocating feeling in the chest ; spas- modic rigidity 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 in- stances Nux v. or Bryonia will be found better adapted to re- move the remaining symptoms. Arsenicum. Is chiefly called for (either in 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 death, 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 be- fore midnight, the patient being disturbed from sleep by a sense of spasmodic constriction in the chest and larnyx, which is soon followed by laborious, panting, and whistling respira- tion with gasping for breath. These symptoms are occasion- ally 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 re- lieved by the accession of a fit of coughing, with expectora- tion of viscid mucus filled with vesicles. Arsenicum, 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, on 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 hpyo- 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- V ment; frequent efforts to obtain sufficient air by deep inspi- rations, accompanied with moaning, palpitation of the heart, and great anxiety. The attacks are often attended by shoot- ings in the chest on taking a full inspiration, also on cough- ing, 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 everything. (Bryonia and ISlux v., are often administered with great advantage in alternation.) Nux vomica. Nocturnal attacks of suffocating tightness, 400 GENERAL DERANGEMENT. especially at the lower part of the chest, preceded by disagree- able 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 re- gion, as also in the hypochondria; feeling of distension in the abdomen and epigastrium ; flatulence ; tension, pressure, and aching in the chest ; palpitation of the heart ; short hack- in? cough, with difficult expectoration ; inability to bear the slightest pressure from the clothing, particularly around the chest and waist; the clothes 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 the temperature be somewhat cold ; dyspnoea after trivial corporal exertion of any kind. Melioration of the asthmatic sufferings when reclining on the back, or on chang- ing from one posture to another, such as sitting 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, es- pecially at the inferior portions ; or suffocating feeling in tho 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 appearing to threaten suffocation : or cough with copious expectoration of mucus. The attacks usually coining on at night, or in the evening when in a horizontal posture; extreme anguish, palpitation of the heart, and some- times 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 disposition. 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 excessive secretion of mucus in the bronchi; this remedy is frequently of great service, either in aged persons or in children. ASTHMA. 401 Opium. Obstructed breathing, either from congestion or from pulmonary spasms, with suffocating cough and livid hue of the face ; loud mucous rattling in the chest, with extreme anguish from dread of suffocation; dyspnoea during sleep resembling nightmare (incubus.) China. Paroxysms of asthma at night, as if caused by an accumulation of mucus in the windpipe ; wheezing in the chest during inspiration; difficult expectoration of thick transparent 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. Sambucus. Rapid and laborious respiration, with loud wheezing ; oppression at the chest as if from a weight, at- tended with anguish and dread of suffocation, and sometimes swelling and livid hue of the face and hands, general heat, tremor, inability to talk much above a whisper ; suffocating cough ; aggravation of the symptoms in the recumbent pos- ture. 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 in- halation of the vapour of sulphur, commencing with a fit of coughing and succeeded by distressing oppressive constric- tion, sometimes to such a degree as almost to drive the pa- tient to exasperation and distraction. Belladonna. Difficulty of breathing, particularly when occurrino- in females of an irritable habit, and subject to spasms, with tension in the chest, and lancinating pain be- hind the sternum ; dry cough at night, with moaning respira- tion which is sometimes deep and full, at others, short and rapid, with gasping for breath and great efforts to dilate the chest to 402 GENERAL DERANGEMENT. the utmost to obtain a sufficient supply of air ; sensation of constriction in the larynx, and feeling as if suflbcaiion would ensue on putting the hand to the larynx, or on turning the neck ; paroxysms of asthma, with loss of consciousness, Sic. Lachesis, is often useful when only partial relief has been effected by the action of Belladonna. Veratrum. In violent attacks of acute spasmodic asthma, with symptoms of threatening suffocation, cold perspiration, coldness of the nose, ears, and lower extremities, this remedy will often afford relief when Cinchona, Ipecacuanha, and Arsenicum have failed lo do so. Dulcamara. In moist asthma (asthma humida) this medi- cine is one of the most useful remedies, and particularly when the attacks are liable to be excited by a cold and damp state of the atmosphere. In severe dyspnoea, with loose sounding cough, rattling of phlegm in the chest, and copious expectora- tion, arising from exposure to wet, it is likewise a valuable remedy. Stannum. Humid asthma with obstructed respiration and fits of shaking, particularly at night, or on preparing for bed, but also when the paroxysms come on during the day, and render it necessary to loosen the clothing. The attacks are attended with oppression at the chest, and mucous rattling ; cough, with copious expectoration of viscid or grumous, or transparent and watery, or yellowish mucus of a sweetish or saline taste. Phosphorus, Sulphur, Calcarea, Sepia, and Lycopodium are also of much value in humid asthma, and of great service in some of the most obstinate cases. In chronic asthma, a dose of the medicine required may be taken at in- tervals of from four to eight days or so ; but in acute cases, or when the remedy is prescribed during the paroxysm, the dose may be repeated at intervals of from half an hour to two hours and upwards, according to the severity of the case. When the medicine first prescribed affords no relief after from two to three repetitions, another must be selected, pre- ference being given to that remedy which corresponds the nearest to the existing symptoms* • Vide note, page 21. CASUALTIES. CONCUSSION, BRUISES, SPRAINS OR STRAINS, WOUNDS, DISLOCATIONS, AND FRACTURES. In Concussion of the brain, (which may arise from a violent shaking of the brain or of the whole body, without any direct violence having been offered, such as a severe blow or fall on the head,) the symptoms vary according to the degree of injury which the brain has sustained When the concussion is very severe, there is immediate deprivation of sense and power of motion, and death is the general result ; but when slight, a temporary stunning or confusion, with some head- ache, is produced, followed by increased action of the pulse, vertigo, and sickness. When, on the other hand, the violence done is greater than in the latter instance, though not so severe as to cause the fatal termination alluded to in the first, the patient is rendered insensible and incapable of movement ; his limbs become cold ; the pulse weak, slow, and intermittent ; the respiration laborious, but. usually without stertor. This has been denominated the first stage of con- cussion.) As the patient begins to recover from this condition, the pulse and respiration improve, and warmth begins to be felt in the extremities ; the sensibility to touch then returns, and the contents of the stomach are in most cases rejected ; still he continues to remain in a dull, confused state, and inatten- tive to, or almost unconscious of slight external impressions (Second stage.) On the gradual subsidence of the first effects of the concussion, the patient becomes enabled to respond to questions spoken in a loud tone. When, however, the stupor has considerably or entirely abated, inflammation of the brain, 404 CASUALTIES. of an active character, will, in many cases, then begin to de- velop itself (third stage), with all its wonted symptoms, (see Phrenitis,) and if not checked, suppuration or effusion within the head, preceded by rigors, will result. Therapeutics. In all cases of injury arising from exter- nal violence, Arnica is the specific remedy, and its timely ad- ministration in cases of concussion of the brain, will in most instances, if the injury be not very severe, suffice to remove all traces and evil consequences of such misfortunes. We may administer internally two globules of the sixth potency, in a teaspoonful of water ; and, if there be an external wound, we may bathe the injured part with a lotion, in the proportion of a few drops of the Tincture of Arnica to an ounce or about two tablespoonfuls of water, twice or thrice a day ; should the swelling, pains, and other symptoms increase, after one or two applications, we must discontinue the lotion, but will al- most always find a marked improvement follow such aggra- vation. When, however, the contusion has been serious, and ex- treme restlessness or jactitation, and irritability of temper with sensibility of the eyes to light, small quick pulse, deliri- um, or subsequently rigors, etc. supervene, the same treat- ment must be pursued as that which has been described under Inflammation of the Brain, and also Hydrocephalus, which see.* After an injury to the head, particularly if it has been of a somewhat severe character, the patient ought not to be allowed to partake of any stimulating liquids, such as wine, spirits, &c, until at least three or four weeks have elapsed, even although he appears to have entirely recovered from the effects of the accident; he ought likewise to be kept quiet, and not be permitted to expose himself to excitement of any kind, otherwise the most serious consequences mav be * In fracture of the cranium the same treatment must be pursued, but when compression of the brain takes place attended with its usual con- comitants, snch as stupor, stertorous breathing, etc , from the effects of a depressed portion of bone, the trephine must be employed if the symp- toms continue unabated notwithstanding the use of the medicines indi- cated. wounds. 405 the result. When the chest has been injured by a contusion or violent concussion, etc., and soreness or a sensation as if from incipient suppuration, with heat and throbbing, is expe- rienced in some particular spot ; fever or alternate chilliness and heat followed by fever, which becomes aggravated in the evening ; sleeplessness or disturbed sleep, with general heat, and sometimes perspiration towards morning; short dry cough which increases the pain, or cough with spitting of blood; further, when the pain in the chest is rendered more acute by taking a full inspiration, laughing or sneezing, or when prick- ing pains or a sensation of fulness or pressure, as if caused by extravasated blood, is experienced, together with a feeling of constriction that obstructs the freedom of respiration,—it will be necessary to have immediate recourse to Arnica and Aconitum alternately, at intervals of from three to six hours, until an improvement in the symptoms becomes manifest; but should a degree of fever continue after the exhibition of seve- ral doses of the foregoing remedies, attended with a sensation as if there were an internal excoriation or wound, Pulsatilla should be administered. In the event of a continuance or even an increase of cough, with expectoration of thick, yel- low mucus occasionally streaked with blood, Mercurius must be prescribed ; if on the other hand, the expectoration has a sweetish taste, and is accompanied by difficulty of breathing, Nux v. is to be preferred. When a degree of delicacy of chest remains behind, after the employment of any of the pre- ceding medicines, with tendency to suffer from shortness of breath, and a short dry cough, combined with paleness of the face, impaired appetite, and restless, unrefreshing sleep, Cin- chona has been strongly recommended. In other cases, espe- cially those which have been neglected, where we have rea- son to apprehend the development of Phthisis pulmonalis, the employment of Stannum, Acidum nitricum, Silicea, and Kali c, or Phosphorus, Sulphur, Calcarea, and Lycopodium, may yet enable us to arrest the progress of that ruthless malady. The effects of a shock to the nervous system, with pains in the limbs, Sic, from stumbling or making a false step, are gen- erally relieved by Bryonia or Pulsatilla. When the accident 406 casualties. has been accompanied with fright, Opium may be prescribed in the first instance ; Aconitum when there is syncope, and Chamomilla when from extreme pain convulsions ensue.* But in almost all such cases, Arnica may be employed with advantage, either subsequently or at the commencement; in the event of headache resulting from a contusion or from stumbling, and Arnica does not afford much relief, Belladonna may be given ;t the patient should at the same time remain quiet, and avoid any exertion, whether of the body or mind, until the pain is removed. Sprains. In the treatment of these troublesome casual- ties, at the commencement, prescribe a lotion of Arnica, when there is much tumefaction and redness, with great pain on the slightest movement. After the employment of the Arnica, we may have recourse to Rhus 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 following remedies have been recommended : Bry- onia, Ammonium c. and Ruta, and in some instances, Bella- donna, Pulsatilla, Nux v., Agnus, or Silicea. Strains. When pricking or other pains are experienced in the back, Sic, after a strain caused by any powerful or sudden exertion, such as lifting a heavy weight, or throwing up a window, with aggravation from the slightest movement of the arms or trunk, Bryonia should be exhibited, and suc- ceeded by Sulphur, if only partial relief is obtained. \\rhen headache results from a similar source, or when the pains are confined to the extremities, or if at all in the back or loins, are equally, if not more severe, during rest as well as on movement, Rhus may be prescribed, followed in turn by Cal- * Ignatia has also been recommended in the event of convulsions; and Coffea when uncontrollable agitation and agonizing jactitation result. t Cocculus, Cicuta, or Acid, phosphoricum, may be required to remove prolonged headache arising from the above-named causes. (See also Ce- phalalgia.) wounds. 407 carea, if the sufferings remain almost unmitigated. When sickness and great pain in the abdomen are produced by the effects of a strain, Veratrum has been recommended as being speedily serviceable. Woun ds are divided into incised, lacerated, contused, punc- tured, poisoned, and gunshot wounds. By an incised wound, is meant one which has been produ- ced by a sharp instrument, as a sword, knife, etc., and is not accompanied with any contusion or laceration. Incised wounds, although more liable to be attended with a greater degree of hemorrhage, are, generally speaking, the least dan- gerous and the most easily healed. Lacerated wounds are those in which the muscular fibres instead of being divided by a sharp cutting instrument, have been torn asunder with some violence; the edges instead of being even and regular, are jagged and unequal. They are commonly attended with little or no bleeding, rarely heal without suppurating, and are frequently succeeded by violent inflammation. The terms contused wounds, or bruises, are applied to those wounds which are occasioned by some blunt instrument, or hard blunt surface, being brought in violent collision with a part of the body. When severe, they are dangerous, from being prone to terminate in mortification and sloughing. Punctured wounds are those which have been caused by pointed instruments ; they partake more of the nature of lace- rated than incised wounds, and are dangerous from the great depth to which they frequently penetrate, and the serious con- sequences they often entail by occasioning violent inflamma- tion of the fascia, and tetanus. Therapeutics. In the treatment of wounds of all kinds, our first object is to arrest the hemorrhage. This is to be done by means of the tourniquet, by compression, by the ligature, by cold water or ice, and astringents, etc., according to the degree and source of the discharge. Wounds of the arteries are for the most part the most seri- ous : they are to be distinguished by the bright color of the 408 casualties. blood, which moreover issues very rapidly and in jets ; while that from a vein flows in a smooth, uninterrupted stream, and has a dark or deep purple hue. When the injured vessels are of a small size, they sponta- neously cease to bleed, or do so, at all events, as soon as the wound is dressed ; but when the hemorrhage is considerable, one or more of the arresting measures above alluded to must immediately be put in requisition. When therefore there is reason to conclude that an artery has been punctured, a tour- niquet should be applied around the limb to check tho flow of blood ; the external wound must then be closed, covered with a graduated compress, and firmly secured with a bandage. When a proper tourniquet is not at hand, its place may be tolerably well supplied by a handkerchief bound round tho limb, and tightened by two or three turns of a stick passed under the handkerchief; or the substitute may consist of a cork cut longitudinally, and securely fixed over the artery, the site of which is readily to be found at the inner surface of the limb, in spare or emaciated subjects, by its pulsation ; but as the finding of the artery is not so easily accomplished in the robust and muscular, it will be advisable first to tie a hand- kerchief, or non-elastic garter, tightly round the limb, above the wound ; this will have the effect of rendering the artery more prominent. In order to make the compression of the cork the more effectual, several plies of lint or linen, or a piece sufficiently large to form a few inches square and one in thickness, should be placed over the cork, (which should be held firmly in the required position during the preparation of the compress,) and the whole then tightened, and retained as long as may be requisite. The application of ice to the wound, or of cold water frequently renewed, is also of une- quivocal service. Compression may in some cases be effec- tually applied by pressing a piece of sponge (which has been dipped in bees' wax and stiffened), down upon the bleeding vessels, then adding compresses of lint and a roller. When the hemorrhage comes from a large artery, it must sooner or later be stopped by ligature. In wounds of veins, or when the bleeding is from any small arteries, also when it is from a WOUNDS. 4O9 vessel which lies over a bone, or when it proceeds from ves- sels situated too deeply for the convenient application of the ligature, compression, with the aid of ice or cold water, is the method to be adopted for the suppression of the hemorrhage. Bleeding from wounds, etc., in the mouth, sometimes re- quires the application of styptics, such as alcohol, and krea- sote water, etc. The same may be said of slight superficial wounds, as also of fungous tumours, and other diseased sur- faces, when cold water fails to answer the purpose. Arnica, Diadema, or Phosphorus, internally and externally, have like- wise been strongly recommended in such cases. Copious hemorrhage after the extraction of a tooth is usu- ally readily suppressed, by pushing a compress of lint into the hollow space left; or by the aid of styptics, and the medi- cines above mentioned, when requisite. A simple, and some- times extremely efficacious mode of checking this current of blood, is by replacing the extracted tooth, and keepino- it there until the risk of further hemorrhage is obviated. Wben severe syncope, with deadly paleness of the face, or when the face assumes a livid appearance, and subsultus ten- dinum and other signs of extreme exhaustion set in from ex- cessive loss of blood, Cinchona ought to be prescribed ; and if the patient should not exhibit any indications of rallying thereafter, a little wine may be given, and subsequently Arni- ca ; but if the stimulating effects of the wine prove only of temporary service, another dose of Cinchona must previously be had recourse to. The next step to be taken in wounds of every description, after the hemorrhage is stopped, is to remove all extraneous matter, as sand, fragments of glass, splinters, shot, rags, etc. ; then relax the muscles so that the wound may not gape ; finally, to place the lips of the wound in accurate contact, and keep thein so by bandages, plasters, sutures, etc Bandages are usually indispensable in deep, and even in small, super- ficial, incised wounds, but care must be taken not to apply them too tight, nor when there is excessive inflammation. Sutures are commonly requisite in wounds of the face, abdomen, and sometimes of the hands, and in old people 35 410 CASUALTIES. generally. In the young and vigorous they are seldom neces- sary, and even improper, when the patient is of an irritable habit of body. Strips of adhesive plaster, cut narrow in the centre or portion which is to cross the wound, and sufficiently long that they may retain their hold the more firmly, and act with the required compressive power, form, in the majority of incised wounds, the most frequently useful means of bring- ing the sides into close approximation and effecting adhesion. It sometimes happens, however, that even incised wounds, particularly when deep and of considerable magnitude, termi- nate in suppuration, it is consequently necessary to leave in- tervening spaces between the strips of plaster, to admit of the exit of the matter in such an event. Again, when it is found impracticable to cleanse the wound of all foreign substances, it ought to be only lightly, and so to speak, incompletely dressed, as it will be necessary to renew the dressings repeat- edly. In some cases it is necessary to dilate the wound, to obtain the abstraction of a splinter, etc. With regard to the constitutional treatment of wounds of all kinds, we should commence with the administration of Arni- ca, of which a few globules at the sixth potency should be given, as soon as the patient shall be made as comfortable as circumstances will admit. The patient should at the same time be kept cool, free from anxiety or exertion, and as quiet as possible, lie should live abstemiously, avoid every thing of a heating nature, and drink cold water. If he be robust and strong, and sympathetic fever run high, a dose of Aconite, at the third or sixth potency, should be prescribed ; followed, in the course of from three to six hours, by Arnica, and so on alternately as long as may be found requi- site ; in favorable cases one dose of each is often found sufficient. The local application in the first instance, if required by excess of pain, heat, and swelling, should con. sist simply of lint dipped in cold water, and frequently re- moistened. In the treatment of lacerated wounds we must, after having carefully cleansed them, closely approximate all the parts that will admit of the process, and retain them in their WOUNDS. 411 place by means of plasters and an appropriate position of the body or limb, for the purpose of endeavoring to unite them by the first intention. Should the wound become inflamed, attended with much pain and swelling, dress it with lint dip- ped in cold water, which must be frequently renewed. If, on the other hand, copious suppuration ensue, and the pain be very severe, the cold water must be discontinued, and Cham- omilla exhibited, followed by Hepar s. ; and should these remedies fail to bring on an early healing action, Silicea will generally answer ; or Silicea and Sulphur in alternation to promote granulation. (See Ulcers.) In contused wounds (or bruises) Arnica must be given internally, and cold water applied externally, in the first instance. When there is considerable extravasation of blood, the tincture,of Arnica* must be applied as a lotion, of the strength of a teaspoonful of this tincture to a teacupful of water, to stimulate absorption and otherwise forward the curcf In the event of an Abscess resulting from the effects of a contusion, see that article. When joints,! or the synovial membranes, are injured by a * We have already remarked that this useful medicament, when em- ployed as a lotion to wounds, should always be discontinued whenever any aggravation of the pains, etc., is experienced ; and I take the oppor- tunity to repeat here, that individuals of what is ordinarily designated an inflammatory habit, or who have very irritable skins, and are liable to be affeeied with erysipelas, must be very guarded how they use it; and invariably dilute the tincture with a larger proportion of water than is indicated in various parts of this work, when they have occasion to em- ploy it. t Arnica oil.—Arnica flowers digested in sweet oil by heat—is the best form in which this medicament can be used for injuries attended by abrasion of the skin, or laceration of the flesh. The flowers of Hyperi- cum perforatum, or St. John's wort, heated with sweet oil, also, exerts an equally salutary influence when applied to incised wounds.—Ed. t In cases of swelling, with considerable pain, stiffness, or inflexibility of the knee, from the effects of kneeling, to which housemaids (hence the name of Housemaid's Knee,) and others, from the nature of their oc- cupations, are liable,—and which affection, it may be added, consists of a decree of inflammation aud consequent thickening of the bursa ynucosa, situated between the patella and the skin, attended with increased secre- tion of the slippery lubricating fluid contained in the sac,—Silicea, po- 412 CASUALTIES. contusion, Rhus has been particularly recommended ; in some cases Silicea will be found of great utility as we can testify from experience. If the periosteum be affected, Rata is said to be useful; we would however recommend an incision to be made in the membrane, if echymosed blood or matter is evi- dently pent up beneath it, and the patient's sufferings are gre;it ; after which, the treatment to be pursued must bo the same as described for open abscesses. When a bruise or contusion is so violent as to squeeze the limb nearly flat, or otherwise disfigure it, cold water ought to be constantly ap- plied, and Arnica prescribed internally. But if gangrene threatens, Cinchona must be given, and when the skin has assumed a livid and black appearance, amputation may still be avoided, and life and limb saved, by having recourse to Lach- esis and Arsenicum alternately, in frequently repeated doses. In the greater number of such unfortunate cases however, am- putation becomes imperative, and ought, to be performed with- out hesitation, when it becomes evident that the patient will fall a sacrifice to further delay. When amputation has been found necessary, the slump ought to be dressed wiih lint dip- ped in cold water, and Arnica given internally : subsequently tency G, or 30, either administered daily, or at intervals of four to eight days in susceptible habits, is a most important and eminently successful remedy. The same remedy is equally efficacious in similar swellings in other parts, such as the ball of the great toe, (where it is usually known under the denomination of a bunion.,) or the joints of the fingers; and indeed in mos.l of the situations where tendons play; the use of these little sacs, or bursa mucosa, being to facilitate the action of the muscles. By means of the specific effects of Silicea in this disease, we are spared the necessity, even in obstinate cases in which the fluid of the bursa be- comes altered in character and contains small granular bodies, of open- ing the sac for thepurposeofobtainingthedischargeofthe.se substances; a procedure by no means free from danger, and but too often the source of considerable suffering and annoyance to the patient, for a length of time afterwards. During the treatment of these swellings, it is very ne- cessary that the patient should at the same lime be careful to avoid pres- sure on the affected part, and that he should walk about as little as pos- sible. In the case of a bunion, when there is active inflammation, his own suffering will sufficiently remind him of the neces.-ity of these pre- cautions. WOUNDS. 413 the said medicine may be employed in alternation with Aco- nitum, if required by the accession of traumatic fever. Hepar, Silicea, and Sulphur may also be required at the ensuing stages in the healing of the stump. (See Ulcers, for indications for the employment of these and other remedies.) In the case of punctured wounds, the treatment to be fol- lowed is the same as that described for wounds in general, but unless compression, by means of adhesive plaster or a bandage can be brought to bear against their entire extent, the cure by the first intention must not be attempted. When suppuration ensues, Mercurius may be prescribed ; after which Hepar s., and then Silicea if required. Chamo- milla, Belladonna, and Rhus may be found serviceable in the event of excessive local inflammation ; the latter two parti- cularly if it partake of an erysipelatous character (see Erysi- pelas.) When spasmodic twitchings make their appearance, Cicuta is frequently serviceable ; but Arnica will generally be found sufficient to subdue the symptoms when timely admin- istered ; when the constitutional disturbance is severe, Aco- nitum may be alternated with Arnica ; and when they arise from violent inflammation of the fascia, incision may in some instances be necessary to be made in it transversely ; in which event a dose of Arnica must be prescribed almost im- mediately afterwards. If tetanus supervene, Arnica must be administered in re- peated doses, and followed, if required, by Augustura or Coc- culus^ etc (Vide Tetanus.) Gunshot wounds must be treated by the exhibition of Ar- nica internally, and cold water constantly applied by means of lint, externally. In some cases it may be found advan- tageous to apply a very weak lotion of Arnica, in preference to water simply, at the commencement. When splinters of bone, a ball, etc., are lodged in the wound, they ought to be extracted with as little irritation as possible, if they press on some important viscera, etc.; but if not, they may be allowed to remain, particularly when deeply seated or difficult to be found, until loosened by suppuration, which process will be materially forwarded by the administration of Silicea. In 35* 414 casualties. other cases Hepar s. and Sulph. may afford valuable aid. In the event of fever, gangrene, etc., see Contused Wounds. When a joint is greatly injured, or much of the soft parts with the blood-vessels and nerves of importance are carried away by a gunshot wound, the bone remaining entire ; when there is fracture of a bone with destruction of the soft parts ; when the bone is shattered, and the principal vessels lacer- ated or ruptured ; or when a limb is completely shot or torn off, or other serious injury done, which renders the prospect of saving the limb hopeless, amputation should be performed. We feel satisfied, however, that the Homoeopathists would succeed in saving many a limb whTch the Allopathisls hastily condemn to the knife. It may be added that Staphysagria has been recommended as a useful remedy in severe incised wounds ; and Aconitum, Cicuta, or Acid. nitr. in addition to Silicea and Hepar s- in wounds from splinters, etc. (For poisoned wounds see Hy- drophobia.) Dislocations. Luxations. Violent pain, swelling, dis- tortion of the joint, loss of motion, with an alteration in the shape, length, and direction of the limb characterize the exis- tence of this injury. Therapeutics. The reduction of a luxation ought to bo effected as soon as possible by the 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 the pain continues violent, and the inflammatory symptoms active. Cold water, or very weak arnicated 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 FRACTURES. 4J5 the wound treated so that it may be healed if possible by the first intention. (See Wounds.) Fractures. The symptoms of fracture are : pain, swell- ing, 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, oblique, and longitudinal ; and also into simple, compound, compli- cated, 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 the bone through the integuments. Again, a fracture is term- ed complicated, when it is attended with a wound of a large artery, extensive laceration of the soft parts, or with disloca- tion of a joint. Lastly, it is designated comminuted, when the bone is bnjken into several pieces. 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 probabil- ities of recovery will be rendered much more unfavorable, par- ticularly if the accident has happened to a debilitated or a^ed individual. In the case of a simple fracture, the reduction 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 Arnica should be administered, for the double purpose of preventing the invasion of undue inflammation, and of promoting the reunion of the fracture. Symphilum officinale has also been most favorably 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 cases of fracture, unhesitatingly declare that the patients are thereby enabled to regain the use of their limbs, and to be discharged with safety from the hands of the surgeon, at an earlier period than when treated according to the old rules ; and 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 the 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 lo 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 s'ate of deliri- um, 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. • ffuta has likewise been mentioned as useful in some cases, BURNS AND SCALDS. 417 It is foreign to our intention to occupy further space by entering into a description of the means to be adopted in the reduction of the various specific fractures which are liable to be encountered in different parts of the body : such a pro- ceeding 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 treat- ment is to be pursued, as has been previously noted for that of contusions, 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 sur- geons in the treatment of ihose numerous and sprious diseases which are usually considered of a surgical character, it is earnestly to be hoped that their colleagues in ihis country may be induced to emulate their example, and thereby be- come enabled to raise their important branch of the profession to a still higher standing than it alreadv, 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 cotton 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 418 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 ; ap- ply it to the injured part, and secure by a bandage. Any blisters which may have formed should, as before prescribed, be carefully punctured, and any loose skin removed. This application will, as in the instance of dry heat, Sic. 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 may be gently removed, and a fresh one substituted ; generally speaking, however, we must be 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, ^, may also be given internally from time to time. Aconitum, -£-, may be exhibited when we find considerable fever present; and repeated in a few hours, if required. Opium, -§{p on the tongue, when the system has received a severe shock from fright at the time of the injury. Urtica urens has recently come into repute as a specific remedy in burns of every 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 little water, or on a piece of lump sugar. Kreasote water has likewise been recommended as a lotion in burns of all kinds, either at the commencement or subse- quently, to induce healthy granulation and cicatrization. Crocus saticus (applied externally) has also been favorably spoken as most serviceable for 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. £, repeated in twenty-four hours, should any of the symptoms remain. Wrhen 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, -3^, when tendency to fainting ensues from the effects of extreme fatigue ; and Coffea Aj-0-, when abstinence from food, combined with violent exercise has produced a state of exhaustion. Cocculus 5j^, when fatigue occurs after the most trivial exertion of either of body or mind. (Veratrum and Calcarea, are sometimes 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.) 420 STINGS OF INSECTS. The severe pain and febrile irritation which sometimes ensues from the stings of insects, such as bees, wasps, Sic 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 : fi§a, in a wine-glassful of water, a dessertspoonful every hour, until relief is experienced. In some instances it will be found necessary to have recourse to Mercurius after Belladonna. Administration. -%-, 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 vomica, Cocculus, Tahacum, Arsenicum, and Ipecacuanha, Nux vomica, £, 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 v., and Arsen- icum alternately every hour or so, at the commencement of sea-sickness. 421 the voyage, or oftener should a degree of nausea have already come on, frequently ward off the sickness, or at all events afford great relief. As soon as decided improvement is ex- perienced 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 aggra- vated by standing erect, Cocculus fl§a may be had recourse to, and repeated every one, two, or three hours, as those symptoms recur. (This remedy has also been found useful in sickness arising fiom travelling in a carriage.) Tabacum 6. Excessive giddiness attended with distress- ing nausea, headache, and deadly paleness of the face ; or nau- sea, 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 some- what relieved by exposure to the fresh air. Arsenicum 6, is extremely valuable when the sickness be- comes 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 Tabacum or Cocculus, to dissipate the symptoms of nausea and swimming in the head that may supervene. Ipecacuanha 3, is useful in attacks of vomiting unattended with the great prostration of strength given under Arsenicum. Of course, in order to avoid interfering with the action of the medicines, the homceopathic regimen should be carefully ob- served during the period of their administration. Petroleum, Silicea, and Therideon, from the close analogy of their symptoms to those of the ordinary forms of this distressing malady, deserve a trial. Administration of the above remedies : six globules of the medicament, at the potency mentioned, a teaspoonful every now and then until relief is experienced. 36 422 APPARENT DEATH. Asphxyia. Apparent death. Asphyxia. In every instance that an individual has to all appearances suddenly expired from ex- ternal causes, animation may only be suspended ; there are many cases of course where sudden death is no mere suspen- sion 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 possi- ble quantity at a time. Milk may be given drop by drop, and gradually increasing it to a teaspoonful, and after some inter- val 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 suffering from starvation, eating too much and too quickly, is in the 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 pa- tient 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 Hering's Hausarzt. apparent death. 423 Apparent death from suffocation, (hanging, pressure, choking.) Remove all tight clothing. Put the patient in a proper posi- tion, 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 cr two globules, or a drop of Opium, dissolved in half a pint of water, and injected slow- ly- 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 eyelids, and see if the eyes contract; put warm clothes on ; hot stones wrapped in blankets to the feet, between the i thighs, to the sides, neck and shoulders. If in an hour no change is produced, take a bitter almond, pound it fine, mixi1 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 maner as recommended for the drowned; as well as the means therein adopted for inflating the lungs. A few globu- les 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 rubbed 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 him over with newly-excavated earth (leaving the face alone ex- posed, which should be turned towards the sun,) until the first signs of returning animation become apparent, after which Nux v., is to be had recourse to as above directed. Apparent death from drowning. Observe the following cautions : 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 and salt, or spirits and water may be injected, and the follow- ing means should not be delayed ;— 424 casualties. 1. Convey the body carefully with the head and shoulders in a raised position to the nearest house. 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. Solanum-mamosum 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 medi- cines 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 water, or hot bricks, to the pit of the stomach, the armpits, between 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 stimulants ; 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 backwards, the upper part of the wind pipe, to allow a more free admission of air ; blow the bellows gently in or- der 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 harts- horn, 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, either 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 degree of heat might annihilate all hope of restoring animation ; at the same time the patient ought to be protected against the slightest draught. He should then, especially if the limbs have become stiff- ened 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 balh of cold sea or salted water,) may be substituted, and the body immersed therein for a few minutes. The processs 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 injec- tions containing Camphor may be administered every quarter of an hour. As soon as any symptoms of approaching resto- ration 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 cnven, in the quantity of a teaspoonful at a time. 36* 426 CASUALTIES. The measures above detailed ought to be persevered in for several hours. Against the excessive pain which is gener- ally experienced when life is restored, Carbo v., should be prescribed in repeated doses.* and if it fails to relieve the sufferings, Arsenicum may be given. The party rescued must avoid subjecting himself to the heat of the fire or stove for a considerable length of time after his recovery, as serious con- secutive ailment, and particularly disease of the bones, is liable to result therefrom. Apparent death from, noxious vapours. The treatment consists in removing the body into a cool, fresh current 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 application of electricity or galvanism,—after life has been restored give Op. or Aeon. 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 success- ful in some few instances having generally failed in all others ; thus rendering it probable that in these supposititious cases of success, the persons bitten might have escaped without any treatment 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, par- ticularly 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 * Vide note, p. 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 bilten 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 oat 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- creased daily; and the patient complains of a state of confusion in the head, or giddiness, with sparks before the eyes ; is af- flicted 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 pressure in the gullet, which occasionally renders every at- tempt 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 tolerable 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 if. is ut- terly impossible 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 dread and horror, although he may, at the same 428 casualties. time, suffer the most excessive thirst; even the sight of water, or the very noise produced by pouring it from one vessel into another, in fact, anything that tends to remind him of that fluid, produces indescribable anxiety, uneasiness, convulsions, and even furious paroxysms of madness ; he dreads even to swallow his own saliva, and is constantly spitting ; vomiting of billious matter soon comes on, succeeded by intense fever, great thirst, dryness and roughness of the tongue, hoarseness, and fits of delirium or madness, with disposition to bite and tear everything within reach, followed at intervals by convul- sive 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, the paroxysms come on more violently and frequently, and in some instances a fit of furious delirium closes the frightful scene ; in others, nature sinks exhausted after a severe attack of convulsions. The disease may be communicated to the human subject, 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 human species as the least susceptible of contagion from the hydrophobic virus ; scarcely one out of twenty, or even thirty, of those actually bitten by an animal in a slate of rabies, suf- fering from its effects. I consider it my duty, while making this statement, which I hope may prove a means of relieving the minds pf 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 treatment 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 con- fidence that if no abrasion of surface exists, there is not the slightest 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- rides* * The use of dry or radiating heat in this disease, and in envenomed wounds by snakes, etc. is recommended by Dr. Hering of America, whose directions for the treatment of envenomed wounds in general, are as fol- lows . Envenomed wounds. The best remedy 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, and 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 lakes 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 the 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 blueish, 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 an amelioration, a new aggravation must be waited for, and the dose ought not to be repeated before its ap- pearance. 430 CASUALTIES. Belladonna. HAHNEMANN, the noble founder of our science, states, in the introductory article to Belladonna, in his Materia Medica Pura, that he considers the smallest dose of that medicine, repeated every three or four days, to be the In cases in which Ars. exercises no influence, though repeated several times, recourse must be had to Bell. ; Sen. also frequently proves effica- cious. Against 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 the application of dry heat, as directed and described above. (See Hydrophobia, on the other side.) If morbid affections or ulcerations exhibit themselves in consequence of a bite from a rabid man or animal, hydrophobic, administered in homoeo- pathic doses, 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 the greatest heat lhat can be borne ; and after this, it will be proper to wash them with soap. ~„The use of Chlorine and muriatic acid, in similar cases, is well known. HvDROPHOBrA. Apply distant heat to the 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 Lach. 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 lancet 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., Ifyos., Merc, or also Stram. or Verat. (See the indications above given for Belladonna, Lachesis, Hyoscyamus, 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 dessert-spoonful 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 exhibi- tion 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 perceptible. Generally speaking, from two to three administrations may be deemed sufficient to pre- vent 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 according 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 appear- ance ;f 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 the administration of a remedy whiclfhas been found to possess the property of producing a train of symptoms in a healthy person, similar to those observed in the disease. t Vide note, p. 21. 432 casualties. 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 the throat, with accumulation of frothy mucus in the mouth or throat, fre- quent desire for drinks, which are immediately pushed aside when presented, or a suffocating or constricting sensation m the throat, on attempting to perform the act of deglutition, 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 : un- governable fury, with foaming at the mouth, and tetanic con- vulsions. Administration. A few globules to be placed on the tonup- ture, we may take the half of a nutmeg, cover it with very soft linen, like a button, and sew it to 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 the body of the child.* This mechanical processf will usually prove sufficient to effect a cure, if not we must exhibit Nux vomica ^, dissolving it in six teaspoonfuls of water, and administering * Gross. Verhalten der Mutter und des Sauglings, p. 103. t The following is a simple and commonly efficacious mode of applying a compress:—Take a piece of lint, just sufficiently large, that when folded five or six times, it will cover the rupture effectually; then press Jin the protrusion, and keep it reduced with the hand until the compress is rightly adjusted and 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 by an intelligent and experienced maker.) MECONIUM. 447 one, which, if no alteration takes place, may be repeated in the same manner in five or six days, and if no effect declare itself, again repeat, bearing in mind the directions upon the Repetition of Medicines given in the Introduction; if, however, we discover no amelioration from the administration of Nux vomica, 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 wonderful promptitude. (See Hernia, Part II.) 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 precautionary measure against its return. In cases of sore- ness of the umbilicus or navel, remaining after the falling off of the ligature, or even before, we may give Sulphur 3°„. a single dose, and repeat in six days. If, however, during that time no amelioration has been observable, we should exhibit Silicea £$, 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 undisturbed, 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 repro- bate the too general practice of administering laxative medi- cines for this purpose, possessing, as they do, a most deleteri- ous 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 * Chamomilla, Aurum and Sulphur, are occasionally found necessary, particularly the last-named, in order to effect a permanent cure. 448 treatment of infants. bowel complaint, debility of the stomach, and a host of dis- eases in after-life. Mothers need not be under apprehension should a temporary delay occur in the passing of the meconium; far greater evil results from the violent methods taken for its expulsion, than could possibly occur from its continuance in the 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, etc., 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 sulphuris ^\ or Opium f to the female herself—for the indication of which medicines see Constipation. SUCKLING OF THE INFANT. While upon this subject, we shall quote the expressions of a well known writer, in whose opinion, in this respect, we per- fectly 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 sup- ply of suitable food would be provided to meet the wants of an infant, 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 prepar- ed and breast milk, still reason and observation demonstrate the superiority of the latter to the former." (Conquest's Out- lines of Midwifery, p. 193.) And again:— " As a further inducement, it should be remembered that medical men concur in their opinion, that very rarely does a SUCKLING. 449 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: "Bat few mothers, comparatively, are to be found who, if willing, would not he able to support their infants, at least for a few months, and parental affection and occasional self-denial would he 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 be- fore the infant has been put to the breast Instinct directs it what to do, and the advantages of allowing it to suck soon af- ter birth are many and important, both to the mother and child. « By this commendable practice, the patient is generally preserved 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 delivery, the act of sucking will encourage and expedite the secretion 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 and tense the nipple itself will sometimes almost disappear, on ac- count of its being stretched ; and without much, and often in- effectual labour on the part of the child, it cannot be laid hold of and even then the pain endured by the mother is exqui- sitely severe, and not unfrequently the cause of sore nipples. (Ibid. p. 195.) Havino- 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 prevent 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 observed, which is equally applicable to both parties. V 38* 450 treatment of infants. THE CHOICE OF A NURSE. In the selection of a nurse, the medical attendant ought generally to be consulted; the following points merit particular attention: She should be apparently of sound health, full and mode- rate plumpness, with a fresh complexion, and clear eyelids, free from 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 excoriation 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 in 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 woman, 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 nature, is injurious, causing the milk to become too rich, and unsuited to the delicate digestion of the infant; the best guide is the regular homceopathic regimen, which may be consulted with advantage. 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- supplementary diet of infants 4bl 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 delete- rious effect of the different ingredients which enter into its composition 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 myself with a single quotation from a well-known medical writer: " There is an evil too generally prevalent, and most perni- cious in its consequences on individuals and society, and by no means confined to mothers in the lowest classes of the com- munity, 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 fol- lowed 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 altogether 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 subti- 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- 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- 452 treatment of infants. 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 nourishment until the front teeth appear, which is a clear indi- cation that the digestive organs are prepared for more solid food; if, however, the 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 alterations 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 nutri- ment 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 nature in giving the food slowly; particular care being taken to ob- serve 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, eemolino, or rusk, may be given twice a day. When milk, even prepared 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 imme- diate change of aliment. The child should be accustomed to take its nourishment from duration of suckling and weaning. 453 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 ubeing 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; 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 this gradual course, is from the first appearance of the 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 the deprivation. Weaning ought not, however, to take place, if the child suffers considerably from the irritation of teething, or any acute infan- 454 treatment of infants. tile disease. When, however, it is found absolutely necessary to wean, Belladonna ^ should be given as a precautionary measure against the inconveniences and not unfrequent dan- gers which sudden weaning entails. Among these may be mentioned, restlessness, sleeplessness, fretfulness, 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.* See the articles relative to this subject in Part IV, Treatment of Females and their peculiar Affections. After the child has been weaned, his nourishment should generally consist of the same simple food before mentioned, with an occasional light pudding, without spice or eggs, made from semolino, tapioca, or other farinaceous 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 to maintain a proper degree of 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- * Vide A. H. Z., p. 8, No. 23. SLEEP. 455 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 regulate its habits of taking its food and rest, as to accustom it to a uniform system, and particular hours. Children, up to two years of age, require rest during the day, and the nurse ought to endeavour to get them into the habit of taking it in the 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 sleep to be disturbed and unrefreshing, 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 456 TREATMENT OF INFANTS. 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 the mother, than a disposition to wakefulness on the part of her infant. A healthy child should always be prepared for its res^ 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 slum- ber, 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 constitutions in after-life, but to it, conjoined with diet, drinks, carminatives, and other quack medicines, together with the highly erroneous practice—sanctioned though it be by names of medical repute—of a frequent administration of that active mineral preparation, calomel, in infant maladies, to say nothing of laxatives, an infinite number of diseases and deaths are annually attributable. Every mother should not only cau- tion her nurse against the use of opiates, but use her utmost vigilance to detect any breach of her injunctions, which should be visited with the immediate discharge of the person so offend- ing ; for she must be truly unfitted for such an important trust who, after being warned of its injurious tendency, will perse- vere in a practice placing in jeopardy the life of her infant charge. Amongst the homceopathic remedies which have been found the more generally useful in removing restlessness and sleep- lessness in children, Cqffea, 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 cir- cumstances, Opium £ may be substituted, particularly if the face of the child looks red. Chamomilla y% will do good when the child is tormented with flatulence, and distention of EXERCISE. 457 die bowels, and appears to suffer from colic, indicated by drawing up the legs, screaming, etc. Against sleeplessness after weaning. Belladonna is the most efficacious remedy. When these remedies do not seem indicated, or fail to relieve, an experienced homceopathist ought to be consulted. (See also Crying and Wakefulness.) EXERCISE. 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 anxie- ty 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 the vertebral column; a neglect of this precaution, and a pre- mature carrying of the infant in an upright position, are a too frequent cause of deformities of the spine, and derangement of the internal functions in after life. As its powers gradually develop, the infant seems inclined to exercise them, and evinces a desire to sit upright, which we 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 the 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 seems 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 _ 39 458 treatment of infants. quarter of an hour, and the period of exercise gradually increas- ed; in fact, if the weather be fine, it can scarcely be too much in the open air. Should its birth occur in winter, advantage 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 generat- ing 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. We may recommend an occasional gentle friction of the hand over the body and limbs, which materially assists in the 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, in which it may very properly 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 ex- citing them to a premature exercise of their powers, is highly reprehensible, causing curvature of the limbs, the bones not being yet sufficiently formed to bear the burden imposed upon them. By allowing nature to act, the infant's powers will be- come more gradually, but at the same time, more fully devel- oped, 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 retarded by evident debility of constitution, Homoeopathy affords us the means of obviating this evil, by acting against EXERCISE. 459 the constitutional cause. Dr. Gross has found Calcarea ^, very useful in a case of this nature; and Dr. Hartmann has ! frequently administered Causticum &, with great effect. i (Silicea, Sulphur, Belladonna, Mercurius, or Staphysagria, etc., may be required in particular cases.) DISEASES OF INFANCY. INFLAMMATION OF THE EYES IN NEW-BORN INFANTS. A sudden 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, we become aware of the existence of this evil, we should administer Aconite ^, which will generally be found promptly effi- cacious 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 ^, and in some cases Cal- carea ^, alternating them every eight or ten days, if we find it necessary to resort to the Calcarea—the Tincture of Sulphur having been found in many cases to act as a specific. Chamomilla -,%, is useful some weeks after birth, when the perceptive faculties are more devoloped, and the child exhibits great intolerance of light; also when redness, swelling, and agglutinations of the eyelids, with other indications, given un- der Acute Inflammation of the Eye (Part II.), are present. Lycopodium may also be named as a useful remedy in some inveterate cases. hiccough, cold. 461 HICCOUGH. This affection, though in itself of slight importance, fre- quently causes no small degree of uneasiness to young mothers; it 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 milch as will cover the end of a teaspoon, dissolved in a tea- spoonful of water, will effectually abate the eviL COLD IN THE HEAD. 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- sient 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„ 39* 462 diseases of infancy. fails to relieve ; but is also of service in cases when there is an accumulation of thick and viscid mucus in the nostril; 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 be had recourse to if Sambucus does 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 im- provement is effected, or another remedy required. Chamomilla, -j%, is very useful when there is cold in the 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. is chiefly useful in obstinate cases, and particu- larly 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. Administration. The doses already given repeated in from one to two days. (See also Coryza, Part II.) 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, inthe 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 fleshj 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. 463 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 irri- tated 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, §, will prove efficacious. (Aconitum, ^. may follow Cqffea when there is considerable heat of skin, and extreme restless- ness.) Chamomilla, y^, 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 de- rangement of the digestive functions, and the child appears to suffer from griping pains, indicated by contortions of the body, drawing up of the little limbs upon the abdomen; and when a whitish, yellowish, or greenish, or watery excoriating diar- rhoea is present. Jalapa, f, in similar cases, but without diarrhoea, or with mo- tions tinged with blood. In other cases, when the screaming and vigilance are at- tended with colic and flatulence, Senna, #, will answer best. Rheum, #, 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. 3°T), 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 wakefulness is accompanied with flatulence and diarrhoea, or with constipation. Remarks. The milk of a nurse who has* suckled for some months previously is much too heavy for anew-born infant; here the only alternative is a change of nutriment. When, however, the above-named or any other infantile derangement * 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. 464 diseases of infancy. arises from congenital weakness of the stomach, the most use- ful remedies in addition to Nux v. and Puis, are Sulphur, Cal- carea carbonica, and Baryta c. REGURGITATION OF MILK. ACIDITY, FLATU- LENCE, 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. Ipecacuanha, %, 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 effi- cacious, when the derangement is evidently owing to their having been over-fed, (a most culpabl» 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 pre- sent, not decrease after some doses of Ipecacuanha, Pulsa- tilla, -^, may be exhibited in a similar manner, and succeeded in turn by Antimonium crudem, T0^, or T0^, if the symptoms continue, though in a mitigated form. Nux vomica, ^, 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 mode of affording temporary relief in cases of flatulent disten- sion of the stomach and bowels. But permanent relief is only to be attained from Pulsatilla, Nux v., Chamomilla; or Carbo * Vide note, p. 21. spasmodic asthma, spasms in the chest. 465 v. and Sulphur, when the former are insufficient. The diet must at the same time be attended to, and altered if of an indigestible nature and the undoubted cause of the mischief. When there is diarrhoea and excessive flatulency, China is very useful. * Chamomilla. Same dose as described for Ipecacuanha, when attended with convulsions, or diarrhcea, as described elsewhere under this medicine (see those articles.) A single dose of Sulphur, ^ followed by Calcarea car- bonica, ^, in from five to ten days, and then again one or more k 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 writh 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 laborious, and painfully distressing to witness. In such cases a globule or two of Ipecacuanha (potency 3 or 6) ought immediately to be dissolved in about a wine-glassful of water, and a few drops of the liquid put into the mouth of the pa- tient. 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 result- ing in from a quarter of an hour to half an hour or so, according to the severity of the symptoms, Sambucus may be given in the same manner. In other cases Arsenicum will be found more efficacious than either of these ; or the employment of Ipecacuanha and Arse- nicum alternately every ten or twenty minutes, until improve- ment takes place. Whenever a sudden aggravation ensues after the administration of any of these remedies, nothing fur- ther should be done, as on waiting patiently for a few minutes, Tf the change arise from the effects of the medicine, the symp- toms will subside, and gradually give way to unequivocal signs of improvement. (See Asthma of Millar.) 466 diseases of infancy. Some children are liable to be seized with obstructed respi- ration 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, distension of the pit of the stomach and region of the lower ribs ; the child affected is at the same time thrown into a state of great anxiety and uncontrollable restlessness, attended with crying or scream- ing, tossing about, etc. Against this indisposition Chamomflla has repeatedly proved to be an effectual remedy. A dose ought therefore to be given as soon as the attack declares itself. MILK-CRUST. MILK-SCAB. Crusta lactea. Porrigo larvalis. 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. The eyes and eyelids, as also the parotid and mesenteric glands, occa- sionally become inflamed, and sometimes marasmus super- venes. Therapeutics. The following medicines have been found serviceable in this affection: Aconitum, Rhus toxicodendron, Viola tricolor, Rhus, Sulphur, Belladonna, Hepar sulphuris, Euphrasia, Staphysagria, etc. • Aconite ^, should commence our treatment, when we find excessive restlessness and excitability produced by this affec- THRUSH. 467 tion, 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. s^s-, 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 sometimes succeed or supersede Viola tricolor, when the scalp is considerably affected and thickly studded with incrustations. Administration. -j%, 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. -£$, dry upon the tongue. Sarsaparilla and Mezereum have also been strongly recom- mended in Crusta lactea. The former in the earlier stage of the malady, when small, burning, itching pustules 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 eruption of vesicles wherever it comes in contact. Graphites, as also Sepia, Hepar, Baryta c, Lycopodium, etc. have been recommended as likely to prove of service in complicated cases. But the remedies above mentioned will rarely fail to cure the affection as ordinarily met with, if had recourse to in due time. (See also Scald Head.) THRUSH, or APTH.E. . 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 ■ 468 DISEASES OF INFANCY. whole of the cavity of the mouth, and in severe cases extend- ing to the throat. This affection, although of itself neither malignant nor dangerous, frequently causes not only consider- able suffering to the child by preventing it from sucking, but great pain and inconvenience to the mother by its being com- municated to the nipples, and causing excoriation, etc. The complaint is most generally produced by the 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 called reared by the hand, either 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 Jong 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 unfrequently 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 to Sulphur ^, given dry. In cases where there is much salivation, and the thrush indicates an inclination to ulceration, we may administer Mercurius solubilis -^, twice in forty-eight hours, followed in a few days, by Sulphur, and then Acidum sulphuricum 5^, after a similar interval if necesssary. In very bad cases, when the aptha? assume a livid, blue, or violet appearance, attended with excessive weakness and diarrhoea, Arsenicum ^ is highly 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. BOWEL COMPLAINTS. 4(59 CONSTIPATION. Obstructio AM 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 pe- culiar diet or want of exercise, such as too much animal food, etc., 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 un- der Constipation (Part II.), which see. Administration. 3^ 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 too, if required, until the medicine has remedied the irregu- larity. BOWEL COMPLAINTS OF INFANTS. Diarrhoza Neonatorum. Diarrhoea, like constipation, is to be regarded merely as a symptom, not as a disease ; the real disease here consists in irritation or inflammation of the mucous membrane of the in- testines, arising from the effects of aperients, indigestible food, cold, fright, etc. I have already mentioned (article Meconium,) 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- * Vide note, p. 21. 40 470 DISEASES of infancy. ence. This unwarrantable and extremely reprehensible con- duct is frequently persevered in even for some time after the expulsion of the first discharge has taken place, and is in many cases the undoubted cause of bowel con.plaints 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, etc., 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 are occa- sionally produced in the stomach and bowels, from want of proper attention and caution in the selection and administra- tion of the food. (See art. Supplementary Diet of Infants.) Fright and exposure to cold are, as already noted, two other most frequent exciting.causes of the disorder. Therapeutics. A healthy infant at 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 factor, 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- BOWEL complaints. 471 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 the pain and difficulty which is so frequently encountered in inducing the little sufferer to swal- low the nauseous allopathic drugs. The following are the principal remedies employed in ho- mceopathic practice against this derangement: Aconitum, Bel- ladonna, Chamomilla, Rheum, Pulsatilla, Ipecacuanha, and also Mercurius, Nux vomica, Arsenicum album, Sulphur, Sepia, Opium, and Veratrum album. When there is inflammation, the constitutional symptoms are pretty clearly indicated by heat of the surface of the body, quickness of pulse, and by rigors; in this case, we must have immediate recourse to Aconitum ~f, 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 * * * 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 bowel- complaints, whether arising from irritation caused by indiges- tible 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 * Vide note, p. 21. 472 DISEASES OF INFANCY. eggs. Chamomilla maybe preferred to Belladonna after Aco- nite in cases of inflammation, when any of the above symptoms present themselves. (See also Infantile Remittent.) Administration. %} in four teaspoonfuls of water; a tea- spoonful every six hours, until benefit results.* 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 whichcase it will be necessary to have recourse to Pulsa- till i, Chamomilla, or Mercurius. as antidotes, according to the nature of the symptoms. Rheum is particularly appropri- ate when acidity or bilious derangement has been generated by indigestion, or has arisen from the prolonged use of antacids, such as magnesia, etc., and when there is flatulent distension of the abdomen, colic, crying, restlessness, tenesmus before and after the evacuations, which are either of the consistence of 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. Adminstration. $, in the same manner as Chamomilla. Pulsatilla. Diarrhoza, arising from " indigestion," or from * a chill, with watery, slimy, whitish, or bilious, greenish- looking evacuations, occurring chiefly at night; want of appetite, fret- fulness. Pulsatilla, as stated, is also very serviceable in obsti- nate cases, where the affection has been brought on by the abuse of Rhubarb, or by Rhubarb and Magnesia, when the symptoms are as above 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.) 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-brash), 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 * Vide note, p. 21. BOWEL COMPLAINTS. 473 bilious, slimy, or greenish yellow, sometimes blackish, or streak- ed with blood, and of a putrid odour; on other occasions, evac- uations 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, we should have recourse to Pulsatilla or to Antimonium crudum, should the vomiting not speedily subside. Administration. $, 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: frothy, or having the appearance of beat-up eggs; attended with symptoms of severe colic, and frequently also with severe tenesmus and protrusion of the intestine. Administration. t°2, in the same manner as Chamomilla. It is necessary to state, however, that the employment of mer- cury in the form of calomel or some other mercurial prepara- tion 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 homceopathic Mercurius must of course he avoided, and its place supplied by an anti- dote, which will generally be found in Hepar sulphuris or Aci- dum 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 cases of diarrhoea from this cause, with the following symptoms: Watery, bilious, or slimy evacuations, of a greenish yellow colour, and occurring chiefly at night. Administration. -g- or ■—, in a teaspoonful of water, and repeated in twenty-four hours, if necessary, (Merc, 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 40* 474 DISEASES OF INFANCY. and tenesmus, sometimes followed by protrusion of the intes- tine; extreme fretlulness. This medicine is also of great service in many cases when the diarrhoea alternates with con- stipation. Administration. 3°^, in three teaspoonfuls of water, one each night at bedtime. Bryonia is a useful remedy in cases of diarrhcea, which re- cur whenever the weather becomes very warm. Administration. §, repeated in from twelve to twenty-four hours. (Carbo r. has been found efficacious when only tem- porary benefit resulted from Bryonia, in diarrhoea during the heat of summer.) Arsenicum. This medicine becomes indispensable in neg- lected cases, or in those at an advanced stage of the disorder, when there is reason to fear that it will terminate in marasmus. The following are its characteristic indications: Watery or slimy stools, of a greenish, whitish, dark, or brownish colour, or of a putrid or gangrenous odour, taking place chiefly during the night, or after drinking or partaking of any kind of food, great thirst, sleeplessness, paleness of the face, sunken cheeks, and blue circles round the eyes, enlargement of the abdomen, with extreme weakness and excessive emaciation. Administration. 3°t, in four teaspoonfuls of water, one night and morning.* Sulphur is an invaluable remedy in protracted cases, or in those occurring in children who are the offspring of delicate parents.—when there is great weakness, emaciation, distension of the abdomen, and excoriations between the thighs and neigh- bouring parts. (Calcarea is sometimes required to complete the cure after Sulphur.) In other cases, Sepia, Jlejiar s., Acid. sulph., Magnesia, or Veratrum may be required. (See Diar- rhcea. Part II.) Administration. ^, in four teaspoonfuls of water, one night and morning. Opium, as has been stated in another part of the work,f is | a most valuable remedy, when immediately employed, for averting the bad results which sometimes arise in consequence of a sudden fright. When convulsions, with derangement in the stomach and bowels are excited in children by such a * Vide note, p. 21. t Vide Mental Emotions. EXCORIATION. JAUNDICE. 475 cause, we ought to administer Opium, followed by Veratrum, should Opium prove insufficient, and the vomiting and diarrhoea become excessive; or we may select a remedy from amongst those above mentioned, in preference, such as Pulsatilla, &c, if the symptoms correspond. Diet. When the derangement can be traced to any par- ticular kind of'food, an alteration in the diet becomes impera- tive : at the same time the quantity of food or drinks must be diminished until improvement sets in. EXCORIATION. Excoriationes Neonatorum. Against this affection cleanliness is the best preventive; however, we frequently find it proceed to such an extent as to require the aid of medicine for its removal. Chamomilla will be found, in most instances, speedily effective, when we are certain that the disease is not the medi- cinal result of chamomile-tea taken by the nurse or child, in which instance Ignatia, Pulsatilla, Borax, or Carbo ve- getabilis, at the same potency, have been recommended to be given. Administration. % or y^, repeated in three days. Mercurius. When a yellow colour of the skin is present, which Chamomilla has not removed, and when the excoriation is extensive and severe. In very obstinate cases we may have recourse to Carbo v. 30, followed in four to six days by Tinc- lura sulphuris, at the same potency. Acidum sulphuricum, Graphites, Silicea, Lycopodium, and Sepia, are also useful in this malady. Administration. ^ in the same manner as Chamomilla. JAUNDICE. Icterus Neonatorum. This disease, as we have before observed, frequently takes its rise from the mischievous practice of administering aperients immediately after birth; exposure to cold is also one of its ex- citing causes. When it has arisen from the last mentioned, and when there is, together with the distinguishing characteristic of the disease—a yellow hue of the skin—considerable distension of 476 diseases of infancy. the stomach, the administration of Chamomilla will be found prompt in affording relief. Mercurius may, in many cases fol- low this remedy if it has only partially relieved; after which, if any symptoms still remain, we may exhibit Cinchona. Nux vomica, when the complaint is combined with costive- ness, and the little patient appears generally of irritable tem- per. Administration of the remedies:—A globule in four tea- spoonfuls of water, one night and morning; again repeating, or selecting another remedy, after an interval of from three to five days, if the case seem to require it. (See remarks on this point in Introduction ; Article, Administration and repeti- tion of the medicines.) For more particular indications for the medicines above given, and further information, sec article Jaun*dice, in Part II. of this work. INDURATION OF THE CELLULAR TISSUE. Erysipelas Neonatorum. Diagnosis. Fever with red spots, generally appearing first upon the nates, but sometimes on the extremities, after- wards upon the abdomen and genital orgns, accompanied with induration of the skin and even of the maxillary muscles. which prevents the child from uttering other than a dull sound; the skin at last becomes as dry and hard as parch- ment. Sometimes, instead of fever, the induration is accom- panied with cold. This affection generally presents itself in the first two months of infancy; its duration is from four to fourteen days, and if not promptly treated, it is generally fatal. Therapeutics. The remedies principally required in this affection are Aconitum, Belladonna, Rhus toxicodendron, Ar- senicum album, Lachesis, and Sulphur. Aconitum. At the commencement, when fever is present. Administration. *%*, in four teaspoonfuls of water, one every six hours, until diminution of the febrile symptoms en- sues. Belladonna may follow the exhibition of Aconitum, parti- cularly when the spots present an ersyipelatous appearance. lock-jaw. 477 Administration. £, in a teaspoonful of water; to he re- peated in twelve to twenty-four hours, and so on if the same indications continue, but at shorter or longer intervals, accord- ing to the effects produced.* Rhus toxicodendron, if the appearance of the skin exhibits a vesicular character. Administration. Same as Belladonna. (In some cases Belladonna and Rhus alternately may be found necessary.) Arsenicum, should the dryness and hardness of the skin remain undiminished, or become increased; should we also find rejection of food from the stomach, evacuations green, watery, acrid, and very offensive ; moreover, when there is a tendency to gangrene, with livid spots and vesications. Administration. ~, repeated in the same manner as Belladonna. LACHEsismay in some cases be called for after Belladonna, when that remedy does not appear sufficient to combat the malady; or it may occasionally be advantageously exhibited in alternation with Arsenicum. Administration. ^, in the same manner as Belladonna. Sulphur may be usefully employed against the sequela? of this affection, such as torpidity of the intestines, and is also in- dicated where we have reason to suspect some constitutional taint. Graphites, Hepar s., or Clematis, may also prove useful. The body during this disease must be kept as dry as possi- ble, and lint applied to the parts affected; when practicable the infant's only nourishment should be from the breast, to which it should be frequently applied, but only allowed to suck little at a time. LOCK-JAW OF INFANTS. Trismus Nascentium. This serious, and so generally fatal disease, under the old mode of treatment, usually occurs in the first few days of infant life; at first the child vainly attempts to suck, and even if it succeed, the milk is returned. On examination, from stiffness of the masticator muscles, the lower jaw cannot be depressed —the jaws gradually close, the whole frame becomes rigid, and death ensues. * Vide note, p. 21. 478 diseases of infancy. The duration of the malady is from two to four days. Causes. Foul air; vitiated milk; taking cold; and local irritation, for example, the umbilical cord being too tightly tied. Therapeutics. We must in the first place remove the causes where known. When local irritation has given rise to the attack, Arnica ought to be immediately given internally; at the same time the seat of the injury may be bathed once or twice with a weak lotion, a few drops of the tincture to a wine- glassful of water. When we can trace the occasional cause to a bad state of the milk, Lachesis, 30, may first be given, and followed by Belladonna, 30 (which, it may be observed, is to be held as a most important remedy in all cases where the affection cannot be assigned to any particular cause), if no signs of improvement transpire after the first or second dose. Mercurius, 12, may also prove useful in similar cases. If cold or sudden chill has evidently given rise to the disorder, Cha- momilla, %, may first be administered, and then Belladonna, if required: or Nux v., ■£$, may be given in preference to Chamo- milla when catarrhal symptoms are present and indicate that remedy especially. (See Cold in the Head, Parts II. and III.) Hyoscyamus,—or Belladonna, Lachesis and Hyoscyamus in alternation, may be useful in some cases. (See also Tris- mus and Tetanus, Part II.) Administration. One globule of medicine chosen may be inserted, if possible, between the gums, or dissolved in a little water, of which a drop or two may be let fall upon the joining of the gums, if closely locked : repeat in from three to twelve hours, according to results. DERANGEMENTS DURING TEETHING. As already stated, about the fifth or sixth month the teeth generally begin to protrude. Under a proper system of treat- ment, if a due attention has been paid to the rules for exercise and diet which we have already laid down, and the child is free from any constitutional infirmity, we may safely calculate upon the period of dentition being exempt from much suffering. Broths and jellies should, during the acute stages, be wholly prohibited, and its food, if it take other nourishment than the derangements during teething. 479 breast, be of the lightest and simplest description. The mother or nurse should pay particular regard to her regimen, and avoid all substances of a stimulating and indigestible nature. Here, again, we may remark, that the indulgence in vinous or fermented liquors is, from their irritating properties, one of the most frequent causes of the suffering of children during this period. During dentition there is always a tendency of blood to the head, which from simple irritation may, if, not quickly checked, terminate in inflammation of the brain; the best preventive against this affection is keeping the head perfectly cool. In order, as much as possible, to allay the anxiety of parents, who may be led to mistake the natural symptoms attend- ant upon dentition for those of disease, we shall in the first in- stance, briefly enumerate those which frequently take place in healthy children, and may be safely left to nature; and afterwards proceed to point out in what cases, from any of the symptoms diverging from the usual track, it may be necessary to have recourse to medicines, or to call in the assistance of the physician. During the teething, the child is more restless than usual, especially at night; has flushes of heat, alternating with pale- ness; the gums gradually swell and become hot; it evinces a difficulty in sucking, sometimes forcibly bites, and frequently lets go the nipple; it drivels at the mouth, and its bowels be- come relaxed ; the two latter symptoms may, in some measure, be looked upon as a wise, precautionary measure of nature, to prevent a congestion to the head and lungs, to which all chil- dren are at this time more or less disposed; and the sudden cessation of either after having once set in, is a sign of derange- ment of functions, demanding prompt attention. Therapeutics. The medicines most generally required are Coffea, Chamomilla, Nux vomica. Belladonna, Cuprum aceti- cum, and Calcarea carbonica. When the child is in an excited state, and unable to sleep, irritable, liable to start, and difficult to soothe, a globule of Cqffea may be administered: if the symptoms remain without alteration, we may have recourse to Aconitum. When benefit 480 diseases of infancy. results from either one or the other remedy, the dose must only be repeated in the event of a threatening relapse. Chamomilla may be given after the lbregoing remedies when they are merely productive of partial relief; or it maybe given in preference thereto, if the following symptoms are encountered: extreme excitability; the infant starts at the slightest noise; evinces great thirst; spasmodic twitches or convulsions in the limbs, during sleep; short, quick, and loud respirations, sometimes with a hacking cough; excessive diar- rhoea, with green, whitish, or watery evacuations; and espe- cially when the mother has been in the habit of taking coffee, which we have already so strongly reprobated as an article of diet to women nursing. Mercurius and Suljdiur are some- times requisite after Chamomilla against the diarrhoea. (See Diarrhoea.) Administration. £, in a teaspoonful of water, repeated at first in twenty-four, then in forty-eight hours, but oftener if call d for. When in the assemblage of these symptoms, constipation takes the place of diarrhoea, we may administer Nux vomica, 3^, repeated in from two to three days if necessary. When strong symptoms of cerebral irritation exist, we should have instant recourse to Belladonna, or Cuprum aceticum. When marked cerebral sensibility de- clares itself, and the child almost spasmodically clenches the spoon or cup with its gums when drinking. Administration, according to the formula given under Scarlet Fever, one fourth of the dose there specified. When the irritation seems to arise from difficulty of teething, we may administer Calcarea, ■£$, repeating it every eight days for about a month, which will materially assist the protrusion of the teeth. When obstinate constipation is present, see that article in this part of the work. CONVULSIONS IN CHILDREN. Early childhood is, from various causes, peculiarly predis- po.-eJ to this distressing malady. They generally arise from the anatomical and physical peculiarities of infancy, in the convulsions in children. * 481 preponderance of the nervous and cerebral systems over the other parts of the frame; hereditary predisposition called into activity by dentition—repelled eruptions, irritating substances in the stomach, intestinal worms, mechanical injuries, fright, and lastly, from some occult cause, frequently a derangement of the organic structure, in many instances bidding defiance to the powers of medicine. When no physician or medicines are at hand, and the danger is imminent, we may, in the first place, recommend immersing the lower extremities up to the knees in water, as hot as can be borne with safety to the infant, for the space of eight or ten minutes, until the paroxysms seem in a measure subdued ; after which, the child should be wiped per- fetly dry, and placed in a warm wrapper; if the first immersion be followed by no relief, it should be repeated, at the same time pour a small stream of cold water upon the crown of the head, until reanimation becomes apparent; when the child ought again to be warmly covered up; this courserfrequently repeated, has been found to restore children, although the prior attempts have proved inefficient—when improper food or foreign sub- stances in the stormch or intestines are the causes, lavements of equal parts of sweet oil and warm milk should precede the foot-bath ;* if homoeopathic medicines be not immediately at hand, the careful administration of Camphor by olfaction, or a drop or two of the tincture, considerably diluted, placed on the tongue, will frequently be found efficacious in giving relief] awaiting the arrival of a physician. Therapeutics. Chamomilla, Belladonna, Ignatia amara, Cina, Mercurius, Cicuta virosa, Arsenicum, Bryonia, Sulphur. Nux vomica, Pulsatilla, Arnica, Opium, Stramonium, Secale cornutum, and Hyoscyamus, forms the most important remedies in the majority of cases.f Among these, Chamomilla stands in the first rank, particu- larly in very young children, when the convulsions have been excited by dentition, as well as for children who have passed that period, who are of a nervo-sanguine temperament, ex- * Some useful remarks upon this subject may be found in the "Ho- mceopathic Examinee," (published in New York, vol. i. No. 2.) t I may remark that in plethoric, well-nourished children, great advan- tage will frequently be derived from administering a dose of Aconite prior to any of the other remedies. 41 482 nisnAPFs of infancy. tremely sensitive, and peevish, or when the attacks have been excited by fever, colic, a chill, or a fit of passion or vexa- tion. The characteristic indications for its administration arc: restlessness, fretfulness, and disposition to drowsiness when awake; one cheek red, the other pale, diarrho-a ; (if this remedy be exhibited at this stage of the disorder it will fre- quently prevent the fit from becoming fully developed;) eyes half-closed; great thirst; quick and loud breathing; rattling in the throat; moaning; cessation of consciousness ; twitches of eyelids and muscles of the face ; contortion of the eye-balls ; jerks and convulsions of the limls, villi clenched thumbs; con- stant rolling of the head from side to side; loss of conscious- ness. (Belladonna may be substituted after Chamom iller, should this fail to do much good.) Administration. We may, for very young children, dis- solve one globule of the sixth potency in four teaspoonfuls of water, and administer one at the commencement of the attack; if fresh paroxysms come on some hours after, but decreased in intensity, we ought not to repeat the remedy, bat allow it to exhaust its action; if the convulsions increase, on a second or third attack, we may give another spoonful; unless other symp- toms declaring themselves, intimate that we ought to have re- course to any other of the undermentioned. Belladonna, besides being useful in cases of suppressed eruptions, is more particularly indicated when the child Ktarta suddenly, when asleep, or stares about wildly; the pupils are much dilated ; the body or individual members become rigid ; the forehead and hands dry and burning; occasionally fol- lowed by clenching of the hands ; involuntary micturition after returning to consciousness ; the slightest touch will sometimes provoke a renewal of the attack. This medicine is also indi- cated when the paroxysms are preceded by smiles or laughter. Ahministration. §£, in the same manner as Chamomilla. It is frequently found that Cliamomilla and Bel lade,una answer in alternation, and that when one has alleviated the evil, the other, sometimes followed by the one first administered, will dissipate the remaining symptoms. In cases that withstand the exhibition of these two remedies particularly during dentition, we frequently find Ignatia suc- cessful, more especially in children that appear of a melancholy temperament, or in pale, delicate infants, of peevish disposi- convulsions in children. 483 tkms, with alternations of vivacity and sadness, and laughing and crying almost in the same breath. Administration. Same as Belladonna. The characteristic symptoms are:—The infant, while repos- ing in a moaning, light slumber, becomes suddenly flushed with burning heat, awakes, and springs with a convulsive start, and the utmost soothing scarcely quiets the excitement; a tre- mor of the entire body, attended by violent crying and agoniz- ing shrieks ; and the muscles of single limbs seem convulsed. Ignatia is further indicated when the fit returns every day at a regular hour, followed by fever and perspiration, or every other day at variable hours. (In other instances Belladonna will be found requisite after Ignatia.) Ipecacuanha is useful when great difficulty of breathing, nausea, aversion to food, vomiting, either precede, accompany, or follow the attacks; and when the child has a constant incli- nation to remain in the recumbent posture. Cina is useful, particularly during the second teething, for children of a melancholy temperament, scrofulous constitution, and who are troubled with worms, or habitually wet the bed ; the characteristic symptoms are; spasms, commencing with constriction of the breast, followed by stiffness of limbs, pallor, and rigidity of the whole frame. Administration. Same as Chamomilla. But in some cases it will be found useful to prescribe £ every four days for a week or a fortnight, in order to remove the susceptibility to the attack, Mercurius is useful in spasms which are caused by the presence of worms; the stomach is swollen and hard before, during and after the fit; the child is attacked with painful eructation, and a species of salivation; the limbs tossed and convulsed, attended by fever and moist skin ; after the parox- ysms, the child lies for a long time exhausted and apparently dying. Administration. Same as Chamomilla. The foregoing are the more generally useful in ordinary cases ; but the subjoined are sometimes called for in the par- ticular instances specified. Cicuta virosa ie exceedingly serviceable when there is a clear indication of the presence of worms; when the child is first attacked with severe griping and colic, terminating in 484 diseases of infancy. convulsions; the characteristic features of the fit are : tremor of the limbs; jerks like electric shocks, terminated by insen- sibility. Administration. Same as Cina. Arsenicum has proved very valuable in severe cases of con- vulsions, during dentition, when a burning heat diffuses itself over the whole body of the child: it stretches its feet out, and the hands convulsively backwards, then throws its hands about, and rolls over with violent shrieks; changes its position, and bends forward with clenched fingers and extended thumbs ; it is irritable, restless, and perverse ; evinces insatiable thirst, but drinks little at a time, with diarrhoea, sometimes of undi- gested food ; frequently vomits immediately after taking food ; the paroxysms recur frequently, and all attempts at soothing seem only to irritate the child. Administration. Same as the foregoing. Bryonia is valuable in convulsions arising from suppressed measles. (See Measles.) Administration. Same as Arsenicum. Sulphur is particularly indicated in spasms arising from repelled chronic eruptions ; but such cases should be confined to experienced medical care, as until the disease is completely eradicated, the constant liability to such attacks still exists. When the disease arises from indigestible substances being taken into the stomach, Nux vomica or Pulsatilla may be given according to the symptoms and disposition, for which the indications have been already given in different parts of the work, to which the reader is referred. (See tabular Index.) In cases of mechanical lesion, Arnica, $, and externally in lotion, where any wound or contusion exists. In cases of convulsions from fright, we may have recourse to Opium, £ or £, when the following appearances are present: general trembling; throwing about of limbs; vacant stare ; cries seemingly unconscious; stertorous breathing, and final insensibility. Stramonium £, when the child becomes suddenly convulsed and senseless from fright. Secale cornutum, ^, in alternation with Stramonium, in cases where the latter does not afford relief. water in the head, 485 Hyoscyamus, t\, when sudden fright causes very violent convulsions. (See Mental Emotions, Part II.) WATER IN THE HEAD, Hydrocephalus. This fatal and frequent disease is liable to be excited by a variety of causes, and is particularly prone to take place in scrofulous children, who are born with unusually large heads, and in whom the fontanels remain long unclosed. The symp- toms are sometimes so mild and insidious, that parents are thrown off their guard, and attribute the apparently slight in- disposition of the little patient to some comparatively trivial circumstance ; such as. teething, or gastric derangement. In other instances, the symptoms are much more striking, and in many respects strongly resemble those described under In- fiammation of the Brain. In general, the skin is hot, pulse rather quick, chiefly at night, and the child becomes peevish whenever it is raised from the horizontal position ; at other times it is affected with fits of screaming; grinding of the teeth; redness of the face and eyes; peculiar expression of countenance ; convulsion and stupor. Therapeutics. The most appropriate remedies are Aconite, Belladonna, Bryonia, Helleborus% Mercurius, and Sulphur, or Sulphuris Tinctura. The indications for the two former have already been given under Inflammation of the Brain, Part II. Administration. Two globules at the potency mentioned, in four teaspoonfuls of water, one daily; in severe attacks every six of twelve hours, carefully studying the effects of each dose, and acting accordingly.* Bryonia, 6, may be administered after Aconite or Bella- donna, if necessary, or may be given at the commencement, when there is heat in the head, with dark redness of the face, and great thirst: eyes convulsed, or at one time closed, and at another wide open or fixed; delirium ; sudden starts, with cries, or constant inclination to sleep: continual movement of the jaws as if engaged in chewing; tongue coated yellow; abdomen distended -t urine suppressed, or the passing of urine appears to cause pain ; great thirst, especially at night; skin hot and dry; respiration hurried, laborious, and anxious; con- stipation. * Vide note, p. 21. 41* 486 diseases of infancy. Helleborus nicer. This remedy, as stated by Dr. Wahle,* will generally prevent a fatal termination, when Bryonia merely produces only temporary benefit. The same authority quotes it as being the most important medicine in all serious cases, and that it should be given in these at the very com- mencement in preference to all other remedies; followed by Sulphuris Tinciura when danger is not removed within a few hours, and when spasms are present. Mercurius, 12, will sometimes be found useful after Bella- donna , or previous to that remedy, when the bowels are much relaxed. Hyoscyamus, Opium, Cina, and Stramonium, may likewise prove valuable in cases wherein the indications corres- pond with those described in Part II., and in some cases^ Lachesis, particularly when the disease has reached an ad- vanced stage. Kali hydriod., Digitalis, Arnica, and Conium, have ako been named as likely to prove serviceable in this malady. In chronic cases, Dr. Wahle recommends Helleborus, Arsenicum, and Sulphur in particular. ASTHMA OF MTLLAR. Laryngismus Stridulus. This affection is by some denominated the Spasmodic Croup, or Acute Asthma of infants; it bears a considerable resem- blance to croup, yet differs from it in many respects, by the extreme suddenness of the attack, while that of croup is gener- ally preceded one or two days, by hoarseness and a slight cough, and by the cessation from suffering the patient enjoys between the attacks, while when croup has once set in the ex- citement is permanent; moreover, this disease generally at- tacks in the evening or at night, whereas croup in most cases makes its first appearance during the day. Croup, as we mentioned in the article upon that subject, is an inflammation of the membrane of the windpipe, exciting the formation of a peculiar secretion, which if not checked, con- cretes into an abnormal membraneous tissue, constituting what is technically called the false membrane of croup; whereas, in the Asthma of Millar, the suffering appears to arise from a ♦ Brit. Journ. of Homoeopathy. No. vii. p. 286. ASTHMA OF MILLAR. 487 spasmodic contraction of the top of the windpipe, impeding the progress of respiration. The attack commences with a sudden spasmodic inspira- tion, with a species of stridulous or crowing noise; if the fit continues, the face becomes purple, and the extremities par- take of the same hue, frequently accompanied, as in convul- sions, with a clenching of the thumbs inside the palm, and spasmodic constriction of the toes, giving an appearance of distortion to the foot; if proper means are not promptly taken, these attacks recur frequently, and at short intervals, and occa- sionally the little patient perishes during one of the paroxysms. The disease rarely occurs except in infants of delicate con- stitution, which due means should be taken to endeavour to eradicate by a proper course of treatment; it is a frequent accompaniment of the period of dentition, and excited by simi- lar causes to those bringing on convulsions. Therapeutics. Aconite, Ipecacuanha, Arsenicum, Sambu- cus, Moschus or Pulsatilla, are the medicines which have been employed by homoeopathists with the most successful results. Administration. A globule every one or two hours, ac- cording to symptoms. Aconite, 12, when a suffocating cough comes on at night, with shrillness and hoarseness of voice; respiration short, anxious, and difficult, more particularly if any marked febrile symptoms be present, or we have reason to dread determina- tion of blood to the head. Ipecacuanha, 3, when there is rattling in the chest, from an accumulation of mucus, with spasmodic constriction, and symptoms as from suffocation; anxious and short, or sighing respiration, with purple colour of the face, and cramps, or rigidity of the frame; it may be advantageously followed by Arsenicum, 30, when many of the above symptoms are still present, or in a measure subdued ; also if we find great anguish, cold perspiration, and considerable prostration of strength, during and after the paroxysms; when these last indications are particularly prominent, Arsenicum may supersede Ipecacu- anha at the commencement. Sambucus. Lethargy, or ineffectual inclination to sleep, with oppressed respiration and wheezing; livid hue of the face, 46S DISEASES OF INFANCY. agonizing jactitations, dry heat of the trunk ; no thirst; pulse small, irregular, and intermittent. Moschus, 3, is frequently of value in cases that occur at a more advanced period of life-, when a constriction in the larynx, as if caused by the vapour of suljdutr, is complained of; difficult respiration and short breathing; severe spasms in the chest.'with inclination to cough, after which (especially in children) the paroxysms become much exacerbated. Pilsatilla, xy, will often be found successful in cases in which the foregoing remedy fails in producing the desired effect. THE RICKETS. Rachitis. This malady almost invariably begins to show itself at the ten- der age of from one to two years, and is distinguished by great development of head, abnormally prominent forehead, project- ing sternum, flattened ribs, enlarged abdomen, with emacia- tion of the extremities, and extreme general debility. As the dis- ease progresses, the muscles become more flaccid, the epiphyses of the limbs increase in size, the bones and dorsal spine be- come more or less distorted, the bowels relaxed and the motions frequent; and frequently, if the disease be not arrested, slow fever, with cough, oppressed breathing and atrophy supervene, and a fatal termination results. Therapeutics. The remedies which have hitherto been employed with the greatest success in the treatment of this distressing affection by homoeopathists are: Belladonna, Mer- curius, . Irsenicum, Sulphur, Calcarea, Silicea; also Assa- foetida, Acidum phosphoricum, Phosphorus, Baryta-muria- tica, Staphysagria, Lycopodium, Acidum nitricum, Mezereum, Petroleum, and Rhus* (See Atrophy.) INFANTILE REMITTENT FEVER. By infantile remittent is here chiefly meant that form of fever which occurs in infants and children, arising from mor- . *^The author begs to refer the reader to a somewhat interesting case of Rachitis, which he published .in the Brit. Joum. of Homoeopathy, No. 10, p. 105. INFANTILE REMITTENT FEVER. 489 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 themselves in a more aggravated form, together with an ac- quisition of abnormal phenomena, such as hurried and oppres- sive breathing, quickness of pulse, with occasional flushes in the face, vomiting of food or bile, distension and tenderness of the abdomen; obstinate constipation ; sometimes diarrhoea, or frequent desire to go to stool with but little effect; motions dis- coloured, fetid, frequently mixed with mucus, and occasionally with blood. The hands and feet are often cold, whfle the rest of the body is parched ; the head hot and heavy, or attended with other symptoms resembling hydrocephalus, such as coma, etc. The tongue, at first moist, loaded, and occasionally very red along the margins, often becomes dry over a triangular spot at the point. When the febrile exacerbation takes place at night, it is accompanied by vigilance and jactitation ; when during the day, there is. on the other hand, drowsiness and stupor. An annoying cough with bronchitic indications, suc- ceeded by wheezing and expectoration, sometimes appears. Although, as is characteristic of remittent fever, the febrile symptoms never entirely subside, still the patient will fre- quently appear to be steadily recovering for a time, and the un- wary or inexperienced may consequently be led to pronounce an unduly favourable prognosis, which will too often be contra- dicted by the occurrence of a relapse, followed perhaps again by another encouraging but deceptive 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 unequivocal signs of cephalic disease become established, or the little sufferer is so emaci- ated 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, Pulsatilla, China, Nux v., Aconitum, Belladonna, Mercurius, Bryonia, Lachesis, Chamomilla, and Sulphur, com- 490 diseases of in-tancy. 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, Ipecacuanha may be given if, as is generally the case, the attack has been excited by over-feeding, or by indigestible food, and particularly wlten the patient has contracted a habit of bolting the food without having previously masticated it pro- perly, and the symptoms encountered are as follows :—General dry heat, or harsh and parched skin, especially towards even- ing; thirst, extreme restlessness, burning heat in the palms of the hands; perspiration at night, quick oppressed breathing, foul tongue, nausea, vomiting, or fastidious appetite with sick- ness after eating; great languor, apathy, and indifference. Should these symptoms remain unaltered after several doses of Ipecac, or should the bowels become very relaxed, the motions fetid, whitish, bilious, or of variable colour at different times, and accompanied with griping and distension of the abdomen ; fever during the night—Pulsatilla must be prescribed, fol- lowed, if required, by Cinchona, especially if the nausea or vomiting has subsided, but the bowels remain relaxed, and are considerably distended, 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, hut 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 infantile remittent fever. 491 Vomiting; no motions, or frequent and scanty evacuations, with tenesmus.' Belladonna 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 edges; thirst; nausea or vomiting; great heat of the abdomen with tenderness on the slightest pressure; oppressive breathing. If the more active inflammatory symptoms yield to 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, exces- sive restlessness, and quick, laborious respiration, particularly at night, with drowsiness during the day, Bryonia is to be pre- ferred. Lachesis may follow Belladonna or Mercurius when the signs of intestinal irritation or inflammation continue with but little abatement. Or it may precede these remedies, when the tenderness and distension 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 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 i\>2 diseases of infancy. character. When, however, the malady occurs in children ol 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 al- luded to in the diagnosis. The remedies from which the most benefit is to be antici- pated under such unfavourable circumstances are, in addition to those previously mentioned: Silicea, Sulphur, Calcarea, Ba- ryta c, Arsenicum, Cocculus, Cina, Sabadilla, etc. Silicea, when there is great emaciation, languor and debil- ity, paleness of the face, want of appetite, or craving for dain- 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 invermination. Cina and Sabadilla, may likewise be found useful along with Silicea in the latter instance. (Sec Invermination.) The indications for sulphur have already been given. Calcakea. 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. Extreme prostration of strength and emacia- tion, with desire to remain constantly in the recumbent pos- ture; dry, 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 sometimes ex- cessive irritability of stomach, so that very little food can be retained; hard and tense abdomen ; restless, unrefreshing 6ieep, 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, distension of the abdomen, constipation; oppressed ATROPHY. 493 respiration: perspiration 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 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. Lethargy, jactitation, or agitation, moaning and muttering, feeble and accelerated pulse. (See Hydrocepha- lus.) 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 degree. (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., Phosp., and Rhus. Sulphur in almost all cases at the commencement of treat- ment; craving appetite; enlargement of inguinal or axillary glands; slimy diarrhoea, or obstinate constipation; pale com- plexion, sunken eyes, &e. Calcarea. 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. 42 494 DISEASES OF INFANCY. Arsenicum. Dryness of skin, which resembles parchment; hollow eyes; desire to drink often, but little at a time; exces- sive agitation and tossing, especially at night; short sleep in- terrupted by jerks; fteces of trreenish or brownish colour, with evacuations of ingesta; extreme prostration. Baryta. Enlargement of the glands of the nape of the neck ; continual desire to sleep; great indolence, and aversion to exertion and amusement. Bell. Capriciousness and obstinacy ; nocturnal cough, with rattling of mucus; enlargement of the glands of ihe neck ; unquiet sleep; precocity of intellect, blue eyes, and fair hair. China. Excessive emaciation; voraciousness; diarrhoea at night, with frequent white evacuations, or of ingesta; fre- quent perspirations, especially at night; univl'resliing sleep. Cina. Venniculous suffering; wetting the bed. (See Worms.) Rhus. Slimy or sanguineous diarrhoea; 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 importance. 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 similibus curantur. Vaccination, when the child is strong and healthy, may be safely 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, af- ter 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 vaccination. 495 frequently transmitted to heallhy 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, although at the time apparently in health. END OF PART III. 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, and headache, with flatulent distension 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 tho different stages, of a decline. CHLOROSIS. 497 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 stage, as when we find an extremely obstinate case, we may feel confident that it requires a regular course of treatment, or originates in some organic derangement. The medicines hitherto found most useful in ordinary cases of this affection are, Pulsatilla, Sepia, Bryonia, Sulphur, and Natrum muri- aticum. Administration. Six globules of the potency mentioned after each medicine, in six dessert-spoonfuls of water, one daily; and so on until benefit results, or it is found necessary to choose another remedy.* Pulsatilla, 12, is peculiarly efficacious when the complaint has been the effect of dampness, or caused by damp or cold air, or when it is accompanied by frequent attacks 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 pressure at the crown of the head, and sallow complexion, alternating with flushes of heat; difficulty of breathing, and sense of suffocation after the slightest movement; palpitation of the heart; cold- ness of the hands and feet, often changing to sudden heat; disposition to diarrhaa and leucorrhaia; pains in the loins; sensation of weight in the abdomen; spasms in the stomach, with nausea, inclination to vomit, and vomiting; periodical 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, 30, when there is retention of the period with congestion of the vessels of the head and chest; dark red flushing of the face, oppression at the chest; and a feeling of anxiety when in the recumbent posture. Graphites, together with Causticum, form two of the most important remedies in scanty, insufficient menstruation. Belladonna is often called for whon the congestion of the head and chest is of an active * Vide note, p. 21. 42* 493 treatment of females. character, and accompanied with violent throbbing of the carotids. Sepia. 30, is also a very valuable remedy in this affection, when many of the above symptoms are present, with, at the same time, hysterical megrims; complexion sallow, with dark- coloured spots; frequent colic and pain as of bruise in the limbs. It may, when the above symptoms declare themselves, advantageously follow Pulsatilla, if the latter have failed to relieve. Bryonia. 6. Frequent congestion in the head or chest; bleeding at the nose; dry cough ; coldness and frequent shivering, sometimes alternated with dry and burning heat; constipation or colic ; bitter taste in the mouth, tongue coated yellow ; sense of pressure in the stomach, as if from a stone ; irascibility. Sulphur, 6, is more particularly indicated when there is pressive and tensive pain in the 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 emacia- tion ; 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 the legs, with great depression after talking; great tendency to take cold; irritability, and inclination to be angry; or, sadness and mel- ancholy, with frequent weeping. In some cases, one or the other of the following medicines may be chosen : Conium ma- culatum, Kali carbonicum, Calcarea carbonica, Phosphorus, Ferrum, Ijnalia, Lycopndium, Acid, nitricum, etc. Valeriana has been found of great service at a low potency ; in daily-repeated doses, when a feeling of constric- tion was experienced in the gullet or chest, accompanied with signs of threatened suffocation, and followed by frequent yawn- ing, as soon as the patient sat down to dinner. Natrum muriaticum, potency 6, 12, or 30, is a most valua- ble 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 dyspnoea, oedema, and anasarca. amenorrhea, menstruatio nimia. 499 AMENORRHCEA. Suppressio Mensium. Suppression of the menses occasionally takes place suddenly from some accidental cause, such as exposure to cold, power- ful mental emotions, etc. In other instances the suppression is symptomatic of some other disease, either organic or functional, and can only be removed by die cure of the primary malady. It is of the former th^t 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 symp- toms generally correspond to those of that remedy, as detailed under Chlorosis. In other cases arising from this cause, Nux moschata, Dulcamara, Sepia, or Sulphur may be neces- sary. (See Chlorosis, for indications for Sulph. and Sep. which are remedies of great service in a large number of cases, when the affection 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. (See 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, Arsenicum, Cinchona, Graphites, Causticum, Iodium. Whilst in those which occur in plethoric subjects, whether of a chronic or recent description, Aconitum, Belladonna, Sulphur, Bryonia, Nux v., Sabina, Opium, Platina, etc. will chiefly be found the most serviceable. When there is not a complete suppression, but the menstrual discharge is scanty and insufficient, Graphites, Causticum, Kali, Conium, Natrum m., Phosphorus, Pulsatilla, Sulphur, Lycopodium, Magnesia, Silicea, Veratrum, or Zincum, are the most important remedies. MENSTRUATIO NIMIA. MENOCHASIA. MENORRHAGIA. The quantity of the menstrual discharge varies a good deal in different women. Considerable influence is for the most 500 treatment of females. part exerted by climate, constitution, and the manner of living. The duration of the discharge and the period of return are also va'riable. 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 va- riation of several days is a usual occurrence, without the slightest disturbance to the general health resulting there- from. When the discharge is excessive, and attended with pains in the back, loins, and abdomen, resembling those of labour, it becomes necessary to prescribe remedies calculated to arrest it, and to correct the tendency thereto. Amongst these the following are of great utility: Ipecacuanha, Crocus, Sabina, Cinchona, Nux v., Chamomilla, Platina, Sulphur, Calcarea, etc. Ipecacuanha is one of the most generally useful in severe cases of this derangement, as well as in flooding after labour, and may in most instances be administe.*d first, unless there are strong indications for a preference being given to any of the others. Administration. Three globules 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. Sabina, 6, when the discharge is excessive, of a bright colour, and occurs in plethoric females who are prone to mis- carry, rheumatic pains in the head and limbs; great weakness; pains in the loins similar to those of labour. Administration. Same as Crocus. Cinchona, 6, 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 dis- charge than natural. Administration. Two globules at the potency mentioned, repeated in twenty-four hours. IVix v., 6 or 12, when the discharge is of too frequent oc- currence, too profuse, and of too long duration; and when it * Vide note, p. 21. dysmenorrhcea. 501 commonly stops for a day or so and then returns, attended with spasms in the abdomen; sometimes nausea and fainting, espe- cially in the morning; pains in the limbs; restlessness; irasci- bility. Nux v. is especially serviceable when the above symp- toms occur in females who are addicted to the daily or frequent Vuse of coffee, liqueurs, and other stimuli. Administration. Two globules 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 periodical return. Chamomilla is frequently useful after Nux v., but particu- larly when there is a discharge of dark, clotted blood, with severe colic, or pains like those of labour; great thirst; pale- ness of the face, and coldness of the limbs. Administration. Same as Nux. Ignatia, 12—30, is of considerable service when the de- rangement happens in hysterical females. Administration. Two globules 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. Two to three globules during the dis- charge ; to be repeated in twenty-four hours if the pains continue. Veratrum, 12 or 30. Too early or too copious menstrual discharge, always attended with diarrhoea. Administration. Two to three globules, 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, Bryonia, Natrum m.. Magnesia m., Sepia, Silicea, or Phosphorus, etc., may be useful. DYSMENORRHCEA. In painful and difficult menstruation, or menstrual colic, the most important remedies are the same as those enumerated under Menorrhagia and Chlorosis, but particularly Chamo- 50:2 TREATMENT OF FEMALES. mill a, Pulsatilla, Belladonna, Nux, Coffea. Sulph. and Calc, etc.,* when the disorder occurs with great vehemence at the critical age (tour (/' dge). 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 follow- ing are likewise of considerable utility ; Pulsatilla, Sepia- Sul- phur, Cocculus, Rata, Conium. Against uterine spasms. Coc- culus, Pulsatilla, Ignalia. Platina, Cuprum, form the most valuable remedial agents ; but in some instances \ux vomica, Cinchona, Sulphur, Graphites, Conium, or Natrum m., etc., may be mere appropriate. 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 in 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 hysteri- cus ;) if it advances further, there is sense of suffocation, stupor and insensibility, with spasmodic clenching of the jaws ; the trunk of the body is moved about, and the limbs agitated ; al- ternate 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 some- times a concomitant, and a very distressing one, in hysteria. These are the usual symptoms accompanying this disease, but the complaint appears in a great variety of forms; and in many cases the patient 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 cada- verous 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 pubecty and that of thirty-five, and generally about the period of menstruation. * We have derived immediate relief from Sabina when all other expe- dients proved inefficacious.—Ed. OBSERVATIONS ON PREGNANCY. 503 The disorder is readliy 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, ex- cessive 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,, Bell., Calc, Caust., Cocc, Con.. Ignat., Lach., Mosch., N. mosch., N. vom., Phosp., Plat., Puis., Sepia, Sil., Stram., Sulp., Verat., Valeriana, etc. When the affection arises from Chlorosis or Amenor- rhcea, see the remedies mentioned under these headings. When from Menorrhagia; see that article. Mental Emotions; see the same. When the attacks are attended with clenching of the jaws, 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 vomica, Belladonna, and Stramonium:—or Hyoscyamus, Vera- trum, Ignatia, Pulsatilla, Cicuta, Bryonia, and Sulphur will be found the most frequently useful. 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 responsibility, 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 conclusion, that the actions of the mother exercise a great in- 504 observations on pregnancy. fluence over, not only the constitutional and physical, but also the mental organization of her offspring. Keeping thin fact in view, we shall endeavour to point out the course that mothers, who prefer the welfue of their future offspring to their own indulgence, should pursue, from which they will derive a double benefit,—an improvement in their own health, with exemption from suffering, and the delight of seeinir their children pass safely through the anxious period of infancy ; while in after life beholding them flourishing around them, in the full enjoyment 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 ages of the parties; errors in dress, diet, and general habits 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 transmitted 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 different members, sometimes disappearing in one gene- ration, 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 supersedes the present erroneous system of medi- cine, 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 wc 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 air and exercise. 505 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 suffering 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 mother enjoys an almost complete exemption from the power of epidemic or infectious diseases, and chronic complaints are frequently suspended; in fact, with the exception of some slight morning sickness, and occasional trifling uneasiness, a well-constituted 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 preserva- tion of the parent and her future offspring, yet are her wise arrangements, in too many instances, rendered nugatory by a direct contravention of her laws. The expectant mother should therefore 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 43 50G OBSEliVATIONS ON PREGNANCi. inconvenience, can scarcely expect to enjoy the benefit thai nature 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 increas- ing vigour of the mother to her offspring ; on the contrary, continual passive exercise in a carriage has been found par- ticularly injurious during, and towards the end of the second period of pregnancy ; and is frequently the cause of premature and abnormal 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 objectionable 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 tem- perament, and others, coerced by hard necessity, frequently overfatigue themselves, go to bed late, rise early, and some- times unrefreshed, and thus in a manner deaden the energies of the organic powers, to their own injury, and that of the un- born 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 unfre- quently 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 CLOTHING. 507 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 cold atmosphere, 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 frnme, 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 natural 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- 508 OBSERVATIONS ON PHEONANCT. etructed mechanism of the mamma? ; 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 places impracticable. Young girls of seventeen or eighteen arc frequently found with pendulous breasts, from the artificial support having taken the office of the muscles, intended by nature for that purpose, and throwing-them out of employment. Garters 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 had mechanical effect upon the future offspring; and, moreover, the foetus shares in the derangements of the mother. Much depends upon the quality 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 every kind are altogether avoided ; indeed, the usual homoeopathic diet (for which see the 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 ■erenity. An easy MENTAL EMOTIONS. 509 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 feeling on the mind of the mother during pregnancy has influence on the future mental organization of the child. This shows how es- sential it is for females to keep their minds well employed dur- ing this period, to avoid both improper meditation, dissipation, and reading works not calculated to improve their understand- ing. Nothing can act more effectually against the future men- tal 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 fash- ionable life, injurious as they are to the most robust constitu- tions, 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 pecu- liarities 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 endeav- our, 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 43* 510 OBSERVATIONS ON PREGNANCY. 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 during the time of nursing; although not permanent, and when commenc- ing early in gestation, usually disappearing before delivery, without material injury to the general health. Therapeutics. As this affection is apt to create some un- easiness, both to 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, Natrum muriaticum, 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 be ex- tremely susceptible to the impressions of the medicines, one or two globules may be given, and only repeated after an interval of from four to eight days or so, according to the effects pro- duced.* 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. Bryonia 30. Great inquietude and fear of the future, at- tended with irascibility and derangement of the digestive functions. Nux vomica 30. Morning sickness and melancholy, with great u.easiness, 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 lactation, 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. * 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 Int*oduction, Part I.) MENSTRUATION. 511 Calcarea 18, is also efficacious when the above symptoms present themselves, and more particularly so, when there is excessive dejection with great lassitude. 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, Plati- na, Aurum, 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 her 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; how- ever, when the female appears to suffer from the continuance of the menstrual flux, we must call in the assistance of medi- caments, among which the principal are, Cocculus, Phosphorus, and Platina. Administration. A30/, repeated every twenty-four hours until improvement takes place, or another remedy appears called for.* Cocculus. A sanguineous mucous discharge, and very se- vere spasmodic pains in the lower part of the abdomen. • Vide note, p. 21. 512 derangements during pregnancy. 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.) 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 gen- erally disappear soon after quickening, but sometimes con- tinue during the whole period. The numerous palliative reme- dies recommended by Allopathists—leeches, cupping-glasses, blisters, aperients, sedatives, &c. &c, unfortunately too often fail in effecting their object; and in severe cases, when the stomach' becomes enfeebled, the hazardous resource of arti- ficially produced premature labour is resorted to. Therapeutics. 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 instances free from complication, with a tendency to relaxation of the bowels, Ipecacuanha is generally sufficient. Administration. ^ in four dessert-spoonfuls of water, one morning and evening.* Nux vomica. When there is nausea or vomiting every morning 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. Excessive vomiting after eating or drinking, with attacks of fainting; great weakness and emaciation. Administration. Same as Ipecacuanha, but at the twelfth or thirtieth potency. * Vide note, p. 21. CONSTIPATION. diarrhcsa. 513 Pulsatilla. Nausea after every meal; vomiting of ingesta, heartburn, depraved appetite,'or longing for particular 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 left to nature, adopting at the same time the homceopathic rules for regimen, and be careful not to overload the stomach. In 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 stimulating liquids,) are generally sufficient. When nature requires further auxiliary:— Nux vomica, 4$r. taken at bed-time will often answer; if after the completion of its action, there still remains some inconvenience, Ignatia, s--^-, should be given as an interme- diate, followed by a lower potency of Nux vomica (■*& ft) : in other cases, when Nux vomica does not show a marked im- provement, and the temper is extremely irritable, Bryonia &$&, will sometimes cure, or Opium -§-, which is especially indi- cated to fo'low Nux vomica when there appears to be a weight in the stomach, dryness of the mouth, and deep flushing of the face. In other cases, Sepia, Lycopodium, Alumina, etc., will be found useful. (See Constipation, Part II.) Dysuria. Pulsatilla, Cocculus, Nux v., and Acid, phos- phoricum, as also Sulphur and Conium, have chiefly been recommended. DIARRHOEA DURING PREGNANCY. See Diarrhcea, Part II. and Diarrhoea in Lying-in Women, in this division of the work. 514 derangements during pregnancy. FAINTING AND HYSTERIC FITS. Many delicate and nervous females are frequently attacked with fainting fits during pregnancy. The attack generally passes over easily and without deleterious consequences ; ex- ercise in the open air, and attention to the rules of regimen, are the best safeguards ; but in cases where these are insuffi- cient, and the attacks prove distressing, we must endeavour to ascertain their origin. If from tight-lacing, warm rooms, or any other obvious excitant, its simple removal is sufficient; should the sufferer remain long insensible, the speediest means of revival is sprinkling the face with cold water. When arising from plethoric habit, returns of the attack may be prevented by Aconite, of which we have had occasion to speak several times, as a general regulator of the circulation. Chamomilla Vim when the fainting is excited by sudden fits of anger. Nux vomica 4$*, when from general irritability of system, and consequent gastric derangement. Belladonna *•$*, 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 ff, when arising from general weakness, and especially from loss of blood. Pulsatilla {f. General excitability and disposition to hysteria, with hypochondriasis and great general susceptibility. Coffea. 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 *f, when the patient suffers from severe headache, as if a nail were driven into the head; sadness; concealed sorrow, and sighing. (See Swooning.) TOOTHACHE. 515 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 ano- ther remedy required.* TOOTHACHE Is a frequent affection with pregnant women, and 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 treat- ment, 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 30, 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 18, when it is excited or aggravated by cold air, or any thing hot or cold, and attended with painful sensation of the gums, and pulsative gnawing or shooting pains, which are aggravated by noise. Alumina 30, 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 30. Nocturnal pains in the teeth, in- supportable when lying down, and compelling the patient to get up and walk; pains generally boring, burning, drawing, tear- ing, and resembling those of ulceration, attended with swelling of the cheek of the side affected; throbbing and shooting in the teeth after a meal; pain aggravated by a cold. The * Vide note, p. 21. 51G derangements during pregnancy. above are the four leading medicines, though there are othera which are demonstrable by peculiar symptoms. (See Tooth- ache, Part II.) 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 rivus, which is of especial service if the swelling of the cheek is accompanied by a drawing, tearing pain, and increased flow of saliva, and considerable erysipelatous red- ness ; followed by Belladonna and Hepar s. if the inflam- mation threatens to extend. (See Erysipelas.) Cham., Bryonia, 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 occasion- ally 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 burst, 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. VARICES. 517 VARICES, or SWELLED VEINS. Many females suffer much during pregnancy from distension of veins in the thigh and other parts, which becoming more exacerbated, eventually cause great pain and inconvenience. These varicose veins generally arise from obstructed circula- tion caused by the pressure of the gravid uterus upon the blood-vessels, but are also frequently a sure indication of the existence of constitutional debility, particularly when they oc- cur in an aggravated form. They are much increased by par- taking of stimulating liquids, which should consequently be avoided. Considerable alleviation is experienced by constant bathing with water, or \vith diluted alcohol; also by bandaging lrom 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 swell- ing of the feet, ankles, etc. In order to afford a considerable relief, we may have recourse to the following remedies:— Pulsatilla 12 is one of the most useful medicines, particu- larly 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 discoloration continue in much the same state, Lachesis may be substituted. Arnica is of material service when the occupations of the patient ren- der it impossible for her to lay up, or avoid much standing and moving about in discharge of her domestic duties. Arnica and Pidsatilla in alternation, every six or eight days, have been found of great efficacy in such cases. Nux vomica 30, when attended with constipation, hemor- rhoids, and irritability of temper. Sulphur is sometimes very beneficial after Nux v. Arsenicum 30, when the veins are of a livid colour, and are attended with severe burning pain. Carbo vegetabilis 30, where the former is not sufficient to subdue the constant scalding or burning. Belladonna 30. Varices, with considerable erysipelatous inflammation. Lycopodium 30, has been employed with success in some inveterate cases. 44 518 DERANGEMENTS 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.* The simultaneous application of the remedy employed, is occasionally attended with benefit. For a permanent eradication, a course of treatment is requi- site, in which—Sulphur, Graphites, Carbo vegetabilis, Sepia, etc., are useful. (See Ulcers, Part II.) PAINS IN THE BACK DURING PREGNANCY. Lumbosacral pains. Some females suffer much from pains in the lower part of the back during pregnancy, which occasionally prove ex- tremely distressing, particularly when they occur during tho night, and tend to disturb sleep. They generally consist of an almost indescribable aching, or of an obtuse, heavy pressure, as if caused by a dead weight resting on the affected part. Kali carbonicum has repeatedly been employed against them with the most satisfactory results, especially when they partake of the character described. In other cases, Bryonia, Rhus, Sulph., Lycopodium, Pulsatilla, Nux v., Sepia, or Causticum, etc., may be given with advantage. If hemorrhoidal sufferings become added to these troublesome pains, and Kali c. prove insufficient to relieve the complaint in this complicated form, Nux v., Sulphur, or Sepia, maybe prescribed with advantage. (See Hemorrhoids ; as also the indications given for the reme- dies under the heading of False Pains.) MISCARRIAGE. Abortus. From the increasing number of homceopathic 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- * Vide note, p. 21. miscarriage. 519 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. Women who have once suffered from this affection are ex- ceedingly obnoxious to its recurrence, and 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 mis- carriage takes place at a more advanced period, it assumes a very serious complexion, and is often accompanied with a con- siderable degree of peril to the sufferer. The premonitory and accompanying symptoms of miscar- riage vary much in their nature ; sometimes the discharge is exceedingly 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, mecha- nical injuries, a luxurious mode of life, fashionable habits, powerful aperients, neglecting to take air and exercise, are a few of the exciting causes of this affection, which is particu- larly 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 by fever, with more or less bearing-down, particularly when occurring late in pregnancy; also, severe pains in the ab- domen, drawing and cutting pains in the 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 derangements during pregnancy. generally established, with their characteristic regular throes, and efforts to dilate the mouth of the womb, miscarriage in almost inevitable. Therapeutics. As preventives of this affection the princi- pal remedies are Sabina, Secale cornutum, Kali c, Lye. Sep., and Calc When the premonitory symptoms declare themselves, Cha- momilla, Nux vomica, Ferrum metallicum, Ipecacuanha. Sa- bina, and Calcarea. The same with the additions of llijascya- mus, Crocus, and Secale cornutum, after the misfortune has taken place. Cinchona is also valuable when the indications which we shall give for that medicine are 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, ^, in the early stage of pregnancy, will frequently prevent its occurrence. Administration. 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, in 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 longer intervals. Hartmann* strongly recommends Secale cornutum f| aa useful in similar cases, but particularly when this misfortune has already occurred more than once; it should be adminis- tered every fourteen days, commencing immediately after the cessation 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- siderable debility; this remedy is also efficacious in cases of inevitable miscarriage, attended with feeble expulsive efforts ; * Therapie akut. Krank. Form. vol. ii., p. 352, 2d od. MISCARRIAGE. 521 the former (Sabina) when there are dragging and forcing pains, extending down the back and loins; profuse, bright-col- oured hemorrhage ; sensation of sinking or faintness in the ab- domen ; frequent desire to relieve the bowels; diarrhoea; nau- sea or vomiting; chilliness and heat, with fever. Lycopodium and Kali carbonicum have also been recom- mended as useful preventive remedies against habitual ten- dency 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. When the symptoms have been excited by an ac- cident, such as a fall, blow, or concussion, etc., this remedy should be immediately administered. Chamomilla 3, when there are present: excessive restless- ness, 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 re- sembling 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 ■e. Obstinate constipation, with a varicose con- dition of the internal organs of generation : also when the pa- tient has been accustomed to a stimulating diet, and the use of coffee; severe burning, or wrenching pains in the loins; pain- ful pressure downwards and mucous discharge. (Bryonia is sometimes of benefit, when Nux v. fails to do much good.) See also Calcarea. Ipecacuanha 3- 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 44* 522 DERANGEMENTS DURING PREGNANCY. region. (Platina or Cina have been recommended when Ipecac, fails.) Hyoscyamus 3-^, when the convulsions are very severe, with cries, great anguish, oppression of the chest, and loss of consciousness. Belladonna v, is perhaps more frequently required either at the commencement, or subsequently, than any other re- medy. 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 expan- sion in the abdomen. It is also particularly valuable in cases of profuse hemorrhage, the discharge of blood being neither very bright or dark coloured after miscarriage. Platina is sometimes to be preferred to Belladonna, when, along with bearing-down pains, there is a thick and dark-coloured dis- charge, attended with venereal orgasm. Ferrum metallicum t, is a useful medicine in cases of miscarriage attended with fever, labour-like pains, and con- siderable sanguineous discharge. Crocus 3, is especially indicated in cases which are attended or followed by discharge of dark, coagulated or viscid blood, with a sensation as of something moving or fluttering about in the umbilical region, and increased sanguineous discharge 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 ff, is valuable in the restoring the exhausted ener- gies, 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 t, is a remedy of considerable importance, in the treatment of cases where the affection has apparently been induced 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 ple- thora, or from local congestions and obstructed circulation, MISCARRIAGE. 523 with sensation 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, an- other remedy must be had recourse to.* When violent he- morrhage is present, and does not cease under the employment 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 misfortune, and have endeavoured to point out the peculiar indications for the selection of the proper medicament as sus- cinctly, 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 suffer- ed 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 employed, to ensure perfect tranquillity of mind. The diet prescribed in cases under homoeopathic treatment should be closely followed, and warm fluids generally avoided. When the misfortune has proved unavoidable, or has actually 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 horizon- tal to an upright posture ; and on future occasions, when a similar period comes round, great care should be taken that * Vide note, p. 21. 524 TREATMENT BEFORE PARTURITION. 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 PARTl/RITION. PREPARATION OF THE BREASTS. Young mothers frequently find great difficulty in suckling their children, in consequence of organic defector incapacity of the nipple. In every case, a preparation of the breasts is necessary 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 compressed them in childhood, from the idea that such a pro- cess 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- derness of the epidermis exists, this evil is much alleviated when the nipples are bathed with brandy twice a day, for several weeks anterior to delivery. Another difficulty, fre- quently accompanying this state, is a shortness or retraction of 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 nipple to elongate and protrude, so as to present sufficient hold for 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 REMEDIES BEFORE LABOUR. FALSE PAINS. 525 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 plethoric 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 6, which may be followed by Belladonna, should there be symptoms of active congestion with fiery redness of the face, accelerated action of the carotids, etc. An artificial evacuation, previous to delivery, maybe obtain- ed by a lavement of lukewarm water, repeated, with a small quantity of linseed oil, when necessary, from a failure in the first attempt 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, * When severe pain9 are experienced in the breast after each applica- tion of the infant, the employment of Phellandrium aquaticum has been found advantageous. 526 TREATMENT BEFORE PARTURITION. 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 abdo- men, with sensibility to touch and movement, and in not increas- ing 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 continue 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. Bryonia, when there are pains in the loins resembling a dragging weight, attended with constipation and irritability, much increased by motion, with abdominal pains preceding those in the back. (This remedy is more particularly indi- cated when the above symptoms have been excited by a fit of passion.) Administration, f, in four dessert-spoonfuls of water, one morning and evening, or oftener if necessary, until relief is obtained.! 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, * If the os uteri be found unaltered, and consequently not enlarged or elongated, it may with certainty be concluded that the pains are spurious. t Vide note, p. 21. PARTURITION. 527 coffee, or spirituous liquors, there is additional reason for se- lecting Nux v. Administration. \ft, taken in a little water at bedtime, repeating it in six, twelve, or forty-eight hours, according to necessity, if required. Pulsatilla f|. 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 particularly valuable when these pains appear to have arisen from indigestion brought on by rich, indigestible food. Administration. Same as Nux vomica. Dulcamara -f|, is chiefly useful when the origin may be 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 emo- tions 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, f, in four dessert spoonfuls of water, 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- section. PARTURITION. Natural labour takes place at the 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 distorted by tight-lacing, &c.,* and their regular functions * It is to be regretted that the attention of mothers is not more particu- larly directed to the development of the female frame by means of calis- thenic exercises, instead of distorting its symmetry by means of stays and tight-lacing; health being destroyed for the sake of that fashionable and unnatural absurdity—a thin waist. 528 treatment before parturition. thereby disturbed—diseases generated by the want of proper air or exercise, or both—hereditary maladies, &c, parturition would be comparatively free from pain and remote from dan- ger, 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 agitation, bordering on despair. When Cqffea 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 Chamomilla if required. Administration. Four or five globules of the remedy selected, in two tablespoonfuls of water, of which a teaspoon- ful 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,— Belladonna, 6, has been found of the greatest value, and will generally prove serviceable in almost every case of tedi- ous 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 TEDIOUS labours. 529 does not become correspondingly dilated, that the Belladonna is indicated. On the other hand, this valuable remedy is fur- ther of equa\ efficacy, when, on the escape of the waters, an almost complete cessation of the labour-pains ensued, or the uterine contractions are rendered so feeble as scarcely to be perceptible, 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 atten- tion :—Nux v., Pulsatilla, Secale cornutum, and Opium. Nux v. 6, when the labour is somewhat protracted, from the irregularity and insufficiency of the pains, and the female com- plains of a continual urgency to relieve nature. Pulsatilla 6, where the labour-throes are imperfect, and frequently extend upwards from the sacral to the epigastric 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 increas- ing in intensity, Secale cornutum 0—3 or 6 ought to be ad- ministered. Again, when we find the pains, although power- ful at first, suddenly cease, followed by a tremor of the whole body, occasionally 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 3 is indicated. Administration. A few globules of the remedy at the potency 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 Cinna- mon have proved of service, especially where the labour is far advanced. * Kallenbach. 45 530 treatment before parturition. We have now, in a great measure, treated of the course to be pursued when nature seems to call for our assistance to further her exertions; but we must, at the same time, repro- bate a rush 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 adminis- tering spirituous beverages, or stimulants, such as chamomile tea. and other ptisans, coffee, and even opium, under the nb- surd impression 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 rational mechanical means* for its expulsion fail, we may have recourse to Belladonna, Pulsatilla, Secale cornutum, or Opium, selecting by the symptoms already mentioned, and wiH rarely be disappointed in our expectations of their beneficial effects. When the parturition is complete, the Administration of a few globules of Arnica 7, in a little water, is always followed * 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. spasmodic pains. 531 by the happiest 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 labour has been very protracted, the Arnica in lotion, one teaspoonful 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 advanc- ing the birth. Therapeutics. The principal remedies against these affec- tions are Chamomilla, Belladonna, Hyoscyamus, Stramonium, Cicuta virosa, Ignatia, Ipecacuanha, and Cocculus; with regard to their Administration, two globules of the potency mentioned, may be administered in a teaspoonful of water, and repeated after a shorter or longer interval if necessary, according to the effects produced, being guided in their selec- tion by the following symptoms: Chamomilla, 3, where there is extremely acute pain, chiefly of a cutting description, extending from the lumbar to the hy- pogastric region, attended by spasmodic convulsions; redness of the face, especially of one cheek; excessive sensibility of the nervous system, and excitement. Belladonna, 6, when the bearing-down is excessive, as if the entire contents of the abdomen were about to be protruded; con- vulsive movements in the limbs; great agitation with continual tossing; occasional throbbing and distension of the vessels of the head; bloated redness of the face, with profuse sweat. (See also the indications for this invaluable remedy at page 528.) Hyoscyamus, 6, when the convulsions are still more severe, accompanied with great anguish and cries; oppression of the chest and loss of consciousness. Stramonium, 6, convulsions, without loss of consciousness, and trembling of the limbs. Ignatia, 6, spasmodic and compressive pains, with sensation of suffocation ; confused feeling in the head. 532 treatment after delivery. Cicuta virosa, 6, general convulsions, or cramp-like con- tortions of the limbs ; pallor or sallow hue of the face. Ipecacuanha, 3, spasmodic convulsions ; paleness or bloat- edness of the face, occasionally with desire to vomit. Cocculus, 6, 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. . \cidum hydrocyanicum, Platina and Cina, have also been recommended against con- vulsions during labour. 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 be carefully avoided, and the 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 the female, 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, pointing out a different remedy, which, if judiciously chosen, will, with almost absolute certainty, afford a satisfactory result. The practitioner 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 isolated cases. (See the article Sleeplessness, Part II.) Here again, we must severely reprobate the practice of ad- AFTER-PAINS. 533 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 in- to 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 alimentary canal is compensated by the vicarious action of the skin (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 interferes with the proper secretion of milk. After the fourth or sixth day, nature generally acts spontaneously, and when it appears 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.) 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. 45* 534 TREATMENT AFTER DELIVERY. 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 oil'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 6, in a little water, followed in about an hour by Nux v. if no change is effected by the former. If the pain is of an insupportably intense description, or followed by convulsions, coldness, and rigidity of body, Coi tea cruda, 3 or 30, 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 6. Secale cornutum and Cuprum metallicum have been strongly recommended in preference to any of the foregoing remedies, in severe and protracted after-pains occurring in fe- males 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.) * 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, *ho having once experienced the lxneficial effects of the homoeopathic treatment generally, during the entire period of confinement, would willingly return to the old method of treatment. suppressed secretion of milk. 535 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 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 aromatic substances, are to be care- fully 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 disease commonly denominated puerperal fever, which, how- ever also results from internal injuries, consequent upon diffi- cult or protracted labour: but if the precaution of adminis- tering 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 536 diseases following parturition. in, from a sudden suppression of the lacteal secretion, the im- mediate administration of Pulsatilla *{|fi or Vau hi 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 -^ followed by Zincum s^, 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 mental emotion, we must consult that article for the suitable remedy, giving perhaps a preference to Bryonia, (Tiamomilla, Pulsatilla, 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 Aconitum and Cqffea. We may here refer back to our remarks upon the evil effects of aperients, which, by their action upon the intestines, fre- quently cause a suppression of the lacteal fluid, and the con- sequent fever. EXCESSIVE SECRETION OF MILK. Sometimes, on the other hand, it happens that too abundant a secretion takes place, causing distension of the breasts, and involuntary emission of milk, productive of extreme emacia- tion, and sometimes development of phthisis. Calcarea t-j, will be found useful in this affection; or should it fail to re- lieve, Phosphorus yjj. Administration. Six globules of the medicine at the po- tency mentioned, may be dissolved in an ounce of water, and a teaspoonful taken night and morning.* When febrile symptoms arise from distension of the breasts induced by excessive secretion, and indications of what is gen- • Vide note, p. 21. PERSPIRATION AFTER DELIVERY. 537 erally denominated milk-fever, (which, however, frequently arises from other causes,) we may administer Rhus toxico- dendron £, in six teaspoonfuls of water, a teaspoonful night and morning.* Aconite &£-, 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 diminished, and the skin rendered moist. PERSPIRATION AFTER DELIVERY, SUPPRES- SION OR EXCESS OF. The increased perspiration which takes place after child- birth, is, as we have before observed, a substitute for the sus- pended action of the alimentary canal; consequently its sudden suppression 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 imme- diate administration of Dulcamara &&-, will often suffice to restore the action of the skin, and prevent further injurious consequences. Should it fail, Nux vomica -^f will fre- quently be found efficacious; or Chamomilla ^f4, in three teaspoonfuls of water, a teaspoonful every six hours: this lat- ter remedy, particularly when there is excessive restlessness and excitability, with colic and relaxation of the bowels. When severe one-sided headache arises, combined or not with distressing pain in the neck, Belladonna may be prescribed. In other cases, Bryonia or Sulphur may be called for, On the other hand, an excessive perspiration is almost equal- ly 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 administer Sambucus niger, which will generally be * Vide note, p. 21. 538 DISEASES FOLLOWING PARTURITION. found effectual in its removal. In other cases, China, Core, Sulph, .etc. Administration. '}, in six teaspoonfuls of wafer, a teaspoon- ful 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 reg- ulation. 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 in- stances, 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 to- wards morning perspiration comes on, with alleviation of suf- fering, or temporary termination of the attack, which not un- frequently 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 system. When the secretion is re- established, and the lochial discharge 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. * Neglecting to put the infant sufficiently early to the breast, with consequent absorption into the circulation of the milk which has been secreted, is a frequent source of the derangement. IRREGULARITIES OF THE LOCHIAL DISCHARGE. 539 Aconite -°°, may be had recourse to in all instances where considerable fever is present, or administered alternately every six hours, with Coffea, when there is extreme restlessness, anxiety, 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 cir- cumstances.* 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 general symptoms of milk fever; this medicament is very efficacious 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. s^-, in a teaspoonful of water, repeated every twelve or twenty-four hours, according to the urgency of the symptoms, until benefit results. Belladonna is very useful in particular cases; a reference to Inflammation of the Breasts, and other places where that medicament is mentioned, will serve to point out in what instances it is most likely to prove efficacious. Rhus 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 THE 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 * Vide note, p. 21. 540 DISEASES F0LL0WIN0 PARTURITION 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. %,* in an ounce of water, a dessert-spoon- ful night and morning.f Bryonia. When of a deep red, with internal burning pains in the region of the uterus. Administration. £, in the same manner as the above. Calcarea is more particularly indicated when there is an itching kind of sensation in the uterus. Administration. -f'.2, in six teaspoonfuls of water, one night and morning. When the lochia are suddenly sitjypressed, which they some- times are, from a variety of external causes, such as mental emotions, &c, and from this source puerperal fever threatens. the danger may frequently be warded off by the administration of Pulsatilla, &-^, repeated in six, twelve, or twenty-four hours, according to circumstances. When the sudden suppression arises from fright, with febrile symptoms. Aconite ■aa1'4u, will generally be found sufficient, or Opium, ■!yyi, when the indications given under Mental Emo- tions are present. (See also the other remedies mentioned under that heading.) When caused by exposure to cold or damp, Dulcamara Yee, will be found efficacious, and may be advantageously fol- lowed by Pulsatilla ^^ On the the other hand, when the discharge continues, but becomes sanious. fetid, and offensive, Belladonna ^f", in six teaspoonfuls of water, one daily, will generally suffice to restore it to its normal state ;J if it prove inefficient, we may admin- ister Carbo animalis £$, in the same manner; and if the occasion still seem to require it, Secale cornutum °ff°, in a teaspoonful of water, repeated every twelve hours until benefit results. * In some cases the 3d, 2d, and even the first attenuation, or potency, of this medicine has been exhibited with marked benefit, when a higher number appeared to produce but little effect. t t Vide note, p. 21. j Vide note, p. 21. ABDOMINAL DEFORMITY. 541 Silicea, when pure blood follows with the lochia each time that the infant is applied to the breast. Administration, e^, in the same manner as directed for Belladonna. The following remedies may also prove useful: Nux v., Hyoscyamus, Zincum, Colocynth, Veratrum,and Secale cornutum, chiefly in the event of a suppression. And Platina, Secale cornutum, Hepar s., Rhus, against too copious or pro- tracted lochia. DIARRHOEA IN LYING-IN WOMEN. Diarrhoea, during this period, is a state to be looked upon as highly injurious, and immediate means should be taken for its suppression, by the administration of Dulcamara, Hyoscy- amus, Rheum, Antimonium crudum, Phosphorus, and Acidum phosphoricum, etc. The first remedy, potency 6, is generally indicated by the cause, being the check of the natural increased perspiration in lying-in women, from a chill: and when timely adminis- tered, it will generally be found sufficient to answer the pur- pose required. In painless and almost involuntary evacuations, Hyoscya- mus 6, is most effectual. Rheum 6, and Antimonium crudum 6, 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'6, followed, if neces- sary, by Acidum phosphoricum, 12 or 30. (Vide also Diar- rhcea, 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 fre- quently find that a number of unpleasant symptoms, generally arising from maltreatment, supervene. Among these we may mention the thickening of the abdominal coats, occasionally ending in a ^permanent malformation and pendulous appear- ance. This affection is more commonly incident to females who have borne many children, or who present a predisposi- tion to corpulency; and is found especially difficult of treat- 542 diseases following parturition. ment, 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 considerably alleviated by the internal and external use of Rhus toxicodendron. The internal administration of Sepia 5T 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 abdo- minal 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 apparatus; but we must in the strongest manner object to this or any other pressure being exercised upon the abdominal region during pregnancy as cal- culated to entail malformation, such as club-feet, &c, upon the offspring. 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 constitu- tion, against which the following medicaments have proved efficacious, and may be repeated every eight days: TlNCTURA SULPHURIS ^, NaTRUM MURIATICUM ^, and Carbo vegetabilis ^, Sepia ^r, Lycopodium t^, and Cal- carea 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 in- stances recommend a commencement with Tiuclura sulphuris. LEUCORRHCEA AFTER PARTURITION. A third evil is Leucorrhcea, which, although at the com- mencement merely a consequence of the relaxation of the * Das Verhalten der Mutter und des Sauglingg, p. 95. " treatment after delivery. 543 lie ig nternal uterine economy, after the completion of the lochial )n lischarge, and at first of an innocuous character, frequently ,e proves exceedingly troublesome, and finally puts on a morbid ,f appearance, becoming acrid, and productive of excoriation. We generally find a predisposition to the disease in scrofulous, I torpid, and leuco-phlegmatic temperaments; 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 attendant, on the one hand, with much patience and strict attention to ■ dietetic rules on that of the patient, on the other, ere a suc- cessful 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, Iodium, Petroleum, Stannum, etc. • INTERNAL UTERINE SWELLING AND PROLAPSUS. A swelling of the interior economy is frequently the result of a difficult labour, and in some cases of mismanaged partu- rition ; we sometimes find it complicated with uterine or vagi- nal prolapsus; if the precaution of exhibiting Arnica *>£■, which we have before noted, (page 411,) have been taken, this will frequently be prevented; if, however, symptoms of pro- lapsus 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, Lyco- podium, Stannum, Cannabis, China, Platina, and Calcarea, etc., have been employed with material benefit in cases of this description of longer standing, as also in other uterine affec- tions, such as Metritis, Retroversio uteri, etc. WEAKNESS AFTER DELIVERY. We frequently find a high degree of weakness or exhaus- tion remaining after delivery; when it has been caused by 544 obstacles to suckling. very considerable hemorrhage, during or after that period, Cinchona js particularly indicated, and will generally be found efficient in restoring the vital energies. Administration. ftgtt, in a teaspoonful of water, repeated in three or four days. When however the derangement depends upon nervous weakness, and is attended with restlessness and want of sleep, we may administer Aconite, followed, if necessary, by Cof- fea, or substitute Veratrum for the latter medicine, when the prostration of strength is excessive. In some instances we must have recourse to Kali carboni- cum or to Sulphur, Calcarea, or Acid, phosphoricum. OBSTACLES TO SUCKLING. DISINCLINATION OF THE INFANT. Where there is a tendency to consumption in the mother, or 6he is of a strumous habit, the infant ought, for its own sake, to be reared with the spoon, or a nurse provided; but even some healthy mothers find a difficulty, before they become accustomed to it, in nursing their children, which a little per- severance will soon effectually overcome; but when (a rare instance, if applied soon after delivery,) the child itself refuses to take the breast, the administration of Cina ~, followed, if not speedily efficacious, by Mercurius solubilis t~ is often found to remove this repugnance in the course of a few hours. Sili- cea ^, is also an excellent remedy in some cases, particularly when the child takes the breast readily enough, but returns the milk almost immediately after; the remedy selected ought to be given to the mother as well as the child. EXCORIATION OF THE NIPPLES. In the majority of those cases in which no malformation of the parts is present, the main difficulty arises from the nipplei excoriation of the nipples. 545 havingbecome sore and cracked, which the efforts of the infant tear open afresh, and cause to bleed. This excoriation of the nipples is frequently prevented by following up the treatment, of which we have already spoken, under the head of Preparation of the Breasts, of course taking the precaution of laving them with a little warm milk and water before the child is applied to the breast; the shield before mentioned ought always to be worn during the intervals of suckling. When there is a tendency, however slight, to rawness or excoriation, great care must be taken lest the shield adhere to the skin; it ought to be frequently removed, and together with the nipple, kept perfectly dry; attention to these particu- lars will generally remove this difficulty. The mother ought) however, gradually to accustom herself to nourish the infant, using a sucking-glass, which should be carefully washed every day. Should, however, the nipples have already become very sore and irritable, from the neglect of these precautionary measures, it is necessary to have recourse to specific remedies, without which, if suckling be persisted in, suppuration fre- quently ensues. In the first stage of the affection, Arnica ^ should be administered internally, and the breasts laved with a weak lotion,* say one or two drops of the Mother Tincture, to one ounce of water. If this fail, we must have recourse to anti- dyscratic remedies, as this disease almost always arises from a constitutional cause, females of healthy temperament being generally exempt from it. Among these Tinctura sulphuris 5^ seems particularly indicated for most cases of this affection, and a dose of one or two globules may be administered every five or six days until improvement sets in, which will generally be the case in the space of a few days; and if this fail, Cal- carea -pg, administered in the same manner, will in most in- stances suffice. We may also mention Graphites, Sepia, Lycopodium, Merc , and Sine, as remedies of much value in some obstinate cases. In the choice of the fitting medica- ment in complicated cases, the physician can be guided by » This lotion may also be applied with advantage in the preparation of the breasts, when irritation or inflammation appears to arise from the pressure of the shield. 4G* 546 obstacles to suckling. the aggregate of the symptoms. (Nux r. has been found of considerable service in soreness of the nipple, with painful ex- coriation of the adjacent surface.) INFLAMMATION OF THE BREASTS. Another, and one of the greatest obstacles to a mother nour- ishing her infant, is an erysipelatous inflammation and swelling of the breasts, of which any thing tending to disturb the lacteal secretion, such as fright, passion, cold, etc, serves for an ex- citing cause, although we frequently find it present, without being able to trace its origin; it not infrequently arises from a too tardy administration of the breast to the infant, or from a sudden cessation of suckling,—from the death of the child, or other reasons,—causing a distension of the lactiferous tubes. When a sudden suppression of the secretion occurs, the breasts become red, inflamed, and indurated, occasionally suppurating in some parts, which open and discharge, while others remain still hard and inflammatory, finally either ending in suppura- tion, or the formation of obstinate nodosities. This disease, if not checked, and but too frequently under allopathic treatment, exhibits a variety of phases; and the suppuration that takes place, leaves behind it disfiguring cica- trices; frequently the breasts are so far destroyed, as to be ren- dered ever after incapable of performing their functions, and in some instances, the foundation of cancer is laid. The principal remedy in this affection before the inflamma- tion becomes fully developed, is Bryonia e, especially when the breasts are hard and tumefied, and the secretion of milk sup- pressed. Belladonna 7, when the inflammation is more in- tense, and the erysipelatous appearance of the skin clearly defined; after which remedy, the disease is generally van- quished. Administration. Six globules of the medicine selected, in as many teaspoonfuls of water, a teaspoonful to he taken every six or eight hours, until improvement follows. When, however, a degree of induration still remains, Mer- curius solubilis Jxq/, should be given, and repeated from two to three days; in more severe cases, Acidum phosphoricum should be resorted to, or Hepar sulphuris, when suppuration has already commenced. * mental emotions affecting the milk. 547 Administration, of the latter, one grain of the third tri- :uration in an ounce of water, a dessert-spoonful to be given hree or four times a day, in order to forward the suppurative >rocess, when it becomes absolutely necessary to bring the natter to ahead, as speedily as possible. In instances in which we find a fetid and serous discharge, svhich is frequently brought about by neglect or by improper treatment, such as the application of deleterious salves, etc., Silicea s^-, repeated in five or six days, will generally be amply sufficient to restore the breast to its former condition; in some extreme cases, 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 -^ ought to be given immediately, and will frequently obviate all injurious consequences. In cases where the disease has arisen from external injury, Arnica st^SL should be administered, and a lotion, one part of the tincture to seven of pure water, locally applied. In strumous habits, Tinctura sulphuris, Calcarea and Graphites, will occasionally be found necessary to complete the cure after Belladonna has removed the active inflamma- tory 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 tffcar this in mind, and after having suffered from fright, passion, &c, should desist from suckling until they are per- fectly composed; and ere the infant be again applied to the breast, a portion of the milk should be drawn off. Fortunately, for evils arising from these causes, Homoeopathy presents prompt and efficacious remedies, (for which, see Mental Emo- tions,) which, if at hand, should be administered immediately, according to the cause and symptoms. 548 obstacles To suckling. 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 secretion arising from an inflammatory action, Vide In- flammation of the Breasts. When the deficiency or suppression arises from the first cause, the chief medicines useful in restoring a proper and healthy flow of milk, are Pulsatilla, Calcarea, and Causti- cum. The physician is the best judge in the application of these remedies, as there are many minute symptoms by which his choice must be guided in the selection—in simple cases Vitex agnus castus and Pulsatilla will frequently be found effica- cious ; but it is more generally requisite for the female to un- dergo a complete course of treatment, if she is anxious to persevere in nursing, in which the two latter, together with Aconitum, Bryonia, Chamomilla, Belladonna, Su/jihur, Sepia, Iodium. will be found of great value. DETERIORATION AND DISCOLORATION OF MILK.- If the milk becomes too clear and watery (or otherwise de- teriorated in quality, or is repugnant to the child,) Cina sf,a- and Mercurius solubilis ^, ought to be administered al- ternately every twenty-four hours for ihree or four days; or Silicea YuS hi obstinate 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, ren- dering 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 mothers not suckling their children. 549 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 particularly careful in heY diet, and until the se- creting process has entirely ceased, she should live as low as possible. The employment of dry cupping at the outer sur- face of the arm, a little below the shoulder, or to the inferior extremities, will materially hasten the suppression of the lac- teal 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 suffi- cient to stop the secretion. A few globules of* the sixth potency may be dissolved in a wine-glassful of water, and a teaspoonful taken night and morning. When suffering from inflammation ensues, we may have recourse to Phosphorus, Belladonna, and Bryonia, for which indications are given under Inflammation of the Breasts ; Calcarea is service- able, when the breasts are considerably distended with milk. These same directions will serve as a guide during the period of weaning. GLOSSARY OF MEDICAL TERMS employed in 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. Excoriation. Aissei.ss. 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 cup- like form, receiving the head of the femur or thigh-bone. Adhesion. 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 natural- ly contiguous, though not adhe- rent, 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. Wings of the nose. THIS WORK. Alkali. A substance which unites with acids indefinite proportions, so as to neutralize their proper- ties more or less perfectly, and to form salts. It changes vegetable blues to green. Alkaloids. Subtances 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. Amygdalje. A popular term for the exterior glands of the neck, as also the tonsils, which 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. Angina. Sore throat. The term is also applied to diseases with difficult respiration. Angina Ml.mbranacea. Croup. Angina Parotidea. Mumps. Angina Pharyngia. Itiflaruination of the membrane which forms the pharynx. GLOSSARY. 551 Anorexia. Want of appetite. Antacid. Substances possessing the property of neutralizing acid- ity. Anthrax. Carbuncle. Anthropohiobia. A dread or horror of the human species. Antiphlogistic. Applied to reme- dies 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 upper jaw, in the middle of the superior max- illary 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 diath. 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 digestive system, in which the food taken into the stomach fails to afford sufficient nourishment. A wasting of the whole, or of individuals parts of the body. Auscultation. The detection of symptoms by the ear in disease. Biliary. Connected with the se- cretion of bile. Blepharitis. Inflammation of the eyelids. * 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. Cecum. 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. Carfhologia. 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. Cephalic Pertaining to the head. Cerebral. Appertaining to the brain. 552 glossary. Cervical. Belonging to the neck Cessatio .M-nsium. Discontinuance of the menstrual flux. Chlorosis. Green sickness. Cholera. See article thereon. Cholerine. 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, dec. Clavi Pedis. Corns. Clonic Spasm. A spasm which is not of long duration. It is op- posed to tonic spasm, which see. Coagula. Clots of blood. Coagulable Lymph. The term given to the fluid which is slowly effused into wounds, and after- wards forms the uniting medium or cicatrice. * Colic Griping in the intestines. Collapse. Failing of vitality. Colliquative. Excessive discharge of any secretion. Coma. Drowsiness. Coma Somnolentilm. 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- of blood to the head. Congestio ad Pectus. Determina- tion of blood to the chest. Congestion. Overfulness of the blood-vessels of some particular organ. Conglobate Glands. Glands of a globular form, composed of a texture of lymphatic vessels. They have no excretory duct. Conjunctiva. The membrane lin- ing 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 conscience. 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 linger upon a part affected with emphysema ; by the ends of a fractured bone when moved ; or by certain salts during calcination. Crepitant Rhoniius, or Kale. The fine crackling noise heard in consequence of the passage of air through a viscid fluid. It is 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 in form ot scales. Diagnosis. Distinction of maladies. Diarrhoea. Looseness of the bow- els. Diarrhoea Neonatorum. The same as the above, in infants. Diathesis. Constitutional tendency. 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. glossary. 553 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. Dvsecoia. Deafness. Dysmenorrhea. Painful menstrua- tion. Dyspepsia. Indigestion; literally difficulty of appetite. Dyspncea. 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 and membranes. Endemic Peculiar to a particular locality. Enema. A clyster. Engorgement. Swelling up of. "Enteralgia. Colic. Enteritis. Inflammation of the in- testines. Ephemeral. Of a day's duration. Ephialtes. Night-mare. Epidemic Diseases arising from general causes. Epigastrium. The region of the stomach. Epilepsy. Epilepsia. Falling sick- ness. EnsTAXis. Bleeding from the nose. Epithelium. The cuticle. Erysipelas. St. Anthony's fire. Rose. A disease of the skin. Erysipelas Phlegmonodes. Phleg- monous erysipelas. Erysipelas CEdematodes. Edema- tous erysipelas. 4 Erysipelas Erraticum. Wander- • ing erysipelas. Erysipelas Gangrenosum. Gan- grenous erysipelas. Erysipelas Neonatorum. Indu- ration of the cellular tissue in in- fants. Exacerbation. Aggravation of fever, &c. Exanthema, plur. Exanthemata. Eruption terminating in exfolia- tion. Expectoration. Discharge of any matter; phlegm; pus from the chest. Exudation. Discharge of fluid from the skin, &c. Fjeces. Alvine excrement. False Joint. When the two frag- ments of a broken bone do not become united by an osseous 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 fas- cia. 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. First Intention. See Union by the. Fistula. An obstinate tube-like sore, with a narrow orifice ; adj. Fistulous. Fistula Lachrymalis. An ulcer- ated opening in the lachrymal sac. Flatus. Wind in the intestines. Flatulency. Fcetus. The infant in the womb. Fomentation. The application of flannel wet with warm water. Fontanel, plur. Fontanella. The mould. Functional Diseases. Those in 554 0L0SSART. which there is supposed to be on- ly derangement of action. Furunculus. A boil. Furunculus Malignans. Carbun- cle. Gangrene. Incipient mortification ; adj. Gangrenous. Gastralgia. Pain in the stomach. Gastric Belonging to the stomach. Gastritis. Inflammation of the stomach. Gastrodynia. Vide Cardialgia. Gestation. Pregnancy. Gland. A small body met with in many parts of the body, and con- sisting of various tissues, blood- vessels, nerves, &c. Glossitis. Inflammation of the tongue. Glottis. Opening of the windpipe. The superior opening of the larynx. Granulation. See Incarnation. Hematemesis, 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- tracted fever. Helminthiasis. Worm disease. Hemiplegia. Paralysis of one side of the body longitudinally. Hepatitis. Inflammation of the liver. Hepatization. Structural derange- ment of the lungs, the result of inflammation ; changing them in- to a substance resembling the liver, hence its name. Hernia. Rupture. Hernia Congenita. Congenital her- nia. Literally hernia from birth. Herpes Circinnatus. Ringworm. Hordeolum. Stye. Hydrocephalus. Water in the head. Hydrophobia Symptomatica — Symptoms resembling those aris- ing from hydrophobic virus, ap- pearing during the course otother diseases. Hypertrophy. A morbid increase of any organ, arising from exces- sive nutrition. Hypocratic. Sunken and corpse - like. Hypochondrium. Region of the ab- domen, contained under the car- tilage of the false ribs. Hypochondriasis. Spleen disease ; great depression of spirits, with general functional derangement; adj. Hypochondriacal. Hypogastrium. The lower anterior portion of the abdomen. Hysteria. Nervous affection ; al- most peculiar to females. Ichor. A thin watery discharge se- creted 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, 6acrum,and ischium, contributes to form the pelvis. Ileus Mnlrere. A form of colic, a twisting pain in the region of the navel. 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, denomi- nated granulations, which form on the surface of ulcers or suppu- rating wounds, &c, and serve the double purpose 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 Orbitary Nerve. A twig GLOSSARY. 555 of the second branch of the fifth l pair of nervcs> It passes out of a small hole immediately below the orbit, (the foramen infra or- bitarium,) and is distributed upon j the cheek, under eyelid, upper side of the nose, and joins with the portio dura of the seventh pair, i 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; puffiness. Invermination. The term given to the morbid states occasioned by the existence of worms in the in- testines (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- veying the milk. Laryngeal. Belonging to the la- rynx. Laryngismus Stridulus. Asthma of Millar. Laryngitis. Inflammation of the larynx. Larynx. Upper part of the wind- pipe. Lesions. Injuries inflicted by vio- lence, &c. 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, I and general inertness of the phys- I ical and mental powers. Leucorrhcea. 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, circu- lating in the lymphatics. Lymphatic As applied to temper- ament ; sameasLeucophlegmatic. 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 im- mortal 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 maxillary bones form the upper and lower jaws. Meatus Auditorius Externus.— The external passage of the ear. 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 disease from one part to another. Meteorismus. Extreme inflation of the intestines. 556 GLOSSARY. Metrorrhagia. Discharge of blood from the womb. Miasm, or Miasma (Marsh). Pe- culiar effluvia or emanations from swampy grounds. Micturition. Urination. Miliaria. Eruption of minute trans- parent vesicles of the size of mil- let seeds; miliary eruption. Miliaria Purpura. Scarlet-rash. Minim. The sixtieth part of a fluid drachm. I Morbus Coxarius. Disease of the hip ; hip-disease. Mucous Membrane. The mem- brane which lines the sides of cav- i ities which communicate with the external air, such as that which lines the mouth, stomach, \c. Mi us. One of the primary animal fluids ; secretion from the nostrils, j Myelitis. Inflammation of the spi- nal marrow. Myopia. Short sight; near-sighted- ness. N kRcoTic. Having the property of inducing sleep. N isal. Belonging to the nose. Nasal Cartilages. The cartilages 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. Obbtructio Alvi Neonatorum. Constipation in infants. Occiput. The posterior part of the head. Octana. An intermittent fever which returns every eighth day. Odontalgia. Tooth-ache. QEdema. Swelling; dropsical swell- ing ; adj. CEdematoua. Olfaction. The 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, lyin^ 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 lach- rymal, 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 arc 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: termed—the malleus, incus, stapes, and os-orbiculare. Otalgia. Ear-ache. Otitis. Inflammation of the ear. Otorrhcea. A di;;i,-liargi■, or run- ning from the ear. Ozena. An ulcer situated in the nose. See Ozeena. Palate Bones. These are placed at the back part of the roof of the mouth, between the superior max- illary and sphenoid bones, and extend 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 GLOSSARY. 557 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. Pectus. The chest. Pediculh Lice. Pelvis. The basin-shaped cavity below the abdomen, containing the bladder and rectum; and womb in woman. Percussion. The act of striking upon the chest, &c. in order to elicit sounds to ascertain the state of the subjacent parts. Perineum. The space between the anus and the external sexual organs. 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. Pi.rniones. Chilblains. Pertussis. Hooping-cough. Petechie. Spots of a red or pur- ple 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. Phlegmatic. Vide Leuco-phleg- matic. Phlegmon. An inflammation ot that nature which is otherwise termed healthy inflammation. 47 Phrenitis. Inflammation of the brain. Phthisis. (Pulmonalis.) Consump- tion, abscess of the lungs. Physiology . The branch of medi - cine which treats of the functions of the human body. Pleihora. 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 frequent- ly met with in the-nose, uterus, or vagina. Porrigo Scutulata. Ringworm ot the scalp. Porrigo C^rvalis. Milk-crust; milk-scab. Posterior Nares. The posterior nostrils which open into the fau- ces. Poupart's Ligament. The tendin- ous portion of the external oblique muscle. It is stretched across from the anterior superior spinous process 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.) Prognosis. The faculty of predict- ing what will take place in dis- eases. N Prolapsus Am. Protrusion of the intestines. Prophylaxis, plur. Prophylaxes. Means or remedies used as pre- servatives against disease. Prosopalgia. Face-ache. Prurigo. Itching of the skin. Psoas Muscles. The names of two muscles situate in the loins. Psoitis. Inflammation of the psoas muscle. Ptisans. Domestic decoctions, such as of pearl barley, &c. 558 OLOSSARt. Pubis. 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. Pyrosis. Heart-burn; water-brash. Quinsy. Inflammatory sore throat. Quotidian. 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. Rachitis. The rickets. Rale, Rattles. Sound in the chest, &.c. on auscultation, &c. Raucitas. Hoarseness. Klcti m. The last of the large in- testines, terminating in the anus. Remittent. A term applied to fevers with marked remissions, and generally subsequent exacer- bation. The yellow fever of tro- pical countries. Repercussed. 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 the sclerotica. Rhonchus. A wheezing or rattling sound. In auscultation, the 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. Kobe. A term applied lo erysipelas, from its color. Rubeola. Measles. Sacrum. The bone which forms the base of the vertebral column. Saliva. The fluid secreted I)y the salivary glands into the cavity of the mouth. Saturnine. Preparations contain- ing lead. Sanguineous. Consisting of blood. Sanies. A thin greenish discharge of fetid matter, from sores, fistu- la?, &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 Ischiatic Notch. This name is given to a notch in the 08 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. Scrobutus. Scurvy. Scrofulous Ophthalmia. Inflam- mation of the conjunctiva, with Blight 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 GLOSSARY. 550 lever, &c. has likewise received this appellation. Specific A remedy possessing a peculiar curative action in certain diseases. Spleen. A spongy viscous organ, of a livid colour, placed on the posterior part of the left hypo- chondrium. 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 blood. St. Anthony's Fire. Erysipelas. 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 tu- mour on the eyelid. Sub-Maxillary. Under the jaw. Sub-Maxillary Glands. Glands on the inner side of the lower jaw. Sub-Mucous Tissue. Placed under the mucous membrane. » Sudorifics. Medicines which pro- duce sweating. Sugillation. Abruise, or extrava- sated blood. Suppuration. The morbid action by which pus is deposited, in in- flammatory tumour, &c. 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 the joints, and secretes the syno- via. x Tenia. 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 spasmo- dic rigidity of the parts affected. Therapeutics. That branch of med- icine which describes the action of the different means employed 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 560 GLOSSARY. 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 operation 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 rub- bing. Trochanter Major. One of the processes of the thigh bone. Tubercle. 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 devel- opment and the texture of part in which they are engender- ed. Tumefaction. Swelling. Tumefied. Swollen. Tumid. Vide Tumefied. 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. Dritj- 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, flatuleut obstruction, or lodgment of wind in the intes- tines, recognized by the emission of wind affording relief:—Tym- panitis abdominalis, when the wind is in the cavity of the abdo- men (abdominal emphysema). Typhoid. Applied to diseases of a low character. Umbilical Cord. The navel string. Umbilicus. The navel. I'nion 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. Venesection. The abstraction of blood by opening a vein. Vesications. 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 GLOSSARY. 561 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. PAGE ^Abdominal Deformity . 541 Abdomen, pendulous ib. Abortus .... 518 Abscess .... 288 Abscessus Nucleatus . 283 Acidity, see Dyspepsia 95 Flatulence, &c. in Infants 4G4 Administration of Medicines 9 After-pains 533 Agrypnia 354 Ague .... 39 Air and Exercise 505 Ambustiones 417 Amennorrhcea 4!)9 Angina, see Sore Throat 81 Gangrenosa sy Maligna ib. Membranacea 210 Parotidea 93 Pemiciosa 210 Anorexia .... 101 Anthrax 285 Anti-mercurial remedies 341 Aphthous Sore Throat 81 Aphthae .... 467 Apparent Death, Asphyxia 422 445 from a Fall 422 Drowning . 423 Frost 425 Hanging 423 Hunger 422 Lightning 423 N oxious Vapours 42G Suffocation 423 Apepsia 101 Appetite, Want of 101 Apoplexia 266 Apoplexy 266 Arthritis 307 Asiatic Cholera . 152 Asphyxia, Apparent Death 4e2 in Infants 445 Asthma 395 Spasmodic in Children 465 Asthma of Millar 486 rAHE Atrophia 493 Atrophy .... 493 Aversion of the Infant to the Breast .... 544 Bastard Pleurisy 2.11 Bilious Complaints 95 Birth, Treatment after 444 Black Water 119 Bladder, Inflammation of 180 Blearedness 333 Blepharitis 333 Bleeding of the Nose . 337 Blood, Spitting of 2.12 Blood-shot Eye 330 Boil .... 2*3 Bowels, Looseness of . 137 Inflammation of . KiK Bowel Complaint of Children 169 Brain Fever 271 Brain, Inflammation of the . ib. Concussion of the . 403 Breasts, Inflammation of 546 Preparation of during Pregnancy 524 Breath, Offensive 34 H 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 in the face 331 lips ib. Cancer of the Mouth . 343 Cancrum oris ib. Carbuncle 285 Cardialgia 112 Carditis 313 Caries of the Bones 341 INDEX. 562 PAGE PAGE Carrying of Infants 458 Cough after Smallpox . 70 Cataract .... 329 Hooping 204 Catarrh 187 Coup de Soleil 275 Catarrhal Ophthalmia . 328 Coxalgia 318 Cephalalgia 370 Coxagra .... ib. Arthritica . ib. Cramps and Convulsions . 531 Nervosa ib. Cramp in the Legs 352 Cephalaea ib. Critical Age, see Dysmenor- Chest, Determination of Blood to 221 rhea .... 501 Cold in . 225 Croup .... 210 Chicken-pox 71 Crusta Lactea 466 Chilblains 285 Crying and Wakefulness of Children, Suckling of . 548 New-born Children . 462 Chin-cough, see Hooping- Cynanche, see Sore Throat 81 cough .... 204 Laryngea . 210 Chlorosis 496 Maligna 89 Cholera .... 149 Tonsillaris, see Quinsy 81 Cholerine 155 Tracheitis 210 Chronic Laryngitis 193 Cynanche Parotidea . 95 Clavi Pedis 287 Cystitis .... 180 Clavus Hystericus 370 Death, Apparent . . 422 ,445 Cleansings, see Lochia 539 Deafness 336 Clothing .... 507 Decubitis .... 241 and Habits 4 Deficiency in the Secretion of Coffee, Derangements from Milk .... 548 the Use of . 355 Delivery, Treatment after 532 Cold, Common . 187 Weakness after 543 in the Head . 193 ,461 Delirium Tremens . 391 in the Chest 225 Derangement of the Stomach, Colic .... 133 Fever from . 107 Concussion .... 403 Derangement of Stomach ib. Confinement, Duration of 535 during Teeting 478 Congestio ad Pectus 221 Dentition .... ib. Caput 260 Determination of Blood to the Congestive Pneumonia 240 Chest .... 221 Conglobate Glands, Diseases Head . 260 of .... 288 Abdomen 323 Constipation . . 123 ,513 Deterioration and Discolora- in Children 469 tion of Milk . 548 Consumption, see Phthysis in- Diarrhoea 137 cipiens .... 241 in Lying-in Women 541 Consumption of the Wind- during Pregnancy 513 pipe, see Phthysis Laryngea 193 in Children 469 Contagious Fever, (Typhus) 37 Diet .... 508 Contusions, see Bruises 403 Diet, Rules .... 14 Convulsions 531 in Fever 20 in Children 480 during Nursing . 450 Cornea, Ulceration of the 329 Difficulty of Breathing, see Opacity of, or Specks on the Asthma 395 ib. Difficult Menstruation, see Corns .... 287 Dysmenorrhea and Chlo- Coryza, Cold in the Head 193 461 rosis .... 501 Cough . - . 196 Discharge, Irregularities of the after Measles 63 lochial .... 539 561 INDEX. TAGE Disinclination of the Infant to Suck . . . • 544 Dislocations and Fractures 403, 414,415 Dose, on the Repetition of the 9 Drowning, apparent Death from . , . . 423 Duration of Suckling and Weaning . . . 453 Confinement * 535 Dyscrasio, Morbid Condition 336 Dysenteria . 141 Dysentery . . . ib. Dysmenorrhea . . 501 Dyspnoea, see Asthma . 395 Dyspepsia ... 95 Earache . . . 333 Emansio Mensium . . 496 Emotions, Mental 438,509 Employment of the Mind du- ring Pregnancy . . 508 Emprosthotonos . 276 Encephalitis . . .271 Enteritis . 168 Enterulgia . . 133, 168 Ephialtes . . . 357 Epilepsia . . .394 Epilepsy ... ib. Epiphora . . 330 Epistaxis . . 337 Eructations . . . 107 Eruptive Fevers . . 48 Erysipelas . . .280 Neonatorum . 476 Excoriation of the Nipples . 544 in Children . 475 see Decubitus . 241 Exercise . . . 505 in the case of Children 457 Expulsion of Meconium . 447 Eyes, Bleardeness of . . 333 Inflammation of . 324 Bloodshot . . 330 Eyelids, Inflammation of . 333 Catarrhal Inflammation of the ib. Face, Swelling of . .516 Faccache . . . 349 Face Ague . . . ib. Scirrhus in the . 331 Warts on the . 332 Fainting ... 367 Fainting and Hysteric Fits . 514 False Pains . . . 525 Fall, apparent Death from a 422 PAG 1 Falling down of the Womb see Prolapsus . .' 543 Fatigue 419 Favus Confertus . . 297 Feet, Sweating of the 353 Fevers, or l'Yhrcs 17 Fever, Brain 271 Contagious (Typhus) 37 Eruptive . 48 Infantile Remittent 4s3 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 464 Fontanels, retarded closing o " the ... 446 Fractures and Dislocations 41 1, 415 Frozen Persons . 425 Fungus Hsematodes 306 Oculi 329 Furunculus 283 Malignans 285 Galling, Excoriation 241 Gangrenous Sore-throat 89 Gangrene 411 Oris 343 Gnstralgia 112 Gastrodynia ib. Gastritis 165 Glands, Conglobate, disease of the 288 Glossitis 346 Goitre .... 3.12 Gonorrhceal Ophthalmia 329 Gout .... 307 Gripes, see Colic 131 Gumboil 346 Gun-shot Wounds 413 Habits during Pregnancy 508 Hair, fallings of 542 INDEX. 565 PAGE Head, Determination of Blood to.....260 Swelling of, in Infants 446 Cold in . . 193,461 Water in the . 485 Headache . . .370 Heart, Palpitation of the . 351 Inflammation of, see Car- ditis . . 313 Endocarditis . . ib. Heartburn . . . 119 Helminthiasis . . . 181 Hicmatemesis . . 119 Hemicrania (Megrim) . . 370 Hemorrhoids . . 128 Hemoptysis . . . 252 Ilemorrhagia Pulmonum . 252 Hemorrhage from the Lungs ib. after Delivery 543 see Wounds 407 Hepatitis .... 156 Chronica . . 160 Hernia . . . 36L Herpes Circinnatus . . 296 Hiccough . . . . 502 in Infants . . 461 Hip-gout . . . .318 Hip-disease . . 318,320 Hoarseness . . . 191 i Hooping-cough . 204 Hordeolum . . .' 332 Housemaid's Knee . . 411 Hunger, apparent death from 422 Hydrocephalus . . . 485 Hydrophobia . . 426 Hysteria .... 502 Hysterics . . 502, 514 Icterus . . . 161,475 Incubus .... 357 Indigestion ... 95 Induration of the Cellular Tis-=- sue .... 47G Infants, Treatment of . 443 Suckling of . . 448 Infants,Supplementary Diet of 451 Infantile, Remittent Fever . 4.-8 Inflammation,Acute,of the Liver 156 Inflammation of the Bladder . 180 Brain 271 Bowels . 168 Brc:i--r . 546 Bronchial Tubes 225 Ears . 333 Eyes 324 48 PAGE Inflammation of the Eyes in new-born Infants . . 460 Heart . 313 Kidneys . 177 Liver . . 156 Lungs . 234 Margins of the Eye-lids . 333 Peritoneum 175 Psoa3 Muscle 315 Pleura . 242 Spinal Cord,&c. 358 Spleen . 162 Stomach . 165 Tongue . 346 Inflammatory Fever . 22 Influence of External Objects upon the unborn Infant Influenza Insects, Stings of Intermittent Fevers Intestine, Protrusion of the . ■ Introduction Invermination Irregularities of the Lochial Discharge Irritation of the Skin Iritis i Arthritica Ischias Itching of the Skin Itch Jaundice Joints, Injuries of the Kidneys, Inflammation of Knee-joint, Diseases of the Labour complicated remedies before tedious Lacerations Laryngismus Stridulus Laryngitis Chronica Leueorrhcea Lightning, apparent death from 423 Lips, Swelling of . .331 Scirrhus of the . ib. Lippitudo, Blearedness . 333 Liver Complaint . 155, 160 Acute Inflammation of 156 Chronic Inflammation of 160 Lochia .... 539 Lochial Discharge, &c. 539 Lock-jaw . . 276 509 219 420 39 132 1 181 539 294 327-328 . 329 318 . 291 291 161, 475 . 470 177 322 528 ib. 525 528 407 486 193 542 566 INDKX. PAGE Lock-jaw of Infants 477 Loins, Pains in . . 391 Looseness of the Bowels 137 Lumbago, Rheumatism in the Loins . .314 Lumbo-sacral Pains 51 J"1 Lungs. Inflammation of the 234 Hemorrhage from the 252 Luxations .414 Lymphatic Tumours . 2?<8 Malignant Quinsy . 89 Measles ... 59 Meconium, Expulsion of 447 Medical Terms, Glossary of 550 Medicines, Administration of 9 Megrim, Headache . . 370 Meningitis Spinalis • 358 Mental Emotions . 438,509 affecting the Milk 547 Menochasia . • 499 Menorrhagia . ib. Menstruation . . 499.111 Scanty . 497 Menstruatio Nimia 499 Miliaris Hahnemanni (Purpura) 55 Miliaris Purpurea • ib. Miliaria, Miliary Fever . 72 Milk, excessive Secretion of 536 Deficiency in the Secre- tion of . . 548 Deterioration and Dis- coloration of . . ib. j Fever . . 538 Milk,Mental Emotions affecting 547 Regurgitation of . 464 Suppressed . 535x 54^ ' Miscarriage . . 518 | Mind, employment of during Pregnancy . . . 508 Milkcrust . . . 4661 Milkscab . . . ib. | Modified Smallpox . . 70 Morning Sickness . .512 Morbus Coxarius . . 320 Mothers not suckling their | Children . . .548 .Mumps ... 93 Mouth, Canker of the . 343 j Scurvey in the . 345 Moulds, Retarded closing of the 444 I Myopia . . . .331 Myelitis . . 358 Navel, Rupture of . 446 i Nearsightedness 331 rA<.E i; 7 24 71 349 544 357 I. 391 337 340 341 450 ib. 123 469 239 77 318 32 1 276 333 ib. 33.") 341 Nephritis Nervous Fever Nettle Kash Neuralgia Facialis Nipples, Lxcoriation Nightmare Notalgia . 31 Nose, Bleeding of the Swelling of the Cancer in Nurse, the Choice of N ursinir. Diet during . Obstructio Alvi Obstructio alvi Neonatorum Occulta Odontalgia Offensive Breath Ophthalmia Opisthotonos Otalgia .... Otitis Otonhcea Ozrena Pains in the Back during Preg nancy False Loins, Lumbago 314, 391 Spasmodic.during Labour 531 in the Hips, Sciatica 316-318 Palsy . . .361 Pal;nation of the Heart . Panaris ... Paralysis Parotitis .... Paronychia Parulis, see Gumboil . Parturition Passio Hysterica Pemwind, see Asthma and Flatulency . . 110,395 Peripneumonia . . . 234 Peiipneumoni Not ha 239 (See also BronchitisChronica.). Peritonitis . .175 Peritoneum, Inflammation of ib. Perniones . . .2^.1 Pertussis . . 204 Perspiration after Delivery . 537 Suppressed . ib. Phthysis Laryngea . . 193 Incipiens . . 241 Phrenitis . . . .271 Piles . . . I2H Pleura, Inflammation of 212 518 r.ori 3.11, 293 361 93 293 346 527 502 INDL'X. 567 PAGE PAGE Pleurisy 242 Rheumatic Ophthalmia 329 Pleuritis ib. Ringworm, Herpetic or Vesi- Muscularus, see Pseu- cular .... 296 dopleuritis 251 Pustular 297 Pleurodynia ib. of the Scalp ib. Pleurosthotonos 276 Rose .... 280 Pneumonitis 234 Rubeola .... 59 Pneumonia ib. Rules of Diet .' 14 Notha, Occulta 239 Rupture .... 361 Typhoid or Congestive 240 Navel, in Infants . 446 Poison .... 434 Scalds and Burns 417 Mineral 435 Scabies .... 291 Vegetable 436 i Scarlatina 48 Animal 437 Anginosa 49 Polypus .... 343 Miliaris . 53, 55 Porrigo Scutulata 297 Maligna,see Ulcerated 49 Lupinosa 300 Sore Throat ib. Furfurans ib. Sequelae of 53 Favosa ib. Dropsical Swellings ' Decalvans 301 after 53 Larvalis 466 Scarlet Fever 48 Potencies of Medicaments 5 Scarlet Rash 55 Pregnancy, Observations on 503 Scalled Head, see Porrigo During Pregnancy 511 Scutulata 297 Prolapsus Ani 132 Sciatica 316 Uteri 543 Scirrhus, Cancer 331 Prosopalgia 349 Scrofula, see Glands 286 Protrusion of the Intestine 132,349 Scrofulous Ophthalmia 329 Prurigo .... 294 Scorbutus 345 Prunella, See Sore Throat, 81 Scurvy .... ib. Pseudo-pleuritis 251 in the Mouth 343 Psora .... 291 Sea Sickness 420 Psoitis .... 315 Shortsightedness 331 Purpura Rubra 55 Sleeplessness 354 Miliaris ib. in Children . 454 Pustula Nigra 2f>5 Smallpox .... 63 Putrid Fever 35 Sore Throat . 81 Sore Throat &9 Ulcerated 89 Pyrosis .... 119 Sores, see Ulcers 301 Quinsy 81 Spasm of the Stomach 112 Quinsy Malignant 89 in the Chest in Children 465 Rachitis 488 Spasmodic Pains 531 Rickets .... ib. Spleen, Inflammation of . 162 Raucitas 191 Splenitis . . . ib. Rash, Nettle 74 Spitting of Blood 2.12 from disordered Stomach 107 Sprains or Strains 403 Regurgitation of Milk.Acidity, Sprains .... 406 Flatulence, &c. 464 Spurious Pleurisy 251 Regimen 1 1 Sputum Cruentum 252 Remedies before Labour 525 Squinting, see Strabismus 330 Rheumatism 310 Strains .... 406 in the Loins, Lumbago 314 Strabismus 330 Hip-joint, Scia- Stings of Insects 420 tica . 316,318 ■ St. Anthony's Fire 280 56S PAGE Stomach, Derangement of 107 Inflammation of 165 Stomacace . 313 Struma, see Glands 2*8 Stye 332 Suckling . • 448,453,548 Suck, Disinclination of the Infant to ... 544 Suffocation, apparent Death from .... 42.) Supplementary Diet of Infants 451 Suppressio Mensium . 499 Suppressed Dysenteiy MS Secretion of Milk 535. 548 Swelled Face . .516 Swelling of the Head in Infants 446 Lips • .331 Nose . 340 Veins .517 Sweating at the Feet 353 Swooning .... 367 Syncope ... ib. Sycosic Ophthalmia . . 329 Synocha ... 22 Synovial Membranes.Injuriesof 411 Syphilitic Ophthalmia . 329 Tea, Derangement from the Effects of ... 356 ■Teething . 47H Te i anus .... 276 Thrush .... 467 Tic Douloreux . . 349 Tinea Capitis . . 297 Annularis . . ib. Faciei . 466 Tongue, Inflammation of . 346 Toothache . . . 77 in Pregnant Females 515 Tonsillitis Maligna . . 89 Tonsillitis, see Sore Throat 81 Treatment of Infunts . 443 after Birth 444 Treatment after Delivery . 532 Trismus . 276 Trismus Nasccntium . 477 Tumours . 288 Tussis Convulpiva Tympanitis Intcstinalis Flatulency. Typhoid or Congestive Pneu- monia Typhus Fever Contagiosus Putridus Ulcerated Sore Throat Ulcers Urine, Suppression of, Cystitis, Nephritis 17! Urine, Frequent, painful, or obstructed Kniission of See also Cystitis and Neph ritis Urticaria Uterine Swelling and Pm!ap sus Vaccination Varices, or Swelled Veins Variola .... Spuria, Varicella Veins, Swelled Vomiting in Infants of Blood Walk, Teaching Children to Slowness in learning t< Warts on the Face Nose Water-brash Water in the Head Watery Eye Weakness after Delivery Weaning Weeping Eye Whitlow Worms Wounds Contused Incised . Lacerated Punctured Gunshot rAGE , 332 20 »