NATIONAL LIBRARY OF MEDICINE Bethesda, Maryland Gift of The National Center for Homeopathy yilaesimund farming "panes Cibrary 19- o^Lc^ H^ • plained of flatulence, nausea, vomiting of phlegm, a watery fluid and bile. He had no appetite and was costive. Oppression on the chest without cough, with a feeling of repletion and malaise in the abdomen. Occasional attacks of vertigo, ill-humor, irritable ACIDUM HYDROCYAXICUM. 19 temper. He felt languid, exhausted, grew thin and looked sallow. For two years he had been trying every possible remedy, without the least success. He then was put on the use of ten drops of Vau- quelin's acid in six ounces of cherry-water, of which he took a tablespoonful every two hours, continuing this preparation with occasional intervals for ten weeks, during which period he took in all three hundred drops. His recovery was perfect; his fretful and irritable temper was likewise entirely changed. Pereira recommends Prussic acid in Gastrodynia as a sort of specific remedy. He writes: "Some time since I prescribed the acid for a lady who had suffered for months with gastrodynia, and who was persuaded, from her sensa- tions, that she had some organic disease. The remedy acted in the most surprising manner; in a few hours, to the astonishment of her- self and friends, she was apparently quite well, and has since had no return of her complaint." To this report Pereira adds: " It can hardly be imagined that irritation of the stomach can be rapidly removed by a substance which is itself an irritant." If Pereira had had the remotest idea of the homoeopathic law of cure, he would have had no difficulty in comprehending, that irritation of the stomach can only be removed by a substance which is itself an irritant. Pereira mentions another case of Uneasiness in the Stomach, for which the patient gradually took the enormous dose of two drachms of the acid prepared according to the Dublin Pharmacopoea. He was seized with tetanic convulsions, but his life was saved, and the complaint had left him entirely after re- covery. If prussic acid was the remedy in this case, the probability is that the potentized acid would have done what drop-doses of the original acid were unable to accomplish. Pereira recommends the acid in Enterodynia in the following paragraph: "I have found hydro- cyanic acid useful in a painful affection of the bowels analogous to that of the stomach, and which, therefore, might with propriety be termed enterodynia. The most remarkable case of this kind which I have met with, was that of a gentleman, a relative of one of my pupils. He had suffered for several months excruciating pain in the bowels, commencing daily about two o'clock, and only ceasing at night. It was apparently a consequence of an ague. He had been under the care of several country-practitioners, and had tried a number of remedies (including opium and quinine) without the least benefit. I advised the employment of the Hydrocyanic acid, and accordingly five minims were administered at the commence- ment of a paroxysm. The remedy acted like a charm; all the unpleasant symptoms immediately disappeared. Several doses of the acid were given before the period of the succeeding paroxysm, but the disease never returned; and after employing the acid for a few days longer, he went back to the country completely cured." 20 LECTURE LIX. Joerg's provers have shown that Hydrocyanic acid may powerfully and painfully affect the bowels. A delicate, sensitive lady was attacked with violent cramp-pains in the bowels depending upon irregularities in the portal system; the pain involved the rectum, causing retention of stool. Every means of relief remained fruitless, except Hydrocyanic acid which helped in a few hours. Pereira commends this acid in English cholera; he says that he has often seen it cure severe forms of this disease after Opium had failed. Our provings do not point to Hydrocyanic acid as a remedy for cholera. This agent may cause vomiting and cramp-pain in the bowels, but, in the case of Joerg's provers, this pain was not asso- ciated with any urging to stool. On the contrary, the tendency of Hydrocyanic acid seems to be to limit the alvine secretions; if diar- rhoea does occur as one of the effects of this agent, it is most proba- bly in consequence of some peculiar idiosyncrasy in the patient's constitution. In Pereira's cases, the acid was most probably used upon the principle of palliative antagonism. Homoeopathic physicians have used this agent in Asiatic Cholera in the very last stage, when the patient seemed threatened with death from asphyxia, with excessive orthopnoea, apoplectic conditions of the brain; the patient is cold, vomiting, diarrhoea and cramps have ceased; innervation seems universally threatened with annihilation. The 2d or 3d potency is said to have saved life under these circumstances. URINARY ORGANS. Our provings show that the acid has a tendency to increase the secretion of urine during the period of organic reaction. A watery urine was secreted by most of Joerg's provers in increased quantity some time after the cerebral and respiratory functions had been affected by the acid. This symptom seems to indicate its employ- ment in spasmodic paroxysms, provided the other symptoms cor- respond. The primary effect of the acid indicates its use in Paralytic Retention of Urine, with which old people are sometimes afflicted. In one prover, the acid caused an increased flow of urine with burning in the urethra. This symptom may lead us to think of the acid in Catarrh of the Bladder, provided the constitutional symptoms cor- respond. SEXUAL GROUP. In a case of poisoning by Hydrocyanic acid, the scrotum was found blue, and_ partially deprived of the epidermis ; the penis was in a state of semi-erection, and there seemed to have been a discharge of seminal or prostatic fluid. ACIDUM HYDROCYANICUM. 21 The acid seems to be possessed of some power to affect the sexual nervous system. Hence it has been advantageously employed in spasmodic affections of the female organs. An unmarried lady who was attacked with the most agonizing cramps previous to the appearance of the catamenia, was radically cured by Hydrocyanic acid, after having used every known anti- spasmodic remedy for eighteen months without the least benefit. In this case, the cure must have been effected in virtue of the law " similia similibus." Hydrocyanic acid may produce venous con- gestion of the uterus, with the violent cramp-pains, such as existed in this case. In view of this mode of reasoning, it cannot appear strange that this acid should have proved an efficient remedy for violent After-pains, as may appear from the following case, which we have extracted from Frank's Magazine. A slender woman had miscarried at three months without any apparent cause. Two hours after the accident, she was seized with convulsions, during which she was unconscious, with her eyes half open. All the muscles of her body were in constant motion, a sort of drawing which was increased by making pressure above the pubic arch, during which the features became distorted. The pulse was small, contracted; there was an involuntary discharge of urine during the paroxysm. The patient was put upon the use of Hydro- cyanic acid, one drop in one ounce and a half of mucilage, of which a small spoonful was given every hour and a half. After using half of the mixture, the convulsions stopped entirely, and the drawing ,pains likewise disappeared soon after. THORACIC GROUP. One of Joerg's provers experienced this symptom: "Scraping at the root of the tongue and in the throat, followed by sensation of foul air at the root of the nose, and prickling sensation." This symptom may indicate the use of Hydrocyanic acid in Chronic Catarrh of the nose, with foul smell, stinging high up in the nose, discharge of disorganized, greenish, brown-looking fetid pieces of hardened mucus. Joerg's provers uniformly complained of a scraping sensation in the throat, followed by secretion of mucus in the bronchia. From two drops, Otto experienced a scraping in the throat, with prickling down the larynx, hacking cough as from little hairs in the throat. Another prover experienced a tickling and scraping in the larynx, with hacking cough. In the formidable proving of the French physician, which I related above, Hydrocyanic acid developed symptoms of an inflam- matory bronchial catarrh, with expectoration of yellow mucus and oppression of breathing. Guided by these indications, we feel justified in recommending Hydrocyanic acid in r.o LECTURE LIX. Chronic Bronchial Catarrh, with tickling, scraping and prickling in the iarynx and bronchial tubes, with expectoration of yellowish or whitish mucus, chilly creepings followed by fever, prostration. In Catarrhus Senilis, with rattling breathing, paralytic # oppression on the chest, sinking pulse, shiverings; excessive prostration, Hydro- cyanic acid may do good service. In Whooping-cough, this agent has been used as a leading remedy by allceopathic physicians. It is used as a palliating anti-spasmoclio. Homoeopathically it can only be used, if the pulmonary affection is accompanied by great prostration, oppression on the chest, and symptoms of violent cerebral congestion during the paroxysm. It will be found particularly adapted to the latter stages of the disease, although it may likewise be homoeopathic to the inflammatory stage, with fever, flushed face and glistening eyes, irritating pulse, vomiting, anxiety, palpitation of the heart. All these pathognomonic signs of the first stage of whooping-cough are legitimate effects of Hydro- cyanic acid. This acid has been recommended by many Old-School practi- tioners as a remedy for Phthisis Pulmonalis; others, on the contrary, reject it as a dan- gerous and mischievous drug in this disease. Joerg's provers have recorded the following effects of the acid upon the lungs: Constriction across the chest; Shooting stitches in the region of the fifth and sixth rib near the sternum; Tightness of the chest, with stitches when taking a long breath; Pressure and tightness in the chest; Aching pain in both sides of the chest, changing to stitching; labored and deep breathing. These symptoms certainly point to congestions of the pulmonary parenchyma, and may justify the use of prussic acid in the prelimi- nary stages of tubercular phthisis, where these congestions occur. There is no reason why this agent should not do good in ulcerative processes which spring from such a pathological basis. Harless con- siders prussic acid, if given in tolerably large doses, a most unreliable and even hurtful drug in cases of fully developed catarrhal and tubercular phthisis, with profuse suppuration, hectic fever, colli- quative sweats, prostration; he thinks that it only palliates these symptoms for awhile, and afterwards hastens the fatal termination of the disease. If the acid is at all indicated in phthisis, it should be given in the higher potencies; they have no such effect as Harless describes. One of Joerg's provers has recorded this symptom: " Sensation as if the larynx were more spacious, with a scraping feeling." We have met with this symptom in Laryngeal Phthisis, where Hydrocyanic acid may be of service in every stage of the disease, using the first six potencies. Prussic acid has moderated attacks of spasmodic ACIDUM HYDROCYANICUM. 23 Asthma, with suffocative paroxysms. Its action upon the heart is undeniable. It has caused " palpita- tion of the heart, with flying stitches in the region of the heart," and "oppression of the heart." We may therefore use this agent in Chronic Congestion of the Heart, when remaining after acute carditis, either permanently or paroxysmally, with anxiety, weight, pressure, stitches in the region of the heart. The pulse is slow and feeble during the paroxysm, or feeble, unequal and somewhat accelerated. In Angina Pectoris, if the paroxysms seem to depend upon the existence of organic disease of the heart, prussic acid may afford either partial or permanent relief. In incurable Heart-disease it may palliate the agonizing oppres- sion, fainting spells and violent palpitation which are often present in organic disorders of the heart. FEYER-GROUP. The first effect of the acid seems to be to retard the pulse. In one of Joerg's provers, the pulse became excited, which must be accounted for upon the ground of an extreme reactive irritability of the sen- tient nervous system. Creeping chills and shiverings are frequently experienced from large doses of the acid. The following group of symptoms exhibits the character of the Hydrocyanic-acid fever in its totality. It shows that the chill has a marked nervous character, that it indicates a deep inroad upon the nervous system; it is not, properly speaking, a fever-chill, but a chill denoting a prostration of innervation characterized by debility, anorexia, irregular and feeble pulse, etc. A girl of eighteen years was treated for a chronic spasmodic cough with Hydrocyanic acid. Her health otherwise was perfect. After having taken four doses of five drops each, she was suddenly seized with colic and diarrhoea; next day her appetite was entirely gone, and she felt so weak that she had to keep her bed. Her pulse was accelerated and unequal, both as regards rhythm and strength. She was attacked with periodical paroxysms of violent chills (without feeling cold,) which were accompanied by some headache, came on every day, lasted several hours and on one occasion a whole day, deprived her of sleep, and shook the whole body, even every muscle except the muscles of the face. The breathing was labored, and the pulse frequent and small. These attacks continued more or less for a fortnight. This case, and the provings instituted by Jcerg and others, show that the fevers to which Hydrocyanic acid is homoeopathic, partake of the character of ataxia, Nervous fevers, the principal feature of which constitutes debility, deficiency of animal temperature; states of Debility rather than fever; or Hectic fevers, with tendency to sudden and exhausting flashes of heat, followed by perspiration. In phthisis, if these hectic symptoms become exceedingly troublesome, prussic acid may act as a good palliative. 24 LECTURE LX. MENTAL GROUP. The symptoms of mental derangement which Hydrocyanic causes, seem to me worthy of note only in so far as they belong to some other superior derangement, such as Hysteria, Hypochondriasis ; it may cause dullness of mind, irrita- bility of temper, a gloomy mood, gay delirium. The following case shows that it may prove useful in cerebral hysteria, with derange- ment of the mental faculties: A girl of seventeen years was treated with Hydrocyanic acid for epilepsy, which had been brought on by fright. Four-drop doses of the diluted acid caused sleeplessness, feverish heat, thirst, exces- sive lassitude, pulse one hundred and twenty. On repeating the dose, she was attacked with merry delirium ; although naturally of a timid and quiet disposition, the effects of the acid induced a con- trary state, singing and warbling, jumping about in the room with a stick in her hand; she felt like a person intoxicated, her pulse was ( very much accelerated. This state lasted three days, although the medicine was discontinued. LECTURE LX. ACIDUM MURIATICUM, (Muriatic or Hydrochloric acid) A compound of hydrogen and chlorine. Serres relates a case of poisoning by this acid, which exhibits its exceedingly irritating properties in a most marked manner. It is found in Orfila's Toxi- cology. A man swallowed an ounce and a half of the acid, after which he experienced great restlessness, his skin became burning hot, the tongue looked fiery-red, the lips became blackish, singultus, a desire to vomit and violent pains in the stomach set in. During the night, he vomited a yellow substance. On the day following, the skin became clammy and cold, the pains in the stomach very violent, the pulse small, delirium set in, and death took place at three in the afternoon. Post-mortem appearances : black lips, brown, swollen, hard and dry tongue ; purple-redness of the fauces and oesophagus, and erosions in these parts here and there ; thickening of the stomach, and inflammation of the external coat; the mucous coat came off in pieces, and revealed gangrenous spots; the duo- denum was likewise somewhat thickened. Wibmer thus sums up the effects of dilute Muriatic acid: Small quantities of it, taken internally, cause an agreeable warmth in the stomach, generally an acceleration of the pulse, a feeling of ease and liveliness, animated complexion, diminished secretion of urine: larger doses cause vertigo and stupefaction. Larger quantities of ACIDUM MURIATICUM. 25 the concentrated acid cause pain; inflammation, a blackish-brown color, thickening, corrosion, perforation and gangrene of the part touched by the poison. The internal use is succeeded by nausea, retching, vomiting, violent pains in the buccal cavity, fauces, oeso- phagus, stomach and intestinal canal, with diarrhoea, tenesmus, etc. Death is frquently preceded by violent convulsions of the neck and spine. If transmitted into the veins, muriatic acid destroys life very speedily by causing the blood in the heart and lungs to coagulate. Guerard reports a case in the Annales d' Hygiene, vol. 48, p. 415, where a woman of twenty-four years swallowed fifty-three grains of concentrated hydrochloric acid. Immediately upon swallowing it, she experienced a burning sensation from the mouth to the stomach, but especially in the throat, attended with a feeling of suffocation and succeeded by uncontrollable vomiting. She was unable to swal- low ; the least attempt at swallowing brought on vomiting. Her voice was low and the respiration frequent and labored. The tongue and fauces were at first covered with a whitish pellicle, which after- wards became detached, exhibiting corroded spots underneath. Death took place two months after the poison had been swallowed ; some time previous, portions of corroded mucous membrane had been passed both by vomiting and by stool. We have extracted these notes from Wharton's Medical Jurisprudence. In a case of poisoning by hydrochloric acid, we administer chalk, whiting, magnesia or its carbonate, and soap; in the absence of these articles, oil, the bicarbonated alkalies, milk, white of egg, or demulcents of any kind may be used. Old-School physicians employ muriatic acid as a detergent in diphtheria, cancrum oris, malignant scarlatina. It is applied locally to the diseased surfaces. The idea undoubtedly is that it corrects the morbid action. This, however is hypothetical; we have no evi- dence, so far, that it causes a diphtheritic disorganization of the mucous lining of the mouth and throat by any other than chemical action. Hahnemann has furnished a few short provings of this agent, which indicate its use in the following affections. CEREBRO-SPINAL GROUP. It causes: tearing pains in the right parietal bone: tensive pain in the right temple; boring pain in the vertex; feeling as if the brain were loose; burning sensation in the head. Dr Marcy has successfully used Muriatic acid in Headaches ac- companying chronic hepatitis, and in the dull and stupefying head- aches occurring in the progress of typhoid and scarlet-fevers. Muriatic acid has been recommended in C"avulsions by Old-School practitioners. In the case reported by Frank, the attack was caused by exposure to severe cold, and pre- ceded by buzzing in the ears and vertigo. The patient fell down, with loss of consciousness. When he recovered his senses, he was 26 LECTURE LX. unable to swallow or talk; the pulse was scarcely perceptible. The patient swallowed thirty drops of the acid in water, and in fifteen minutes another dose of forty drops. This was followed by shiver- ing and gritting of the teeth lasting half an hour. After this, the patient felt hot and complained of headache. Next night he had another, but milder attack, which was checked by twenty-five drops of the acid. I should not have alluded to this case but for the fact that it is occasionally referred to by homoeopathic physicians as illustrative of the power of Muriatic acid to control convulsions. This case is a very poor test of the anti-spasmodic virtues of the acid. The con- vulsions in this case were of a purely rheumatic character, a violent irritation of the ganglionic system induced by continued exposure to severe cold, which would have yielded to a few small doses of Aconite or Belladonna as the homoeopathic specific. ORBITAL AND AURICULAR GROUPS. , This acid has caused : itching of the eyes; slight inflammation of the eyes; burning in the eyes on washing them; one half of every object appears to be cut off from the other half in a perpendicular line; twinkling before the eyes. Hardness of hearing; tingling and humming in the ears; sensi- tiveness to noise; itching pimples on the ears; heat and dryness in the ears; ulcerative pains in the left ear, aggravated by boring with the finger. These symptoms point to Muriatic acid as a good remedy for Chronic Sore Eyes, when of a scrofulous nature, with alteration of the visual power. Chronic Otalgia of a scrofulous character, such as may be devel- oped by the scarlet-fever miasm. Dr. Marcy informs us that he has seen good effects from this acid in the Deafness and ringing in the ears accompanying typhoid fevers. Muriatic acid has been of use in Herpetic and Pustulous Eruptions upon the ears of scrofulous persons, more particularly when breaking out as sequelae of scarlet- fever. The higher potencies will be found preferable. CHYLO-POIETIC GROUP. Muriatic acid causes: inflammation and swelling of the gums • scurvy of the gums; diphtheritic disorganization of the mucous membrane; red and dry tongue; smarting, burning and ulceration of the throat. In accordance with these symptoms, it has been used as a remedy for the Aphthx of children, when inveterate, and involving the pharynx and oesophagus; also for Diphtheritis in scarlatina or malignant fevers; and for Chronic Sore Throat, with malignant ulceration of the lining mem- ACIDUM MURIATICUM. 27 branc, discharge of a foul, ichorous pus. The drug may be used internally and as a weak gargle. Other symptoms belonging to this group are: ptyalism, bitter, acrid and putrid taste; aversion to meat; hiccough before and after eating; frequent eructations; efforts to vomit; vomiting of yellowish fluids, and of shreds of disorganized mucous membrane. These symptoms indicate Muriatic acid in Dyxjxpsia characterized by similar marked symptoms, foul taste after eating, brown-looking tongue, putrid eructations, waterbrash. This form of dyspepsia may occur in impoverished constitutions, or among persons who are afflicted with liver complaint which they contracted by a residence in tropical climates, where severe bilious derangements are endemic. This form of dyspepsia may also develop itself in consequence of the habitual use of heavy, indigestible food; rich pastry or half-fermented.flour. It is well known that Muriatic and Lactic acid constitute two important ingredients of the gastric juice, not in a free state, but discovered by chemical analysis subsequently to the destruction of Jthe gastric juice as a vital fluid. Christison justly repudiates this doctrine of free hydrochloric acid in the stomach in the following language: " The most important fallacy of all is, that free hydro- chloric acid constitutes an essential part of the gastric juice, and an ingredient of the secretions of the stomach in various states of dis- ordered digestion." I allude to this fact, because it is my duty, Gentlemen, to warn you against the mischievous tendencies of the chemico-physiolo- gical School of the day, whose teachings have poisoned even the minds of homoeopathic physicians. " In some forms of dyspepsia," writes Dr. Peters in the North American Journal of Homoeopathy, " Muriatic acid will have to be assisted or alternated with Lactic acid ; this acid has been incontestably proven to be an important ingre- Xient of the healthy gastric juice ; it is a colorless, syrupy liquid having a very sour taste ; it coagulates albumen, and dissolves a large quantity of freshly precipitated phosphate of lime, properties which render it of great importance to the animal economy. It has been proposed by Magendie as a remedy in certain forms of dys- pepsia, and for the removal of phosphatic deposits in the urine." It may seem very attractive to some minds to serve up a dish of chemio-physiological learning from the table of Lehmann and other chief-cooks of the chemical kitchen of this asre; but how does this benefit the cause of therapeutic truth ? How does it benefit the students of Homoeopathy, when they are led to infer from such am- biguous teachings as I have quoted, that a deficiency of gastric juice may be remedied by pouring into the stomach alternate quan- tities of Muriatic and Lactic acid ? Gentlemen, all such doctrines are subversive of rational progress. Muriatic acid is sometimes discharged in large quantities in the fluid of waterbrash. Dr. Prout once discovered between four and five grains of the pure acid in sixteen ounces of the fluid. Toxicology 28 LECTURE LX. acquaints you with the appropriate method of discovering the pre- sence of this acid in the ejected fluid. That element in the brain whose business it is to employ the muriatic acid of the gastric juice as a solvent of the organic matters introduced into the stomach, is deficient in power. My belief is that some inimical principle, some principle specifically adverse to the vital uses of the muriatic-acid element in the gastric-juice, renders the assimilative power of the brain inoperative in this direction. It does not seem to me a base- less theory to suppose, that the Muriatic acid suitably dynamized, may be enabled to neutralize this inimical influence. I apply a similar mode of reasoning to diseases of the osseous sys- tem, where a deficiency of the calcareous element constitutes a chief feature, as in ramollissement of bones. In this disease, the calcareous phosphates, instead of nourishing the bones, are often expelled with the urine in enormous quantities. That element in the brain, which is entrusted with their assimilation to the osseous tissue as elements of growth, is deficient in power, chained perhaps by an inimical force or agent which it may suit us to term the scrofulous element. Will massive doses of lime help the matter ? No, indeed, they may make the matter worse. Potentize your Calcarea; the highly- dynamized agent may be able to disembarrass and consequently* stimulate the action of the brain, whereas the crude drug might have proved ineffectual. Muriatic acid causes a burning tension in the right hypochon- drium. The liver looks congested after death by this acid. It has been employed in Chronic Hepatitis, especially in tropical climates. In the East- Indies, English physicians have employed Nitro-muriatic acid for this affection both internally and in the shape of baths. Muriatic acid causes heat and burning in the stomach, with a feeling of repletion, violent pains in the epigastric region. We may there- fore use this acid in Chronic Gastritis, with heat in the stomach, feeling of weight, full- ness and oppression in the stomach, soreness to pressure, nausea, retching, vomiting of food, water, mucus, blood and bile. This acid causes diarrhoea with burning at the anus, discharge of blood with stool, itching at the perineum. Small doses cause inac- tivity of the rectum, the stool comes away in small pieces. Marcy recommends this acid in Chronic Diarrhoea, with tenesmus, colicky pains before stool, burning at the anus, stools occasionally bloody, prolapsus of the rectum after stool. It has cured several cases of diarrhoea, with soft clay-colored stools, alternating with hard and difficult stools. Diarrhoea occur- ring in typhoid fevers and in scarlatina, scanty, loose and bloody stools, with rumbling in the bowels, colicky pains before and durino- the discharges, tenesmus, burning at the anus, chilliness and pros- tration after each stool, constitute leading indications for Muriatic acid. ACIDUM MURIATICUM. 29 URINARY GROUP. Muriatic acid causes frequent desire to urinate, followed by inef- fectual urging or complete paralytic inability to void urine. This condition of the bladder may occur in typhoid fever. Orfila has proposed Muriatic acid as a means of counteracting the formation of phosphates in the urine. In the phosphatic lithiasis, Muriatic acid generally acts as a chemical dissolvant; in the uric acid lithia- sis, it may act as a therapeutic agent, if the disease can be traced to disorders of the biliary and gastric functions, for which Muriatic acid is specifically adapted. RESPIRATORY GROUP. Muriatic acid causes catarrhal feelings in the nose, sneezing, sting- ing pains, stoppage of the nose, acrid discharges. If these symptoms are ingrafted upon a scrofulous diathesis, with other scrofulous symptoms, sore eyes and ears, foul, purulent dis- charges from the nose and ears; more especially, if these symptoms show themselves after measles or scarlet fever, with ulcerated sore throat: Muriatic acid may prove of immense benefit. The vapors of this acid, when inhaled, have caused obstinate hoarseness, moaning inspirations, bloody cough. Symptoms thus obtained are of not much practical value. In Frank's Magazine, this agent is recommended for WlLooping Cough; when the paroxysms terminate in vomiting, expulsion of a quantity of disorganized mucus. Small doses of Ipecacuanha are likewise recommended. Kopp warns against the use of Muriatic acid in this disease, and in other affections of childhood. In order to use it effectually, it has to be used in tolerably large doses, too large not to become dangerous to the vegetative life of the childish organism. In the last stage of Bronchitis, with constrictive oppression, hoarseness, bloody and purulent expectoration, inhalations of Muriatic acid carefully ad- ministered may palliate the sufferings of the patient. FEYER-GROUP. This acid has been used with great advantage in Typhus, paralytic stage, when the patient shows a constant ten- dency to settle down in bed ; depression of the lower jaw, the eye- balls are turned up ; boring with the head into the pillow ; slavering, parchment-like dryness, and clammy coldness of the skin; hurried, compressible pulse, muttering delirium. A few drops of the diluted acid in ten tablespoonfuls of water have effected a permanent reac- tion in such a critical moment. -30 LECTURE LX. EXANTHEMATOUS GROUP. We have employed Muriatic acid with some advantage in Malignant Scarlatina, when the eruption assumes a faint, dark-red petechial appearance, with foul, greyish ulcerations in the throat; the patient is delirious, lethargic, prostrated ; the breath very foul, with involuntary discharges from the bowels, black sordes on the teeth, tongue dark-red, dry or covered with viscid phlegm, lips dry, blackish and cracked, purple spots on the cheeks; ichorous, fetid discharges from the nose, cold extremities, rapid and compressible pulse. Likewise in Malignant Small-pox, when the pustules assume a dark, dubious color, with tendency to collapse, foul discharges from the bowels, cold and clammy skin. A mild lotion of Muriatic acid has been applied with good effect to Ulcers with burning pain and secreting a fetid ichor ; they become covered with a dark scurf. For Scurvy Tetter on the eyelids and ears, this agent has sometimes been used with benefit. ACIDUM NITRICUM, (Nitric Acid, Azotic Acid) This acid was already known to the Arabian physicians in the seventh century. It is a compound of nitrogen and oxygen. It makes a permanent yellow stain upon the skin which is distin- guished from the yellow stain made by Iodine and Bromine in this, that the latter, if recent, can be readily removed by the application of strong alcohol or caustic potash. Wibmer sums up the poisonous effects of concentrated nitric acid in the following comprehensive statement: " Immediately after swallowing the acid, an intense burning pain is experienced in the parts having come in direct contact with the acid (mouth, fauces, oesophagus, stomach); there follows a develop- ment of gas; eructations; frequent vomiting of an acrid, burninc substance; feeling of coldness externally; anxiety; shiverino-; a small contracted, hurried pulse ; restlessness; sleeplessness ; inability to keep any thing on the stomach; symptoms of a fully developed gastritis; difficulty of swallowing, costiveness. The inner mouth tongue, etc., look whitish, sometimes yellowish, furrowed ; if the patient does not soon die, this layer becomes detached, leaving for some time a raw surface. Even if the patient recovers, the stomach remains sensitive and even disorganized in consequence of which the patient will die sooner or later. After death, the border of the lips generally looks yellow, the inner mouth white and sometimes lemon- colored; the teeth are loose, with yellow crowns; the pharynx oesophagus, stomach, and frequently the duodenum and ileum are ACIDUM NITRICUM. 31 inflamed, in most cases lined with a whitish-yellow, granular, fatty and frequently chalk-like layer of flocks, representing the disor- ganized mucous membrane. The other coats of these viscera are inflamed, injected, sometimes exhibiting gangrenous spots; these coats are at times found thickened, and at other times much thinner than before the poisoning, they tear quite readily and are sometimes found perforated. The pylorus is generally contracted. The other organs are healthy, except if the stomach should have become perfo- rated, in which case the abdominal organs may become injured by the acid. Similar disorganizations take place in the rectum, if it should be touched by the poison. If applied externally, the concentrated acid acts as a corrosive irritant, changing the animal tissue to a fatty, yellow-colored mass, followed by inflammation of the surrounding parts. In small quantities, the diluted acid excites the appetite, increases the secretion of a lightly-colored urine, causes a whitish coating on the tongue, dryness of the mouth; about the fifth day after commencing the use of the acid, the teeth begin to become loose, the gums bleed; in some cases ptyalism sets in; the continued use of the acid is followed by digestive derangements, colic, fetid breath, headache, languor, constipation or diarrhoea." In a case of poisoning, we first administer an emetic, from twenty to forty grains of the sulphate of zinc; or even three grains of tartar emetic dissolved in tepid water and to be repeated in a quarter of an hour, if the emetic have not operated. After the emetic has operated, we administer the chemical antidotes, viz.: chalk, whiting or magnesia suspended in water. In the absence of these, soap-suds, an infusion of wood-ashes, weak solutions of the alkaline carbo- nates, white of eggs, gelatine, milk, oil, or in fact any mild diluent, should be immediately administered. External parts burnt with Nitric acid should be washed with a solution of soap or simple water (Pereira). This drug has been extensively used in Old-School practice, and is likewise extensively used by homoeopathic physicians who had been for years attached to the allceopathic flag. It is not an easy business for some of these gentlemen to divest themselves of the habits and predilections of an inveterate empirical routine. Nitric acid will be found principally adapted to diseases depending upon the presence of some virulent miasm, especially the scrofulous, syphilitic and mercurial miasms. According to our usual classifica- tion, we obtain the following categories. CEREBRO-SPINAL GROUP. Nitric acid is useful in headaches arising from mercurial or syphi- lid* poisoning; it is likewise adapted to chronic headaches depending upon liver-complaint; the pains are thus indicated by our provings: pressure and heat in the head; painful tension in the interior of the head; the head feels as if it were surrounded by a tight bandage; throbbing pains in the temples. 32 LECTURE LX. ORBITAL AND AURICULAR GROUPS. It is particularly in syphilitic and mercurial ophthalmia that Nitric acid has been found useful. Purulent Ophthalmia, when caused by the gonorrhoeal or syphilitic virus; Ulceration of the Cornea, arising from similar causes or having a strumous origin; opacity and other degenerations of the cornea, have been cured by means of the middle or higher potencies of Nitric acid. Deafness and Purulent Otorrhoea, of a syphilito-scrofulous character, have yielded to this acid. NASAL GROUP. In Syj)hilitic Ozcena, nitric acid is eminently serviceable. Caries of the Zygomatic Process has been arrested by means of this agent. CHYLO-POIETIC GROUP. We use this acid with advantage in Mercurial and Syphilitic Angina, with ulcerous disorganization of the mucous lining which has a whitish appearance as if the throat were lined with chalk or flour; with intense burning and stinging pains, and occasional bleeding; foul odor from the mouth; copious ptyalism. In Diphtheritic Ulceration of the Throat, such as is frequently present in malignant scarlet-fever, with foulness of breath, viscid ptyalism, suffocative and burning dryness and swelling of the throat, Nitric acid has proved very useful. Common and obstinate Sore Throat of a scrofulous nature has been cured with it. It is likewise homoeopathic to Mercurial Ptyalism, with ulceration and sloughing of the mucous membrane, spongy swelling and bleeding of the gums, looseness of the teeth, etc. Nitric acid causes dull pains in the stomach, very much aggravated by pressure; nausea and vomiting; vomiting of a dark and glairy liquid; vomiting of a lemon-colored liquid; vomiting of dark blood- burning pains in the stomach; sour eructations. In accordance with these indications we may prescribe Nitric acid for Dyspepsia, with pain and tenderness in the epigastric region, sour eructations, burning distress in the stomach, occasional retchino- and vomiting of yellow mucus. Chronic Hsematemesis or vomiting of black, fluid blood and mucus with pain and burning in the stomach. Pyrosis or heatburn, with sour eructations; Cardialgia, with dull pains in the stomach, excessive sensitiveness to pressure, vomiting of yellow mucus and blood; the attacks set in paroxysmally. ACIDUM NITRICUM. 33 Frank has extracted a case of poisoning by Nitric acid, where the patient lived several months after the acid had been swallowed. The opening of the pylorus was found very much contracted, not ex- ceeding one line in diameter; the walls of the pylorus and upper part of the duodenum were quite hard, and half an inch thicker than in their natural state; upon cutting through this indurated and hypertrophied portion of the duodenum, the surface presented a greyish-white and somewhat bluish appearance; its tissue looked like lard and creaked under the knife. This disorganization pre- sented all the characteristics of scirrhus of the stomach, according to Andral's description of this disease. Upon the strength of these post-mortem appearances, Nitric acid is recommended by Dr. Peters "as the only known, absolute homoeo- pathic remedy for hard cancer of the stomach, especially of the pylorus." This recommendation is too hasty. Every member of the French Academy, before whom this case was read, rejected the conclusions of the reporter, Dr. Bouillaud, viz.: that the cancerous disorganiza- tion was the result of chronic gastritis caused by an irritant poison. Delens and Yelpeau suppose that the cancer existed previous to the poisoning: Gualtier de Claubry, who had some previous acquaint- ance with the patient, thought that the dietetic excesses and the abuse of spirits to which the patient was addicted, might have been the first cause of the disease. I make these statements in order to show how much caution is required in making post-mortem appear- ances the standard by which the homoeopathicity of drugs to given diseases should be determined. In the present case, the patient, after having been relieved of the first effects of the irritant poison by means of magnesia, presented himself for admission in the hospital with the following symptoms: the inner cheeks, uvula, velum, fauces as far down the throat as one could see, were covered with ulcers exhibiting slightly yellowish- grey crusts; the parts were swollen and painful, with fetor from the mouth; roughness of voice, pain in the oesophagus when swal- lowing ; features somewhat sunken, pulse contracted, ninety-two to ninety-six. After some treatment, the patient only complained of a feeling of embarrassment at the lower and in the middle portion of the oesophagus, and left the hospital for some three weeks, when he returned. The pains in the oesophagus and stomach, the nausea,_ vomiting, colic and constipation had re-appeared, He was emaciated; ^ the features very much altered; nausea, vomiting, fetid eructations, bloating of the epigastrium with constipation; tongue pale, rather moist; breath fetid, pulse sixty-six to sixty-eight; temperature of the skin almost natural; swelling in the left hypochondrium. The patient sank very suddenly. In Chronic Gastritis, where these symptoms occur, and which may lead us to suspect the gradual supervention of scirrhus, more par- ticularly in the case of inveterate topers, Nitric acid, in the middle potencies, may do us much good. vol. n.—3 34 LECTURE LX. In a case of chronic poisoning by Nitric acid which occurred in my practice, one of the most troublesome symptoms was diarrhoea, with soreness of the bowels. We may prescribe this agent success- fully in Chronic Diarrhoea, with soreness of the intestines, discharges of a serous liquid, loss of appetite, emaciation, symptoms of intestinal phthisis. Indeed in fully developed Intestinal Phthisis, this agent may still be of great use. Also in Cholerine or Cholera Diarrhceica, diarrhoea remaining after an at- tack of Asiactic cholera. In chronic Dysentery, or Dysenteric Diarrhoea, with tenesmus, dis- charges of blood, serum and disorganized mucus, Nitric acid may afford relief. In Prolapsus of the Anus, Dr. Marcy has effected a cure with Nitric acid, 30, given every night for six weeks. Also in a case of Fistula in ano of two years' standing, given in alternation with Ignatia 30, one dose every night, in alternate weeks. Torpid Hoemorrhoidal Tumors of long standing, when the vascular tissue seems to have lost all elasticity or natural contractility, may be diminished by the external application of dilute Nitric acid. In Chronic Hepatitis, with enlargement of the gland, alternate watery diarrhoea and constipation, sallow complexion, Nitric acid is useful. In organic Liver-complaint, with ascites, the acid has effected cures. The following interesting cure by Dr. Wilkinson is reported in the London Lancet for 1845, where the dilute acid was used in large doses; smaller quantities might perhaps have effected the same result; the usual alloeopathic accompaniment of calomel and jalap was undoubtedly unnecessary in this case. "E. D----, aged thirty-nine, carrying on the business of a coach- maker in London Wall, in the city, was brought to me in the month of October, 1839, laboring under dropsy of the abdomen, with diseased liver. When he entered my room, he was supported by his friend, Mr. Lester, who came with him. His countenance was sallow and shrunken, his abdomen and legs swelled to an enormous size, the latter resembling in shape the limbs of an elephant. His scrotum hung half way down his thighs, and the skin of the penis was distended to the thickness of a man's arm. His pulse was small and weak, and beat not more than thirty strokes in a minute. His history was soon told. He had been a constant frequenter of a public house, had been ill about two years with diseased liver, and then dropsy had supervened about ten months before paying me his first visit. He had been under medical treatment, and taken mercury in small doses, with other remedies; but was now considered by his medical attendant as past cure, and unable, for his weak state to undergo the operation of paracentesis. His bowels at this time were costive; he passed his urine in small quantities, not more than a tablespoonful at a time. I ordered him six grains of calomel and ten of colocynth, in three pills, to be taken at bed-time. I visited ACIDUM NITRICUM. 35 him at his own residence two days afterwards. He had passed two motions, both as black as, and of the consistence of, melted pitch. I desired him to repeat the dose, and saw him again in two days; he had passed three motions, the first two in color and consistence as the last, but the third was more of a brownish cast, and looser. From his uneasy state and difficulty of breathing, in the presence of Mr. Hunt, apothecary to the Provident Dispensary, I passed a trocar below the umbilicus, and drew off a pail and a half of water. The fluid, on being placed in an iron spoon over a candle, was found to be highly albuminous. I did not examine his urine. Took six grains of hyd. cum creta at night, a drachm of supertartrate of potash with eight grains of jalap, on the following morning. The evacua- tion was watery, and contained yellow bile. This was repeated in four days with a similar result; pulse continued the same in frequency, but fuller. Ordered friction over the region of the liver with the palm of the hand three times a-day, an hour at a time. I now determined to give the nitric acid, beginning with thirty drops of the dilute every four hours, in a glass of decoction of cinchona. This was increased ten drops per diem till he took two hundred and fifty daily, and continued it for two months. The dropsy had entirely disappeared, and his pulse risen to ninety in a minute, and full. The secretion of bile and urine had returned; he could eat a beefsteak for breakfast, and was ready for another before his accus- tomed hour of dining, which was one o'clock. In less than six months, he was as fat and as well as ever he had been during his life. The most singular part of this case is that my patient after- wards returned to his old habits of drinking, but, I believe, not to his former excess. I saw this person three years afterwards; he had no return of his complaint whatever. He took the nitric acid nearly three months." In the following case reported by Dr. Wilkinson, Nitric acid likewise showed great curative powers in what was supposed to be a case of Fungoid Disorganization of the Liver, " Thomas P----, aged fifty-two, butler to Mrs. C----, of Montague Square, consulted me in the month of October, 1840, about a large tumor in the throat. The apothecary who attended him told him that it was an enlarged tonsil gland. On making an examination, I found a large tumor, occupying the left side of the fauces, descending down the pharynx, but its extent in that direction could neither be seen nor felt. It ascended behind the bony palate, and continued its course along the roof of the mouth; below, it pressed down the tongue, and pushed the velum palati diagonally forwards as far as the teeth. On one side it was connected to the pharynx by a base as broad as the tumor itself, whilst the other surface came nearly in contact with the opposite side of the throat. The tonsil on the diseased side seemed involved in the disease, but whether it com- menced in that gland or lower down does not appear, as he never suspected the existence of such a companion till it had assumed the frightful size of a turkey's egg. The mucous membrane covering 36 LECTURE LX. the tumor was tense, and somewhat glistening, of a dullish-red color. It had not the least doughy feel, but was semi-elastic in some parts, whilst other portions of the swelling had a firm, fleshy feel. His countenance was rather sallow, but from his general good health, I proposed the operation of removing it piecemeal by ligature, as it was evidently too vascular and in too awkward a situation for the knife. His mistress had sent him to Mr. Lawrence, of Bartholomew s Hospital, who pronounced it malignant, and would not interfere with it. I then proposed that Mr. Liston should see him, when it was agreed to pass a bistoury straight into the tumor, and evacuate any fluid that it might contain. A small quantity of straw-colored fluid was evacuated from a superficial puncture, but on the instrument being continued further downwards, a rush of arterial blood took place, and he lost nearly a pint in less than two minutes. Cold vinegar and water and syncope fortunately put a stop to the haemor- rhage, and I accompanied him home from the hospital in a coach. In a day or two he had a great deal of irritative fever, the lips of the wound opened, and an excrescence, having a yellowish-white cauli- flower appearance, protruded. This kept on increasing in size for six weeks, was hard to the touch, and now of a magnitude between a shilling and a half-crown. His appetite entirely failed him, and he could scarcely swallow fluids of the consistence of arrowroot. The debility of body was now much increased; he had lost all his flesh, his countenance very sallow, and his features much attenuated. The glands of his neck on the side of the tumor formed a chain along the sterno-mastoid muscle, as hard as marbles; he was literally skin and bone. Mr. Liston and myself, who daily attended him, now thought that death would soon terminate his existence, and my friend took his final leave. Mr. Aston Key, of Guy's Hospital, was now sent for, and I met him. He pronounced it at once a fungus, that in all probability he had another in his liver, and that the patient would not live four days. Though all hopes seemed now at an end, I observed that he would constantly call for the nitric acid gargle which I had ordered him. I was, therefore, determined to give large doses of it internally, which I did every four hours, beginning with thirty drops, thrice a day, in a glass of water; increasing five drops each dose per diem. In less than a week the excrescence sloughed and came out; the nitric acid was continued, and he got rapidly well in six weeks. T. P. is still in his situation, in good health, and has been so ever since his recovery, four years and a half ago. "In justice to that well-known and accomplished surgeon Mr. Liston, I must confess that without that gentleman's operation the patient would in all probability long ago have been either choked or starved. Without the nitric acid, he would most inevitably have sunk." In Chronic Jaundice, depending upon enlargement and induration of the liver, with obstinate constipation, fetid, dark-colored urine, ulcerative pains in the epigastrium, Nitric acid has afforded much relief. ACIDUM NITRICUM. 37 URINARY GROUP. Nitric acid in small doses causes an increased flow of urine; in larger doses it causes frequent and ineffectual attempts to urinate; it also causes fetid urine. Dr. Maroy states upon the authority of Reil, that "after taking Nitric acid, pain in the lumbar region and kidneys is observed, and from there to the bladder, attended with great urging to pass urine, followed by diminution, even suppression of the secretion of urine for some days, and enuresis. The urine burns when passing the urethra, is very turbid, has a bad smell and is very dark, even brown in color, depositing fibrous nubecula, and much brown-red, greasy sediment. The mucous membrane of the urethra is likewise affected as in the first stage of blennorrhoea; pains in the orifice of the urethra commence very soon after the use of the remedy, as in case of stone in the bladder. It is not known whether albumen in the urine is produced by Nitric acid." In Enuresis, with fetid urine, discharge of a purulent sediment, especially at night, this agent has proved very useful. Also for Ulcers in the Urethra, with stinging and burning, profuse suppura- tion, dry skin, loss of flesh. Give from 3d to 6th potency, or lower, if necessary. In Diabetes, it may diminish the secretion of urine and moderate the thirst and heat. SEXUAL GROUP. In syphilitic affections of the sexual organs, Nitric acid is emi- nently useful. In Syphilitic Ulcers of the breasts, it has effected a cure. We read in Hufeland's Journal that a nurse of thirty two years was infected by a baby. Ulcers with red and inflamed edges broke out on the breasts ; they discharged a thick, yellow pus; shooting pains in the throat which is sometimes red and swollen, but without a trace of suppura- tion. Nitric acid was given in doses of one to two drachms a day. The patient was completely cured without experiencing any medi- cinal symptoms. Chancrous Ulcers on the labia, penis, nose, hairy scalp, etc., have likewise yielded to the internal and external use of the acid, after caustics and mercurials had failed. Condylomata at the anus and on the sexual organs have disap- peared by the internal and external use of Nitric acid. In Leacorrhcea, especially when syphilitic infection may be sus- pected, or in scrofulous leucorrhoea, with greenish or pinkish dis- charges, having a foul smell and corroding the parts, Nitric acid is serviceable. 38 LECTURE LX. RESPIRATORY GROUP. This acid causes hoarseness ; dry and barking cough, with puru- lent and bloody expectoration, difficult respiration. It is therefore useful in Chronic Laryngitis, when depending upon a scrofulous or syphi- litic element; also in laryngeal Phthisis, when similar causes prevail; and in Pneumonia of old, emaciated individuals, when the disease speedily threatens to terminate fatally by paralysis, with dry cough ; copious green, blood-streaked expectoration ; violent stitches, mostly on the left side, excessive difficulty of breathing, soft and intermittent pulse, profuse sweat, rapid failing of strength. The lower potencies may be required. FEYER-GROUP. Nitric acid has been used with success in Fever and Ague, and likewise in Typhus Abdominalis, last stage, with haemorrhage from the bowels, and haemorrhagic petechiae. Mercurial and Scorbutic fever, or hydrargyrosis when assuming the form of a scorbutic diathesis. EXANTHEMATOUS GROUP. Nitric acid is particularly adapted to Syphilitic Eruptions, rubeola, herpes, condylomata, ulcers, tuber- cles, etc. Dr. Cooke has employed this acid successfully in desperate cases of Elephantiasis or Lepra Leonina, the patients being emaciated and covered with sores, secreting a foul and offensive pus. The acid was given in doses of ten to sixty drops in six ounces of water, repeating this quantity twice every day, and augmenting the dose every two or three days by six drops, and gradually decreasing again in the same ratio. Four patients were discharged cured in four weeks ; the other two had to be treated somewhat longer, on account of a syphilitic infection, but they too were ultimately cured. In Malignant Scarlatina, the acid has been employed by Diirr, if the following group of symptoms developed itself at the onset: Small and hurried pulse, stupor and sopor; occasional discharge of a fetid, glutinous, corrosive ichor, which at first looked whitish and afterwards brownish; delirium only at night; they escape from the bed, and can only be brought back with great difficulty; breathing short, tongue dry, and looking like smoked beef; eyes violently inflamed and glassy. Glandular swellings, especially parotitis were always present. Exhausting nocturnal emissions, itching of the scrotum and root of the penis, were likewise of frequent occurrence among the precursory signs of scarlatina. ACIDUM NITRICUM. 39 Nitric acid has been found an excellent means of arresting Hemorrhage from Varices, or of reducing and even removing Varicose Veins, by applying a mild form of the dilute acid. Varicose Ulcers can likewise be made to disappear by this means. Common Ulcers, painless, readily bleeding and emitting an ichor- ous pus, may likewise heal under the internal and external use of Nitric acid. The following fine cure of an ulcer on the upper part of the wing of the nose is reported in the London Lancet for 1845, by Dr. Wil- kinson : " I was consulted, in the year 1839, by Mr. W----, an ironmonger, in Crawford street, about thirty years of age, for an ulcer on the upper part of the ala of the nose. It was first observed about three years before, in the shape of a small pimple, which discharged a watery humor. He had been under half a dozen surgeons, but none of them could succeed in getting it to heal. I advised him to take five grains of Plummer's pill every night, and Hudson's syrup of sarsaparilla during the day, for a month. At the end of the first week I applied the lunar caustic, which I repeated at convenient intervals, which checked the discharge; and I was in hopes, when the black eschar had separated, that cicatrization would have been completed. I was, however, disappointed. A very thin skin cer- tainly had come over it, but I saw it was soon to be absorbed, which was the case in a week afterwards. Its base being very hard, and his friends alarmed lest it should turn out cancerous, I proposed to dissect it out, The thoughts of the operation frightened him, and he went to Mr. C----, a well-known surgeon in the borough, who advised him to continue what I had before prescribed, probably thinking I had not pushed the medicine far enough. This gentle- man applied the caustic more freely; the result was, however, the same. When about six months had elapsed, he sent for me, and I removed the hardened base and ulcerated surface, which was a little larger than the section of a large pea. I had some difficulty in getting the wound to heal, the granulations being glassy and ash- colored. A little diluted nitric acid was applied to the wound with a camel-hair brush, for four or five successive mornings. In a fort- night it assumed a more healthy appearance, and it was healed in a month after the operation. It caused little or no scar, the part resembling a pit from the small-pox. It has never again returned. The patient took the nitric internally during the healing process." We have alluded to the curative virtues of Nitric acid in fungoid growths of the liver. Here is another case illustrative of these cura- tive properties in other fungoid diseases. The case is likewise reported by Wilkinson, in the Lancet. " Mr. S——, aged sixty, a tobacconist, an old inhabitant of the Edge ware road, long subject to erysipelas, observed, in the month of September last, a small tumor on the middle of his right eyelid, of a dark-red color. It increased in a month to the size of a horse-bean when he pricked it with a needle, and says he lost about a gill or blood. The puncture soon increased in size, and an excrescence 40 LECTURE LX. made its appearance, which had grown by the middle of November, to the size of an old English strawberry. In this state I first saw it; he had then a poultice to his eye, which from its pressure and the tumor together on the globe, had produced considerable inflamma- tion of the conjuctiva. As he was under medical treatment, I refused to interfere, but considered a poultice, from its weight, at all times a most inapplicable thing for the eye This was changed for something worse—namely, a zinc lotion, which produced considera- ble inflammation both of the eye and eyelid. As the surgeon thought an operation useless, believing it to be the true carcinoma, I was con- sulted professionally. The tumor was hard to the touch and bled easily and profusely, considering its size. It was composed of one sac within another, so that when its surface appeared to be about to suppurate, it would come off, and the sac underneath made its appear- ance. The eyelid was swollen, of a dark-red color, and could not be raised by the patient. On opening the eye, there was chemosis of the conjunctiva, the cornea sunken and dull, and two large patches of lymph thrown out. I ordered him a constant application of warm water, three grains of calomel, and a quarter of a grain of tartar emetic directly, with a black draught two hours afterwards. I saw him again at night; medicine had operated ; put a blister behind his ear. He afterwards took small doses of blue pill for three or four days, and applied another blister. The inflammation had sufficiently subsided for the Nitric acid and bark, which he took a week previous to the operation. " I performed the operation as follows : The patient being seated in a chair opposite a window, I stood behind him, and he reclined the back of his head on my breast. Mr. Blizard Power, a student of Bartholomew's, who assisted me, stood in front, and fixed the prongs of a hook I use in the squinting operation just above the tarsus, and put the eyelid on the stretch. With a small scalpel I made a circular incision around the base of the tumor, having only just room for the blade of the knife between it and the cartilage. It was very vascular, and I was obliged to pause more than once that I might see my way clear. As the sac was incorporated into the lid, I took in a little skin with its circumference, and behind, a few of the fibres of the orbicularis palpebrarum. I got it clean out, but the haemorrhage, considering the small size of the tumor, was almost incredible. The patient lost more than half a pint of blood, and I had great difficulty in stopping it, as I could not use pressure in so delicate a situation, and it was desirable for the oozing to cease, as I dressed the wound simply with a piece of gold-beater's skin. My patient continued the Nitric acid for a fortnight afterwards, and he got well in three weeks. " It would require the eye of a very acute person to see where this operation had been performed. There is not the least shorten- ing of the lid, nor even stiffness in it. He says his sight is better than it has been for years, and I am sure his general health is, if a most excellent appetite is any criterion. I think it will be some time oefore he has another attack of erysipelas." ACIDUM OXALICUM. 41 ACIDUM OXALICUM, (Oxalic Acid) This acid was first discovered by Sheele in 1783 by decomposing sugar and strong Nitric acid. It is found in wood-sorrel. It is another irritant poison which may destroy life in ten minutes to one or more hours. In one case of poisoning half an ounce of the acid which was swallowed by mistake for Cheltenham-salt, caused the following symptoms: Burning pain in the stomach ; Swelling of the tongue which was thickly lined with a white coating; Difficult respiration; Feeling of icy coldness throughout the body; Clammy sweat over the whole body; The pulse at the wrist and temples was scarcely perceptible; Cold extremities; The nails look brown; Haematemesis; Shaking of the whole body ; Increasing prostration, as if the end were approaching; Feverish condition, with profuse perspiration ; Itching of the fingers, with remarkable keenness of the under- standing ; Fainting and vomiting of a pint of fluid ; Yiolent eructations, spasms and extraordinary hiccough; Pulse one hundred, feeble; numbness of the right arm, with shiverings on the feet; Swelling of the face; Hoarseness; Dryness of the throat and tongue which was covered with spots, and looked reddish-brown; Emaciation, increase of debility and anxiety, restless sleep; Delirium; Wart-shaped, itching eruption, followed by the breaking out of a general redness; Death. I have enumerated the symptoms in the order in which they developed themselves in this case. A post-mortem examination revealed symptoms of inflammation on the inner surface of the stomach and in a small portion of the intestinal canal: the stomach contained a small quantity of a dark fluid; the villous coat was com- pletely destroyed, even high up in the oesophagus. In some parts it seemed intact, but might easily be detached with the finger or with a sponge. The muscular coat of the stomach and of the oesophagus very much thickened, injected, of a dark, gangrenous appearance; the circular and longitudinal fibres very distinct and 42 LECTURE LX. readily detached; the cardiac portion was more inflamed than the pyloric portion. The small intestines presented a similar appear- ance, but much less marked. In another case of poisoning, where the patient, a girl of twelve years, recovered, the pains in the stomach and bowels were speedily counteracted by antidotal treatment; next morning the patient felt well, except an intense feeling of debility in the lower extremities. A number of other cases of poisoning by this acid which is frequently taken for magnesia, are reported in English periodicals. A girl of fourteen years swallowed an ounce of the acid and died soon after in convulsions. The stomach contained a substance resembling coffee grounds; the vessels were distended with black blood, but the coats intact. In a case related by Johnson, where death took place a quarter of an hour after the poison had been swallowed, the mucous coat was detached, the blood vessels were filled with black blood, the stomach was perforated in several places, friable, pultaceous; the spleen disorganized. In another case, the bowels were found inflamed and distended with gas; the stomach was inflamed externally, shrunk, the inner coat flocculent, destroyed and filled with tenacious masses. These are the effects of large, corrosive doses of the poison. The dilute acid, when acting by absorption, not by its local corrosive effects, causes the following symptoms in animals: rigidity of the hind-legs, sadness, general debility, drowsiness without loss of sensi- bility, without spasms; from these effects the animal soon recovers. If larger doses are introduced into the stomach, the breathing be- comes embarrassed, with paroxysms of tetanic convulsions which arrest the respiratory process entirely for the time being. The heart and respiratory organs act more and more feebly, and the animal finally dies convulsed. If death does not take place too suddenly, the lungs are found marked with red spots, without any signs of effusion. If death takes place previous to the stage of insensibility, the right ventricle is filled with dark, the left with a more bright- colored blood; if death takes place during a tetanic convulsion, the heart continues to beat for a time, although the breathing may have ceased; the blood in both ventricles looks black. Dr. John Mollan, in a casje of poisoning related by him in the Dublin Hospital Reports, says, " one circumstance deserves notice from its infrequency, namely, the discovery of air in the right cavi- ties of the heart. I am not aware that any thing similar has been observed in cases of sudden death, produced by any deleterious sub- stance, and I am at a loss to account for its production." ANTIDOTAL TREATMENT. In cases of poisoning, Thompson recommends large quantities of chalk with which the acid forms an insoluble oxalate of lime. Chris- tison considers magnesia the best of all chemical antidotes. Ammo- ACIDUM OXALICUM. 43 nia and Ether may likewise be tried, though the former antidotes seem to deserve a preference. This acid has undoubtedly a powerful action upon the brain and spinal cord. This is its constitutional effect which it produces by absorption. It then annihilates the functional power of the cere- brospinal axis, and sometimes destroys life with extraordinary suddeness. We have as yet very little clinical experience with this agent, and for the present I shall content myself with suggesting its use in the following affections where it is indicated by its toxicological as well as by its physiological effects. CEREBRO-SPINAL GROUP. Tremor of the Limbs, more particularly when symptomatic of irritation of the motor portion of the spinal system. Paralytic Numbness throughout the limbs, with coldness and a feeling of rigidity as if the blood would become congealed, the pulse being small, rapid, tremulous and intermittent. Spinal Neuralgia, with acute pain in the back, extending down to the thighs, numbness, tingling and pricking in the lower portion of the spine. INFLAMMATORY GROUP. Chronic Sore throat, with burning dryness and aching pain, has been relieved by means of this acid. It may prove useful in chronic Castro-enteritis, with burning pain in the epigastric region, and sensitiveness to pressure; thirst, dryness, redness and swelling of the tongue. Pyrosis, with rising of a sour and burning fluid every evening or otherwise periodically. In Gastralr/ia, with extreme sensitiveness of the stomach to the touch, pains, disposition to costiveness, the acid may prove useful. Likewise in Colica Umbilicalis and Colicodynia, with distressing feeling in the abdomen and umbilical region, frequent inclination to stool. The therapeutic properties of this agent will undoubtedly be investigated as they deserve to be; at present I should have to indulge in speculation more than would be useful to you, if I were to extend my remarks on this subject much farther. 44 LECTURE LXI. LECTURE LXI. ACIDUM PHOSPHORICUM, (Phosphoric Acid) Phosphoric, acid occurs both in the organized and inorganized kingdoms. It is obtained by distilling together phosphorus and nitric acid in distilled water. The United States Pharmacopoea gives the exact proportions and describes the mode of operating. In cases of poisoning the antidotes are chalk, whiting or magnesia suspended in water. In the absence of these, we may resort to soap- suds, weak solutions of the alkaline carbonate, infusion of wood- ashes, white of eggs, milk, oil, or any mild diluents. Symptoms of gastro-enteritis are afterwards combated with Aconite, etc. We have some excellent provings of this agent furnished by Hahnemann. Krumsieg experimented with it in heroic doses. He took forty grains of dilute Phosphoric acid at one dose, gradually increasing to two drachms, after which he was attacked with a painful cough, and had to discontinue his provings. The stool became more fluid and scanty; from the nose issued a peculiar odor like that of Phosphoric acid. CEREBRO-SPINAL GROUP. This acid has caused a dull headache, with buzzing in the head ; crampy pains in both parietal bones as if the sides of the head were pressed together; tearing, drawing and stitching pains in the head or in one side of the head ; painful shocks in the head. These pain's are of the nature of Nervous Headache or hemicrania, where, however, we have very little clinical experience to show with this acid. It has caused peculiar attacks of Vertigo; objects seem to turn ; the table seemed to fall over ; on looking down on the floor, he felt like tumbling down oa the face, and had to hold on to something. Phosphoric acid also causes a peculiar Dullness of Mind, heterogeneous ideas crowd upon him, confusing his intellect; he is unable to call past things to mind without a great effort. Phosphoric acid is particularly adapted to states of Debility caused by sexual excesses. We are told by Bertrand and Pelletier, that a man who had exhausted his strength by sexual debauch until he was threatened with complete marasmus, speedily- recovered his vigor by the use of a lemonade prepared with honey and Phosphoric acid. ACIDUM PHOSPHORICUM. 45 Trinks looks upon Phosphoric acid, iron and Peruvian bark as the three leading restorers of the sinking vital energies in the hands of a homoeopathic physician. Sundelin recommends this acid for " Hysteric Affections of young women with irritable fibre. It is particularly indicated, if an excess of sensibility and irritability is accompanied by extreme delicacy and sponginess of the organic tissue, and if this condition is moreover characterized by vascular orgasm or atonic debility." These indications are sufficiently homoeopathic to deserve our attention. Phosphoric acid causes an abnormal sensibility and irri- tability of the organic fibre, with tendency to vascular erethism. ORBITAL AND AURICULAR GROUPS. Phosphoric acid acts powerfully upon the eyes. It causes : pain as if the eyeballs were compressed, and pressed into the head ; burn- ing of the eyes, and stye on the upper lid ; smarting lachrymation of both eyes ; heaviness of the lids ; dilatation of the pupils, especially of that of the right eye ; dimness of sight; black streaks before the eyes; the eyes are dazzled by looking at bright objects. These symptoms indicate the use of this acid in conditions of the eye characterized by weakness and nervous irritation, such as may be induced by straining the eyes in reading, sewing, or by self-abuse. It will be found useful in Chronic Scrofulous Ophthalmia, with burning lachrymation, dim- ness of the cornea ; also in Amblyopjia caused by onanism or nightly abuse of the eyes by reading or writing. Phosphoric acid has caused whizzing, ringing and roaring in the ears; musical sounds are disagreeable. It may, therefore, prove useful in Hardness of Hearing, where these abnormal conditions occur, par- ticularly among scrofulous children and old people. These weaknesses of sight and hearing may occur during the course of typhoid fever, where Phosphoric acid may happen to be the most appropriate homoeopathic agent. CHYLO-POIETIC GROUP. It causes bleeding of the gums from the slightest contact. This symptom indicates Phosphoric acid as a remedy for Scurvy of the Gums or Stomacace, with tendency to bleed, where it may be applied locally beside being used internally. It causes a putrid, flat taste; violent thirst; nausea, vomiting, oppression at the stomach, acute distress in the region of the stomach. Hence we use the acid successfully in Cardialgia, where it is recommended even by allceopathic practi- tioners. 46 LECTURE LXI. It causes, and therefore cures, Diarrhoea, the discharges having a whitish-grey appearance; it is also beneficial in Cholerine, as a sequela or precursor of Asiatic cholera. In Asiatic cholera, it is considered by Altschul inferior to Phos- phorus. Drysdale gave it in the progress of this disease when there was " much tossing of the head, fullness and rapidity of the pulse, frequent sighing, semi-stupor with contraction of the pupils, moist and furred tongue, some delirium and yellowish diarrhoea; also when there were whitish, watery motions, vomiting every hour, white tongue, quick pulse, pale face, sunken eyes, and warm skin; also when there was restless tossing, semi-stupor, sunken features, frequent sighing and yellowish diarrhoea." URINARY GROUP. Phosphoric acid causes a desire to urinate, with scanty emission; frequent micturition, the urine being either watery or cloudy; painful, spasmodic constriction of the bladder, without urging. This acid is recommended as a remedy for phosphatic deposits in the urine. It dissolves these deposits in the kidneys and bladder, but whether it will cure the phosphatic diathesis, is not quite so certain. It has been used with good effect in the strangury of old people. Aegidi has used it with advantage in Diabetes Mellitus, and Dr. Hering in the so-called Milky Urine, the urine looking as if it had been stirred with lime, mixed with coagula of blood and gelatine and a white, cheesy sub- stance, having the odor of raw flesh, attended with pains in the back and kidneys, emaciation, frequent involuntary emissions, succeeded by nervous debility. Chapman has used it in the milky urine of children with good effect; the children who had a cachectic appearance, soon recovered flesh and health. In a case of Albuminuria of six months' standing which gradually developed chorea-like spasms of the extremities, trunk, head, spasms of the trachea and oesophagus, and occasional attacks of paralysis of these parts, we effected a perfect and lasting cure by the persistent use of Phosphoric acid duringsix weeks. We commenced the treatment with five drops of the acid in the course of twenty-four hours, which dose was gradually increased to fifty drops. The patient was a fine girl, twelve years old; for the last two years she has enjoyed perfect health. SEXUAL GROUP. Phosphoric acid is an important remedy in affections of the sexual sphere. Sundelin informs us that " many experienced practitioners especially Berends, recommend this acid for Impotence, especially when the sensibility of the parts is excessive ACIDUM PHOSPHORICUM. 47 and the semen is discharged shortly after an erection or even before the erection is completed." Kopp relates in his Memorabilia that he cured a case of impotence brought on by sexual excesses, by giving three times a day twelve drops of the diluted acid. The night-sweats with which the patient had been troubled, soon disappeared, and the patient's virility was entirely restored. The attenuated acid had entirely failed in this case. According to Kopp, Phosphoric acid acts specifically upon the sexual organs, especially upon those of the male, prostate gland, seminal vesicles, testicles, urethra, urinary bladder, kidneys, spinal nerves. It increases the tone of these organs, diminishes their morbid irritability, exalts their virile power. If, after an affection of the testicles, the patient should still complain of a sensation as if the testicles were pulled at; and if the hanging of these organs causes pain, a suspensory should be used, and the Phosphoric acid in doses of from twelve to sixteen drops four times a day. This acid has been employed for involuntary Seminal Emissions by physicians of both Schools, especially if these emissions are the results of onanism. As a general rule, large doses of the diluted acid, from ten to twenty drops three times a day, are much more efficient in this disease than the potentized drug. Phosphoric acid causes leucorrhcea and passive haemorrhages from the womb. Ruster arrested by means of it Metrorrhagia, in the case of a lady of sixty years ; the haemorrhage had returned from time to time, and was accompanied with spasmodic attacks. Liitzelberger cured with it haemorrhages from the womb, mouth, nose, rectum, attended with deep prostration of the vital forces. A case of metrorrhagia is reported by Frank, in a small and deli- cate woman after confinement, after other remedies had failed to relieve. The flooding had been going on for a week, in consequence of which the patient had become reduced to a very low condition. The cure was promptly achieved with a few doses of the second potency. Sundelin has seen good effects from Phosphoric acid in Leucorrhcea when the discharge consisted of a thin and acrid mucus. RESPIRATORY GROUP. It causes great dryness of the nostrils and suppression of all dis- charge from them; expulsion of bitter phlegm from the posterior nares into the mouth and fauces ; purulent discharge from the nose; fetid odor from the nose; catarrhal fever, with pains in all the limbs; violent coryza, with redness and soreness of the margin of the nostrils. Dr. Marcy has removed with the first potency of the acid a puru- lent and fetid catarrhal discharge from the nose. 48 LECTURE LXI. It causes: Pressure and burning, tingling pain in the chest, with desire to cough; violent pressure over the whole chest, in the night, shifting to the abdomen, and disappearing after the emission of flatu- lence ; violent hoarseness; cough with expectoration smelling like herbs. Yogt recommends this agent in Phthisis Pulmonalis, if colliquative sweats and a copious, fetid expectoration are present. In Chronic Bronchitis, with burning pain in the chest, oppression over the whole chest, bloody and purulent expectoration, Phosphoric acid may be found very useful. Altschul recommends it in Haemoptysis, with burning, piercing pains in the chest, oppression of the lungs, fever and night-sweats. Dr. Hartmann recommends Phosphoric acid in Pneumonia of a slow and torpid character, especially when weak- ness with profuse sweats are predominant, or when diarrhoea, insen- sibility, strong, irregular and often-intermitting pulse, with swelling of the veins are present. In Typhoid Pneumonia, when the patient's face is pale and sunken; the patient feels about with his hands; with hardness of hearing, dryness and blackness of the nostrils; bad taste in the mouth, diarrhoea, dry cough, hot skin, excessive weakness, oppression and shortness of breath; also in pneumonia scorbutica. The most appropriate dose in these different chest-affections seems to be from the third to the twelfth potency. FEYER-GROUP. Phosphoric acid has been found principally useful in Typhoid Fevers, and more particularly in abdominal typhus, where Altschul limits its employment to the milder forms of the disease, characterized by arterial erethism, sopor, flushed cheeks, heat and dryness of the skin, or else profuse sweat which does not afford any relief. In severer forms of typhus, with painfulness of the ileo-coecal region, copious and exhausting diarrhoea; Rhus tox., Arsenic, Phos- phorus, etc., will have to be resorted to. In Hectic Fever, with debilitating night-sweats, profuse suppuration, the sweat, loss of matter, and fever are, if not cured, at least modified by the use of Phosphoric acid. This agent is not adapted to gastric fever, but may be serviceable, according to Trinks, in Gastric Conditions, where the following symptoms prevail: white coating on the tongue; foul odor from the mouth, putrid taste, incli- nation to diarrhoea, prostration, restless and unrefreshino- sleep, exhausting morning-sweats, thick urine which deposits a good deal of mucus. In Hemorrhagic or Scorbutic Fever, Phosphoric acid has been found very useful. Frank reports a case of this disease, a form of Morbus Maculosus Werlhofii, which yielded to the greatly diluted acid in doses of ten, fifteen, twenty drops every half hour. The ACIDUM PHOSPHORICUM. 49 patient was a delicate boy of eight years, who, after having had measles and scarlet-fever, was repeatedly attacked with cough and feverish motions. During summer, the patient improved, but in the fall the symptoms re-appeared, and, in the winter following, he was attacked with haemorrhage from the nose, whereby he lost several pounds of blood. Shortly after, all the symptoms of morbus macu- losus developed themselves, petechiae upon the skin and mucous membranes, haemorrhage from the bowels, nose, mouth, eyes, skin; extreme prostration, sunken countenance, dimness of sight; low tone of voice. After trying a number of drugs in vain, the disease yielded rapidly to Phosphoric acid. We recently treated a remarkable case of Purpura caused by a heavy fall upon the back. The patient, a boy of twelve years, lost pounds of blood from the nose, mouth, bowels, and seemed to bleed from every pore of the skin; frightful convulsions supervened ; he was rapidly cured by the alternate use of tolerably large doses of the acid and Hyoscyamus. EXANTHEMATIC GROUP. Phosphoric acid causes formication of the whole body; rash over the whole body, more burning than itching ; itching pustules on the nates and toes; red blotches in the face, on the arms and legs. shoulders, abdomen, hips and knees, such as may occur at the age of pubescence. It also causes burning and efflorescence of the skin, somewhat resembling scarlet-spots. The symptoms may suggest the use of this acid in the Acne Rosacea of young people ; in Malignant Scarlatina and Erysipelas. It is also used in Inveterate Ulcers, with flat edges, indented bases, and secreting a foul and offensive pus. In Scrofulous Caries of Bones, Curvatures of the Spine, Phosphoric acid has proved an excellent remedy. In a case quoted by Frank, a large portion of the tibia, the upper part of the fibula, the patella, and the lower part of the femur were almost entirely destroyed. The soft parts were correspondingly injured. The patient was very much emaciated; every evening and noon, a paroxysm of hectic fever set in; pulse always irritated; night-sweats and hacking cough; the patient complains of violent seated pains in the other limb, and in other parts of his body. He was put on the use of Phosphoric acid, two drachms to half an ounce of the concentrated acid in ten ounces of water, a tablespoonful every three hours. This solution was likewise injected into the carious parts. He commenced to improve very soon after he began to use the acid, and was en- tirely restored in eight months. Lentin speaks very highly of the curative virtues of Phosphoric acid in caries of bones. It has cured caries of the ribs, articulations of the arms, femur, etc., and is used both internally and externally, provided the absence of acute inflammatory action in the sore admits of the external application of the acid. vol. ii.—I 50 LECTURE LXI. In Caries as a symptom of mercurial cachexia, Phosphoric acid likewise acts as a specific neutralizer of the poison. Frank reports a case of Sp>hacelus Senilis, where this acid effected a cure. Owing to ex- posure and bad diet, the fingers became cold, livid, cadaverous, with intense pain in the fingers, especially in bed. They felt numb, were painful to pressure which left pits, the roots of the nails became tuberous: friction was more agreeable than external warmth. The toes having likewise become invaded, the patient sought professional aid. Nothing seemed of any avail except Phosphoric acid; after using it perseveringly, the mortified joints became detached, and the patient's health, which was declining, became restored. MENTAL GROUP. It is adapted to Hypochondria arising from sexual abuse, and to the chronic con- sequences of grief, chagrin, care, anxiety, disappointed love, etc. ACIDUM SULPHURICUM. (Sulphuric acid) Mr. Tartra, in his treatise on poisoning by Nitric acid, has given the first systematic description of the poisonous effects of Sulphuric acid. We transfer the following summary of these effects from Christison's work on Poisons to our pages : " M. Tartra considers that four varieties may be observed in the effects of the mineral acids: 1. Speedy death from violent corrosion and inflammation; 2. Slow death from a peculiar organic disease of the_ stomach and intestines; 3. Imperfect recovery, the person re- maining liable ever after to irritability of the stomach; 4. Perfect recovery. " 1. The most ordinary symptoms are those of the first variety— namely, all the symptoms that characterize the most violent gastritis, accompanied likewise with burning in the throat, which is increased by pressure, swallowing or coughing; eructations proceeding from the gases evolved in the stomach by its chemical decomposition; and an excruciating pain in the stomach, such as no natural inflam- mation can excite. The lips are commonly shrivelled, at first whitish, but afterwards brownish in the case of Sulphuric acid. Occasion- ally there are also excoriations, more rarely little blisters. Similar marks appear on other parts of the skin with which the acid may have come in contact, such as the cheeks, neck, breast or fingers • and these marks undergo the same change of color as the marks on the lips. I had an opportunity of witnessing this in the case of the man who was disfigured by the Macmillans with Sulphuric acid He was cruelly burnt in the face, as well as on the hands, which he had raised to protect his face; and the marks were at first white but in sixteen hours became brownish. The inside of the mouth is also ACIDUM SULniURICUM. 51 generally shrivelled, white, and often more or less corroded; and as the poisoning advances, the teeth become loose and yellowish-brown about the coronoe. The teeth sometimes become brown in so short a time as three hours. Occasionally the tongue, gums and inside of the cheeks are white, and as it were polished, like ivory. There is almost always great difficulty, and sometimes complete impossibility. of swallowing. In the case of a child, related by Dr. Sinclair, of Manchester, fluids taken by the mouth were returned by the nose ; and the reason was obvious after death; for even then the pharynx was so much contracted as to admit a probe with difficulty. On the same account, substances taken by the mouth have been discharged by an opening in the larynx which had been made to relieve impend- ing suffocation. The matter vomited, if no fluids be swallowed, is generally brownish or black, and at first causes effervescence, if it falls on a pavement containing any lime. Afterwards this matter is mixed with shreds of membrane, which resemble the coats of the stomach, and sometimes actually consists of the disorganized coats, but are generally nothing more than coagulated mucus. The bowels are obstinately costive, the urine scanty or suppressed; and the patient is frequently harassed by distressing tenesmus and desire to pass water. The pulse all along is very weak, sometimes intermit- ting, and towards the close imperceptible. It is not always frequent; on the contrary, it has been observed of natural frequency, small and feeble, in a patient who survived fifteen days. The countenance be- comes at an early period glazed and ghastly, and the extremities cold and clammy. The breathing is often laborious, owing to the movements of the chest increasing the pain in the stomach,—or because pulmonary inflammation is also at times present,—or because the admission of air into the lungs is impeded by the injury done to the epiglottis and entrance of the larynx. To these symptoms are added occasional fits of suffocation from shreds of thick mucus stick- ing in the throat, and sometimes croupy respiration, with sense of impending choking. "Such is the ordinary train of symptoms in cases of the first variety. But sometimes, especially when a large dose has been swallowed, instead of these excruciating tortures, there is a deceitful tranquillity and absence of all uneasiness. Thus, in the case of a woman who was poisoned by her companions making her swallow, while intoxicated, aqua fortis mixed with wine, although she had at first a good deal of pain and vomiting, there were subsequently none of the usual violent symptoms; and she died within twenty hours, complaining chiefly of tenesmus and excessive debility. Occasion- ally eruptions break out over the body; but their nature has not been described. "Death is seldom owing to the mere local mischief, more generally to sympathy of the circulation and nervous system with that injury. According to Bouchardat, death arises from the acid entering the blood in sufficient quantity to cause coagulation. But although this certainly happens sometimes to the blood in the vessels of the sto- mach and adjacent organs, as will be proved under the head of the morbid appearances, there is no evidence that the same takes place 52 LECTURE LXI. throughout the blood-vessels generally, or in the great veins and heart in particular. Bouchardat's proofs of the detection of Sul- phuric acid in the blood are not satisfactory. " The duration of this variety of poisoning with the acids is com- monly between twelve hours and three days. But sometimes life is prolonged for a week or a fortnight; and sometimes, too, death takes place in a very few hours. The shortest duration among the numer- ous cases of adults mentioned by Tartra is six hours; but Dr. Sin- clair, of Manchester, has related a case which lasted only four hours and a half; a man lately died in the Edinburgh Infirmary within four hours; and Professor Remer, of Breslau, once met with a case fatal in two hours. "The quantity required to produce these effects has not been ascertained, and must be liable to the same uncertainty here as in other kinds of poisoning. The smallest fatal dose of Sulphuric acid I have hitherto found recorded was one drachm. It was taken with sugar by mistake for stomachic drops by a stout young man, and killed him in seven days. An infant of twelve months has been killed in twenty-four hours by half a teaspoonful, or about thirty minims. A man has recovered after taking six drachms. "2. The second variety of symptoms belong to a peculiar modifi- cation of disease, which is described by Tartra in rather strong lan- guage. It begins with the symptoms already noticed; but these gradually abate. The patient then becomes affected with general fever, dry skin, spasms and pains of the limbs, difficult breathing, tension of the belly, salivation, and occasional vomiting, particularly of food and drink. Afterwards membranous flakes are discharged by vomiting, and the salivation is accompanied with fetor. These flakes are often very like the mucous membrane of the stomach and intestines; and such they have often been described to be. More probably, however, they are of adventitious formation; for the mere mucous coat of the alimentary canal cannot supply the vast quantity that is evacuated. There is no doubt, however, that the lining membrane of the alimentary canal is occasionally discharged. Dr. Wilson has mentioned an instance of the ejection by coughino- of about nine inches of the cylindrical lining of the pharynx and gullet, six days after Sulphuric acid was taken. Sometimes worms are dis- charged dead, and evidently corroded by the poison. Digestion is at the same time deranged, the whole functions of the body are lan- guid, and the patient falls into a state of marasmus, which reduces him to a mere skeleton, and in the end brings him to the grave. Death may take place in a fortnight, or not for months. In one of Tartra's cases the patient lived eight months. The vomitino- of mem- branous flakes continues to the last. "3. The third variety includes cases of imperfect recovery. These are characterized by nothing but the greater mildness of the primary symptoms, and by the patient continuing for life liable to attacks of pain in the stomach, vomiting of food, and general disorder of the digestive function. '•' 4. The last variety comprehends cases of perfect recovery, which are sufficiently numerous, even under unpromising appearances. ACIDUM SULPHURICUM. 53 From the average of fifty-five cases recorded by Tartra, it appears that the chances of death and recovery are nearly equal. Twenty- six died, nineteen of the primary, seven of the secondary disorder. Twenty-nine recovered, and of these twenty-one perfectly. Suicidal are for obvious reasons more frequently fatal than accidental cases. " Tartra has not taken notice in his treatise of another form of poisoning with the strong acids, in which the injury is confined to the gullet and neighboring parts. In Corvisart's Journal there is the case of a man, who began to drink Sulphuric acid for water while intoxicated, but suddenly found out his error before he had swal- lowed above a few drops; and consequently the chief symptoms were confined to the throat. After his physician saw him he was able to take one dose of a chalk mixture ; but from that time he was unable to swallow at all for a fortnight. Martini likewise met with a similar instance of complete dysphagia from stricture in the gullet caused by Sulphuric acid. His patient recovered. " It also appears exceedingly probable, that the strong acids may cause death without reaching the stomach or even the gullet, by exciting inflammation and spasm of the glottis and larynx. Such an effect may very well be anticipated from an attempt to commit murder with these poisons; as the person, if he retains conscious- ness at the time, may become aware of their nature before he has swallowed enough to injure the stomach. "Thus, Dr. A. T. Thompson, says, in 1837, that he once met with the case of a child, who, while attempting to swallow strong Sul- phuric acid by mistake for water, died almost immediately, to all appearance from suffocation caused by contraction of the glottis; and it was ascertained after death that none of the poison had reached the stomach. Professor Quain describes a similar case, occurring also in a child, where impending death was prevented by artificial respiration, and acute bronchitis ensued, which proved fatal in three days. In this instance, thickening of the epiglottis and great con- traction of the upper opening of the larynx showed the violent local injury inflicted there, inflammation could be traced down the trachea into the bronchial tubes, but no trace of injury could be detected in the gullet and stomach. In a very interesting and carefully detailed case by Mr. Arnott, where the poison taken was the Nitric acid, the injury was confined in a great measure to the gullet and larynx, the stomach, which was distended with food at the time, being very little affected. The chief symptoms at first, besides great general depres- sion, were croupy respiration and much dyspnoea, which became so urgent, that laryngotomy was performed, and with complete relief to the breathing. But the patient nevertheless rapidly sunk under the symptoms of general exhaustion, and died in thirty-six hours, without presenting any particular signs of the operation of the poison on the stomach; and the traces of action found there after death were trifling. • " The importance of the fact established by these cases will appear from the following medico-legal inquiries: A Prussian medical col- lege was consulted in the case of a" new-born child, in which the stomach and intestines were healthy, and did not contain poison, 54 LECTURE LXI. but in which the cuticle of the lips was easily scraped off, the gums, tongue and mouth yellowish-green, as if burnt, the velum and uvula in the same state, the rima glottidis contracted, and the epiglottis, larynx and fauces violently inflamed. The College declared that a concentrated acid had been given, and that death had been occasioned by suffocation. Sulphuric acid was found in the house; and the mother subsequently confessed the crime. A case was formerly quoted, where MM. Oliver and Chevallier found traces of the action of Nitric acid on the lips, mouth, throat and upper fourth of the gullet, but not lower. In this instance, the reporters came to the opinion from the absence of injury in the more important parts of the alimentary canal, as well as from the marks of nail-scratches on the neck, and the gorged state of the lungs, that death had been produced by strangling, after an unsuccessful attempt by the forcible administration of Nitric acid. It is quite possible, however, that death might quickly ensue from the effects of the poison on the throat and gullet. In the course of the judicial inquiries, M. Alibert stated that he had known repeated instances of death from swallowing Nitric acid, although none of it reached lower down than the pharynx. Ollivier, in his paper, doubts the accuracy of this statement; but the cases quoted above show clearly that such injury may be done to the glottis as will be adequate of itself to occasion death. " It seems farther not improbable, that among the terminations of poisoning with the strong mineral acids, scirrhous pylorus must also be enumerated. This is a very rare effect of the action of corrosive poisons. But M. Bouillaud has related an instance of death from scirrhous pylorus in its most aggravated shape, which supervened on the chronic form of the 'effects of Nitric acid, and which proved fatal in three months* " In some circumstances, the stomach seems to acquire a degree of insensibility to the action of strong acids. Tartra, in alluding to what is said of certain whisky-drinkers acquiring the power of swal- lowing with impunity small quantities of the concentrated acids, has related the case of a woman at Paris, who, after passing successively from wine to brandy and from that to alcohol, at last found nothing could titillate her stomach except aqua-fortis, of which she was seen to partake by several druggists of veracity. The fire-eating mounte- banks, too, are said to acquire the same power of endurance: but much of their apparent capability is really legerdemain. On the other hand, a very extraordinary sensibility to the action of the diluted mineral acids has been supposed to exist in the case of infants at the breast—so great a sensibility, that serious symptoms and even death itself have been ascribed to the nurse's milk becoming im- pregnated with Sulphuric acid, in consequence of her having taken it in medicinal doses. By two writers in the London Medical Re- pository, griping pains, tremors and spasms have been imputed to this cause; and a writer in the Medical Gazette says he has seen continued griping, green diarrhoea and fatal marasmus ensue, appa- rently, he thinks, from ulceration of the gastro-intestinal mucous * This case has been referred to, p. 33, Vol. II., of this work. ACIDUM SULPHURICUM. 55 membrane. Without questioning the great delicacy and tenderness of that membrane in infants, I must nevertheless express my doubts whether so small a quantity taken by a nurse, amounting in the cases in question only to four or six drops a day, could really pro- duce fatal or even severe effects on her child. " Sulphuric acid is not less deadly when admitted into the body through other channels besides the mouth. Thus, it may prove fatal when introduced into the rectum. A woman at Bruges, in Belgium, had an injection administered, in which, being prepared hastily in the middle of the night, Sulphuric acid had been substituted by mis- take for linseed-oil. The patient immediately uttered piercing cries, and passed the remainder of the night in excessive torture. In the morning the bed-clothes were found corroded, and a portion of intestine had apparently come away; and she expired not long afterwards. " Death may also be occasioned by the introduction of this acid into the ear. Dr. Morrison relates a case of the kind, where Nitric acid, which is analogous in action, was poured by a man into his wife's ear, while she lay insensible from intoxication. She awoke in great pain, which continued for two or three days. In six days an eschar detached itself from the external passage of the ear; and this was followed by profuse haemorrhage, which recurred daily more or less for a month. On the day after the eschar came away, and with- out any precursory symptom referrible to the head, she was attacked with complete palsy of the right arm, and in eight days more with tremors and incomplete palsy of the rest of that side of the body. These symptoms subsequently abated; but they again increased after an imprudent exertion, and she died in a state of exhaustion seven weeks after the injury. The whole petrous portion of the temporal bone was found carious, but without any distinct disease of the brain or its membranes. • " Sulphuric acid and the other mineral acids are equally poisonous when inhaled in the form of gas or vapor; and they then act chiefly by irritating or inflaming the mucous membrane of the air-passages and lungs." The Post-mortem appearances, in cases of poisoning by Sulphuric acid, are contained in the following resume from a number of cases reported in Frank's Magazine and Wibmer's Toxicology. We avail ourselves of the translation contained in the American Journal of Homoeopathy: Brain • Softening of the cortical substance of the brain. Dura mater, sinuses and pia-mater distended with blood. Pia-mater covered with lymph; cerebrum covered with red blood-spots. Lateral ventricles contained about a drachm of liquid. Choroid plexus very dark. Under the tentorium and in the vertebral canal were found about three ounces of watery exudation. Membranes of the brain very much thickened and opaque; and here and there firmly adhering to the brain. Sinuses filled with black blood. Mouth, Pharynx, Oesophagus: Tongue very much swollen. Mem- brane of the mouth uncommonly white and indurated, and in some 56 LECTURE LXI. places corroded. Tunica villosa of the oesophagus and stomach detached. Tonsils and soft palate of a yellowish-white color and shrivelled. The whole mucous membrane of the oesophagus cor- roded. Behind the larynx a stricture, so that the oesophagus pre- sented an opening not larger than a feather-quill. Pharynx very much constricted, and denuded of epithelium. Stomach: Tunica villosa detached. Muscular coat of the stomach and duodenum much inflamed. Posterior parts and pyloric orifice of the stomach much disorganized. Stomach diminished in size, with several cicatrices, and some ulcers in process of healing. Mucous membrane of the pylorus very much thickened. Puckered, shrivelled appearance of the stomach. Stomach perforated. Intestines: Inner surface of the intestines covered with a brownish- black thick fluid. The lower part of the spleen blackish-brown and as if corroded by the acid. Mesentery mostly destroyed. Spleen dark-red. Liver bloodless. Liver very much enlarged. Small intestines distended with gas and inflamed. Omentum, liver, intes- tines and peritoneum highly inflamed. Mucous membrane of the duodenum thickened. Gastro epiploic artery, on the right and left side, and its branches, also the superior mesenteric, filled with dark coagula. Larynx and Trachea: Mucous membrane of the trachea and bronchial tubes much inflamed. Epiglottis covered with a thick layer like false membrane; epiglottis of a deep scarlet-red color, intensely inflamed, but not corroded; ulceration of the larynx and trachea. Thorax: Lungs paler than natural. Yery much collapsed and bloodless. Pericardium filled with a quantity of yellowish fluid. Right auricle and ventricle filled with blood. Left ventricle and aorta empty. Yeins very much distended with blood. Both pleurae inflamed. Both lungs very much inflamed and hepatized. Coronary artery distended with thick, coagulated blood. Right side of the thorax containing much bloody serum. Heart atrophied; auricles empty. Blood-vessels and Extremities: The blood in all the vessels was found coagulated. Lower extremities rigid, upper extremities limber. The chemical effects of Sulphuric acid are regarded by a few homoeopathic practitioners, and more particularly by Dr. Peters of the North-American Journal of Homoeopathy, as therapeutic indi- cations upon which the selection of a homoeopathic remedial agent may be made to depend. Gentlemen, let me caution you against the fallacious analogies suggested by this species of materialism. It is recommended in the North-American Journal as " one of the most homoeopathic remedies against true membranous croup; also ulcera- tion and stricture of the larynx." This pretended homceopathicity is inferred from the fact that Sulphuric acid, when coming in contact with the mucous lining of the larynx, inflames it; but would any man in his senses undertake to assert that, if this mucous lining has become inflamed or corroded, and the physiological life of the organism sets up a formative process for the purpose of restoring ACIDUM SULPHURICUM. 57 the integrity of the disorganized membrane: this physiological product is similar, in a therapeutic view, to the pathological product formed in membranous croup ? One of the most effectual methods of utterly perverting and destroying the truths of Homoeopathy, is the application of chemico-physiological doctrines to the law "similia similibus." We can comprehend that a burn, which is a purely external injury as it were, should be successfully treated by the application of some corrosive acid which is capable of producing a similar injury; but we are utterly unable to see any similarity between gangrene as the final termination of inflammation, and gangrene resulting from the destructive action of a corrosive poison. Pereira's remarks on the chemical action of mineral acids upon the blood, are well worthy an attentive perusal. Although no believer in Homoeopathy or small' doses, yet he opposes the baseless absurdities of chemical therapeutics with conclusive good sense. According to Pereira mineral acids may act both locally and consti- tutionally. I will quote his very comprehensive statements bearing upon this point, in his own words: " As the acids become neutralized by combination with bases before their absorption into the blood, it follows that, as free acids, they operate topically only. They are useful as such for the following purposes: " 1. As escharotics. " 2. As antalkalines in poisoning by the alkalies and their carbo- nates and in some forms of pyrosis which are attended with an alkaline condition of the gastric secretion. "3. As astringents and styptics in hemorrhage from the stomach and bowels. They constringe the blood-vessels of the mucous mem- brane of the alimentary canal, and coagulate mucus and blood. "4. As lithontriptics. Yery dilute solutions of the mineral acids (hydrochloric and nitric) have been injected into the bladder as solvents for phosphatic calculi. They have proved useful in chronic inflammation of the mucous membrane of the bladder, accompanied by a deposition of the phosphates. They are serviceable in two ways ■—by their solvent action on the concretions, which they assist in disintegrating; and by benefiting the condition of the mucous mem- brane of the bladder. The acids are also efficacious, as remote or general agents, in several cases in which their chemical influence is not very obvious. Thus they are used— " 5. To check profuse sweating in hectic fever. " 6. To allay the distressing itching and irritation of the skin in prurigo and lichen. "7. To lessen preternatural heat and reduce the frequency and force of the pulse ; as in febrile complaints and haemorrhages (pulmonary, uterine, &c.) " 8. To relieve narcotism after the poison has been evacuated from the stomach and bowels. " 9. In dyscrasias or diseases which have been supposed to depend on, or be connected with a depraved condition of the animal fluids; as scorbutus, secondary syphilis, and mercurial cachexia. 58 LECTURE LXI. " The efficacy of vegetable acids (especially citric acid) and fresh vegetables and fruits in the treatment of scurvy is too well estab- lished by experience to be affected by the hypothetical objections of Dr. Stevens to the use of acids in this malady. A satisfactory explanation of their methodus medendi is still wanting ; for through the assumption that non-nitrogenous food in scurvy is useful by acting, in the oxidizing processes of the system, as a substitute for the animal tissues which are thereby preserved, accounts for the fact that the pure acids are less efficacious than acid vegetable juices, yet it fails to account for various circumstances (such as the inefficacy of the fatty substances, and the occasional failure of even lemon- juice to prevent or to check scurvy,) and, therefore, cannot be con- sidered as a satisfactory explanation. "10. In the so-called putrid fevers, the mineral acids have fre- quently proved serviceable. They were originally employed under the idea that they checked the supposed putrescent tendency of the fluids. May they not be useful by abstracting from the system basic matter ? "11. In phosphatic deposits in the urine, the acids, both mineral and vegetable, are often resorted to, and occasionally with relief. They are, however, very uncertain, and at best, are but palliative. " 12. As tonics, the diluted mineral acids (especially the sulphuric) are frequently employed in conjunction with the vegetable bitters ; as cinchona and quinine." I would add to this very logical and comprehensive enumeration of the therapeutic uses of mineral acids, which may, in many respects, be accepted by a homoeopathic physician, that if Pereira or his fol- lowers will turn for light to the Homoeopathic School, they may per- haps find it. _ It is certainly no more difficult to understand, why the vegetable acids should cure scurvy, than it is why any other drug should cure any disease. A principle of homoeopathicity, or homo? opathic affinity underlies the whole. "The diluted mineral and vegetable acids,"says Pereira, "when swallowed in moderate doses, at first allay thirst, sharpen the appetite, and promote digestion. They check preternatural heat, reduce the frequency and force of the pulse, lessen cutaneous perspiration, allay the troublesome itch- ing of prurigo, sometimes prove diuretic, and occasionally render the urine unusually acid. Under this use, the milk often acquires a griping quality, and the bowels become slightly relaxed. By their long-continued employment, the tongue becomes coated with a whitish but moist fur, the appetite and digestion are impaired ; while griping and relaxation of the bowels, with febrile disorder, frequently occur. If their use be still persevered in, they more deeply injure the assimilative processes, and a kind of a scorbutic cachexy is established." Sulphuric acid has been successfully used in the following affec- tions : ° CEREBRO-SPINAL GROUP. ^ Dr. Marcy says that " the sixth dilution of this acid has several times afforded permanent relief in obstinate constitutional headaches ACIDUM SULPHURICUM. 59 occurring in cachectic individuals. It has proved particularly use- ful hi those cases which have been accompanied by profuse and debilitating leucorrhoeal discharges. Frank reports a case of Chorea, which yielded to this acid. A woman who had become exceedingly debilitated by a continued lochial discharge, in conse- quence of which the whole body had become oedematous, and a most frightful chorea had set in, was cured in the course of six weeks by Sulphuric acid. A boy who had become subject to attacks of Convulsions, probably in consequence of self-abuse, was likewise cured. Epilepsy, in the case of a female who had tried every known remedy in vain, was speedily relieved, and, at the end of three weeks, completely cured by nothing but Sulphuric acid; she took from two drachms to half an ounce of the acid, much diluted, every day. PHARYNGEAL GROUP. In Aphthse of children and nursing females, Sulphuric acid will sometimes help, when every other remedy fails. It may be used internally and as a mild gargle. Dr. Peters and others recommend it for Croupous Inflammation of the pharynx, larynx, trachea and oeso- phagus ; also for gangrenous or putrid inflammation or ulceration of the throat; in syphilitic angina; in the malignant angina of scarlet- fever ; stricture of the oesophagus. In Mercurial Ptyalism, Mr. Pearson found great benefit from this acid. We read in the British Journal of Homoeopathy that Dr. Schneider uses Sulphuric acid in obstinate Hiccough occurring in both sexes and in all ages, and occasioning great suffering and exhaustion. CHYLO-POIETIC GROUP. A case of Hsematemesis, where the vomiting returned about a dozen times within eight days, causing complete exhaustion and deathlike pallor, was^ completely arrested by means of large doses of Sulphuric acid. Individuals who have weakened their digestive powers by exces- sive drinking, mental exertions, excessive sexual intercourse, etc., frequently complain of an acrid, foul, almost stercoraceous taste in the mouth, accompanied with a burning and smarting sensation in the 1 hroat, and an offensive odor from the mouth, particularly early in the morning, and sometimes waking them at night by an acridity and prickling in the throat. This trouble is relieved by means of Sulphuric acid, from fifteen to twenty drops in water, before retiring 60 LECTURE LXI. at night. The foul taste yields even to the first dose, and the offen- sive breath is removed by two or three doses. I mention this upon the authority of Hufeland's Journal; Sul- phuric acid may not always act as a curative in such cases ; it cer- tainly palliates these symptoms. In Acidity of the Stomach, Sulphuric acid has effected permanent cures. In a case of Polydipsia, quoted by Frank, which came on after an attack of gout, causing prostration and emaciation, Sulphuric acid in doses of ten drops in a cupful of gruel every three hours, effected a cure. The only perceptible symptom in this case was "an exces- sive dryness of the tongue." In Diarrhoea, this acid has been successfully used by both alloeo- pathic and homoeopathic physicians. It is particularly in the cho- leraic forms that it has been found useful, when, according to Dr. North, as reported in the American Journal of Homoeopathy, "the symptoms are severe, with a tendency to lapse into low fever; when the attack arises without any error in diet, the diarrhoea being pro- fuse, soon becoming like dirty water, with nausea and vomiting of a large quantity of fluid, severe spasmodic pains in the stomach and bowels, cramps in the limbs, often violent; pulse small and frequent, skin cold and clammy, countenance anxious; these symptoms being followed by a continued fever for a few days or a week or two."' URINARY AND SEXUAL GROUPS. In Lead-colic, the acid has been used with excellent effect, a perfect cure having been effected in three to five days. The acid is a grain sufficient to effect a cure in cases where the Nitrate fulfills all the requirements of the law of specific Homoeopathy. For immediate purposes triturations with sugar of milk may be allowable, provided they are made with as little exposure to the light and air as possible ; otherwise a watery solution is preferable, from which alcoholic attenuations may be derived in accordance with the rules which have been fully indicated in my fifth lecture. Kopp has given the Nitrate with perfect success for other spasmodic affections, when a correlation seemed to exist between the spasm, and an abnormal crowding of the blood-vessels. Some of these cases which we find reported in his Memorabilia, are both interesting and instructive. A woman of 46 years whose menses had been very profuse for the last year, and had made their appearance every three weeks, had been attacked with violent spasms of the right side of the face and neck, of the tongue, of the right upper and right lower extremity, and of the muscles of the right side of the trunk, during which she lost her consciousness and frothed at the mouth. Immediately after the paroxysm her memory was either much impaired or entirely gone, her face was drawn to one side, she experienced a drawing and creeping in the right arm and leg, and very frequently com- plained of headache and fever, which had been attended with vomit- ing for some time past; during the trismus she bit her tongue until it bled; the epileptiform spasms emanated from the brain; there was no hereditary disposition, but the spasms seemed to be in rela- tion with the menses; they either set in shortly before or during the menses, and generally on waking from sleep. After having tried a number of remedies in vain, she took the Nitrate of Silver, one grain made into twenty pills, first one pill every two hours, and afterwards 35 of a grain six times a day. The spasms ceased very soon, the health of the patient improved more and more, and at the expiration of a year, during which period she continued to take the remedy at intervals, she was quite well. Krahmer and others range the Nitrate of Silver among the anti- phlogistics. In a case like the one which we have just described, Aconite may prove eminently useful either alone or in connection with the Nitrate. Another case is related by Kopp which bears a strong resemblance to the former, and to which the same remarks apply. A girl of 19 years, who had always enjoyed good health, and looked healthy, had 86 LECTURE LXIII. moved to a different section of country, in consequence of which, as it appears, her menses came on every few days; for the last three months, had lost a quantity of blood, had cold feet continually, and was occasionally attacked with a slight haemorrhage from the lungs, although her chest seemed perfectly sound, and the blood was often expectorated without any cough. The consequences of these losses were nervous paroxysms, spasms and fainting fits. Such an attack was accompanied by loss of consciousness, chills, cold ex- tremities, suppression of pulse, palpitation of the heart, nausea, retch- ing, vomiting, screaming, spasmodic laughter, convulsive movements of the limbs. She took the Nitrate in pills, y^ of a grain to a pill; the nervous symptoms ceased at once; after the fifth pill the haem- orrhage was arrested, and after having taken two grains in all, she was perfectly restored. In Chorea, this agent has likewise been given with good effect; it will probably prove curative only in cases where the disease can be traced to cerebral disturbances. FACIAL GROUP. The face looks sunken, pale, sickly; it has an appearance of old age. This change may occur as a symptom of the mercurial cachexia; or in cachectic individuals who are afflicted with chronic syphilis, or both combined. ORBITAL GROUP. The Nitrate of Silver seems to develope all the characteristic signs of Chronic Conjunctivitis, with redness of the canthi and eyeballs, agglutination of the lids, pressure as from a grain of sand, and heat in the eyes; the eyes are filled with mucus which dries up in the lashes. In the case of cachectic individuals, afflicted with chronic con- junctivitis of this description, the Nitrate of Silver will be found useful, if administered in small doses. We find that this salt produces Opacity of the cornea; a large portion of the cornea looks white and opaque, If this defect is the result of scrofulous action, the middle potencies of the salt may be very useful. In Disorganizations of the Conjunctiva, when it looks puckered hypertrophied in consequence of interlamellar exudations, hio-her potencies of the Nitrate may likewise be of much avail. As an external application to sore and inflamed eyes, this ao-ent has been abused by allceopathic physicians from time immemorial. In cases where the ophthalmic affection seems purely local, and the general constitution in no wise involved, this external application ARGENTUM NITRICUM. 87 of the Nitrate, by means of a camel's-hair pencil, is justifiable. Dr. Dudgeon, of the British Journal, is of opinion that, in the Purulent Ophthalmia of children, the external use of the Nitrate should not be dispensed with. In purulent ophthalmia, it is of the utmost importance to combat the inflammatory character of the disease with Aconite and Bella- donna ; in alternation with either of these agents we may use such medicines as the pathological nature of the disease may require. Arsenic may be one of these remedies; Nitric acid may be another, more especially if syphilitico-mercurial dyscrasia is ingrafted upon the morbid process. Under these circumstances it may often be absolutely necessary to apply the Nitrate externally for the purpose of counteracting the destructive blennorrhoea, removing malforma- tions or healing dangerous and rapidly progressing ulcerations. In reference to the external use of the Nitrate in purulent ophthalmia, Dr. Krahmer presents the following statement: " At the commence- ment of the disease, powerful solutions of the Nitrate should only be applied, if the disease is a local affection, and the morbid process is confined to the conjunctiva; its application is especially efficacious, if the conjunctivitis is caused by the syphilitic or the gonnorrhoeal virus. If the ophthalmia is at the outset the localized expression of a constitutional affection, even if there should be a doubt on the subject, a gently antiphlogistic treatment, combined with frequent and careful cleansing of the eyes, is preferable. (A homoeopathic physician would resort chiefly to Aconite and Belladonna for such a purpose.) This treatment is assisted by the simultaneous application of weak solutions of the Nitrate, if the conjunctiva is the only organ involved in the disease. As the disease progresses, the Nitrate becomes an invaluable remedy which cannot be replaced by any other; more especially, if we desire to touch the granulations which cannot be removed by any other means, or in case ulceration or perforation of the cornea should have set in, if the cornea is inter- stitially distended, or hypertrophied and studded with granulations. The local action consists principally in the rapid removal of the mechanical irritation which impedes the healing of the ulcers, and favors the increased bulging of the eye-ball. For this reason it seems unnecessary to touch at the same time the ulcerated surface. The Doctor prefers touching the eye to injecting a powerful solution, more especially in that form of prolapsus of the eyeball which is designated by the term " melon." He never touched the prolapsed portion of the eye ; moreover he deems it indispensable to acquaint the nurse with the danger which is involved in changing the posi- tion of the child from the back to the side or stomach, or in making a hasty movement, in pressing upon the eye while cleansing it, or while the child is nursing, or in the continual cries of the child, or even in the#act of coughing or vomiting, etc. In 86 cases the eyes were touched 127 times by everting the lower lid, and rapidly and lightly passing the rounded extremity of a stick of the Nitrate over it, after which the same part is quickly painted with a little olive oil by means of a camel's-hair brush; one 38 LECTURE LXIII. touch was sufficient only in four cases generally; it had to be repeated from three to five times, sometimes even from six to eight times; but it was repeated only in case all inflammatory reaction had ceased. In the Berlin Hospital, the disease is treated and cured even in the most violent grades by means of a solution of from one to six grains of the Nitrate to an ounce of water. From one to three drops are dropped into the eyes very cautiously twice or three times a day; at the same time the eyes are carefully cleansed of the secreted matter by washing them as often as may be required. AUDITORY GROUP. The Nitrate of Silver causes: ringing in the ears, with hard hear- ing ; whizzing and a feeling of obstruction, with hard hearing in the left ear. Painful stoppage of the ears, with headache. In affections of the ears, such as Deafness and fetid Otorrhoea, this agent is applied externally by some allceopathic physicians to the inner lining membrane, touching even the tympanum. In otherwise perfectly sound conditions of the system, this proceeding may be proper, provided the remedy itself is appropriate to the case. NASAL GROUP. Yiolent itching in the nose; he had to rub it until it bled; Ulcerated scurfs in the nose ; Coryza, with chilliness, sickly look, lachrymation, sneezing, stupe- fying headache; she had to lie down. This condition may occur as a symptom of chronic hydrargyria, or as a catarrhal attack in persons who have taken much Mercury, and where this medicine, although indicated, might prove unavail- able. In Ozaena, not only when of a syphilitic, but likewise when of a scrofulous nature, it may sometimes be necessary to touch the ulcer- ated surface with the Nitrate. DENTAL GROUP. Nitrate of Silver causes: Inflamed and loose gums, and white indentations, readily bleeding; the prover, who had never had a toothache, was troubled with it all the time during the proving, a grumbling and digging pain, especially when chewing, eatino- sour things, or putting cold water in the mouth. >■ Krahmer found that some of the dogs upon whom he experimented with the Nitrate of Silver by injecting it into the veins, were attacked with bleeding of the gums. We therefore recommend this agent for such a ARGENTUM NITRICUM. 89 Toothache as is described in our provings, and for Stomacace with much bleeding of the gums, whether of a mercu- rial or scorbutic nature. PHARYNGEAL GROUP. Ptyalism; tongue painful as if burnt, sore feeling of the fauces as if scalded ; dark redness of the fauces and uvula ; ulcerative pain in right side of the throat; sensation as if a splinter were lodged in the throat, when swallowing, eructating, breathing, stretching and moving the neck; sometimes an undulating jerking and throbbing were, felt in the throat, continuing for several days. Throat full of mucus, tenacious or watery, obliging him to hawk all the time. Balls of soapy mucus accumulate in the larynx, occasioning slight turns of cough, by means of which they are expelled. Dr. Miiller remarks that " These pharmatoxical affections of the mouth, fauces and throat are not acute, phlegmonous, sthenic inflam- mations, but chronic, asthenic, adynamic, sucn as occur at times in the shape of an exceptional irritation, in cachectic individuals affected with some chronic disease, or as a secondary specific manifestation of some deep-seated affection; such pharmatoxical affections are generally seated in the mucous membranes, resulting in disorganiza- tions of structure, hypertrophy or thickening of the mucous mem- brane, granulations, exudations." These remarks show in what forms of sore throat, chronic or acute, the Nitrate of Silver is indicated according to our law of cure. Positive experimentation does not justify the horrible abuses which Old-School practitioners render themselves guilty of by their deter- gent practice. A Nitrate of Silver solution will wash off any kind of inflamed surface in their hands; whereas, as Dr. Miiller shows, its legitimate sphere of action is the chronic sore throat of cachectic individuals who secrete a foul mucus in the throat, whose throats are easily invaded by torpid inflammatory irritations, resulting in tedious suppurative and ulcerative processes and disorganizations of the lining membrane. A Chronic Angina of this character may be entailed upon a patient in consequence of scarlet-fever or even measles. Argentum nitricum 6 to 12, may be given internally, and a mild gargle of the same salt may likewise be resorted to. CHYLO-POIETIC GROUP. In this direction, the provings furnish us a number of valuable symptoms: Bitter, astringent, chalky taste; most of the gastric derangements are accompanied by eructations; Yomiting of glassy mucus in the morning; she had two paroxysms of this kind of vomiting, after which she felt the whole afternoon a desire to vomit, a tremulous weakness, and a sensation in the head as if it were in a vice. 90 LECTURE LXIII. Cardialgia with internal chilliness. Cardialgia with violent gnawing pain. Cardialgia, griping and burning in the stomach. Cardialgia: After yawning, a sensation is experienced in the stomach as if it would burst; wind presses upwards, but the oeso- phagus feels spasmodically closed; hence an ineffectual effort to eructate, with excessive strangulation, pressing pain in the stomach, fainting sort of nausea, flow of water in the mouth and inability to stir; the paroxysm ceases after a quarter of an hour, amidst fre- quent and violent belching of wind. Troublesome feeling of malaise in the region of the stomach, re- lieved by pressure; the patients frequently press the clenched fists into the stomach. Feeling of emptiness in the stomach, desire for piquant food or drinks, insatiable hunger, depression of spirits, watery urine. Little need be added to these symptoms in the way of explana- tory remarks. They show that the Nitrate of Silver must be pos- sessed of excellent curative powers in the treatment of certain forms of Cardialgia or Gastralgia. According to Dr. Miiller, the gastral- gia for which the Nitrate of Silver is successfully used, is character- ized by the following symptoms: it is particularly suitable to delicate nervous females, when the affection arises from depressing causes, nightly watching, etc.; a troublesome feeling of malaise in the region of the stomach, relieved by pressure; the patients fre- quently press their clenched fists into the region of the stomach; feeling of emptiness in the stomach; desire for piquant food and drinks, insatiable hunger, depression of spirits, water-colored urine. Miiller likewise recommends the Nitrate for Vomiting of Water or Waterbrash consequent upon suppressed itch; for chronic affections of the stomach, whether assuming the form of a Neurosis or consensual Gastrosis; Chronic Gastritis; Gastralgia, with oppressive or burning-drawing distress, either continual or paroxysmal; Cardialgia after a meal, with acid or black vomitino-. These affections are more fully described in the work of Dr. Krahmer where he communicates a good deal of useful information concerning the use of this salt advised by Autenrieth, Johnson and Ware, in several important affections of the digestive apparatus; Autenrieth recommends the Nitrate for the Vomiting of an insipid fluid, and for the Cardialgia of young people from the period of pubescence to the age of a fully matured manhood, if the affection has been occasioned by the violent suppression of the itch or of some other exanthem. The affection is characterized by loss of appetite, bitter taste, con- tinual sensation of pressure which frequently increases to a violent attack of cardialgia after the use of food, and by torpid stool. At ARGENTUM NITRICUM. 91 first the vomiting takes place only in the morning; but, as it gets worse, it likewise occurs in the day-time more or less frequently after a meal. The ejected fluid has a sour reaction. In the case of females, the affection is complicated with derangements of the menstrual functions, leucorrhcea, hysteric complaints; men are afflicted with oppression of the chest, cough, expectoration of small fibrous balls, or of black masses. The affection of the chest very frequently terminates in pulmonary phthisis of an atonic character. Autenrieth likewise recommends the Nitrate for Miliary Affections of the Stomach complicated with metastatic itch. In the case of women the affection sets in in consequence of debilita- ting influences, frequent and difficult labor, hemorrhages, constant nursing, grief, care, etc; it proceeds from the previously described cardialgia, and is characterized by loss of appetite, thirst, saltish, or else smarting taste as if the patient had pepper in her mouth. The tongue looks clean, red; the epigastric region feels as if it were con- stricted by an iron belt, constipation alternates with diarrhoea; the circulation of the blood is irregular, there are frequent congestions to the head, chest, or sexual organs; metrorrhagia alternates with bleeding of the nose; not unfrequently febrile symptoms are ob- served which terminate in copious and sour sweats, attended with miliaria. The Nitrate is further recommended by Autenrieth for Cardialgia in the middle period of life, when attended with sour vomiting and complicated with an arthritic diathesis. Also for Cardialgia which threatens to pass into cancer of the stomach, and for actual Scirrhus of the stomach. Johnson has directed attention to the good effects of the Nitrate in allaying an excessive irritability of the stomach, more especially in Nervous Dyspepsia and the complaints incidental to this affection. Krahmer recommends it for affections of the stomach consisting in or resulting from a stasis or passive engorgements of the mucous lining, and having still retained the character of hyperaemia. These chemico-physiological indications are strictly conformable to the em- ployment of the Nitrate in conformity to the homoeopathic law; for this salt determines a state of hyperaemia which is not inflammation, and is the concomitant anatomico-pathological condition of an ab- normal irritability of the nerves of the stomach, for which Johnson has already recommended the Nitrate as a leading remedy. Frank has extracted a number of cases of affections of the stomach from various Old School publications, one of which I will briefly relate. A tanner, aged 35 years, had been affected for the last twelve years with the following symptoms: Penetrating, but not continual pain in the region of the stomach, most generally and violently breaking out after a meal; spreading to the back, chest, heart, occasioning nausea and vomiting. The substances vomited consist of food, sour fluid, and occasionally blood. Sometimes the pain continued for hours without nausea; the appetite was pretty fair; at times pyrosis with sour eructations; stools irregular; if several evacuations oc- 92 LECTURE LXIII. curred during the day, the pain became intolerable; it was least troublesome when the bowels were not moved ; the discharges looked burnt, like sheep's-dung, often mixed with blood. Epigastric region sensitive to pressure; region of the liver somewhat bloated. From July 30th to August 23d he was put on the use of the Nitrate in doses of one-fourth of a grain, gradually increasing to one grain, and, at the end of this period, was discharged cured. Kopp regards the Nitrate of Silver as one of the most reliable remedies for inveterate cardialgia. A number of interesting cures of this distressing affection are mentioned in his Memorabilia. The symptoms are comprised in the following summary: Burning, malaise in the pit of the stomach, contractive rising from the pit of the stomach to the throat; violent shivering in the back, nausea, eructations, loss of appetite. Disposition to vomit, acrid burning in the throat, expulsion of water with retching, distress in the region of the stomach. Pressure in the pit of the stomach, pain in the region of the spleen, vomiting of black blood. Pulling and contracting sensation in the region of the stomach with griping, ascending from the epigastrium to the throat; when this reached its acme, the patient lost her senses, was unable to talk, hear, see, stir; the face became flushed and she became delirious; pulse accelerated during the attack, but not intermitting; sometimes the hands would twitch convulsively; the attack came on four, five, and even ten times a day, and could be prevented by taking a little food during the precursory symptoms. These are some of the leading groups of symptoms, all of which were speedily and permanently removed by the Nitrate of Silver, in doses of one-twelfth to one-thirtieth of a grain. Much smaller doses are abundantly sufficient, indeed more efficiently curative than these comparatively large doses. It is not only to nervous affections of the stomach and duodenum, but also to nervous pains in the bowels, that Argentum nitricum is homoeopathic. Among the abdominal symptoms, we may record the following as the most characteristic: Stitches in the liver; Sensation of fullness in the liver; Affection of the liver, ending in fatal dropsy; Pains in abdomen as if sore, accompanied with great hunger, abating after eating, with trembling instead of the hunger; Stitches dart through the abdomen like electric sparks, especially during a sudden transition from rest to motion, on left side; Coldness in abdomen, which is painful; Sensation as of a ball ascending from the abdomen to the throat. The last symptom may often be considered as a symptom of hyste- ria and may likewise usher in an attack of epilepsy. Enteralgia has been effectually cured by the Nitrate of Silver. Kopp relates several interesting cases of this disease. In one case, a ARGENTUM NITRICUM. 93 female of thirty-eight years, the abdomen became distended during the attack, painful to pressure below the umbilicus. While urinat- ing, the stream suddenly ceased to flow, and the stoppage was accompanied with a pain near the umbilicus. Eructations, depres- sion of spirits, sexual desire, which, however, remained even after gratification, were likewise present during the attack. The patient was afflicted with piles. The symptoms show that these paroxysms of enteralgia may some- times be accompanied by, or perhaps depending upon, liver-com- plaint. In one case, the continued use of the Nitrate by an epileptic female terminated in disorganization of the liver with fatal dropsy. If the liver is involved, the attack may be characterized by diarrhoea and vomiting, swelling of the bowels, excessive sensitiveness in the right hypochondrium, haggard appearance. The alvine secretions are considerably disturbed by this agent. We distinguish the following symptoms: Colic followed by sixteen green mucous stools in one night, very fetid, with much flatulence; Costiveness, dry and firm stool; Itching of the anus, he has to rub until he becomes sore; Discharge of taenia. These symptoms justify the use of the Nitrate in Diarrhea, of a bilious character, when the attacks are preceded by colic, accompanied with chilliness along the back and extremities, debility, pale and haggard appearance. If positive experimentation upon the healthy is of any value, we cannot possibly approve of the indiscriminate use which allceopathic physicians make of the Nitrate of Silver in all sorts of discharges from the bowels; no matter what the disease is, as long as there is a discharge of some sort from the bowels, some sign of abnormal secretion of the intestinal mucous membrane, the Nitrate of Silver is thrown up the bowels or forced down the throat as an universal sore- healing panacea. We believe that this gross mode of practising upon the sick will be condemned at no very distant day, by all enlightened practitioners. In the Bulletin General de Therapeutique, Michel reports the case of a man who had always enjoyed good health, but had ruined him- self by excessive drinking. He had become very much reduced in consequence of frequent attacks of colic, complicated with frequent discharges of blood, pus, and undigested food. His case had been very much aggravated in consequence of the heterogeneous methods of treatment that he had resorted to. He was restored in eight days by the Nitrate of Silver, in doses of -,5 of a grain internally, and injections, each of which contained 2 grains in a sufficient quantity of water. In all he took 2 grains internally, and 20 grains in injections. In regard to the cathartic action of the Nitrate of Silver, Krahmer 94 LECTURE LXIII. offers the following statements which, in many respects, are inter- esting to a homoeopathic practitioner: " Our predecessors, Angelus Sala, de la Bos, Boerhaave, Fred. Hoffmann, Cappe, Portal and others, were convinced of the drastic nature of the Nitrate, and erected upon this belief their theory of the anti-dropsical and anti-epileptic effects of this salt. On the contrary, Lombard, (see Rust's Magaz. Yol. 16,) states that of twenty-four patients who took the Nitrate, only five were attacked with diarrhoea, which continued only in one case, disappeared in three patients even while the drug was continued, and in one did not set in until after the drug had been discontinued. Graves, Boudin, (see Gaz. Med. de Paris), Kalt, (see Organon fur die gesammte Heilkunde), Hirsch, Ruef and others, found the Nitrate efficacious even ' against diarrhoea), even when of a typhoid character, and against dysentery arising from teething. Dr. Krahmer accounts for these diversified statements by the different quantities in which the Nitrate was prescribed. Sala, for instance, gave from four to six grains, Lombard only half a grain to one grain, and Hirsch only 3\T to ^ of a grain. (An illustration of the homoeopathic law). His own provings show that small doses do not alter the alvine discharges, but that large doses hasten them. The doctor is of opinion that the Nitrate does not act directly upon the peristaltic motion; either it acts indirectly in consequence of large doses of the Nitrate coagulating the intestinal mucus, by which means the bowels become more sensitive to the irritating action of their contents: or else the Nitrate deprives the blood which is cir- culating within the walls of the intestinal canal of water, by which means the chyle and the faeces are kept in a state of fluidity, a chemical explanation of the same sort as any other, accounting for the phenomena of the living organism by the same laws which govern the combinations and elementary changes of brute matter. The Nitrate being endowed with a power of disorganizing the blood and imparting to it a scorbutic taint, we shall find this agent useful in many cases of Atonic Diarrhoea or Dysenteric Diarrhoea of a putrid nature, when the discharges are chiefly composed of foul blood. Such a diarrhoea may be symptomatic of a typhoid condition of the intestines. It may be necessary to inject a watery solution of the Nitrate into the bowels ; in connection with this agent some other remedies may be given internally as the condition of the brain may require. In Helminthiasis, with irritation at the nose and anus, bulimia paroxysms of gagging and vomiting of water and mucus, emaciation' chilliness followed by nightly fever, the Nitrate, six to twelve, may prove eminently useful. The itching at the anus, when caused by worms, or when arising from a strumous habit, may yield to this agent. Taenia solium may require the internal exhibition of the Nitrate. Hartmann reports the case of a lady who, besides beino- afflicted with profuse, irregular menstruation, had paroxysms of pain in the bowels, liver and stomach, with nausea, retching and vomitino- of ARGENTUM NITRICUM. 95 tenacious phlegm and a jaundiced complexion; she took the Nitrate, second trituration, a powder three times a day, for a week ; during this time, fragments of tape-worm were expelled in large quantities, after which the patient gradually recovered her health. URINARY GROUP. In this range we may mention the following symptoms: Frequent emission of pale urine; Emission of a few drops of urine, after which the urethra feel as if swollen, Burning during urination; Sensation as if a drop were running along the urethra from behind forward; Cutting, from the posterior portion of the urethra to the anus, when emitting the last drop of urine; Ulcerative soreness when urinating ; Ulcerative soreness in the middle of the urethra, as from a splinter; The urethra feels swollen, hard and knotty; Inflammation and violent pain of the urethra, priapism, chordee, bloody urine, fever. The two-last-mentioned symptoms in this group are the results of strong injections into a urethra irritated by the gonorrhoeal virus. I look upon the method of burning the delicate membrane of the urethra with Nitrate-of-silver injections as a most abominable abuse of an agent which may be productive of much good in the hands of a humane and rational physician. If Argentum nitricum is in specific rapport with Gonorrhoeal Urethritis, the medicine may be given internally, and' a mild injection may be thrown up at intervals. In the end, we accomplish much more good by this gentle proceeding than by using brute force. Ricord advocates the abortive method in the treatment of gonorrhoea before the inflammation has become fully developed; many of our best practitioners coincide with him regarding the pro- priety of this course. I apply to this treatment the same mode of reasoning which I have used when speaking of the employment of the Sulphur ointment in a- case of recent itch. Every organism is endowed with a receptivity to the gonorrhoeal virus, and absorption of the virus is effected at once, we might say, in the twinkling of an eye. But constitutional absorption does not mean constitutional disease. • Here is the error into which Hahnemann has fallen, when he launched his anathema without discrimination against all external applications of the Sulphur ointment or the Nitrate of Silver; he believed constitutional absorption and constitutional disease to be one and the same thing. On the other hand, the advocates of the abortive method err in overlooking or denying the fact, that absorp- tion takes place immediately after the reception of the poison by the urethral membrane. A constitutional disease is no more nor less than the internal receptivity or potency developed into some definite con- 96 LECTURE LXIII. Crete form by the immaterial or semi-material miasm ; in other words, this form is the pathological product arising from the action of the miasmatic virus upon tissues endowed with receptivity of a correspond- ing order. In the case of the itch, and of the syphilitic and gonor- rhoeal virus, the connection between the external product and the internal receptivity may be of a very transitory or superficial nature for the first few days, so that the removal of this product by ade- quate external means may be tantamount to a reconverting the pathological process back again into a harmless potency. The physician who neglects the use of external means, assumes a grave responsibility, as well as the one who resorts to it indiscreetly. The omission of the former may give rise to an immense deal of trouble and suffering which he might have prevented ; whereas the indiscre- tions of the latter may entail untold misery upon the patient, by the development of secondary constitutional disorders. These remarks likewise apply to the treatment of chancre which the external appli- cation of the Nitrate may either convert into a simple sore by extinguishing the syphilitic element, or the suppression of which may lead to the most fearful constitutional ravages. These are questions which have to be decided by a physician's own tact and experience. The sweeping generalizations of such a man as Ricord have to be taken with a grain of allowance. He treats patients in the gross; five or perhaps only two patients made miserable among one hundred, ninety-eight of whom are cured, may seem a very small number, small enough to be overlooked; but such omissions do not satisfy the stern demands of science, much less of the humane science of Medicine. We may observe that if gonorrhoea can at any time be considered a local disease, we can adduce the testimony of positive experimenta- tion to show that the Nitrate of Silver, as a local agent, acts homoeo- pathically to the morbid irritation. About nine o'clock in the evening Dr. Debeny injected twelve grains of the Nitrate in one ounce of water into his urethra which was perfectly sound. In half a minute he experienced a frightful pain for about five minutes, after which it began to abate and was quite moderate for an hour, extending all along the spermatic cord. In the night a copious quantity of a thick, white mucus was excreted. At seven o'clock in the morning he voided his urine with some diffi- culty, and considerable burning, and expelled with the urine shreds of a whitish membrane, the scurf of the mucous linino-. At ten o'clock there was still some secretion, but the urine was voided with- out any pain. About noon all was over. _An inflammatory irritation of the urethral mucous membrane might undoubtedly be induced by other irritating substances but this inflammation, so far from resulting in a diminution and gradual cessation of the natural disease, would, on the contrary, produce a permanent complication and consequent aggravation of the symp- toms.^ We know that in thousands of cases the irritation induced by the Nitrate, has extinguished or devoured, as Trousseau and Pidoux ARGENTUM NITRICUM. 97 term it, the natural disease. Hence we infer that the Nitrate possesses a specific influence over the gonorrhoeal disease, or, as we term it, acts homoeopathically to it. The quantity of Nitrate which is used in these injections, is from four to twenty grains, according to the judgment of the physician, the nature of the case, and the knowledge which he may have of the patient's constitution. Five grains to an ounce of water is generally sufficient, . provided the injection is repeated at suitable intervals. Hundreds of cases are cured by this sort of treatment, both in hospi- tal and private practice, year after year. The so-called anti-phlogis- tic treatment and emollient fomentations are often required in con- nection with the Nitrate. In the place of leeches, the tincture of Aconite answers our purpose much better. Injections are one of the methods by means of which the gonorrhoeal virus may be ex- tinguished, and the patient's health may consequently be restored. He may have to pass through a temporary aggravation of the symp- toms, violent pain in the urethra, and even in the testicles and all along the spermatic cord, horrid burning during the emission of urine and difficulty in voiding it; but these symptoms are soon superceded by a copious discharge of healthy-looking pus, which gradually becomes transformed into urethral mucus until the secre- tion ceases altogether, sometimes in a few days, and at other times in one or two weeks. The treatment of gonorrhoea by means of injections of the Nitrate of Silver is not the only method of removing this loathsome disease. We shall hereafter show that Copaiva, Cubebs, Cannabis, the Nitrate of Potash are likewise specifically adapted to the treatment of certain forms of this disease. It is for the physician to determine which of these agents may be most serviceable in special cases. A mere glance at the symptoms of the URINARY GROUP shows at once that the Nitrate must be useful in Chronic Urethritis, as a sequela of acute gonorrhoea. The higher potencies of this agent have been found more efficient in this disease than the lower. Hahnemann has recommended this salt for Diabetes ; others for Irritable bladder, with an excessive flow of urine. SEXUAL GROUP. In this group we note the following symptoms: Deficient sexual desire; Atrophy of the genital organs; Chaiicrous Ulcers on the prepuce, flat, with a tallowy base; Enlargement and hardness of the right testicle; vol. ir.—T 98 LECTURE LXIII. Some of these symptoms may occur as the consequence of Self-abuse. The development of a chancrous ulcer by the Nitrate of Silver shows that this agent is homoeopathic to some forms of Chancre, more particularly to the flat, superficial chancre, which shows a tendency to spread on the surface rather than to penetrate into the substance of parts. Enlargement and Induration of a testicle in consequence of sup- pressed gonorrhoea, may likewise yield' to the internal use of the Nitrate. The Nitrate seems to excite the action of the uterus. It may in- duce capillary engorgements, and may, therefore, be useful in affec- tions resulting from such abnormal conditions. Allceopathic phy- sicians use it locally in Ulcerations of the mouth and neck of the womb ; Leucorrhcea^ depending upon inflammatory irritation of the mucous lining; Gonorrhoea, with discharge of pus which excoriates the parts. If homoeopathic to these affections, it may be used internally with benefit, although the external use is not at all inconsistent with rational homoeopathic treatment. Many homoeopathic physicians cauterize the ulcerated os and cervix of the womb at stated inter- vals, four, five, six times, until the ulcers have assumed a healthy appearance and bid fair to heal. In chronic blennorrhoea of the vagina, more especially if traceable to a gonorrhoeal taint, an injec- tion of 2 grains of this salt to 6 ounces of water, may prove highly useful. If necessary the quantity may be increased to 3, 4, and even 6 grains. THORACIC GROUP. Among the recorded symptoms, the following deserve special attention: Dry, almost burning titillation in the throat, occasioning a cough; Hoarseness and violent titillation in the larynx; Suffocative cough, for several days, at noon; Aching-tensive pain in the chest, in various parts of the chest, of the size of half a dollar. In chronic Laryngitis, characterized by the above-mentioned symp- toms, this drug may be of great value. These symptoms may con- stitute the preliminary stage of Laryngeal Phthisis. The middle and higher potencies will be found the most suitable. Argentum nitricum has caused violent palpitation of the heart with faintish nausea, three paroxysms in one afternoon. The symptoms may occur as parts of a group denoting an irrita- tion of the pneumogastnc nerve, which affects the digestive apparatus as well as the heart. We may designate a pathological condition ARGENTUM NITRICUM. 99 where such a group of symptoms occurs paroxysmally, as a case of nervous Dyspepjsia. The peculiar influence which the Nitrate of Silver seems to exer- cise over the functions of the heart, has induced Kopp to prescribe it in cases which seem like Angina Pectoris and Asthma. In Angina Pectoris, or the so-called Asthma Dolorificum Koppii, this eminent practitioner prescribed the Nitrate on the supposition that it stimulated the nervous energies of the heart. Kopp regarded this angina as a purely nervous, independently existing disorder, whereas modern investigations have shown that, in a majority of cases, it is a diseased condition of the process of innervation which leads to a degeneration of the sub- stance of the heart, and a passive dilatation of its cavities. In sthe- nosis of the orifice of the heart, which is sometimes very consider- able, the angina is wanting. Nevertheless it may be affirmed, upon the authority of observers whose testimony seems unimpeachable, that the Nitrate is useful in certain forms of angina pectoris which, according to Krahmer, emanate from a disturbance of the gastric functions, derangement or excessive irritability of the stomach—an indication which seems somewhat justified by our last-mentioned symptom: although the same author admits that, " however certain it may be that the attacks of Angina Pectoris are excited in most cases by a derangement of the gastric organs, yet experience teaches that, in some cases at least, the cause of the disease must be traced to an affection of the spinal cord and brain. Here, too, the Nitrate of Silver may prove useful by limiting and retarding the abnormally increased metamorphosis of the cord, but hardly in so short a space of time or after exhibiting a few eighths or quarters of a grain." He says that, in some cases, even Kopp has given one and more grains daily for weeks. Regarding the curative influence of the Nitrate in Asthma, Krahmer thinks that this influence is limited to such forms of this disease as. are excited sympathetically by gastric disturbances. According to this author " true asthma, where periodical paroxysms of violent difficulties and anxiety of breathing set in, while the sub- stance of the lungs is perfectly sound, in consequence of an essential affection of the nerves of respiration or their origin in the brain, is of an exceedingly rare occurrence; and that, leaving the habitual dyspnoea which is caused by an aneurism of the arch of the aorta, or by a medullary degeneration of the oesophagus or some other tumor pressing upon the recurrent nerves, out of count, most parox- ysms of dyspnoea can be traced to an organic ulceration of a portion of the pulmonary parenchyma, which unfits it for the business of respiration." In all such cases of sympathetic Asthma Kopp gives 3Yj> to or even \ of a grain, only for a short time. Asthma, however, like angina pectoris, may result from a diseased condition of the brain or spinal cord, and may render essential ser- vice in such cases. 100 LECTURE LXIII. EXANTHEMATIC GROUP. In the course of this Lecture we have taken many opportunities of mentioning the cases where the Nitrate of Silver may and perhaps ouo-ht to be used by homoeopathic practitioners as an external agent. Sores of a malignant nature, more especially chancrous ulcerations, may have to be touched with it, by which means they are often converted into a common sore, or one more readily impressed by some specifically appropriate agent. The Nitrate seems to be essentially inimical to the mercurial and the syphilitic virus, and, in otherwise sound constitutions which naturally repel these taints — not in constitutions of a decidedly scrofulous or cachectic habit, that are unable to scarcely offer any resistance to such deleterious influences—a timely cauterization with the Nitrate may extinguish the malignant type of the ulcer. These cauterizations should not be resorted to indiscriminately, lest the constitution itself should become vitiated by the destructive processes of a secondary or tertiary syphilitic disease. Mitscherlich offers the following explanatory statements concern- ing the manner in which the cauterizing process affects the tissues : " After touching the parts, certain vital phenomena take place different according to the different tissues where the cauterization took place. The cauterization of a thick epidermis does not cause any pain, but if the skin is very thin, a slight burning is experienced. This cauterization does not cause any perceptible inflammation ; the white skin turns brown and even black ; it does not separate until after the lapse of some days, sometimes even a week or a fortnight, and is replaced by a deeper layer of the epidermis. If the skin is denuded of the epidermis, or if the parts are ulcerated, the Nitrate may touch the sensitive nerves, and a pretty severe pain may be experienced, but only for a short time. If the atmospheric air has access to the cauterized surface, the water evaporates, and a dry and brown scurf forms, whose thickness varies according as the action of the cautery penetrates the tissues to a less or greater depth. After the scurf has become detached, we see a red surface like that of a sore which secretes a small quantity of a thickish substance, and is surrounded by a pretty intense inflammation. The inflamma- tion which is excited by the process of cauterization, is more or less intense in different parts, according as the vitality of the part is more or less readily affected." Krahmer relates the cases mentioned by Hille where the pain caused by Callous Cicatrices was arrested in a very short time by the parts being touched with the Nitrate of Silver. In one case the first phalanx of the index-finger had been contused, and, after a rapid cicatrization of the volar surface, a painful swelling had formed, and the patient was attacked with epileptic spasms whenever he attempted to move the finger. The swelling was touched with the Nitrate, and the patient was cured in four days. Krahmer speaks of a similar ARGENTUM NITRICUM. 101 case that came under his own notice. A perfectly healthy man had cut himself with an axe in the anterior surface of the leg, and had severed the superficial branch of the nervus peronaeus. The wounded part had peeled off, and a portion of the integuments had been lost; the lower extremity of the cut nerve had become involved in the cicatrix, and formed a small swelling. Below the wound the nerve had lost the power of conveying sensation, but in the swelling the most violent pains were felt if the part was touched ever so lightly, for instance, if the stocking rubbed against it; these pains extended to the dorsum of the foot. After touching the swelling several times very thoroughly with the Nitrate of Silver, the pain was entirely removed, but the power of conveying sensa- tions did not return. The cauterization of Ulcerated Nipples in the case of nursing females, and of fistulous ulcers, is sometimes exceedingly useful, and indeed necessary to a cure. After touching the nipples, which should be done carefully and gently, it has to be washed with tepid milk and water. MENTAL GROUP. This agent causes apathy, hypochondria. In the affections with which it is in specific curative rapport, such a depression of the spirits is often present. ANTIDOTAL TREATMENT. The Nitrate of Silver is antidoted by common salt which decom- poses the former, giving rise to nitrate of soda and chloride of silver, which latter compound is innocuous according to Orfila. The contents of the stomach should be removed, and the inflamma- tory symptoms combated by demulcents and the internal exhibition of Aconite. The pain caused by the local application of the Nitrate, may be diminished or arrested by washing the parts with a solution of com- mon salt. ._ . To diminish the slate-colored tint of the skin, dilute nitric acid may be used externally as well as internally; the continued use of these ascents is said to have removed the discoloration. 102 LECTURE LXIV. LECTURE LXIV. ASAFCETIDA. This gum-resin is obtained from a shrub which grows in Affgha- nistan and the Punjaub (Asafoetida ferula). Stem two or three yards high, six or seven inches in circumference at the base. It is obtained by making incisions into the upper part of the root; the collected juice is exposed to the sun to become harder, and is con- veyed home in baskets. Asafoetida occurs in irregular pieces of variable size; externally they are yellowish or of a pinkish-brown color. It is fusible and inflammable, burning in the air with a white flame and the evolution of much smoke. Its taste is acrid and bitter, and its odor strong and alliaceous; hence the Germans term Asafoetida " Teufels-dreck" or devil's dung. However, this dislike to Asafoetida is not universal, some of the Asiatics being exceedingly fond of it, taking it with their food as a condiment, or using it to flavor their sauces, or even eating it alone. Hence among some of the older writers, we find it denominated " food of the gods." Cap- tain Kinnear tells us that in Persia the leaves of the plant are eaten like common greens, as is the root when roasted; and Lieutenant Burnes, in his Travels, says: "In the fresh state it has the same abominable smell, yet our fellow-travellers greedily devoured it." It is stated by experienced gastronomers, that the finest relish which a beefsteak can possess, may be communicated by rubbing the grid- iron on which the steak is to be cooked, with Asafoetida. From this resin we obtain a tincture having a saturated brown-red color, and the peculiar nauseous and fetid odor of the gum-resin. Asafoetida is the most powerful of the fetid gum-resins. It is devoid of those acrid and irritating properties possessed by gamboge, euphorbium, scammony, and many other resinous and gummy resi- nous substances. In the mouth and stomach it causes a sensation of heat, and it causes eructations from the stomach. Professor Joerg and liis pupils experimented upon themselves in doses of one grain to one scruple. Messrs. Trousseau and Pidoux have likewise ex- perimented with Asafoetida; they took half an ounce at a time, with no other effect than that of altering the odor of their secretions, by which they were kept for two days in an affected atmosphere, pos- sessing a more horrible degree of fetidity than that of Asafoetida itself. These apparently contradictory results might lead us to infer that Asafoetida acts differently upon different individuals, but to the careful observer they reveal another important part, it is this: that the business of proving drugs is a science which implies the know- ledge and consideration of several important circumstances: 1. The prover must be possessed of an adequate susceptibility to the action of the drug to be proved; ASAFC3TIDA. 103 2. The dose must be within the limits of the reactive power of the organism; and 3. The dose must be graduated in accordance with the organic reaction; for it is by the phenomena of organic reaction that we determine the therapeutic sphere of a dwig; in some, the organic reaction may be powerfully developed by a very small dose; in others, a much larger dose may be required to effect the same result; and, if an idiosyncratic relation should exist between the organism and the medicine, the merest shadow of a dose may be sufficient to determine the therapeutic character of a drug, in this one specific direction. Moreover it is very probable that Messrs. Trousseau and Pidoux violated certain inevitable conditions of a successful proving. 1 allude to those general hygienic and dietetic measures which have to be obeyed by every one who is desirous of seeing his efforts at provings crowned with success. A Frenchman who keeps up the use of his strong coffee, his claret, his spices, and his cigar, while he is proving a drug, cannot expect to develop those finer shades of drug-action by which the physicians of our school obtain a know- ledge of the homoeopathicity of a drug to certain diseases. We have some very excellent provings of Asafoetida. These provings reveal the fact that diseases to which Asafoetida is homoeo- pathic, are characterized by more or less inflammatory and febrile action. It seems to be particularly adapted to scrofulous and ner- vous individuals, with a venous and haemorrhoidal constitution and a phlegmatic temperament. Professor Joerg's provings have furnished the following highly interesting and instructive results: Guentz swallowed at various intervals one, two, three, four, five, six and ten grains of the drug. One, two, three and four grains had no other effect than to cause frequent eructations having a garlic- odor. Five grains caused a painful pressure in the pit of the stomach, as from excessive repletion and distension of the heart; this pressure was accompanied by a smaller pulse, and followed in a few hours by diarrhoeic stool. Ten and fifteen grains caused eructations, nausea and aversion to food. Lippert experimented with one, two, four, eight and ten grains. Half an hour after swallowing one grain, he experienced a copious flow of saliva and frequent eructations. In an hour he was seized with dullness of the head which soon increased to a pain as if the whole brain were compressed ; vertigo, increased warmth of the skin, and accelerated pulse. In the afternoon he passed a quantity of fetid flatulence, and had no stool until the following morning, when a soft, brown and fetid discharge from the bowels took place. Two grains caused a similar acceleration of the pulse, and a violent headache which continued more or less the whole day. 104 LECTURE LXIV. Four, eight and ten grains had a similar effect, but superinduced moreover diarrhoeic stool. Otto swallowed two grains which induced a pain in the head as if the whole brain were compressed with a handkerchief tied over it; this pain was accompanied by a spasmodic tightness of the chest; the symptoms lasted an hour and a half. Three grains caused the same symptoms, except that the eructa- tions were accompanied with a copious flow of saliva, and the prover experienced moreover a drawing in the glans penis during an emis- sion of urine. Four grains caused eructations with flow of saliva, rumbling in the bowels, and a slight pressing and drawing pain in the region of the cardia whence the pain first extended to the spleen and after- wards to the region of the liver; it was made worse by an inspira- tion in consequence of the depression of the diaphragm; the chest- symptoms were the same; the alvine discharges seemed to be less tinged with bile, but were without the odor of the drug. Five grains induced the same symptoms, but the painful pressure in the cardia rose higher up in the oesophagus. In the afternoon the abdomen was distended, and there was an occasional emission of flatulence which had the odor of Asafoetida. On the following morning he had a hard stool which had a dark-brown appearance and had somewhat the odor of the drug. The pain in the chest only amounted to a slight drawing, the respiration was only slightly accelerated, the pulse was smaller, more hurried and contracted; in the afternoon the head began to feel dull, and a pain was expe- rienced in the brain as if a string were drawn around it; the drawing in the glans was likewise felt, but the dark-brown urine was passed without any difficulty; it deposited no sediment, but had a pungent smell. After six grains the painful pressure ascended still higher in the oesophagus, with a sensation as if a foreign body was rising in it. The abdomen and chest were affected as before; "the drawing in the glans were much more severe, coming and going in paroxysms. Towards evening, when the action of the drug seemed to have ceased, the prover was attacked with a feeling of malaise, vertigo and Vanishing of sight; soon after a cold sweat broke out on the forehead and extremities, and a violent cutting distress in the bowels obliging him to lie down, after which the pains gradually subsided. He spent a restless night, and in the morning had a hard, dark-brown discharge from the bowels having the oclor of Asafoetida. Eight grains induced an insipid taste in the mouth, soon changing to that of the drug; this lasted all day. The pulse and the beats of the heart were small, quick and irregular. The accompanying oppression on the chest was very moderate and the respiration not much accelerated. These symptoms occurred in the forenoon. In the afternoon there was copsiderable rumbling in the bowels. At this time the spasmodic oppression of the chest became very severe and was accompanied by a titillation in the trachea and a dry, irri- ASAFCETIDA. 105 tating cough; after the cough had lasted half all hour, the prover experienced a slight shivering from the last to the second lumbar vertebra; this was accompanied by the above-mentioned painful pressure in the cardia and a small and hurried pulse. After the symptoms of the chest and abdomen had lasted three hours, the prover experienced a general malaise, the oppression of the chest increased to a feeling of anxiety, and the embarrassed respiration induced restlessness and obliged him to shift from place to place; the head felt confused, and thinking was very much interfered with ; from time to time a shudder was experienced over the whole body, without any subsequent heat. A walk in the open air gave him relief. Towards evening he experienced in a marked degree the sensation of a foreign body ascending from the stomach along the oesophagus to the pharynx, which was always relieved by swallow- ing. The urine was clear but had a pungent odor. The symptoms continued more or less on the following day, especially the pain- ful pressure in the stomach and the distension of the bowels. Nine grains induced a similar group of symptoms, with the exception of the nervous and congestive symptoms in the chest and head, which were more marked in some respects; the breathing was interrupted by occasional turns of coughing and groaning; the pulse was small and contracted, there were congestions to the head, with hot face and headache; sensation of the eyes as of grains of sand between the lids and the eyeball, and as if cold air were blowing upon the eyeballs; the pupils were somewhat dilated, and in the articulations of the jaw a peculiar drawing was experienced more or less the whole day, and sometimes increasing until it became painful. Ten grains induced most of the former symptoms, but in a more marked degree; rumbling in the bowels, followed by painful pres- sure in the region of the stomach, which afterwards changed to a drawing pain that was aggravated by external pressure. The stricture across the chest and the accelerated breathing were accom- panied by a large, full and strong pulse; a few shooting stitches were occasionally experienced in the head, and the sensation of a foreign body ascending in the oesophagus became so violent that it was no longer possible to suppress it by swallowing; it was finally complicated with a feeling of loathing and a scraping sensa- tion in the pharynx. Shortly after the appearance of this symptom the congestion about the head and the trouble in the eyes set in. Then came the feeling of general malaise, the shuddering, yawning, restlessness, distension of the bowels, and, in the afternoon, a hard stool having a dark-brown color and a pungent smell, and causing a pain in the rectum while passing through this organ. In the afternoon the symptoms gradually abated, but returned again at eight o'clock in the evening. The drawing in the articulations of the jaws now invaded the muscles of the neck. Next morning there was a blackish-brown, soft, fetid discharge from the bowels. After an interval of five days the same experiment was repeated with nearly the same results, except that the prover was troubled with frequent inclination to stool, the sensation in the oesophagus 106 LECTURE LXIV. and pharynx, and the eructations were accompanied with a sensa- tion in the mouth as if the prover had deranged his stomach by eating fat food; the above-mentioned drawing pain in the neck now extended from the occiput through the back of the neck as far as the upper arms, resembling drawing and tearing, rheumatic pains. Pienitz took half a grain, one, two, three and six grains; the drug induced watery stools with violent pressing towards the rectum and followed by rumbling and distension of the bowels; the pulse was small, feeble and somewhat accelerated. From four grains he experienced eructations accompanied with trembling of the whole body, coldness of the skin and a small, feeble pulse, loss of appetite, two stitches darting from the forehead to the occiput, watery stools. Six grains induced, among other symptoms, an increased desire for sexual intercourse. From two grains Siebenhaar experienced a copious expectoration of mucus from the trachea; four grains induced, among other symp- toms, an oppression of the chest resulting in the expectoration of mucus; five grains induced nausea, an inclination to vomit, a general feeling of malaise and, after riding in a carriage for two hours, a peculiar pressing sensation towards the genital organs, with pain in the testicles which was aggravated by contact or motion. Professor Joerg commenced the experiments upon his own person with half a grain which he swallowed at nine o'clock in the morning; it caused the usual eructations, and in the evening he experienced a rancid taste in the mouth as after deranging the stomach by fat meat; the sensation moreover was as if the epithelium had become detached. One grain caused eructations and a cutting pain in the region of the stomach which was increased by pressing upon the part, and accompanied with peculiar crampy contractions of the stomach alternating with a feeling of loathing and inclination to vomit; fre- quent urging to stool resulting in four scanty, hard or papescent discharges; abdomen distended in spite of copious emission of flatulence. One grain and a half caused the cutting pains in the umbilical region, occasioned crampy pains with sensation as if the gums would become sore; one hour after swallowing the drug, the taste in the mouth became bitter; two hours after, it became insipid and acrid, mingled with slight nausea. About eleven o'clock in the forenoon, two hours after swallowing the drug, a sensation set in as if the peris- taltic motion of the intestines had been reversed, and as if the oeso- phagus acted from the stomach upwards; the prover likewise expe- rienced several painful flying stitches under the sternum in the middle, followed at a later period by pressure and burning in the same region, and frequent inclination to cough. ASAF03TIDA. 107 Two grains caused violent cutting in the umbilical region, burn- ing in the region of the stomach and diaphragm, distension of the abdomen and frequent urging to stool with or without a scanty discharge; tightness of the head, with frequent stitches in the frontal and temporal regions, the above described sensation as if the move- ments of the oesophagus were taking place from the stomach up- wards ; in the afternoon the prover felt rheumatic pains in the upper and lower extremities, in the region of the scapulae, more particularly in the joints; they occasionally shifted from one locality to another, and disappeared towards evening. Next day the pains in the bowels continued, the bowels remained constipated in spite of a continual inclination to stool; the oesophagus felt irritated, the taste in the mouth was rancid and greasy, the urine rather darker than usual, and having a pungent, ammoniacal odor. Mrs. Ch., experimented with one grain, a grain and a half, two and three grains. The gastric symptoms were the same as those experienced by other provers: horrid eructations, warm risings from the stomach, in addition to which she complained of dryness in the oesophagus and an oppressive pain in the forehead. Two grains and a half caused eructations, a burning in the oesopha- gus and stomach, oppressive headache, especially in the right half of the head, and a violent, labor-like distress in the region of the uterus which lasted five minutes and returned again in one hour. The burning continued until the morning of the third day, when it ter- minated in a feeling of dryness without thirst. Three grains caused immediately a violent, increasing burning in the stomach and oesophagus, with sensation as if these organs were excoriated; oppressive headache, especially in the forehead, with a remarkably small pulse, which had increased by ten beats; *in. the afternoon she was attacked with the same labor-like, pressing and cutting pains in the region of the uterus; the attack lasted several minutes and occurred several times in succession. During the whole period of the proving the experimenter complained of a feeling of weariness and languor, the bowels remained costive for three days in spite of a continual urging to stool; the menses appeared ten days before the regular time, very scantily at first, but afterwards in the normal quantity. Several other provers made experiments producing nearly the same effects. In the case of Miss L., the headache assumed the form of an op- pressive heaviness in the forehead; she complained of weariness and her sleep was very much disturbed. In Edward Joerg's case the tightness of the head started from the vertex on the left side of the head, extending towards the eyes where it assumed the form of a pressure, and lasted with more or less intensity for several hours. From two grains Theodor Joerg experienced a sensation as if in- carcerated air were pushed to and fro in the bowels. 108 LECTURE LXIV. Two grains and a half caused, beside the ordinary pains, transitory stitches in the left cavity of the thorax. From three grains the distress in the head amounted to an oppres- sive headache extending to the eyes and nose, and lasting until the afternoon. These experiments show conclusively that Asafoetida has a marked action upon the abdominal ganglia, and, from these centres extends its disturbing agency to the brain where it induces marked symp- toms of congestion. This tendency to produce congestion of the larger vessels and capillaries, may even involve the eyes, lungs and heart. It is shown that the sexual system is likewise influenced by our drug. Upon a more careful inspection of the results of these provings, it will be found that they present a coherent group which cannot well be separated into its component elements. This group, for instance, presents all the symptoms of a certain form of hemicrania ; but we shall find that Asafoetida will not remove these symptoms unless the patient is more or less subject to pulmonary or abdominal irrita- tions like those which Asafoetida is capable of producing. The same remark applies to the pulmonary, abdominal and sexual range. Not every element of the group need be distinctly developed as a pathological fact, but if we expect curative results from the action of Asafoetida upon any of the subdivisions of the series, we must be previously assured by observation and induction that the character of this subdivision connects it truly and fully with the series integ- rally, not symptomatically, and that the series as a whole inheres in the constitution of the patient as so many morbid predispositions which, if acted upon in appropriate conditions by corresponding forces«of disease, will result in the pathological series typified by the totality of the symptoms of our drug. The symptoms of Asafoetida, if viewed in their totality, represent a pathological condition which may be aptly termed Hysteria or Hypochondria. The symptoms seem to arise from an irritation of the abdominal ganglia which are in supervisory relation with the hepatic system. The sexual system is likewise very much involved. Hence we feel justified in recommending our drug for either of these affections, if the existing symptoms can be traced to torpor or irritation of the biliary secretions, and such symptoms as Asafoetida is capable of exciting, constitute characteristic symptoms of the case; we may have tightness of the head, irritation of the eyeballs as if grains of sand were lodged between the lids and the eyeballs, sensation as if a cold wind were blowing upon the eyeballs; dryness and burning in the oesophagus, cutting and crampy-pains in the umbilical region, globus hystericus, watery discharges from the bowels, or constipation with continual urging; dark colored urine having a pungent odor; oppression and constriction of the chest, with tickling in the larynx, inclination to cough, expectoration of mucus; creeping chills, mingled with flashes of heat, hurried and small or also strong and excited pulse; the sexual functions may be abnormally excited, and this abnormal excitement may ASAFffiTIDA. 109 arise from continued and unnatural abstemiousness. The spirits are depressed or fitful. As detached members of this series we may be called upon to prescribe for Hysteric Hemicrania, with flushed face, heat in the head, dryness of the eyes and consensual gastric derangements such as rancid taste in the mouth, distension of the bowels, rumbling, diarrhoea or constipation. Globus Hystericus or the Hysteric Ball, as if the peristaltic emotions of the intestinal canal were carried on in the reverse order. Diarrhoea or Constipation, with watery discharges, or soft papescent and fetid stools or costiveness with continual urging, and scanty dis- charge of hard, dark-colored and badly-smelling faeces; the urine is likewise darker than usual, and has a strong, ammoniacal odor. This condition of the bowels is accompanied by distension of the abdomen, rumbling of the bowels, cutting or crampy pains either preceding or succeeding the alvine discharges. Cardialgia or Gastrodynia when the attack is characterized by cutting pains in the umbilical region, crampy pains in the stomach, burning and soreness in the stomach, and epigastrium increased by pressure being made upon the part, nausea and inclination to vomit, without any vomiting taking place. We have seen that Asafoetida, in the case of our female prover, induced premature menstruation. We may therefore commend it for Premature Menstruation with severe bearing-down and cutting pains in the uterine region, febrile irritation, congestion of blood to the head. These symptoms may likewise characterize a group of Dysmenorrhea, where Asa may therefore prove useful. The action of Asafoetida upon the sexual organs of both the male and female, is remarkably illustrated. In No. 51 of Casper's Journal the following important facts are stated by Dr. Boas: "In consequence of the application of Asafoetida-plasters to the abdomen, I have seen the testes swell considerably, and the pudendum likewise become inflamed and swollen; some time ago, this inflammation became so violent in one case that I had to resort to antiphlogistic treatment. Although the patient was a lady of fifty, and had ceased to men- struate long since, yet the mammse became turgid and secreted a milky fluid, as during the ninth month of pregnancy." Kallenbach, who is a homoeopathic practitioner, guided by this experience, has employed Asafoetida in several cases for the purpose of restoring the milky secretion. These cases have been reported in the Homoeopathic Gazette of 1844, and are likewise quoted by Frank in his instructive Magazine. A woman of thirty-four years, remarkably healthy, and of an athletic frame, who had had six children without being able to nurse one of them, on account of loss of milk which took place soon after each confinement, again gave birth to a child in the month of April, 1843. On the fourth day after her confinement, the milk began to 110 LECTURE LXIV. decrease, so that in a fortnight thereafter only a few drops could be squeezed out of the nipple. ' Kallenbach mixed a drop of the tinc- ture of Asafoetida in one drachm of alcohol, and gave her three doses of this mixture every day, of five drops each. The second day after using this mixture, the milk again flowed abundantly, and, on the third, the passages of the infant smelled very strongly of Asafoetida. The preparation was continued for eight days. The milk flowed regularly for three weeks and a half, when it again began to flag. The patient, who complained of the bad taste of the drug, now was put on the third Hahnemannian potency, which still revealed the taste and odor of the drug. The milk again began to be secreted for eight and thirteen weeks, at which periods it stopped, but was each time restored by the third potency of the drug. In the eighteenth week the woman had a violent fit of anger, in conse- quence of which the milk remained suppressed permanently, in spite of all treatment. In another case the flow of milk was likewise restored whenever it ceased in the case of a primipara, the milk began to vanish in the sixth week, but the flow was permanently restored by the same agent. To these cases Frank adds the following comment: " In these cases we are struck by the efficacy of the small doses, given in accordance with the law 'contraria contrariis.' Both the Old and the New School may profit by tMs lesson; the Old School may learn from it, that very small doses may become efficient therapeutic agents; and the New School, that not every drug, when exhibited in a very small dose, must necessarily act in accordance with the homoeopathic law." This comment is evidently based upon a misapprehension of the true action of drugs. Every drug produces a double series of phenomena which are in direct or polaric opposition to each other; one series corresponding with the primary action of the drug; the other, opposite to the former, corresponding with the reaction of the antagonizing organism. There is no difficulty in understanding that Asafoetida may be in homoeopathic rapport with Galactorrhoea as well as with Agalactia. Some principle, inimical to the legiti- mate functional life of the sexual system, fastens upon the brain', endeavoring to extinguish its organizing power in this direction; this principle is overcome by the living organism which sets up an opposite condition, thus aiming at a restoration of the suspended equilibrium. Our provings have shown that Asafoetida causes a spasmodic constriction and oppression of the chest, with occasional stitches in the chest, and a burning sensation under the sternum in the middle region; these symptoms are accompanied by slight alteration in the pulse which is rather more accelerated and smaller than usual. This condition of the pulse would seem to show that the character of these symptoms is that of spasm and congestion. An attack of this ASAFQ3TIDA. Ill kind may occur more or less paroxysmally as a form of hysteria. The symptoms may represent a case of Hysteric Asthma or Hysteric Pulmonary Congestion which may terminate in loose cough with expectoration of mucus. We have seen that this drug may likewise cause a tickling in the windpipe and great inclination to cough, with expectoration of mucus. This group of symptoms may likewise occur as a form of hysteria, and might be described as Hysteric Cough, to which women of a florid complexion and ner- vous temperament are sometimes subject and which Asafoetida may either arrest entirely, or at least palliate. In a case of Suppressed Expectoration, in females who are habitually subject • to hawking up mucus in the morning or after eating, and who are of an hysteric habit of body and temperament, Asafoetida may sometimes counteract the unpleasant consequences of such a sup- pression, more particularly if it is owing to violent and unpleasant excitement or exposure, and gives rise to fluttering of the heart, oppression and constriction of the chest, burning and dryness in the air-passages, creeping chills. If the suppression is owing to rheu- matic exposure, Aconite may have to be given in alternation with Asafoetida. This agent has been exhibited in some dangerous forms of Whooping-cough, not as a remedy for the cough, but for the pur- pose of palliating the dangerous complications and more especially the suffocating spasm which seems to threaten the life of the little patient. In such cases the drug has to be given in sufficiently large doses to produce a palliating effect. It may be administered in a solution of Gum Arabic flavored with the essence of orange-blossom. A teaspoonful every hour or two hours of the following preparation may be administered : Ten grains of Asa in half an ounce of liquid Gum Arabic, mixed with half an ounce of the syrup of orange- blossom and one ounce of an infusion of linden-blossoms. The spasm being arrested, the cough afterwards runs a mild course. A small dose of Ipecac, or Belladonna, or sometimes of Aconite may often be preferable to Asafoetida. We have seen that Asafoetida produces rheumatic pains which seem to be of a nervous character. Hence in Neuralgic Rheumatism, or rather in nervous pains of a rheumatic character without any apparent signs of congestion, Asa may prove useful. The pains are drawing and tearing and affect the articula- tions of the jaws, and may invade the posterior cervical muscles as far as the arms, or they may be felt in both the upper and loAver extremities. Asafoetida has been used by allceopathic physicians in the treat- ment of Scrofulous Caries, Ehachiiis, and likewise for Mercurial and Scrofu- lous Ulcers; I am not prepared to affirm that it is of much use in these affections. You will recollect that our provers generally found relief from 112 LECTURE LXV. their pains by a walk in the open air; in determining the homceo- pathicity of our drug to a given pathological group, this fact may be of importance. Regarding the dose we may use the tincture up to the 6th or 18th potency; the triturated gum-resin may likewise be employed, either in the form of powder or made into little pills by means of Gum Arabic. LECTURE LXV. AURUM METALLICUM. (Metallic Gold) Of the finest gold-beater's leaf we make triturations in the pro^ portion of 1 :10 or 1 : 100, continuing this potentizing process according to the rules laid down for silver. Hahnemann has furnished some interesting provings of this agent, which, however, do not reveal any very extensive, although in some respects important, therapeutic virtues. The curative virtues of gold have been doubted, and, in fact, denied by a great many practitioners of former times, for no other reason than the theoretical one: that gold is not soluble in the gas- tric fluid. We know that this objection is untenable since many other medicinal substances of extraordinary power are not chemi- cally acted upon by the acids secreted by the stomach. Gold, how- ever, and any other substance, can be made soluble by first destroying the cohesion of its constituent particles, by means of the process of trituration adopted in our School and first invented by Hahnemann. In his brief but interesting introduction to the provings of gold, Hahnemann mentions several authors who have recommended this agent as a medicine for conditions to which it is eminently homoeo- pathic, as is shown by the results of the experiments instituted by Hahnemann and his disciples. Geber, an alchymist of the eighth century, extols gold as a " mate- ria laetificans et in juventute corpus conservans," (a substance which cheers up the mind and preserves the youthfulness of the body.) Serapion the younger, who practised towards the end of the tenth century, says: " Pulverized gold is useful against melancholy and weakness of the heart." Avicenna, at the commencement of the eleventh century, says of it: Pulverized gold is one of the medicines against melancholy, removes fetid breath, is a remedy against baldness, (even when taken internally,) strengthens the eyes, is good for cardialgia and palpita- tion of the heart, and is eminently useful in dyspnoea." Hahnemann states that he has cured several cases of melancholy AURUM METALLICUM. 113 with inclination to suicide by means of a few doses of gold of the one-hundredth of a grain each. He thinks that the one ten-thousandth of a grain will likewise prove efficient. Indeed, caries of the palatine and nasal bones, caused by abuse of Mercury, has been cured by this very small dose. The following series presents a complete list of the affections where Gold has been used as a specific homoeopathic agent with undoubted success: 1. Headache of a corniesilve character. By our provings, Gold causes: rush of blood to the head; pain in the head as if the brain felt sore, and had been bruised ; semi-lateral, acutely-throbbing, headache; pain in the skull-bones, when lying down, as if they were broken. These symptoms show that Gold may be of great use in Hysteric Hemicrania with rush of blood to the brain, and in Mercurial-syphilitic headaches, with excessive pain in the skull- bones, as if they should be crushed, a violent hard-aching bruising pain. 2. Hypochondriasis,^ with suicidal mania; our provings show that Gold depresses the spirits, causes melancholy, a longing for death. 3. Hysteria, attended with profuse menstruation. 4. Scrofulous Affections, more particularly when complicated with mercurial and even syphilitic poisoning, such as Ozena, with caries of the nasal bones. Among our provings we note: painfulness of the right nasal bone and of the superior maxilla; swelling of the nose after a walk in the open air; ulceration of the nostrils. Caries of bones, nasal, palatine, mastoid. Otorrhea, with caries of the ossicula. Exostosis of skull and pelvic bones. Our provings have: osseous tumor on the right side of the vertex, with boring pain which is made worse by contact; small osseous tumor on the left side of the forehead. Orchitis of a chronic nature. Our provings show : swelling of the lower portion of the right testicle, with aching pain when touching or rubbing the parts, commencing at six o'clock for several even- ings in succession, and disappearing again about eleven. Chronic Catarrh, with purulent discharge from the nose. Fetid Breath. Palpitation of the Heart, especially when arising from a rheumatic or arthritic diathesis, or from excessive loss of blood. Dierbach mentions the following interesting case illustrative of the curative virtues of Gold in this affection : A lady was attacked with haemorrhage from the womb in conse- quence of the expulsion of a mole. Palpitation of the heart, anxiety and violent congestion to the upper organs, which are the usual results of the increased efforts of the heart to keep up the equili- brium of the circulation, set in with great violence alter the arrest of the haemorrhage. Nothing seemed to be of any avail to counteract this weakness but Gold, of which one-sixth of a grain was prescribed VOL. II.—8 114 LECTURE LXV. three times a day. After taking a few doses, the patient began to improve, the improvement being attended with a violent itching of the soles of the feet which spread thence over the whole body, but gradually disappeared in a few days. The patient took in all two grains of Gold. Similar results were observed in other cases where violent palpitation, rush of blood, oppressive anxiety even unto fainting, were the consequences of metrorrhagia after confinement. Aurum proved the best restorer of the vital energies. In syphilitico-mercurial affections, where Gold is indicated, the Muriate of Gold will be found to act with much more intensity than metallic gold, and, as a general rule, is preferred by homoeopathic physicians in all such affections. According to Chrestien, the Muriate of Gold acts similarly to cor- rosive sublimate, except that it does not irritafe the salivary glands as powerfully as the bichloride of mercury. Taken to the extent of one-tenth of a grain daily, it has occasioned violent fever. This fever, according to Chrestien, if restrained within proper limits, is not accompanied with any remarkable or even sensible lesion of the functions. The mouth is good, the tongue moist, the appetite con- tinues, the bowels are not disordered, and there is ordinarily only augmentation of urine and transpiration ; but, if carried too far, we incur the risk of producing general erethism, inflammation of this or that organ, according to the predisposition of the patient, which will not only check the treatment, but may even induce a new disease often more troublesome than the original one. One-fifteenth of a grain has occasioned gastric irritation, dryness of the tongue, redness of the throat, colic and diarrhoea. Magendi,e has seen it cause gastritis, accompanied by cramps and pains in the limbs, agitation, loss of sleep, and afterwards great heat of the skin, obstinate sleeplessness and fatiguing erections. These physiological effects of the Chloride of Gold may occur as elements of a group of mercurial and syphilitic poisoning. As an antidote to Mercury, mercurial stomatitis, ptyalism, ulcers, this agent deserves our highest regard. The fact that it abnormally increases the flow of urine, has led to its employment in Albuminuria, where a cure has been effected with the 6th potency of the drug even after the full development of ascites. A case of this kind, successfully treated, is related by Dr. Wurmb of the Yienna Hospital. Frank reports a case of Incontinence of Urine which was cured by the Muriate of Gold. The patient was an old man who had had the dropsy; the inconti- nence was most probably owing to a paralytic condition of the uri- nary bladder, and was particularly troublesome at night. Yet the diuretic property of the Muriate is a well-established fact, so much so, that Dr. Delafield, of New York, recommends this drug, alloeopa- thically, in diseases which depend upon a suppression or considerable decrease of the urinary secretions. Syphilitic Inflammation of internal organs, heart, lungs, stomach • AURUM METALLICUM. 115 or rheumatic inflammation of these organs in persons whose consti- tutions are undermined by the syphilitic virus, may be materially benefited and often cured by the use of the Muriate of Gold. Condylomata at the anus and on the prepuce, have yielded to the internal and external use of this agent. Chancres which failed to yield to mercurial treatment; more par- ticularly flat chancrous ulcerations on the scrotum and prepuce, have been cured by the Muriate of Gold. Nocturnal Erections, which remain after mercurial treatment, and drive the patient to despair, may be subdued by this drug. A mismanaged Gonorrhea with inability to retain the urine, con- tinual urging to urinate, stricture of the urethra, has been thoroughly cured with the Muriate of Gold. In these syphilitic affections, it may be necessary to give this agent in doses of T(')TJ to *% of a grain. Allceopathic practitioners give much larger doses. In some of these cases, this drug may have to be continued for several months. A man who was affected with constitutional syphilis, and who had been thoroughly saturated with mercurials, had obstinate nodes on each tibia with violent bone-pains. The Muriate of Gold restored him perfectly after using it for eight months. Another syphilitic patient was covered all over with sores, and carious ulcerations of the articulations of the extremities. He was emaciated and had hectic fever. All treatment had been, unavailing. The Muriate of Gold cured him gradually but perfectly, after a per- severing use of this agent for ten months. The right elbow-joint remained anchylosed, but painless. The scrofulous element may often be extinguished by this agent. Ascites depending upon diseased liver, has been cured with the Muriate of Gold, when every other remedy failed. Anasarca, after fever and ague, and likewise after scarlatina, has yielded to this drug, when other well-tried remedies had failed. Blepharophthalmia, with swelling and inflammation, and scurfy incrustations on the lids, has yielded to the internal and external employment of the Muriate of Gold; for external use, a solution of two grains in six ounces was prepared. Herpetic Ulcerations and scrofulous sores on the extremities have been cured with the Muriate of Gold. Dr. Keil states in the "Zeitschrift fur Homoeop. Klinik," Yol. Ill, No. 24, that a robust female was attacked with a stitching pain in the left side of the forehead, and a similar pain in a decayed tooth of the same side, whenever she took a dose of the Muriate of Gold. This peculiar effect of the drug certainly shows that in Hemicrania, where this stitching pain constitutes a leading symptom, the Muriate of Gold may manifest curative powers. It 116 LECTURE LXV. matters not whether the pain is of a scrofulous, arthritic or syphili- tico-mercurial nature. Poisonous effects of the Chloride of Gold are antidoted by the same means which we use in cases of poisoning with Corrosive Sub- limate. Our principal antidote is the white of eggs. BISMUTHUM, (Nitrate of Bismuth) This is a compound of Bismuth and Nitric acid. Christison re- ports a case of poisoning with Bismuth which is more fully stated in Wibmer's Toxicology, and seems to be the only case of poisoning on record: A man took two drachms by mistake, and died therefrom on the ninth day. In addition to the usual symptoms of gastro-enteritis, there was a disordered condition of the nervous system, indicated by cramps of the hands and feet, disordered vision and delirium. It is deserving also of remark that there were difficulty of breathing and salivation. A post-mortem examination showed inflammation throughout the alimentary canal, accompanied here and there by gangrenous spots; the spinal vessels were gorged with blood, par- ticularly towards the cauda equina ; there was fluid in the cerebral ventricles; and the inner surface of both ventricles of the heart was very red. This case shows that Bismuth exerts a most powerful specific action upon the cerebro-spinal axis, more particularly upon the spinal marrow, and through it, upon the various parts of the diges- tive tube. Hahnemann has left us a few interesting provings of this agent confirmatory of the toxicological results. These provings are more particularly distinguished by the following symptoms of gastric derangement. " Slight nausea, pressure at the stomach passing into a burning pressure in the frontal region, vertigo with humming in the ears, redness of the conjunctiva, and quick, rather hard, small pulse. "Yomiting with oppressive anxiety, small pulse, vertigo and prostration. " Yomiting and diarrhoea, with retching and burning in the throat. " Spasmodic retching and pain in the stomach. " Burning pain and oppression in the stomach, with frontal head- ache, vertigo, contracted, hard and frequent pulse, warm skin, coated tongue, flatulence, bilious stools. " Frequent emissions of watery urine." A few instructive provings with massive doses of the dru°- are reported by Wibmer. Werneck gave six grains of the Nitrate of Bismuth to four young BISMUTHUM. 117 ladies from eighteen to twenty-one years old, on an empty stomach, and to six robust men between the ages of twenty and thirty. Eight of these persons experienced no symptoms whatsoever. Two of the girls experienced, one hour after taking the drug, some degree of heat and dulness of the head; the pulse became somewhat accele- rated, small and tense. One of these girls ate her dinner and supper with an appetite, .slept well; her tongue was moist and red ; the urine remained normal; next morning, early, she had some griping in the bowels, followed by two liquid, somewhat bilious stools. The other girl, an hour after taking the drug, complained of a pain in the frontal region, and some dizziness when moving about; in two hours, heat in the whole body; the pulse was some- what accelerated, contracted, the temperature of the skin not increased, no perspiration. Three hours after: frequent empty eructations, feeling of malaise in the stomach ; soon after, a liquid stool, which was, however, not bilious. A boy of six years complained of nausea, followed by inodorous eructations, without the least symptom of pain. Eight robust. men took respectively six, eight, ten and twelve grains ; they experienced headache, vertigo, and the pulse was con- tracted. This was followed by pressure in the region of the stomach, and empty eructations. A robust man of twenty-eight years swallowed fifteen and next day twenty grains. He was attacked with headache, vertigo, pres- sure in the forehead, heat all over the body. The conjunctiva was considerably reddened, the pulse tense and contracted, the tongue somewhat coated. Three hours and a half after taking the drug, he experienced a troublesome pressure and burning in the stomach; half an hour after, he belched up a good deal of wind. Another man took fifteen grains; he had the same symptoms, but more slightly, eructations followed by thin bilious stools. A robust man of forty, swallowed forty grains at one dose. In half an hour, he had pressure at the stomach, vertigo, headache, especially in the frontal region, red eyes, dimness of sight. Tongue slightly coated, taste bitter, thirst increased, appetite gone, pulse small, tense and jerking. In one hour: burning at the stomach, violent eructations, griping in the bowels, slight vomiting of bile, and afterwards a liquid, bilious stool. Werneck himself took twenty grains, from which he experienced pressure at the stomach, rumbling in the bowels, frontal headache, vertigo, redness of the conjunctiva, eructations, burning at the stomach, bilious vomiting, oppression of breathing, increased fre- quency and volume of the pulse. These symptoms show a great deal of uniformity in the action of Bismuth, and reveal, to some extent, the curative range of this agent with remarkable distinctness. In Gastrodynia and even Gastritis characterized by the above-men- tioned symptoms, and accompanied by symptoms of crebral derange- ment, such as : frontal headache, vertigo, humming in the ears, and 118 LECTURE LXV. perhaps by inflammatory irritation of the conjunctiva, Bismuth is a most valuable agent. We know from the post-mortem examination in the above-men- tioned case of poisoning, that Bismuth has a specific inflammatory action upon the internal surface of the ventricles; and we know from our provings, that it causes violent beating of the heart. In Endocarditis accompanied by inflammatory irritation of the stomach and by cerebral symptoms analogous to those which I have described before, Bismuth may be thought of as a useful agent, in connection with Aconite, Pulsatilla, and other drugs. In a case of poisoning we have to evacuate the poison from the stomach, and afterwards use albuminous and emollient drinks, such as milk. If inflammation has set in, we resort to Aconite. This drug has been woefully abused by Old-School practitioners. More recently, a French physician, Dr. Monneret, has been in the habit of giving it in such incredible quantities that the apothecaries hesitated to put up his prescriptions. " From whatever cause pain manifest itself during digestion," writes this humane genius in the Gazette Medicale for June, 1849, "we may relieve it by mixing the subnitrate freely with the articles of food." He has never given less than two or three drachms daily, nor more than twenty. He declares that he never saw any inconvenience to follow these doses, and that he gives it to the children in his hospital by tablespoonfuls, so innoc uous does he regard it. Commenting upon these facts, Professor Mitchell of Jefferson College, writes: " We are not prepared to deny the truth of these statements, but really it does seem to us, that such wholesale admi- nistration looks very much like an argument in favor of the poetry of Homoeopathy." May the Professor feel disposed to listen to the argument, and turn homoeopathic poet! BORAX. The term borax comes originally from the Arabian baurach, a name which the Arabians applied to the nitrum of the Greeks. Subsequently, after the difference between nitrum and borax became known, the term borax was exclusively applied to the latter article. Borax or the Biborate of Soda is found in a lake in Thibet Asia the water of which contains common salt and borax in solution. The latter crystallizes on the edges and shallows of the lake, and is taken up in large masses, which are broken and dried. It is im- ported from Calcutta under the name of Tinkar (Persian for borax) or Tincana (Hindoo name for borax,) in the form of flattened six- sided prisms. Borax of a superior quality is found in China. Refined Borax is obtained from the commercial Borax by destroy- BROMIUM. 119 ing the fatty matter which coats the crystals of tincal; various pro- cesses are resorted to for this purpose which we cannot detail here. In homoeopathic practice we use this drug chiefly for the Aphthae of nursing infants. A few grains of the salt may be dissolved in half a cupful of tepid water, with which solution the mouth may be washed every time the infant has nursed. It is likewise recommended as a good remedy for a flow of the Menses during the period of nursing. For Hepatic Spots; and for the Acne with which plethoric young females are sometimes troubled, Ilufeland recommends a wash consisting of a solution of Borax in rose-water, half a drachm of the former to an ounce of the latter. The solution is applied three or four times daily, and left to dry. In all recent cases, a few drops are sufficient to remove the difficulty. This proceeding is likewise resorted to by many homoeopathic physicians, and seems to be harmless as far as the general constitution is con- cerned. If these eruptions are of long standing, and symptomatic of chronic liver-complaint, internal treatment has to be resorted to. BROMIUM. (Bromine.) Discovered by Ballard of Montpelier in 1826. He at first termed it muride (from muria, brine,) in allusion to the substance from which he procured it; but at the suggestion of Gay Lussac, he altered this name to that of brome or bromine (from bromos, a stink,) on account of its unpleasant odor. Bromine is obtained from bittern, the mother-liquor of sea-water, from which chloride of sodium has been separated by crystallization; from kelp, or from the mother-ley of the salt-springs near Kreuz- nach in Germany. We have some very excellent provings of this agent and of some of its salts, instituted by Hoering, Butzke, Wernek and Heimer- dinger with small and large doses. Hoering belongs to the progressive men in the great School of Medicine who are not ashamed of admitting, that the true action of drugs must be studied by experimentation upon the healthy. He shows that " the morbific or disease-begetting properties of drugs constitute, on the other hand, their therapeutic powers, whence we have a right to infer, from the effect of drugs upon the healthy body, what are their curative virtues against certain diseases; all we require to know, in order to cure most cases of sickness, are the effects which medicines are capable of producing in healthy persons by administering them in quantities just large enough to affect them." Dr. Hoering prepared a solution of six drops of Bromine to half an ounce of alcohol; of this solution he swallowed six and eight drops, and experienced the following symptoms: nauseous taste of the 120 LECTURE LXV. liquid; rough, disagreeable sensation in the pharynx and slight pinching in the bowels. There was an increased flow of saliva. After having taken seventy-two drops in all, the evacuations became papescent. In the evening he was attacked with an oppressive anxiety, oppression about the heart, and some headache. The pulse remained unaltered. After swallowing about one hundred and eighty drops in the course of a fortnight, the pulse became rather slow and hard. Forty drops caused diarrbcea, acrid burning from the throat to the stomach, excessive nausea, with desire to vomit, ptyalism, diffi- cult and painful inspirations ; a few hours after swallowing this dose, he was attacked with headache, violent stitches in the lungs; when attempting to draw a long breath, he had to cough several times; his pulse was full, rather hard, at first a little slower than usual, but afterwards rising to eighty or eighty-five beats in the minute. The urinary secretion seemed somewhat increased. Butzke obtained the same symptoms, except the alterations in the alvine secretions; these remained natural even after swallowing thirty drops of a solution of thirty drops of Bromine in four ounces of water. Five drops of Bromine in half an ounce of distilled water, swal- lowed before breakfast, caused an immediate paroxysm of suffocative cough, the breathing was somewhat embarrassed, he had to gasp for air; in the fauces he experienced a disagreeable, astringent sensation followed by burning and soreness, ptyalism, increased secretion of mucus in the mouth and nose, frequent eructations, vomiturition, with rising of a quantity of phlegm in the oesophagus. Disagreeable sensation of warmth in the abdomen, pulse seventy (ordinarily sixty- four ;) a few minutes after, slight attack of giddiness, accompanied with loathing; tongue remained moist. Eight drops caused all these symptoms, and a natural evacuation from the bowels, attended with some tenesmus. Inhalations of the vapors of Bromine have caused violent oppres- sion on the chest, cough, troublesome burning in the eyes with spas- modic contraction of the orbicularis palpebrarum muscle, increased flow of tears and dullness of the head. In twelve minutes, bleeding at the nose, which afforded relief; pulse somewhat accelerated. These effects are recorded by Heimerdinger. Several weeks previous to the conclusion of these experiments, Hoering broke out with boils on various parts of his body, particu- larly in the left axilla and on the left arm where the Bromide of Potassium, the provings of which will be mentioned in the chapter on the preparations of Kali, had been applied endermatically. These boils were attributed by Hoering to the influence of the Bromine, since he had never before been afflicted with them. If one of them healed, two others broke out in its place. He had no rest day or night, and had finally to cure himself by resorting to the springs at Wildbad. 6 Andral has instituted a number of experiments with Bromine on BROMIUM. 121 arthritic patients in the Hospital la Pitie. The result of large doses of the tincture and salts of Bromine in chronic arthritis was to deaden perfectly and rapidly the pain in the joints. This treatment cannot be imitated by a practitioner who acknowledges the law " Similia Similibus" as the true principle of Therapeutics; but we may take cognizance and avail ourselves of the medicinal effects which these massive doses have produced, as therapeutic indications. Two drops of the tincture produced no other sensation than that which is experienced in the mouth and throat when swallowing a spoonful of brandy. From six to eight drops produced a quarter of an hour after taking the drug, a tingling sensation in the fingers, twitehings in the feet and in the neighborhood of the knees. These symptoms occurred from time to time during the night, and were even felt on the following morning. A quarter of an hour after these first effects of the drug were felt, the patient likewise complained of colic and rumbling in the bowels. Ten drops induced in a quarter of an hour a feeling of weight on the stomach, drowsiness, eructations, colic, hawking. One hour after swallowing the drug, the patient experienced from the wrist as far as a little below the elbow, a sensation of tightness as if these parts had been in a vice; soon after lancinating pains darted through the fingers and flashed through the whole head; afterwards these symp- toms disappeared, and the patient enjoyed a remarkable feeling of quiet. The same group of symptoms occurred every day after each similar dose. The doses were gradually increased to 45 drops. This quantity produced such a violent sensation of burning and acridity, that the patient's face and limbs seemed for some moments convulsed. After this he experienced a desire to vomit and violent retching, but he never vomited. In about five minutes these symptoms disappeared, and the'patient was not further inconvenienced by the drug. His appetite was excellent, and his digestive functions were in perfect order. Andral's disciple, Dr. Fournet, who relates these experiments, informs us that under the use of Bromine the appetite and digestive functions of their patients, and their general health improved more and more. Bromine tinges the skin yellow and gradually deadens it. Homoeopathic physicians make alcoholic attenuations of the tinc- ture of Bromine, but they are used less frequently than watery attenuations prepared at the time when they are required. A drop of the tincture in ten tablespoonfuls of distilled water, makes a pretty strong solution. A tablespoonful of this solution may again be mixed with ten tablespoonfuls of water. This second solution is strong enough for all practical purposes. In chronic affections the alcoholic potencies have been'employed as high as the 12th and 30th. An alcoholic solution of the pure Bromine has a beautiful deep-red color, a strong and unpleasant odor, and an acrid taste. It is ex- 122 LECTURE LXV. ceedingly volatile, and should be kept in a dark vial provided with a glass stopper, and to be kept in a cool place. Bromine has a range of action similar to that of Jodine, more par- ticularly in affections of the respiratory organs. It may be employed in Bronchial Catarrh, with a sensation as if the air-passages were full of smoke, a rough and scraping feeling, with oppression of breathing. Bromine may be of use in Pulmonary Affections, more particu- larly when partaking of the nature of Tubercular Disease, with sudden paroxysms of suffocative cough, embarrassed respiration, violent stitches through the lungs, headache, pulse somewhat accelerated, full and soft; tendency to diarrhoea. Bromine has been used by homoeopathic practitioners in Membranous Croup, more particularly in the last stage of the disease, with variable and rather doubtful success. In Diarrhea depending upon a scrofulous element, watery or slimy, with irritation of the mesenteric ganglia, this agent may prove of great use. Some homoeopathic physicians have recommended Bromine for Hypertrophy of the heart; it causes a few marked symptoms in the region of the heart, such as oppression and anxiety; but we have as yet no clinical experience to adduce corroborative of the homoeopathicity of Bromine to hypertrophy of the heart. This agent seems homoeopathic to the Furuncular Diathesis; Floering's experiments have shown this very satisfactorily. Bromine may possibly be of use to us in the treatment of Neuralgic Rheumatism; the symptoms experienced by one of Andral's patients seems to point to this affection: colicky pains and rumbling in the bowels, a feeling of constriction in the lower arms, tingling in the fingers succeeded by lancinating pains in the fingers and around the head. In cases of poisoning we resort to the same antidotal treatment which has been recommended for Iodine. The first thing to be done is to remove the poison from the stomach by means of emetics, after which we administer tepid demulcents, more especially such as con- tain a good deal of amylaceous matter, such as starch, wheaten flour, potatoes, sago, arrow-root; these should be boiled in water and ad- ministered without stint. The Bromine combining with the amy- laceous principles, a compound is obtained which has very little local action. If nothing else is within reach, milk, eggs beat up with water, or even tepid water merely, may be given to produce vomiting. Barthey recommends Magnesia. The effect of Bromine-inhalations can be neutralized by the vapors of Ammonia. Hoering found in his experiments that the water of Ammonia antidotes the pure Bromine as well as the Bromine diluted with water. CALCARIA. 123 LECTURE LXVI. CALCARIA, (Lime) The salts of lime are important constituents of the human frame. They are found in large proportion in the bones, and, indeed, in every animal tissue. They not only fulfil important physiological uses in the development and support of the animal frame, but they are like- wise useful therapeutic agents when these uses are interfered with by inimical principles of disease. In the homoeopathic school, we employ the following salts of lime as medicinal agents: CALCARIA CARBONICA. (Carbonate of Lime) This preparation is made of oyster-shells. Brush off the dirt, boil them for half an hour in water feebly acidulated with muriatic acid; put a layer of them in a wind-furnace upon a layer of glowing char- coal, then alternate layers of common charcoal and shells ; fan to a glow until the shells are perfectly white and can easily be pulverized; take them cautiously out of the fire, and expose them to the air until the lime has imbibed sufficient carbonic acid. After a while, pour diluted acid upon a little powder, to see whether all the caustic lime has disappeared ; reduce the mass to powder, which, if sifted, should be of a dazzling white and loose. We make triturations. CALCARIA ACETICA. (Acetate of Lime) Made of the former by boiling it in acetic acid ; dilute the neu- tral liquid a little; then filter, evaporate by a gentle heat; make the first decimal solution by means of one part of strong alcohol and three parts of distilled water; next attenuate with dilute alcohol, and after that with strong alcohol. Preserve the acetate in a well- stopped bottle, with a little alcohol floating over it. 124 LECTURE lxvi. CALCARIA CAUSTICA, (Oxide of Calcium) Roast oyster-shells to a red heat, longer than is required for the Carbonate of Lime; then triturate in a mortar, sift through linen, and preserve in airtight vials; we make a tincture of this substance with dilute spirits of wine, of a straw-yellow color, caustic taste and calcareous odor. CALCARIA PHOSPHORICA, (Phosphate of Lime) _ Prepared by mixing together watery solutions of the acetate of lime and phosphate of soda. Wash the phosphate of lime (which goes down as a crystalline powder), collect upon a filter and dry it; it is a white, loose powder, having a chalky taste. We make tritu- rations. CALCARIA SULPHURATA, (Sulphuret of Lime, Hepar sulphuris, Liver of Sulphur) Mix equal parts of caustic lime and pure sulphur, pound to a lump in an earthen crucible, cover this with a layer of moist pow- dered chalk from half an inch to one inch thick; then cover it with a lid; expose the mass to a gentle fire, increasing rapidly as soon as it begins to glow; keep it for half an hour at a red heat; take it out, cool slowly; remove the covering layer of chalk; the yellowish- white contents are preserved in well stoppered, dark vials. We make triturations, and also a tincture with dilute spirits of wine. CALCARIA CARBONICA, Calcaria carbonica is found in Nature, in form of chalk, marble marie, plaster, crustaceae, mother-of-pearl, red and white corals' snail-shells, egg-shells, oyster-shells, and crab's eyes and claws of crabs. Crab's eyes are two hard pale-red bodies on the sides of the stomach. Physicians of the dominant school use: chalk conchae praeparatae and crab's eyes. The uses of Calcaria not being under- stood by Old-School physicians, it is therefore recommended empiri- cally for opposite diseases. Goelis cured with pulverized snail-shells scrofulosis and rhachitis; according to Richter, it developes a dispo- CALCARIA. 125 sition to these diseases; Richter teaches that lime is a diaphoretic, and Pringle and Camper recommend it for the colliquative sweats of consumptive persons; Yogt tells us that lime causes dyspepsia; Blanc gives it for troubles arising from deficient digestion. Calcaria acts upon definite systems, enveloping membranes; upon the fibrous, mucous, serous, osseous, cutaneous, and abdominal ner- vous systems; it is adapted to abnormal conditions of reproduction ; hence it is useful in scrofulosis and rhachitis; it is suitable for lymphatic constitutions, venous-haemorrhoidal, plethoric individuals, and for such as are subject to blennorrhoea, glandular swellings, enlargement of the abdomen, profuse menstruation, hysteria, melan- cholia. It is more adapted to children and females than to males. I am disposed to think that Calcaria, although an agent of import- ance and undoubted efficacy, yet has been overrated as regards the extent of its curative powers. Old-School practitioners use it prin- cipally for its antacid and astringent qualities. In the hands of homoeopathic physicians, this agent is used much more extensively and likewise more correctly than it is in the hands of their opponents. Ranging the pathogenesis of this drug under our usual categories, we obtain the following results: CEREBRO-SPINAL GROUP. Dr. Schreter has cured a chronic headache in the case of a scrofu- lous patient; the headache was worse during exercise in the open air, by a change of weather and by some violent emotion. Hysteric Hemicrania, with eructations, nausea and feeling of cold- ness in the head. ORBITAL GROUP. Calcaria has caused a pressure and burning in the eyes, with redness and sensation as of a foreign body in the eyes. Swelling and redness of the eyelids, with ulceration and suppurative aggluti- nation over night. Profuse lachrymation in the open air (epiphora.) Photophobia, dimness and specks of the cornea (leucoma.) In accordance with these effects of Calcaria, this agent has been used in Scrofulous Ophthalmia, with lachrymation, eruptions around the eyes, photophobia, agglutination of the lids, stinging pains, twitch- ing of the lids. It has also been used for Scrofidous Blepharophthalmia, with redness, swelling and scurfi- ncss of the lids. Leucoma of the cornea, specks of the cornea, photophobia. Epiphora, profuse lachrymation in the open air. In these affections, Old-School oculists have used lime-water on account of its astringent properties. On this account, Richter re- commends it for Hypopyon (purulent eye), and Beer used injections of lime-water in Fistula lachrymalis. Calcaria has likewise been useful in 126 LECTURE LXVI. Amblyopia, or amaurotic weakness, with dimness of vision, sparks, presbyopia. Frank reports that a woman of sixty-six years, who had been troubled with weakness of sight for some years past, accidentally got some lime-water into her eye. Yery soon after this accidental medication she fancied she saw more light; she, therefore, continued the use of the lime-water, and her sight improved so that she was able to use her eyes without experiencing the blurs which had troubled her so much. AURICULAR AND FACIAL GROUPS. iEgidi has used Calcaria in Scrofulous Otorrhea, and for Deafness, setting in after suppression of fever and ague. Calcaria is recommended for a variety of affections of the nose, where it has effected total or partial cures. Scrofulous Nasitis, with swelling, redness and painfulness of the nose. Ozena, with discharge of green and yellowish pus from the nose. Anosmia, loss of smell, with dryness of the Schneiderian membrane. DENTAL AND BUCCAL GROUPS. We use Calcaria for Toothache of pregnant females. Difficult Dentition ; it causes heat and swelling of the gums, with throbbing and sensitiveness to contact, ptyalism. CHYLO-POIETIC GROUP. Ricter, Yogt and Hufeland testify to the fact that the use of the carbonate of lime causes loss of appetite, and from my own experi- ence I can assert that it causes a rising of an acrid alkaline fluid off the stomach. It also causes distension of the bowels; large doses cause constipation ; small doses may loosen the bowels as a si