INDEX   RAISONNtf
                          TO

THE   NEW  MATERIA   MEDICA.
                    BY

Dr. J. C. PETERS  &  R  G. SNELLING.
                              A.
  Acids play a  most important  part  in* the  organism;  the  gastric
juice  is distinguished for its acidity, Muriatic and Lactic-acids being
predominant; the acidity  of the muscular juice is equally marked,
Lactic-acid alone being present; the  parenchymatous fluids  of the
spleen, thymus gland, smooth muscles,  liver and supra-renal capsules,
all contain free  acid, the acid-phosphates being internally present;
the serum of the blood is always alkaline, but the contents of the red
blood corpuscules  have either an actually acid reaction, or else con-
tain  substances  which are able  to saturate alkalies;  the urine, it is
well known, is  always acid in health, mainly arising from the pre-
sence of Acid-phosphate of Soda,  although no  less than thirty-one
grains of Sulphuric  are  secreted  by the kidneys in  twenty-four
hours, also  from fifty-two to seventy-five grains of Phosphoric-acid,
and from seven and a half to' fifteen grains of  Uric-acid—the  acidity
of urine also often increases rapidly after  its discharge, owing to the
formation of Lactic or Acetic-acid in it.
   From the above it is evident that there must be a proper supply of
acids to  the system  for the maintenance of health;  sometimes the
supply must be diminished, at others increased.  Muriatic and Phos-
phoric-acids are regarded  as powerful  tonics; Sulphuric,  as the
most efficient astringent;  Nitric, as an alterative and hepatic remedy.
   Acidity J  Acid.-acet. p. 7.  Acid-fluoric. 18. 21.  Acid.-sulph. 82.
Amnion.-carb. 270.
   Acidity.—Acetic-acid is sometimes  found in the stomach;  thus in
one  case  after vegetables  and a little meat, but no vinegar had been
taken, the vomited matters were  analyzed, and Lehmann satisfied
himself with certainty regarding the presence  of Acetic-acid.
   Fluoric-acid is also sometimes developed in  excess in the stomach.
                A 
2
Index Raisonni
  In  the  healthy state, when the stomach is empty, the fluid which
moistens its  surface  is  slightly alkaline  or  neutral; the contact of
food excites  the secretion  of gastric juice in which Muriatic-acid
exists in conjunction with a certain quantity of Lactic-ac'\d ; this acid
fluid is nature's solvent for the nitrogenous or albuminous constituents
only  of the  food; while the saliva, pancreatic and intestinal juices,
which are all  alkaline,  digest the starchy elements.   The gastric
juice gradually dissolves the albuminous food, and as the food becomes
more  and more digested,  the acidity  of the gastric fluid increases ;
the acid passes  out  of  the  stomach with the chyme, and the larger
portion of it  is  then neutralized by the alkaline secretions of the liver,
pancreas and small intestines, so that the contents of the small bowels
when examined a little way down are generally, or ought to be, slight-
ly alkaline, or neutral.
  Excessive acidity  of  the stomach  may be excited, in a four-fold
manner; 1st, Acid may be poured out in excess by the glands of the
stomach;  2d, It may  be  taken in  with  the food;  3d, It may be gene-
rated  from the food in the stomach  by some fermentative process ; 4th,
the natural function of the saliva is to convert starchy substances in-
stantaneously into sugar, which sugar  is subsequently converted into
Lactic-acid.
  Muriatic,  Lactic and  Carbonic-Acids may  be secreted from the
walls  of the stomach; the fermentative process  may  form  Lactic,
Acetic, Oxalic, Butyric, Carbonic, and  probably many other varieties
of Acid.
  Carbonic-acid  seems  to  be only troublesome or injurious from the
excessive flatulent distension it occasions.
  Butyric-acid  causes the eructation or vomiting of a nauseous acrid
or rancid-smelling volatile acid.
  Oxalic-acid causes  a  peculiar  form of indigestion, attended  with
great  melancholy.
  Muriatic-acid is  most common  in those who eat much meat;  Lac-
tic and Acetic-Acids in those  who prefer vegetable food.
  Mere mechanical irritation of the inner  surface of the stomach will
excite the secretion of gastric  juice; the irritation of chronic gastri-
tis, or simple ulcer,  or cancer, will do the same; also the irritation
from  the  presence of some hard or indigestible  substance, or reflex
nervous  irritation;  a  deficiency of gastric juice  will allow acetous
fermentation  to arise in the food;  unhealthy gastric juice will permit
the same; obstruction  of the pylorus, or feeble action of the muscular
coat of the  stomach  by which the food  is detained too long in the
gastric cavity, will be followed by  the same effect; as also a catarrhal
state  of  the  stomach  in which gastric juice is poured out sparingly,
and unhealthy mucus secreted, which rapidly decomposes and acts as
a ferment.

  Acne.—Prus.-acid.  p.  30.  Acid.-muriat. 39.  Acid.-nit. 49. Acid.-
phos.  70.   Agar. 166.  Ammon.-mur. 297.  Amyg.-dulc. 336. 
                 to the  New Materia Medica.                3

  Acne is defined as a chronic inflammation  of the sebaceous glands
and of their excretory hair-follicles; in consequence of inflammation
of the lining  membrane of the gland, impaction of the  altered se-
bacious matter follows; the pimples which ensue are hard, conical
and isolated elevations, of moderate size, and various degrees of red-
ness; the apices of the-pimples generally become pustular and burst,
while their bases remain for sometime in an indolent state  before they
disappear; in  some of these  elevations the purulent  fluid, is mixed
with  softened  sebaceous substance;  others subside  slowly without
suppuration; some  are  scarcely  at all reddened,  while  others are
highly congested,  and  surrounded by an inflamed base of vivid red-
ness.  Acne is usually accompanied by other signs of disorder of the
sebaceous follicles, which may either pour out an inordinate quantity
of secretion which gives to the skin a greasy appearance, or the se-
baceous fluid may be concreted into a solid form  and distend the ex-
cretory duct and hair-follicle, forming when its top is soiled by the
dust and  dirt  of the  atmosphere  with which it comes in  contact, the
so-called comedones, or acne punctata, or skin-maggots.  Acne simplex
is most  common during the middle period of life, and in females is
often connected with disorder of menstruation.   The term acne indu-
rata is applied when the eruption is remarkable for the indolence of
its course, the pimples being very  hard  and deeply rooted  in the skin,
the suppurative stage being prolonged for two or three  weeks, and af-
ter suppuration is  completed, purplish or livid tubercles continue for
months, sometimes becoming  permanent,  and at others  leaving in-
delible  cicatrices.  Acne rosacea  is remarkable  for the redness and
congestion which attend the pimples, by the enlargement and frequent-
ly varicose  state  of the veins of  the skin, by the indolent character
of the livid  and indurated tubercles which are left behind, by the
most common  seat of the disease being about the  nose, which is often
considerably enlarged  by the  morbid  action, the  integument and sub-
cutaneous textures  becoming infiltrated and hypertrophied, and the cu-
taneous veins  tortuous and varicose.   From the nose  the disease of-
ten extends to the  cheeks, and even entire  face, disfiguring the fea-
tures very  seriously.   Mentagra,  or sycosis is  only another variety
of acne, differing  only in its  favorite site, viz., on the hairy parts of
the face, chin, upper-lip, submaxillary region, &c.
   The  milder forms  will yield to Arnica;  more obstinate cases to
Hepar-sulph.,   or Carbo-animalis;  Stibium is a very reliable remedy
when suppuration  is excessive or indolent; while  Staphysagna is
perhaps the most specific remedy of  all;  Selenium  and  Sabma are
often useful, the latter  especially when there  are derangement of men-
struation ; Staphysagria where there is irritation  of the ovaries.

  Adiposis.—Ammon.-mur. 296.
  Adiposis is  most  common in childhood and about the 40th year of
life; naturally, fat  forms ^th part of the weight of the  body; very
fat  persons have proportionally small  arteries, they bear the loss of 
4
Index Raisonne
blood badly, breathe  imperfectly, are  apt to be dull and sleepy, have
a great susceptibility to atmospheric influences, sweat easily and take
cold readily, are predisposed  to  gout, apoplexy and more especially
to dropsy.
   The  obesity  of  persons with  weak gastric digestion is peculiarly
distressing;  the  defect  in muscular power prevents the use of exer-
cise for a time  sufficient to prevent its increase and hence it becomes
a  daily augmented inconvenience.  The encroachment also  of the
adipose upon the  other  tissues,  and  the dilution of the  insufficient
blood through an unnaturally large quantity of capillaries, tend to pro-
duce atrophy of important parts, and  hence we find as consequences
of corpulence, dilatations and degenerations of the heart, fatty depo-
sits on the same, Bright's kidney, drops*-, &c.  The addition of many
pounds to the body in the shape of fat, requires certainly a very large
addition of blood  and blood-vessels to nourish it, yet the same heart
has still to undertake this extra  labor ;  the  balance then between the
systemic  and pulmonary  circulation must be destroyed, and the lungs
be  inequal to  the secretion of so much' more Carbon than they were
 made for; hence the blood becomes more venous, more liable to form
 congestions, and to  dilate the cavities of the heart, by its retarded
 pace.
    A most important  part of the treatment of adiposis is the dietetic;
 thus mutton owes its  good  character for digestibility to  the little fat
 there  is  among its  close  grained fibres, even  in joints loaded with
 adispose tissue;  while  beef is  infiltrated with  oleaginous  matter
 throughout.  The absence of fat in fish and poultry is one great cause
 of their  easy digestibility;  in  the cod, haddock and whiting, fat is
 found  in  the  liver only, hence these are the preferable kinds of fish
 for fat persons, who wish to reduce their weight; fat abounds in oys-
 ters, while the rabbit is  said to be almost entirely destitute of fat, and
 in some instances none  at all can be  discovered.
    Acids prevent the digestion of, and remove fat;  a Spanish  general,
  who was enormously  corpulent, is said to have removed the fat so ra-
  pidly by drinking large quantities of vinegar, that he could wrap the
  loose  skin around  him like a  cloak;  another  case of adiposis was
  promptly cured by Nitric-acid; yet when  Nitric-acid is made to act
  on fibrin  apparently  deprived  of its fat, an oily substance is disen-
  gaged ;  and during  the  action of  Nitric-acid on  starch, an oily matter
  is set free.  The best time to take acids, to prevent fatness, is before
  and during meals.  Alkalies, such as Soda and  Potassa cure adiposis
  in a different way,  they cause  the fat to be reabsorbed from the fat-
   cells, then combine with it  to form a soap or emulsion, after which it
   is burned up with oxygen, as a calorific element; the best time to take
   alkalies to remove corpulency is from four to  six hours after meals;
   if taken with, or shortly after food, they will solve or saponify all the
   oil and fat in the food, favor its absorption  and appropriation.
     Starch,  sugar, gum, also distilled and fermented liquors favor the
   development of  fat,  and  should be  avoided; in fact oils and fats can 
to the New Materia Medica.
5
be formed from starch and  sugar, thus, if a strong solution of sugar be
mixed with a  small  quantity of casein ami powdered chalk and ex-
posed  to a temperature of more than eighty degrees, Carbonic-acid
and Hydrogen  are evolved and Butyric-acid forms, as the Butyrate of
Lime; this  acid is a colorless  oily liquid, having the odor of rancid
butter, in which indeed it exists.
   Bile removes fat from the system, in fact the deposit of fat and the
production of bile seem to be  inversely as to each other; fat animals .
yield less bile than lean ones, and the hasty inference has even been
drawn that accumulation  of fat  is a consequence of the diminution of
the secretion  of bile;  in  this  connection we may state that the pro-
portion of fat in the blood  is higher in jaundice than any other known
disease, and persons are very apt to grow fat  after  being salivated
 with  Mercury.
   Fats and oils are formed from Carbonic-acid and water, and to Car-
bonic-acid and water they return when consumed in the act of respi-
ration;  hence fat persons should be encouraged to breathe deeply and
fully; their lungs  as  well as  their muscles should be put through  a
regular course  of  gymnastics.

   After-pains.—Amyg.-amar. p. 335.
   To prevent after-pains, the patient should not be  allowed to leave
 the horizontal posture for some  hours after delivery ; if she be raised
 up in bed, the blood again accumulates in the uterine veins, blood is
 poured into the cavity of the uterus, and a very severe attack of after-
 pains, or dangerous flooding may come on.
   Ordinary after-pains generally present themselves while  the uterus
 is contracting;  they are  rare with  first children, except they be of  a
 simple spasmodic, rheumatic or neuralgic nature; coagula collecting
 in the womb is one of  the most common causes, an(l  if this happens
 soon after delivery the patient  experiences pains as severe or greater
 than labor-pains.  Flatus in the bowels also  gives rise to severe after-
 pains.  When a eoagulum is present, th^e womb is generally  large, pro-
 minent and exceedingly  painful on pressure, but every other part  of
 the abdomen is free from pain and generally soft,  if not flaccid.   When
flatus is  the  cause, the abdomen is tympanitic, the uterus cannot be
 felt, and the slightest touch gives intense pain, but if the pressure be
 increased, the pain diminishes  until  it quite disappears ; still, if after
 this the hand  be suddenly withdrawn from  the abdomen, the pain in-
 stantly returns with great violence, so  that the patient may scream
 with agony.   When inflammation is present, which is also attended
 with tympanitis, the greater the pressure the greater the pain.   Spas-
 modic  and neuralgic after-pains may be distinguished by the natural
 feel of the abdomen, which is soft and free from  pain, and by the size
 of the uterus, which is very little  increased; it usually feels firm un-
 der the hand,  and is exceedingly painful when pressed upon.
   After-pains  from coagulae and flatus are most  common in those wo-
 men who  have had many children ; for the muscles of the abdomen 
6                      Index  Raisonne*
 have been  so stretched and debilitated by frequent pregnancies, that
 they give no  support to the intestines when the uterus leaves the ab-
 domen ;  hence they become over-distended with air and tormina are
 the result: the womb also is deprived of that equable pressure which
 it is so necessary to maintain, hence it yields more readily to the dis-
 tension of coagulae, and in place of promptly expelling them, allows
 them to accumulate and produce after-pains.
   Secale, Nux and Arnica are the most homoeopathic remedies to se-
 vere  spasmodic after-pains ; Arnica and Chamomilla  when there is
 much flatus ; Aconite and Coffea when the pains are neuralgic and are
 so severe as  almost to drive the patient to despair.
   In the severest  cases of pain and spasm Opium and Morphine act
 like a charm; when there are many coagulae and much flatus, Tere-
 binth will relieve when other remedies fail;  Pulsatilla is said to re-
 gulate the uterine  contractions, but Conium and Belladonna are more
 efficient;  when  there is inflammation,  Aconite and Veratrum-viride
 are the  most reliable remedies.   Ol-Amygdal-amara  deserves more
 attention in neuralgic and spasmodic cases  than it has received.

   Albugo.—Ammon.-mur.  p. 297.
   Albugo is  one of the varieties of opacity or speck of the cornea;
 1st, Nebula is the  slightest degree, occurring most frequently in the
 superficial layers of the cornea,  occasionally in the  lining membrane,
 rarely inthe proper substance ; sometimes it arises  from serous effusion
 into the substance  of the cornea, in others from fibrin effused between
 the layers; nebula includes only those opacities which are cloudy or
 hazy, its  most common cause is scrofulous comeitis, although it is a
 frequent consequence of muco-purulent ophthalmia, inverted eyelashes,
 or granular  conjunctiva; whenever the upper half of the  cornea is
 nebulous  or  vascular we may suspect the  presence of granular con-
junctiva of upper lid.
  2d, When  the effusion  of lymph into any part of the cornea is so
 dense as  to present a pearly appearance, it is called albugo, the most
 common  source  of which is a phlyctenula on the cornea which has
 receded  without bursting;  for a phlyctenula is a small abscess with
 walls formed by coagulable  lymph, the pus may be absorbed and the
 lymph remain;  onyx or abscess of the cornea when the pus is dis-
 persed, leaves an albugo behind, formed by the adhesion of the once
 separated layers of the cornea by coagulable lymph; albugo is some-
 times red and vascular in scrofulous persons and then is extremely apt
 to spread across the  cornea, unless the vascularity is removed.
  3d, Leucoma  is the third variety of speck and is  always the result
 of cicatrization,  after a loss of substance of the cornea by ulceration.
  All these three kinds  of  specks have a natural tendency to disperse
 as soon  as the disease  which caused them is removed ; in  children
 and young persons many very dense and extensive opacities are  gra-
 dually removed by nature alone; in fact, it  is supposed that when the
 disease is removed nature will  sooner or later accomplish the whole 
to the New Materia Medica.
7
amount of removal of opacity which is possible ;  some opacities yield
only under  the influence  of sea-  or  country-air and generous diet.
Mackenzie has seen good effects from the vapor of Hydrocyanic-acid
in many cases  of  speck,  especially in nebula from corneitis, in leu-
coma combined with vesication of the cornea, or watery effusion un-
der the epithelium,  and in vascular albugo;  in the latter case, the ac-
tion of the  vapor causes the vessels to shrink, after which the speck
ulcerates and disappears ; Nitrate of Silver, Corrosive-sublimate, Io-
dide of  Potash, Tartar-emetic,  Sulphate  of Cadmium  and the bile of
various animals are  considered useful local applications, but if  their
use  be commenced before the cause of the opacity is removed, the
patient will be tormented  and the cure  retarded.  Hartmann says, that
Sulphur one day, and Calcarea the next, in alternation, will frequent-
ly  cure  scrofulous ophthalmia of years' standing in a  fortnight; He-
par-sulph.  is the  most important internal remedy against specks, al-
though Euphrasia,  Rhus,  Cannabis and Silver deserve  attention.  Am-
mon.-mur. should be used in- and externally more than it is.

   Albuminuria.—Acid-Gallic, p. 25.  Acid-nitr.  53. Acid-tannic. 89.
   Albuminuria as  a term merely refers to the  presence of albumen
in the urine ; it occurs more especially in  connection with three dis-
eases of the kidney, viz. :  the fatty enlargement, the chronic contract-
 ed kidney,  and the waxy enlargement.
   1. The fatty condition of  the  kidney  is generally attended with
 dropsy, much greater in amount, and of a more persistent  and  obstinate
 character,  than either of the others, which unless accompanied by
 some diseased or enfeebled state  of heart, are frequently quite free
 from dropsy,  and  generally have it  only to a slight  amount.  1 atty
 kidney may be detected by means of the microscope,  from the pre-
 sence of abundant  fat-cells, fatty casts, and  free oil with albumen m
 large quantity  in  the urine.   Mercurius-corroswus and Hydriodate oj
 Potash are the most important remedies in  this disease ;  they will not
 only remove the  dropsy, but will do much to alter the fatty  condition
 of the kidney; Ether is also a very useful remedy, especially Fhos-
 phonc-ether,  which is almost  as  useful  as  Kali-hyd. in dropsy and
 against the fatty condition of the renal organs.   Apocynum-cannabi-
 num is a most useful palliative.                                ____
    2 In  the contracted  kidney,  fat-cells or  fatty casts  are  either not
 present in the urine, or are  discoverable in small numbers only by
 S of  the  microscope, and  then  only occasionally ; and in  its advan-
 ced stages the albumen is never by any  means so abundant  as to ren-
 der the urine nearly solid under Nitric-acid and heat.
    3 The waxy kidney, according to Todd, exhibits  clinical phenomena
  sufficiently distinct from those  of the  fatty disease; instead of  he
  white anemic complexion with the puffy  ace, which  accompanies the
  litter  malady-we find  the  patient  looking sallow, and,  generally
  p"akinl  free from any swelling of the  face ; dropsy, either does not
  exist at all  or is very  trifling;  it also does not show itself until the 
8
Index Raisonne"
disease  has advanced considerably, and it rarely, if ever, is so pro-
minent and chronic a symptom  as in the fatty disease, nor is it often
as much as in the contracted kidney.   In  most of the cases the pe-
culiar waxy degeneration is not limited to the kidneys, but affects the
liver and spleen, causing enlargement of these organs ; the increased
size  of  these  viscera, therefore, becomes an aid to the diagnosis of
this  affection, in  addition  to those signs of its presence found  in the
urine; the quantity of the albumen is generally .large, almost as large
as in the fatty disease ;  but fat-cells are not found by the microscope,
nor the fatty  casts; while transparent fibrinous casts and the  debris
of epithelium  are the most common appearances, but even these may
be absent at times.   In  this disease Phosphorus is the most important
remedy; it may have to be aided by Phosphoric-ether.
   The symptoms in  these chronic forms of Bright's disease are often
trivial for months, or even for a few years;  there may be more or less
aching in the back, but never of a severe character ; rather more fre-
quent inclination  to pass urine,  especially at night; with scantiness
of urine in the large fatty kidney,  and a  rather profuse flow  in the
small hard and contracted ;  there is much albumen in the urine in the
large,  white,  or fatty kidney, but little in the opposite state ;  in all
varieties there  is more or less tendency to dropsy, marked by puffi-
ness of the face and eyelids, and some oedema of the feet and ankles, but
when the small hard kidney is present the blood is less robbed of its
proper albumen and, therefore, less impoverished, while as the urine is
rather abundant its watery portions are plentifully, or at least sufficiently
drained away, so that the occurrence of dropsy is long postponed; but
any sudden check to the quantity of urine from  exposure to cold  and
wet, or  the occurrence of  fever,  a fit of indigestion, &c. is apt to be
followed by extensive dropsical effusions  and speedy death; in fact,
this  small hard contracted kidney is very  frequently at the bottom of
the disease, called diabetes insipidus, or anazoturia.  The urine in all
varieties of Bright's disease is apt to have a peculiar smoky look, as
if a  cloud  of  tobacco-smoke had been blown through it, or it may be
dark and obscurely turbid  like muddy beer; these hues depend upon
the  presence  of a little of the coloring matter of  the blood darkened
by the acid properties of the urine ; it also  froths more than usual, and
if one blows into it through a tube, bubbles rise like those in soap-water,
and the bubbles remain long unbroken ; it is a little singular that spon-
taneous deposits rarely form in albuminous urine, but more or less co-
pious ones are thrown down when it is heated-to the boiling point, or
Nitric-acid is added in excess.  Another peculiarity of albuminous
urine is the small amount of urea which it contains; in fact, the urea
is retained in the  blood, where it irritates and excites almost every
organ in  the  body, causing more or  less tendency  to headache, con-
vulsions or stupor ;  or it irritates or inflames more or fewer of  the se-
rous and mucous membranes, so that pleurisy, bronchial irritation, dis-
order of the stomach and bowels, such as nausea, vomiting, flatulence
and diarrhoea are common occurrences ; rheumatic pains are  also 
to the New Materia Medica.
9
common ; it is a plausible, and probably a true explanation that these
affections of the mucous,  serous  and fibrous surfaces are excited by
the poisonous material retained in the blood, and seeking vent through
supplementary channels'of excretion ;  at least large quantities of urea
have  been detected in the vomits and stools, and even in the perspi-
ration and breath of the patients, and more  or less relief has followed
copious evacuations by vomiting, diarrhoea,  or perspiration.
   The acute varieties of Bright's disease are the most common cause
of acute general dropsy, or anasarca.  In this form the whole kidney
is gorged with  blood,  which sometimes drips freely from it, when it
is cut open ;  the  whole  organ is large, somewhat flabby, of a deep,
dark-red,  or  even  of a chocolate or purplish color, nearly uniformly
diffused, except that the cut surface is usually diversified by still dark-
er  tuft-like  spots,  which have been ascertained to be the Malpighian
bodies,  turgid  with blood.  The  symptoms are fever, often  preceded
by rigors, uneasiness or dull pains in the loins, nausea and vomiting,
a  very  scanty secretion of  urine, which is sometimes  tinged with
blood, and always  albuminous ;  occasionally  there  is complete  sup-
pression of urine ; to  these symptoms there  is presently added, in
most  cases, sudden and general anasarca, forming what is commonly
called inflammatory, active or febrile dropsy, which is only too fre-
quently  attended  with  some  acute  internal inflammation,  such  as
pneumonia, pleurisy, pericarditis,  or peritonitis.
   In  this variety Aconite  and Digitalis, aided by Antim.-tart.  or Ve-
ratrum-viride are the most  important remedies at first; Apocynum may
be required  if the urine  become very scanty and the dropsy exces-
sive ; Phosphoric-ether if the  pneumonic symptoms are predominant,
with progressive debility.

   Alopecia.—Acid-fluoric, p. 19.  Acid-phos. 69.   Ant.-tart. 403."
   Alopecia is  defined  as  falling out of the hair, or loss of the hair ;
when the disease is confined to the crown  of the head, it  is called
calvities; when it is congenital, it is called alopecia adnata; when it
occurs in later years, alopecia acquisita;  when it takes place in patch-
es, alopecia circumscripta, or porrigo decalvans, or alopecia areata, seu,
utiligo  capitis; another form  is  called tinea tondens, or herpes ton-
surans.
   The principal causes are congenital predisposition, mercurial or sy-
philitic  disease, severe  fevers, debilitating losses, various skin-aft'ec-
tions  of the  scalp, such  as irritability  and congestion of the scalp,
ptyriasis or dandruff, ezema, &c.
   The  local  treatment  must  be  varied  according to the state of the
scalp; if it be tender,  irritable, easily reddened, with much dandruff,
quite  soothing remedies may be used, such  as, weak  solutions  of Bo-
rax, or  Chlorate of Potash, Glycerine,  Cod-liver-oil,  &c.
   If  there be great torpor and insensibility of the scalp, irritants and
stimulants may be used, such as Bay-rum,  Tinct. Cantharides, &c. 
10
Index RaisonnS
  Amaurosis.—Aeon. p. 119.   Agar. 165.  Ambra 246.  Amnion.-
caust. 285.   Ammoniac. 319.  Ant.-tart. 422.
  Amaurosis is defined as partial or complete loss of sight from dis-
ease of the  optic nerve, retina, or brain.   The simplest form arises
from loss of power of the  optic nerve or retina, and a large propor-
tion of these cases are relieved by the internal and local application
of Strychnine,  two grains to  the ounce.   The next least complicated
variety is  caused by  congestion  or inflammation of the optic nerve
or retina, against which Mercury is relied upon in the dominant school;
Travers says, he  has been a  witness to its  powers in suddenly arrest-
ing the disease in too many instances not to entertain a higher opinion
of it, than of any other article  of  the Materia Medica, and Laurence
says, when a  fair trial of Mercury fails he tloes not believe that we
can  effect  any essential good  by other means.   An equally  simple
form of amaurosis, or loss or diminution of the power of vision some-
times comes  on from certain  causes, which diminish the vigor  of the
system generally, such as, long-continued  nursing, menorrhagia, pro-
fuse diarrhoea,  or salivation; in all these  cases Strychnine, Quinine
and Phosphorus are calculated to produce greal and permanent advan-
tage, yet singularly enough,  both Quinine and Phosphorus have  been
known  to  produce blindness.   Bright's disease  of the  kidneys is a
common cause  of Amaurosis  ; in  a case of poisoning with Phospho-
rus a peculiar  symptom showed himself,  viz., deprivation of sight;
the patient, who retained perfect consciousness, stated that in the  hori-
zontal  posture  he  could perceive a feeble  ray of  light, but that when
he sat up he could not see at  all; the pupils were so dilated that only
a narrow ring of the  iris was visible, and they were insensible to
light;  he had darting  pains in the eyeballs;  the urine also contained
albumen and exudation-cells, and  this state  of the urine continued
during the whole course of  the case, while the cortical substance of
the kidneys was found to be granular after death ;—as the patient's
health  was excellent before he took the Phosphorus, it is not likely
that these signs of Bright's disease were present before the reception
of the  Phosphorus.

  Amblyopia.—Acid.-phos.  p.  69.  Agar. 165.  Anac. 346.
  Amblyopia is incomplete amaurosis ; the difference between ambly-
opia and amaurosis being in  degree only.  It is, however, often mis-
taken  for asthenopia,  or weakness of sight, or morbid sensibility, or
debility of  the  retina;  but in  amblyopia there is constantly present an
indistinctness of  sight,  extending to all objects,  large and small; in
asthenopia  vision becomes obscure, only after being excited upon near
objects ; in amblyopia  the patient generally sees best after fixing, or
somewhat  straining his eyes, or steadying them as he often terms it,
for some time on  the object;  in  asthenopia, it is then only that he be-
gins to see  ill.   Asthenopia has  often been treated as amblyopia, or
incipient amaurosis, but there is no necessary connection between the
two  diseases, nor  does the  one  lead to the other; on the contrary, 
to the New Materia  Medica.
11
asthenopia may last for many years, yet vision will not be absolutely
impaired, for the patient can see for a few moments at a time as well
as ever,  but  his eyes quickly become fatigued, or strained; while in
amblyopia indistinctness  of vision is  always present,  and in most
cases gradually and steadily increases.
  The most important remedies are  Aurum-muriaticum, Cicuta, Phos-
phorus, Ruta, and Agaricus.

  Amenorrhea.—Acid-benzoic.p.14.  Aeon. 126. Agnus-cast. 171.
Aloes 218. Alumina 240.  Catechu 240.  Ammon.-caust. 287.   Am-
mon.-mur. 304.  Arom.-spts. Amm.  315.   Apis 443. 460.
  Amenorrhoza, absent or defective menstruation may arise from a va-
riety of causes :
  1st, The menses may have been retarded by imperfect development
and  general debility;
  2d, From congenital defect of the ovaries, uterus, &c.
  3d, Although naturally secreted they may have been retained by an
imperforate condition of the os-uteri or vagina;
  4th, They may have been established for a time, and then become
suspended or suppressed;
  5th, They  may  be retarded  or suppressed by an unhealthy con-
dition  of the  chylopoetic  viscera, including the stomach, liver, bow-
els, &c.
  6th, They  may have become retarded or suspended  by disease in
some other organ, such as the lungs, by rheumatism, &c, &c.
  When they are retarded by imperfect development, we find that the
various changes in the system connected  with puberty have not been
effected; the  patient  is  still a  child when she ought to have become
a woman ; her frame instead  of becoming more expanded and robust,
remains delicate, her circulation feeble and growth stunted.  In these
cases fresh air, plain nutritious food, early hours, active exercise, salt-
water-baths,  friction  with coarse towels,  Phosphate of Iron, Aloes
and Nux-vomica are indicated.
  When there is  a congenital defect of the ovaries, without an ab-
sence of these organs or the  uterus—Phosphorus, Ferrum,  Strammo-
nium, &c. are indicated.
  When the  menses  have been retarded or suppressed by  disease ot
the chylopoetic viscera, we find the bowels confined and unhealthy, the
liver  torpid,  the urine high  colored,  loaded and probably scanty, the
skin dry and harsh, or cold, moist and clammy, the face pale and sal-
low   the  pulse feeble and easily excited,  with occasional palpitation,
the 'breathing short  and imperfect, the  tongue loaded with a thick, yel-
low  fur   through which  the red, elongated papillae often project or
else it is pale, large and  flabby, with  the  marks of the teeth on the
edees and the breath foul.  In these cases Pulsatilla, Mercunus, Sul-
phur Conium, Chamomilla, &c. are the most important remedies ; an
occasional laxative dose of  Mercurius and  Aloes may be required,
assisted  or  not by  Conium; by these means a large quantity of un- 
12                     Index  Raisonne

healthy faecal  matter is often removed, the complexion begins to lose
its  dusky,  sallow hue, and  becomes clearer and brighter;  the very
expression of the patient's  face is improved, the  apathetic restlessness
and the nervous timidity have cleared away,  and looks of  intelligence
and animation have taken  the place of dullness  and depression.
  When there is a tendency to disease of the lungs, Phosphorus and
Pulsatilla should be used; when there are rheumatic  affections, Sul-
phur  and Pulsatilla ; catarrhal  affections require Mercurius  and Pul-
satilla—congestions of the head, Aloes and Strammonium, &c,  &c.
  When the vagina is closed at its outer extremity either by adhesion
of its walls, or by an imperforate hymen, the menses being prevented
escaping, accumulate in the uterus and upper part of vagina;  the pain
in the back becomes severe and returns in paroxysms, probably from
the  distended womb being excited to contractions; the patient suffers
from  bearing  down, tension and a sense of  weight in the pelvis, the
abdomen swells, there is a frequent desire to empty  the bladder and
difficulty in doing  it, from the pressure of the  distended vagina, and
this sometimes amounts to complete retention  of urine;—the faeces
are  also passed with difficulty from the  obstruction caused by the dis-
tended  uterus pressing upon the rectum.   These  symptoms at  first
appear  every  four  weeks, continue some  days and then disappear;
finally, a large amount of fluid accumulates and the distress  now be-
comes constant, although  much  aggravated  at times ;  by degrees ge-
neral  disturbance of the health follows,  the spirits are affected, the
face becomes pale,  the abdomen swells and  is painful, there are ver-
tigoes and sleepless nights, with frequent inclination to bear down as
in labor.  An  examination soon detects the cause of these symptoms;
if the membrane be not very thick and firm it may become so distend-
ed as  to project  between  the  labia like a pouch of blood ;  the ope-
ration is simple and usually performed without  difficulty, and a quan-
tity of tar-like  blood comes away, to the great relief of the patient;
the  vagina should be well washed  out with warm water, and a roll of
lint dipped in oil inserted between the divided parts to prevent reunion.
  Next to imperforate  hymen, the most common form of imperforate
vagina is, when the labia andnymphae are adherent together,  or where
the  parietes of the vagina are  united  either partially, or throughout
their  whole  extent; the  first is rarely  a congenital defect, the  latter
is occasionally, at least.   Adhesion of the labia and nymph as are
usually induced in early infancy from want  of  cleanliness, neglected
excoriations,  &c, and these adhesions,  may in  some cases extend up
the  vagina to a considerable distance.  Every now and then  we meet
with cases  in which this  cohesion of the vaginal walls can be safely
separated, either by the finger, or the  sponge  tent;  an early exami-
nation should  not  be neglected, for these cases may be mistaken for
dysmenorrhoea, until  the  retained  fluid  has distended the  fallopian
tubes  and  passed  into the abdominal  cavity.  In most of the above
cases, there is a slight depression between the  labia, and if the  point
of the finger be firmly pressed against the deepest part of it and gent- 
to the New Materia Medico,.
13
ly rotated with  a boring motion, the parts according to Digby, usu-
ally  begin to yield and separate, and this may be followed up by the
same process, aided or  not by sponge tents; where  the depression is
very  slight,  it  may  be necessary  to fix a little ball of compressed
sponge  tightly  against  the  part, by means of a T bandage; a bougie
of proper size, will have to be worn subsequently.
   In a great  many  congenital  cases of imperforate vagina, this tube
is only a blind sac,, which passes up a little way and then terminates;
in other  cases it reaches nearly to the uterus, but does not communi-
cate  with it.  It is fortunate, that these congenital defects of the va-
gina seldom occur  to a  very hopeless degree, without the uterus itself
being absent, or more or less defective, so that no menstrual secretion
is, or can be formed    A few cases, however, have  happened, where
the  vagina was  nearly  absent, yet  the uterus has  become enormously
distended with  menstrual fluid,  producing much suffering and  danger,
 and  in  which  an  incision had to  be carried to a considerable depth
 before the womb could be reached.
   Obstructed vagina,  resulting from the sloughing and cicatrization
 after a severe labor, seldom leads to retention of the menses, although
 it may much interfere with coition and parturition.
   The most common form of imperforate os-uteri is where the edges
 have adhered together ; this may be a  congenital defect, or occur as
 the result of sloughing and cicatrization produced by severe labor; or
 the  os-uteri  may  be covered  by   a preternatural  membrane, or be
 entirely wanting.  Inthese cases  the uterus will be found distended,
 not  only sunk low in the vagina, but also may be felt above the sym-
 physis pubis;  if the obstruction be very firm, the blood may find a
 passage  through the fallopian tubes into the abdominal  cavity and
 cause a fatal  peritonitis ;  if they  be less  dense,  the distention and
 contractions of the womb are  sometimes sufficient to make them give
 way, and thus effect a cure.   Early and careful  examinations should
 be  made, with the finger for the os-externum, with the uterine sound
 for the os-internum; in occlusions of the external os, a slight depres-
 sion or  groove will generally mark the probable situation of the os-
 uteri ; a trocar passed  at this spot, will usually penetrate  the uterine
 cavity and give vent to a large quantity of thick tar-like blood.
    Acute suppression of the  menses is  caused by violent impressions
 on  the system  during,  or just before the menstrual period, such as ex-
 posure  to  cold and wet, a sharp attack of fever, violent affections of
 the mind, or a  heavy meal of indigestible food.  The patient is seized
  with violent pain  in  the  pelvis and loins, sometimes extending over
 the whole  abdomen,  and  assuming more or less of a dangerous con-
  gestive, or acutely  inflammatory   character;  the pulse  is quick and
 throbbing, the face is flushed, skin hot and dry, and there is usually
  intense headache.

    Anasarca.—Apis. p. 454.   Apoc.-cann. 484-5
    Anasarca is a dropsy of the skin, or more properly, an infiltration 
14
Index RaisonnC
of serous fluid in the cellular or areolar tissue, passing therefore, up
through and amongst the more loosely connected parts of the body ge-
nerally, such as between the skin and  muscles.   The simplest form
of anasarca arises  from general debility, and a thin and watery con-
dition  of the  blood; we see  this frequently in  weak chlorotic girls
with bloodless cheeks and pale lips; besides the anasarca there will
generally be a loud and unmistakable bellows' sound about the heart;
all  the  muscles are  weak and flabby,  and the heart partakes of the
general  debility of the muscular system and becomes not only inca-
pable of sending the blood forwards  with the requisite  energy, but
also actually  dilates under the existing pressure of the blood which
enters  its chambers; these  cases are readily cured by Ferrum, China
and Nux,  the former  to improve the condition of the blood  and the
latter to sustain the action of the heart and invigorate the whole mus-
cular system.
  In a large  number  of cases of anasarca the  skin is dry  and the
urine scanty,  and the  dropsy is observed to increase, or diminish as
the quantity of urine decreases or augments; the aqueous  fluid which
should  escape from the surface and through the kidneys, collects in
the subcutaneous  cellular tissue.   As the disorder advances  the ten-
dency  to effusion of serum through the sides of  the blood-vessels is
probably  increased, not only  by the sluggish movement of the blood
in  the  veins,  from  progressive  debility of the heart, but also by one
of the  causes  of that  debility, the thin and watery condition of the
blood itself.
  In other cases the dropsy arises from disease of the heart; we in-
fer  that  the dropsy in a given case, has this origin, if  we find that
thoracic symptoms, such as cough and dyspnoea, preceded the  dropsy;
or  if we perceive  direct signs of heart-disease,  such as, distended
jugular veins,  irregular movements of the heart, unnatural  impulse, or
altered  sounds.   As long as the mitral valve remains healthy and ef-
fective, dropsy does not occur, but the left auricle and pulmonary veins
become choked and distended, and the blood is detained in the lungs;
then commences dyspnoea ; at  first only occasionally, whenever the
heart is tasked with the conveyance of  a greater quantity  of  blood in
a given  time than usual, as in brisk movements of the body, or sud-
den emotions  of the mind, or when it is oppressed by a full meal, by
flatulent  distention of the stomach and bowels,  or by the recumbent
posture; afterwards the  shortness  of breath  becomes more   or less
constant and  distressing.  Now this loaded and embarassed state of
the lungs even when it is permanent and has reached a considerable
degree,  may exist  without materially  interfering with the functions
of the  riodit or venous  heart;  for the pulmonary plethora may be  re-
lieved  by increased secretion from  the bronchial  mucous membrane;
but dyspnoea may precede for some time any appearance of  dropsy.
The following train of symptoms is very  common in persons over forty
years of age; irregularity  of  the  pulse, increased impulse  of the
heart, occasional shortness  of  breath, large crepitation, habitually au- 
to the New Materia Medica.              15
  dible in the lower and hind portions of the lungs, more or less expec-
  toration, sometimes tinged, or even loaded with blood; eventually the
  ankles begin to swell and  the patient becomes by degrees decidedly
  and universally dropsical.  But before this occurs, more or less drop-
  sy of the  chest may take place;  besides if the patient takes cold, or
  from  some other accidental cause, a  most intractable form of inflam-
  mation  of the lungs  may  set in; the lungs are already so crowded
  with blood, that inflammation  easily arises and subsides with difficul-
  ty ; as  it  yields  in one  quarter, it will progress in another; and the
  suffering  from  difficulty of breathing, arising from a complication of
  congestion and oedema  of the lungs, with  more  or less effusion of
»  blood in  the air-tubes and cells, and  transudation of serous fluid into
  the cavity of the  chest, will be very great  and intractable.  In these
  cases Phosphoric-ether  is  more useful against the inflammation  and
  congestion of the lungs  than  Phosphorus or Arsenicum;  Apocynum
  and Hydriodate  of Potash will often carry off the serous  fluid  at the
  rate of  many quarts per  day to the great present relief of the patient.
  Iodide of  Iron, China and Quinine, Nux and Strychnine will improve
  the condition of the blood, and sustain the failing action of the  heart.

     Aneurism  of Aorta.—Alum p. 221.
     Aneurisme of the aorta generally arise from aetheromatous disease;
  they are most common in the ascending pai;t and in the arch.
     Aneurismal pouches often form at the very entrance of the aorta, or
  in the coronary arteries, and then  generally defy detection ; finally it
  bursts, and the patient all at once drop down dead.
     Aneurism of the  ascending aorta and arch, often attains a large size,
  and the first  evidence of its presence may be  the effects of its  pres-
  sure on neighboring parts; aneurism of  the  arch of the aorta may
  press on the trachea and impede the breathing; or by pressure on the
  recurrent  nerves,  may cause  a very accurate mimickry of laryngitis,
  producing  raucous  voice, and stridulous  respiration, and  perhaps a
  cough with a peculiar metallic clang ; then if  the patient has a  sense
  of pulsation  within the  chest, we may suspect aneurism.  Again, it
  may press on the  oesophagus and cause the ordinary»symptoms of
  stricture of that  tube; if pulsation within the chest be also present,
  we may get upon  the track of  the disease.  It may  also press  upon
  the vena cava superior, and cause  a most curious example of dropsy,
  for the face, neck, chest  and arms may become tumid and  anasarcous
  to an extraordinary degree, while there is not a trace of  dropsy be-
  low  the ribs ;  still  this is more common in malignant tumors  of the
  chest, than in aneurism.  A difference in the force of the pulse in the
  two  radial arteries is apt  to occur;  the pulse  in the left wrist may
  become feeble  and even disappear.  Although the patient may long
  have  a sense of pulsation  in the  chest, and we may have heard a
  knocking or jogging sound by auscultation, we  can not always be quite
  sure  of  the presence of  aneurism until it comes near the surface and 
16                     Index  Raisonne"
causes an external prominence or tumor which pulsates visibly to the
eye, or touch.
  The pulsating tumor, if  the  aneurism is in the ascending aorta,
usually makes its appearance on the right side of the sternum ; when
it springs from  the  summit of the arch it produces a  bulging above
the sternum and the  sternal ends of the clavicles, although pulsation
may be felt long before by pressing the finger deeply down behind the
sternum or clavicle;  of  course, dullness on percussion  behind the up-
per part of the sternum  will also have been present for some time, in
connection with the  jogging or  knocking  impulse heard with the
stethoscope or ear, and more or less of a  bruit.
  If the  aneurism be in the fore part of the arch of the aorta it will  <
finally produce a bulging at the sternal extremities of  the upper ribs
of that side,  although long before dullness on  percussion will have
been present, and that peculiar jogging sound which almost seems to
be felt will  have been heard  on  auscultation.  The beating of an
aneurismal tumor is the  well-known steady, heavy pulsation, synchro-
nous with the systole of the heart.
  Aneurism of the descending aorta may exercise its pressure on the
vertebrae  and  cause pain in the  back, often radiating in the course of
the intercostal nerves, and ultimately  may produce palsy of the parts
below that portion of the spinal cord ; a bruit heard in  the back along
the left side  of the spine, if slight dysphagia, or dyspnoea, with pain
in the back  are  also present, would be of considerable significance
as pointing to aneurism ; although no bruit is usually audible, yet I
have met with cases in  which it was.
  Lycopodium has been  used successfully in three cases of aneurism,
one  of them  treated  by Dr.  Ball, of New-York.   Dr.  Bolles  has
treated several cases of naevus  or aneurism by  anastomosis success-
fully with internal remedies.

  Angina-pectoris.—Acid-acet. p. 9. Prus.-acid. 35.  Arg.-nit. 510.
  Angina-pectoris commonly occurs suddenly in paroxysms, while the
patient is  walking, and more particularly if he walks soon after eat-
ing; it consists  of a painful  and most disagreeable sensation in the
chest,  always referred  to the region of  the heart, which seems as if
it  would  take his life  away, if it were to increase or continue ; the
moment  he stands still all  this  uneasiness  vanishes ; all this time
there is no difficulty of  breathing, the patient is  not out of breath, yet
the impression is constant that to stir another step would prove fatal;
he lays hold  of  any  adjacent object for support, his face is pale and
haggard,  he  seems  actually at the point of death;  but in the earlier
attacks of the disease the  pang is soon over and the patient entirely
himself again, so that he is often able to resume his walk for a long
time, without any repetition of the distress.
   After  the  lapse  of some mcyiths the  attacks may come on sponta-
neously,  even while  the patient is  quiet in bed ; they do not  subside
so  easily ; he feels as  if the action of the heart'were arrested, and 
Angina-pectoris.—Alkalies.
17
may be obliged to rise every night for weeks together; the pain often
shoots from the heart towards  the spine, to the left shoulder and down
the arm, often accompanied by a sort of numbness.
   In  eighty-eight cases, only eleven occurred in females ; in eighty-
four cases, seventy-two were above fifty years of age;  of sixty-four
patients forty-nine died suddenly, only two of them being women;  and
fifteen recovered, or were relieved.
   The principal cause of the disease is fatty degeneration of  the mus-
cular structure of  the heart, and the attack consists in a sudden stop-
page or temporary paralysis of the softened and weakened  heart; the
pain and anguish arise from over-distension of the unsound heart, are
generally  attended  with a sense  of impending dissolution, and often
by actual  syncope ;  the heart  may become so distended as to give the
idea of spasm or constriction of  that organ;  similar sensations  may
also be felt in the chest, for the blood may be so retarded in the left
lung, that that organ may suddenly become as solid  as if  hepatized;
or  they may  be  simple spasms of the lungs or respiratory  muscles,
for some  patients describe the sensation to be as if  the sides of the
chest were held together with "a hoop, or transverse bar of iron.
   Formerly, disease of the coronary arteries was regarded as the es-
sence of the disorder ;  and of thirty-nine  cases, there was ossification
or  cartilaginous thickening of these vessels in  sixteen  cases ; but
there was also ossification  or  other disease of the valves of the heart
in  sixteen other  cases; organic  disease of the  heart  alone in ten
cases, of  the aorta alone in three cases, while the disease  was strict-
ly  confined to the  coronary  arteries alone in one case only; there
was preternatural  softness  in twelve well-marked cases,  and it  pro-
bably existed  in  all ; there was ossification or dilatation of the aorta
in twenty-four cases.
   It is evident from the  above that the majority of cases must  ulti-
mately prove fatal, sooner, or  later.
   To remove  the  fatty degeneration of the heart, Iodide of Iron,  Hy-
driodate of Potash, or  Carbonate of Ammonia are  the most impor-
tant remedies; to  sustain  the failing action of the  muscles  of the
heart,  Nux-vomica, Strychnine, Angustura,  Ignatra, or Quinine  will
prove useful.
   During a paroxysm cordials  and stimulants, Brandy and Ammonia
have  proved  most useful;  but if  the pain is lasting as well as  very
severe, Opium is the only reliable remedy ; in milder cases  Spigelia,
Assafoetida, Camphor, &c, may be relied upon.

   Alkalies.__The blood is naturally alkaline, but this  condition  may
be  materially  altered in disease.   It may become preternaturally acid,
as in gout and acute rheumatism, or neutral or nearly so, as in severe
inflammations.  This alkalinity is  due to soda and-  potash in its dif-
ferent forms.  According to Bowman the blood is found to contain the
Albuminate of Soda, the Phosphates of Lime,  Magnesia and Soda, the
Sulphates of Potash and Soda, the Carbonates of Lime, Magnesia and
                B 
18
Index RaisonnS.
Soda  the  Chlorides  of  Sodium  and Potassium, and the Lactate and
Urate of Soda.
  Nasse found most  alkaline  Phosphates in the blood-ash of swine,
geese and hens, and least in that of goats and  sheep ; he found most
Sulphate of Soda in that of sheep and least in that of hens and geese ;
most alkaline  Carbonates  in that  of sheep  and least in that of hens
and geese; and most alkaline Chlorides in that  of goats and hens, and
least in  that of rabbits.
  In disease these conditions may  become very much altered.   Leh-
mann mentions, that very considerable quantities of  Ammonia, which
does not exist  in healthy blood, are often found in the blood  in acute
diseases, as well as in the urine.  Winter thought that the presence
of Ammonia in  the  blood  explained the phenomena of  typhus ; but
Ammonia  may be  detected in the blood in all very severe  cases of
acute disease, especially  in variola and scarlet-fever; and Lehmann
thinks  there  is  no more  constancy in  the presence of  Ammonia in
the blood during typhus,  than in the presence of the crystals of the
triple Phosphate in the excrements.  It is by no means strange that
in such conditions of the system Ammonia should abound, since it is
the product of decomposition; though in healthy blood it is never found.
  Lehmann and C.  Schmidt  have found Carbonate of Ammonia in
the blood of cholera; and  Lehmann thinks that to the presence of
Ammonia  and not of Urea are to be ascribed the symptoms of urae-
mia in  cholera, Bright's  disease  and scarlatina.
  Acting upon such hints as these  the treatment of some diseases has
been  modified accordingly.   For instance  in rheumatism, arguing
from the  preternatural acidity of the urine and blood, that there was
a larger amount of acid circulating in the system than was called for,
or,  in  other words a deficiency of the normal alkalies, the Rochelle
salts have been given with a good  deal of success,  especially in the
N.-Y.  Hospital, where we have  ourselves  witnessed the success of
the treatment.   We append a  case or two, reported by Dr. Metcalf.
  Case I.—D. V., aged 30;  male.   Admitted February 26th, eight
days  ill,  with general  acute  rheumatism; skin hot, dry; pulse 96;
tongue coated; urine acid.   Treated with Rochelle salts.  Feb. 28th.
Urine  alkaline.   March Sd. Pains disappearing; convalescent. No
return by March 29.  Discharged, cured.   No complication.  Dura-
tion to  convalescence, thirteen days.  From beginning of treatment,
five days.
   Case II.—W. C, aged 46,  male.  Has had frequent attacks before
the present.   This came on four days before admission, Feb. 26, be-
ginning in left ankle and knee; joints swollen  and painful; skin warm
and dry;  pulse 88;  urine alkaline.  Rochelle  Salt, as above.   Alka-
line lotion to  painful articulations.  28th. Right elbow swelled and
painful.   March Sd.  Improving.   8th.  Well.    No  return  by  21st,
when  was discharged cured.  Urine continued alkaline;  no compli-
cation ;  duration to  convalescence, nine  days; after commencement
of treatment, five days.                               • 
Alkalies in Rheumatism.
19
  Case  III.—F. B., aged 22 ; male.  Second attack.   Taken eight
days before admission (March 5)  with the rheumatic pain and swell-
ing of the  ankles and wrists.  Skin, as in the last case: pulse 116 ;
urine  acid.   Treated, as above, by the Salt and alkaline lotion.  By
the 11 th, the rheumatic  pains had nearly disappeared ;  the urine was
alkaline  on the 12th.  No interruption to convalescence, which al-
lowed him to be discharged, April 6th.   Duration to convalescence,
fourteen days ; from beginning of treatment, six days. No complication.
  Case IV.—J. V., aged 27 ; male.  Third attack. Admitted March
6th, on  third  day  of rheumatic fever, affecting the joints generally.
Skin  warm, perspiring,  pulse  108 ; urine acid.   March 8th. Urine
alkaline.   10^. Convalescing.   March  21th.  Discharged,  cured.
No relapse;  no  complication.   Duration  to convalescence, seven
days ; from beginning of treatment, four days.
  Case V.—D. L.,  aged 26. First attack,  fourth day.  Admitted
March 14th.  Rheumatic inflammation general, severe; much febrile
excitement; urine acid.   March 17th. Under the use  of  the Ro-
chelle Salt, the  urine became alkaline, with coincident relief of the
pains.   18th. Urine acid,  pains  aggravated.   20th. Slight diar-
rhoea.  2lst. Urine  again alkaline, with  relief to the rheumatic suf-
fering.   Convalescence  went steadily on.   Duration, eleven  days.
From beginning of treatment, seven days.  No complication.
  Case VI.—M.F., aged 18; female.  First attack. Admitted March
31, after  seven days illness.  Rheumatism   commenced in  ankles;
thence to knees  and right wrist; joints  painful and swollen; pulse
quick ; skin warm and  moist; urine acid.  Rochelle Salt, every two
hours.  Alkaline and opiate lotion to joints.  April 6th.  Urine neu-
tral ;  pains nearly gone ;  the  urine became alkaline on the next day.
9th. Pains  gone;  suspend  medicine.   lQth. Discharged,  cured.
Duration to convalescence, thirteen days.  From beginning treatment,
six days.   No complication.
  Case VII.—P. H., aged 30; male;  May 14th;  fifth day; several
previous attacks ; at present, in joints of lower extremities; signs  of
hypertrophy of  heart;   pulse  108, intermitting,  strong;  respiration
short, hurried; face  anxious,  pallid ;  skin warm, perspiring; urine
acid.  Roch.  Salt,  every two hours.  17th.  Urine becoming alka-
line.   19^.  Joints  of fingers  attacked.   Alkaline  lotion.   21st.
Urine alkaline; pains diminished; convalescent.   23a?.  Entirely re-
lieved.  No return.   To  convalescence, twelve days.   From begin-
ning of  treatment, seven days.
  Case VIII -B. S., female, aged 26; April 23;  third attack, four-
teen  days;  general; pulse  84; skin moist  and  warm; joints very
painful  and much swollen; urine acid.   The Salt every two hours.
26th  Urine slightly alkaline.  27^. Decidedly so ;  convalescence.
There were several  relapses with this patient, to a slight  degree.
June  Ath.  Discharged  cured.  To  convalescence, eighteen  days ;
from treatment, four  days.  No complication. 
20
Index Raisonne".
  Case IX.—E. M., male, aged  27; April 26th;  seventh day, first
attack;  arthritis general and severe; skin  warm, perspiring;  pulse
112, full; urine  acid.   The  Salt every  second  hour.   May 1st.
Urine alkaline ; pains less.  Discontinued  medicine,  with result of
one  or  two slight relapses.  July 2d. Discharged cured.  To con-
valescence, twelve days; from treatment, five days.  No complication.

  Anesthetics.—The use of anesthetics, like every other innovation
in medicine, has  received  the  most virulent abuse, and at the same
time the most extravagant encomiums which could be lavished upon
it.  The truth probably  lies  midway between these extremes, and al-
though  their indiscriminate and incautious use is much to be depre-
cated there is at  the same time  scarcely a department of practical
medicine into which they may not with propriety be carried.  They
have received the strongest opposition, perhaps, in the practice of ob-
stetrics, yet even here, where perhaps more plausibly than anywhere
else the fiat of sacred writ is brought forward, " In sorrow shalt thou
bring forth," even here, we say, their use is steadily gaining ground.
  The  only  possible objection which can be  urged again  it, in a me-
dical point of view, when used in parturition, is  that it undoubtedly,
does in  some cases,  when pushed to  positive anaesthesia,  deaden and
hinder in  a measure the uterine contractions, rendering them less for-
cible, efficient and expulsive.  Yet I am inclined to think that we may
here detect its peculiar  and specific action upon the voluntary centres,
leaving intact the involuntary or sympathetic system; for  we may sa-  ■
tisfy  ourselves  by the touch or  even  by questioning the patient at in-
tervals, that the contractions of the womb, per se, are still strong,
energetic, and acutely distressing across the small of the  back, while
the  concurrent  actions  of all  the abdominal muscles,  which are ex-
clusively  supplied from the  spinal system, are entirely at a stand still.
   In surgery  I believe that anesthesia has now  come to be looked
upon as  an integral part of every operation of any severity, and its
manifest  and positive advantages  are so far beyond its possible  ill ef-
fects, that even its most strenuous opposers have withdrawn their ob-
jections in this  quarter.  I have lately heard that the mortality of am-
putations has increased in the great English hospitals, since the in-
troduction of Chloroform, but I can hardly look upon this as cause and
 effect, since every physician knows that in insomnia, or cases of ter-
 rible nervous irritation, the nervous force is actually husbanded by
large draughts of Opium—that terrible exhauster of the nervous sys-
 tem  when  not demanded  by some unusual drain; and surely this is
 quite  as  likely to  be  the  case when a patient is shielded from the
 fright,  agony and shock, to say  nothing of  the nervous exhaustion, of
 a bloody  operation.
   Ether  is  most commonly used in  this  country—Chloroform in Eu-
 rope ; but a  combination, or alternate use  of the two is perhaps pre-
 ferable.  Thft  length  of time  necessary to bring a patient under the 
Anesthetics.—A ngina-tonsillaris.             21
influence of Sulphuric Ether makes the use of Chloroform a great
desideratum in some  cases,- but it is undoubtedly safer to continue the
operation under the more manageable and slow operation of the Ether,
and a great majority of the surgeons in this country pursue this mode.
   The pulse, breathing, countenance, &c. should be strictly watched
during  the  operation,  but  as this  subject will be treated at length,
where it is reached in due course in the Materia Medica (Chloroform)
we will not enlarge upon  it here.

   Angina-tonsillariS.—Acid-acet.  6.    Acid-benzoic. 12.   Allium-
sat. 210.   Ammon.-caust. 285.   Ant.-tart. 399.   Apis 452.
   According  to Watson angina-tonsillaris occurs with very unequal
severity in different cases, depending upon the number and variety of
the  parts which it  involves,  for it often  spreads to the uvula, velum
palati, salivary glands, pharynx, and  even to the root of the tongue
and neighboring cellular tissue.
   When the inflammation is superficial (mucous pharyngitis and ton-
sillitis)  it does not produce any great distress; when it penetrates be-
yond the mucous membrane, (sub-mucous variety,) it is apt to end  in
suppuration and harass the  patient much, as the tonsils often swell to
an enormous size ;  it is worst of  all when the back part of the tongue,
and the muscular  and cellular tissues become  implicated, for it may
even reach the larynx, and then is always extremely perilous ; when
the muscular  coat  alone is affected, (muscular pharyngitis,) although
swallowing is difficult and  exceedingly painful, there is no appear-
ance in the fauces, which can account for these  symptoms ;  when the
mucous crypts are the principal  seat of the disease, (follicular tonsil-
litis,) opaque whitish spots appear on the red tonsil, consisting of the
discharged contents  of the follicles, and are often mistaken for ulce-
rating or sloughing points ;  when the inflammation is violent, the sub-
maxillary and  parotid glands sometimes swell,  and become tender to
pressure,  and  the  patient -may be troubled with profuse ptyalism;  in
severe cases  the pain often shoots from the throat to the ear along the
eustachian tube, and  suppuration occurs in the majority of cases at-
tended  with  this  symptom.  Sometimes both tonsils are attacked  at
once ; very frequently one only is affected at first, and the disease be-
gins in the other as it subsides in the first, just  as it does in mumps.
When the back of the tongue is involved, the patient is unable to open
his mouth sufficiently  to  allow  the fauces to be seen, and even the
finger cannot be introduced into the  mouth.
   The  milder  and superficial cases often terminate  by resolution in
about three days ;  the follicular cases frequently end in the  formation
of small abscesses, for we often notice a small yellow spot or phlyc-
taena, which  may burst  unnoticed, on the fourth or fifth day, either
during sleep or in a fit of  coughing,  and the small quantity of matter,
which  is  discharged, is not  noticed, or its nauseous taste and smell
may attract attention ;  the patient at once feels essentially relieved and
the rest of the disorder  subsides rapidly.   When the abscess is deep- 
00
Index Raisonne.
 seated, the patient often passes four, or five, or seven, or ten sleepless
 days and nights, when finally it bursts, or is opened artificially.
   Treatment.—A large proportion of the difference of symptoms de-
 pends  as much or more upon the  seat of the disease, than its nature;
 the treatment can generally be  commenced with a few doses of Aco-
 nite and Stibium, as the constitutional disturbance  often runs higher
 than might have been expected, considering  the limited extent of the
 local inflammation and the comparatively small importance of  the part
 inflamed, for smart inflammatory fever,  severe headache and pains in
 the limbs, with a rapid pulse of 100 to 120, or more are not uncommon.
   When the difficulty of swallowing arises mainly from the soreness
 of the  mucous membrane, especially  if the mucous follicles are much
 affected,  Mercurius and  Hepar-sulph., or Ammon.-caust. are the most
 important  remedies; when the muscular coat is much involved, the
 rheumatic remedies, such  as Mercurius and Mezereum come in play,
 although Belladonna often proves highly palliative and curative ; when
 suppuration  threatens  to  ensue,  Hepar-sulph. and  Stibium are most
 useful; when  there is much  oedematous or  erysipelatous swelling,
 Rhus,  Cantharides, or Apis-mell.  relieve more quickly than other re-
 medies ; when the salivary glands, both submaxillary and parotid be-
 come involved, Mercurius and Stibium afford most relief.
   As regards  the local treatment, Watson recommends gargling with
 warm milk and water,  every hour or  two; currant-jelly-water is often
 useful, or  the  inhalation of the vapor  of hot water, with or without
 the addition of vinegar, or Nitric-acid; although Dr. Jeane? -ecom-
 mends Benzoic-acid.

   Anorexia.—Aeon. 123.  Actea-rac. 137.   Anis.  377.
   Anorexia  is defined as  loss of appetite without loathing ; Actea-rac.
 deserves more attention than it  has received.   If the ordinary reme-
 dies fail,  Cocculus may be tried when there is a feeling of hunger
 almost all  day, and not  removed by  eating; Aconite, Cicuta-vir.,
 Chin.,  Sulph., Granatum and  Lycopodium produce  an intense and
 continual feeling of hunger even after eating copious meals.

   Anthelmintics.
   Anthelmintics are medicines calculated to expel worms from the ali-
 mentary canal, and to effect this object two modes may be adopted.
   1st.  They may be either killed by  the medicine, and thus  expelled
by the  natural  peristaltic efforts  of the bowels,  or 2d, they may be re-
moved  by removing the diathesis  and condition of system, which fa-
vors their propagation and growth.
  The  former  of these is the  mode usually adopted in  the dominant
school; the  second is that to which homoeopathy generally looks.
   But even in  the mere killing  and expulsion of them there  are dis-
tinctions and differences.   Thus they may be mechanically destroyed,
as by the sharp spiculae of the macuna or cowhage, and this has even
been experimentally tried, (by Kuchenmeister, 1 believe,) out of the 
Anthelmintics.
23
 body—or they may be poisoned by  some medicament which is com-
 paratively harmless to man, and thus die and  be thrown off—or they
 may be merely sickened by an anthelmintic remedy, and so release
 their hold upon the mucous coat of the bowels through pure debility—
 and they may even be caught  by a dose  of  purgative medicine off
 their guard, as it were, and  be  carried off in  spite of themselves.
 Some  writers, finally, think that they sometimes make voluntary efforts
 to escape in consequence  of  some  unusual and  (to  them)  offensive
 condition of the bowels.
   The method to which homoeopathy usually looks is  the correction
 of the marked and  well-known  constitutional derangement causing
 and accompanying,  except in the  case of tenia, the helminthiasis.
 There can be but little doubt  that in most cases, helminthiasis is di-
 rectly  ascribable to the peculiar dyscrasia which accompanies the dis-
 ease, and to this is to be ascribed  the development and growth of  the
 germ which in another and  more  healthy condition of the gastroen-
 teric mucous membrane would have  been thrown off effete and dead.
 We can hardly admit any other hypothesis, (except as regards the te-
 nia,) for  doubtless the exposure to the ingestion of the  germ of  the
 parasite is very much the same at one time as at another.
   It appears to us that these  two means may be very happily com-
 bined,  and that while we remove the predisposition to the development
 of the parasite in its unnatural position, we at the same time  may  en-
 deavor to remove the one  which  is  already existing, and which, of
 course, greatly tends to favor  the morbid condition.
   The first of  these objects, viz.,  the removal of the  helminthic dia-
 thesis, is  to be brought  about  by  a  judicious  administration of such
 remedies  as the condition of the system calls for, and in this we should
 be guided by general principles, and not by any fancied anthelmintic
 power  of a dynamized remedy. If, however, we can find a dynamized
 homoeopathic remedy which is potent both to destroy the worm and to
 restore to order the confused and disordered system which has favored
 its growth, it would of course  be proper to give the preference to this;
 but until such a specific is found, we must content ourselves with a less
 direct course.
   Diet.—One of the  first and most important matters to be regulated
 is the diet.  The child or patient  should have enough to eat, but not
 too much.   The first  thing  is to  relieve  the  stomach of all burden,
 while at the same time the system is as well supplied and nourished
 as may be compatible with  the powers of that organ.  It is by the
 overloading and  habitual trying  of  the stomach  with rich, sweet,
heavy, unhealthy and indigestible  food, that the  alimentary canal is
brought into this condition which favors the development of the worms;
 and once produced, the irritation caused by them serves to perpetuate
 and increase the constitutional disturbance.   Therefore all cakes, con-
fectionary, pastry, unripe fruits, sweetmeats, raisins, Sic, should  be
prohibited, and a wholesome, plain, digestible and nutritious diet sub-
stituted, such as meat, roast or boiled mutton, beef or chicken, an oc- 
24                      Index RaisonnS.
casional  plain pudding not too sweet, bread, &c.  Regular and mode-
rate exercise and fresh air should also be strictly enjoined.
  Treatment.—Pulsatilla will go far to relieve this peculiar form of
indigestion.  It is particularly adapted to the heat and weight at the
pit of the stomach, the sense  of discomfort in the abdomen, bad taste
in the mouth, offensive breath, and capricious appetite.
  Belladonna  should be thought of, where in addition to the  distress
of the stomach,  the disorder  of the alimentary canal, &c,  there is
headache, stupor, drowsiness, delirium or  coma, and where  there is
starting during sleep, and considerable nervous excitement.
  Aconite is indicated  where there is considerable febrile action with
restlessness and irritability of temper,  constant itching and burning in
the  rectum and anus, and crawling in the throat.
  Carbo-veqetabilis is more particularly indicated when the tongue is
heavily coated, and there is a very offensive and fetid odor from  the
breath.
  Chamomilla will often  serve to set right the digestive organs when
the  following  complications are  present,  viz., teething, with watery,
slimy, bilious, green or yellow  evacuations, or fetid,  resembling the
odor of rotten eggs, thirst, want of appetite, &c, particularly in young
infants.
  China is indicated where there  is looseness of the bowels in conse-
quence  of  indigestion, particularly if it follows  fruit or flatulent food,
and if there be griping pain accompanied with want of appetite, thirst,
and great weakness.   It will  also be found useful after improper treat-
ment of this affection.
  Cina is more  particularly adapted to those cases where the worm-
symptoms are especially marked, such as boring at the nostrils, obstruc-
tion of the  nose, irritability, restlessness, heat, fits of crying, pale face,
livid circle about the eyes, constant inclination to take food, griping,
distressing heat, with discharge of worms; irregularity of the bowels,
evening  chills, hard, quick  pulse,  starting  and  calling out in sleep;
Tongue covered with tenacious mucus, disagreeable eructations, vomit-
ing, itching in the anus, urethral irritation, weakness, lassitude,  and
occasional convulsive movements.
  Calcarea-carb., however, is looked upon as the great remedy against
tape-worm, and whenever this species of worm is suspected, it should
be administered.
  Merc.-vivus should be  especially thought of where there is in addi-
tion to the  worms, a constant  inclination to go to stool, and diarrhcea
with tenesmus, distention and hardness of the abdomen, and profuse
flow of saliva.
  Nux-vomica should  not be forgotten  in prescribing for the disordered
condition of the alimentary canal.
  Sulphur and Silicea are indicated where there are vermicular diffi-
culties in lymphatic children, who become frequently affected with  cold
in the head ; who have a bitter, slimy taste in the mouth, aversion to
meat, irresistible  longing  for sugar,  variations of appetite, sometimes 
Anthelmintics.
25
voracious, at others the reverse;  frequent regurgitation of food, and
heartburn;  hiccough, vomiting and rumbling in the stomach and bow-
els, and soreness and itching of the anus.   The Sulphur may be used
first, and afterwards the Silicea.
  In chronic cases of worms, or invermination, great success has at-
tended the use of Nux-vomica, Mercurius, Sulphur, and Calcarea.
  To remove the parasite  itself, we  find in the dominant  school  a
large number of remedies of greater  or less reputation.  Perhaps  the
first and most commonly used against  the common  round  worm is
Spigelia or pink-root.  Wood says that experience has fully established
its virtues, a knowledge of which was obtained from the Cherokee In-
dians, and he regards it as one of the best vermifuge remedies that we
have against lumbrici.   It is apt, however, when given in very large
doses, to occasion some disturbance of the  nervous system, and it also
occasionally acts as a cathartic.   Spigelia  appears  to hold in this
country the position  as  an anthelmintic, which Santonin  holds in
Europe, and is probably more frequently used than any other.
   Santonin, or the  active principle of the European Worm-seed, is the
preparation usually resorted to in Europe.  Its general effects are said
to be those  of a mildly stimulating tonic.   Kuchenmeister found that
when the worms were placed in an albuminous fluid and kept at a tem-
perature of 77 Fahrenheit, that  the addition of an oleaginous solution
of  Santonin killed  the round worms  sooner than  any  other anthelmin-
tic, even the most  powerful, which he tried.  This, therefore, is pro-
bably one of the most  powerful of the anthelmintics,  but Wood, from
whom we have  taken this description, recommends that it be adminis-
tered dissolved in oil, as it is insoluble in water.
   Chenopodium, or American Worm-seed.—Of this anthelmintic, Meigs
in his work on  "Diseases of Children," gives the most glowing' ac-
counts.  Thinking it best  not to give an irritating violent vermifuge in
doubtful cases, he was led to the employment of  this in small quanti-
ties, and he says that he rarely  gives any other remedy in slight and
 doubtful cases unless this has been tried and failed.   He believes it to
 be all-sufficient in a large majority of the cases occurring under his eye,
 as they were almost always of a mild character, and as it not only pro-
 cures 'the expulsion of the  parasites where  they exist, but  also acts
 beneficially upon the  forms of digestive irritation which simulate  so
 closely the symptoms produced by worms.  He thinks that of all the
 cases which have  come under his notice in which it seemed probable
 that worms might  be present, none were  expelled in nearly half, and
 yet the signs of disturbed health have passed away  under the use of
 the remedy  He  gives  the oil in   doses of four to ten drops,  ac-
 cording to  the age of the child, three times a  day for three days, to be
 followed on the fourth day by a cathartic.
    The Aspidium-Filix mas, or Male-fern,  is another of the much-
 vaunted anthelmintics for the expulsion of taenia, and there is no doubt
 that in a great majority of cases it is effectual, but there are also cases 
26                      Index RaisonnS.
where  it fails.  In these cases the Turpentine or Koussu will proba-
bly be effectual.

  Anury.—Aeon. 126.   Apis. 458.
  Anuria should  be regarded as synonymous with  ischuria renalis;
the term should be  confined to cases of entire  suppression, and not
extended to cases of simple retention.  It is most common in persons
inclined  to corpulency, or those with organic renal  disease.  If any
water, however small the quantity, be made, mild remedies may afford
relief;  but if not a drop  be found in the bladder for thirty-six or forty-
eight hours, grain-doses of Cantharides should be given, and  a large
blister  applied to the back; except in cholera, where the profuse dis-
charges from the  bowels carry off the urea, and some patients  recover
although they have not secreted a drop of urine for several days.

  Aphonia.—Acid-nit. 54. Ammonium-mur. 305. Ammon.-caust. 286.
   Aphonia is defined as a more or less complete loss of voice.  The
most common form is the catarrhal, occurring during the course of
influenza, or some other catarrhal  affection of the throat and larynx,
and depending upon more or less relaxation of the vocal cords.  The
nervous variety is also not very uncommon, arising from an affection
of the recurrent  nerves.  The paralytic variety is occasionally wit-
nessed in cases of lead-poisoning, and it is probable that in the catar-
rhal and nervous forms, there is more  or less of a paralytic affection
of the  laryngeal muscles and of the recurrent nerves;  paralysis  of the
recurrent nerves  may arise from the pressure of a large or small tu-
mor in the neck,  or even in the chest, and  the application of Corro-
sive-Sublimate to a strumous affection of the neck  has been followed
by paralysis  of the  recurrent nerves and  consequent loss of voice;
worms in the intestines and affections of the genital organs have been
supposed to cause aphonia in a few  cases;  poisoning with Hyoscia-
mus, Stramonium,  and  Belladonna  has  produced the  same  effect.
General debility, such  as occurs after long-continued  or exhausting
disease, will cause  it;  also local debility of the laryngeal  muscles,
when  they have been overstrained by protracted and excessive efforts
in speaking or singing.   Catarrhal laryngitis is a common cause.
   Treatment.—In the catarrhal variety, Pulsatilla,  Phosphorus Spon-
gia  and  Ammonia are the principal remedies.  When there is more or
less laryngitis, Stibium, Mercurius  and Phosphor  deserve attention.
When there is  paralysis of the vocal cords,  recurrent nerves,  or
laryngeal muscles, Plumbum, Nux, or Strychnia may be used; when
a tumor  pressing upon  the recurrent nerves is present,  Baryta-muria-
tica, Hepar,  Sulphur, Spongia, or Iodide of Mercury may be used.

   Aphtha.—Prus.-acid. 30.  Acid-nit. 50.  Acid-Sulph. 86.
   Aphtha is  most common in  young children, from  acidity of the
 stomach or an acid or uncleanly state of the mouth, and in adults from 
Aphtha.—Apoplexy.
27
debility, such as occurs in nursing women, or in the latter stages of
consumption, or other exhausting disease.
  They consist in small, irregular, but usually roundish white specks
or patches, scattered over the surface of the tongue, the lining mem-
brane of the mouth and fauces, angles of the lips, cheeks, palate, ve-
lum, tonsils and pharynx; they look like little drops of tallow, or mor-
sels of curd sprinkled over these parts; they project a little above the
surface, and in fact are mostly formed by elevated portions of the mu-
cous  epidermis, covering a small  quantity of a serous or gelatinous
fluid, which separates the epidermis from the subjacent corium; these
portions of the epidermis detach themselves  and fall off, leaving be-
hind them a reddish, raw-looking surface, or sometimes a foul or  ash-
colored spot; successive crops are apt to be formed.
  The most homoeopathic remedies  are  Cantharides, Rhus, and Sti-
bium; I have seen most extensive cases in  which the pharynx and
larynx were involved and danger from croupous exudation seemed im-
minent, relieved by these remedies.   Borax  and Chlorate of Potash
are useful palliatives.

  Apoplexy.—Acid-fluoric. 19. Acid.-prus.  29.  Aeon. 117. Aloes.
211.   Ambra. 246.  Ant.-tart. 420.
  Apoplexy.—When a person falls down  suddenly and lies without
sense or motion, except that his pulse keeps  beating, and his breath-
ing continues, he is said to have been attacked with apoplexy; he ap-
pears to be in a deep sleep, but cannot be roused; he is not in a  state
of syncope, for his pulse beats perhaps with unnatural force,  and often
his face instead of being  pale, is flushed and turgid, and his respira-
tion goes on, though it may be labored  and stertorous.   This is the
most common form of apoplexy, and  may arise  from simple conges-
tion, from serous effusion, from poisoning of the blood, from  Bright's
disease of the kidneys,or from previous softening of the brain, followed
by  extravasation of blood.  Under proper treatment with Aconite and
Arnica, most of the congestive cases recover;  when there  is serous
effusion or uraemic poisoning, remedies which  act upon the kidneys,
such as Hydriodate of Potash or Colchicum, are most useful; when
there is softening of the brain, Arnica and Plumbum, or Ferrum, are
the best remedies.  Some of these  patients recover without any ill
effect of the attack remaining; others recover from the coma, but are
left paralytic on one side, or with some imperfection of speech, or of
one or more of the senses, in which  cases Arnica  followed by  Nux
should be used;  this paralysis or imperfection may last a few days,
or gradually depart, or remain for life.
  In a second and very fatal form, apoplectic  coma is not the earliest
symptom  for the attack  commences with sudden and sharp pain in
the head-  the patient becomes pale, faint and sick, usually vomits,
and sometimes falls down in  a state of syncope, with a bloodless and
cold  skin  and a feeble pulse, and some degree of convulsion ; at other
times the'patient does not fall, but with the sudden pain in the head.only 
28
Index Raisonne*.
has transient confusion of mind; in either case he commonly recovers
in a short time, becomes quite  sensible,  and is  able to walk, but the
headache does not leave  him; after a while, however, he becomes
heavy, forgetful, incoherent, and sinks into coma, from which he never
rises again.  This form of attack is much more fatal than the more or-
dinary one, and it is of great use to know this, for to an inexperienced
eye these cases do not seem so terrible as those in which the patient
is profoundly comatose from the first;  the apparent amendment Ts fal-
lacious and apt to lead one astray.  These attacks always arise  from
the giving way of some one of the cerebral vessels, and at the moment
when the vessel is ruptured a shock is given to the brain, like a blow
upon the head, which renders the patient confused and faint; after a
while reaction comes on, the circulation is aroused,  bleeding recom-
mences and goes  on till such a quantity of blood has escaped into or
upon the brain, as is sufficient to produce coma.   In these cases the
early  use of Arnica is most important; when reaction  comes on, Ve-
ratrum-viride and  Aconite, aided by some styptic remedy, are very
important remedial means.
   The third variety is formed by the paralytic cases;  it is character-
ized by sudden loss of power on one side of the body, and frequently
by impairment or loss of speech,  without coma, or loss of conscious-
ness; the patient is sensible, listens to  and comprehends  questions,
and answers them as well by words  or signs as he is able.   These
cases generally arise from preceding white softening of the brain, and
may be followed by more or less extravasation of blood; in many ca-
ses a gradual  recovery takes  place, which is not complete for some
weeks or months; in others the paralysis gradually passes over  into
apoplexy; in others, again, the patient rallies up to a certain point and
then the improvement stops ; he may recover the use of his paralyzed
leg wholly or partially, or  his arm remains feeble, and his  speech in-
articulate, or he remains bed-ridden  and completely paralyzed on one
side.   In these cases the Phosphate of Iron and Arnica are the most
important remedies at first, to be followed by Arsenicum, Nux-vomica,
Strychnine, or Plumbum.

   Arachnitis.—Acid.-muriat.  38.   Ant.-tart.  414.
   Acute Arachnitis is rarely attended with severe pain or much de-
lirium;  according to Watson, the first and the  most common and strik-
ing phenomenon is a sudden and  long-continued paroxysm of general
convulsions; sometimes it comes on  after  a  few days of discomfort,
slight headache and vomiting; the convulsions  recur  frequently, and
finally end  in  coma;  at other times the first attack of convulsions  is
preceded by violent pain  in the head, setting in quite suddenly,  and
attended with screaming.
   The proper  recognition  of this  disease is of  great importance;  by
far the greater number of cases are  mistaken for simple eclampsia;
anodyne and anti-spasmodic remedies  are used in vain, valuable time
is lost, and a fatal result is almost always the consequence; the prog- 
Ardor  Urina.—Arthritis.
29
nosis is grave under any circumstances, and the loss of life under the
best treatment is fearfully great.  The treatment must be that for in-
flammation, not for a simple or aggravated convulsive disorder.  Aco-
nite, Digitalis, Veratrum-viride, &c,  are  the  important  remedies;
time is lost in giving Assafcetida, Nux, Belladonna, Ignatia, &c;  the
tincture of the root of  Aconite  may be applied over the  whole of the
head.

   Ardor  Urinae.—Acacia.  5.   Ammon.-mur. 295.
   Ardor urince is defined as a scalding of the urine, or a sense of heat
 in the  urethra; also a  scalding  sensation occasioned by the  urine in
 passing over the inflamed mucous  membrane of the urethra, or over
 the neck of the bladder.
   Diluents and demulcents, such as Gum-Arabic water, Barley water,
 Flax-seed tea, &c, are given with the view of augmenting  the amount
 of urine  and rendering it less acrid.  Salines  affect the composition
 of the urine; of  these the Muriate of Ammonia deserves more atten-
 tion than  it has  received of late.   Among the  less frequently used
 remedies, Sabadilla should be thought of when there is much scald-
 ing;  Ruta and Verat. when there is excessive  urging to urinate, with
 painful burning during micturition.

   Arthritis.—Benzoic-acid. 15. 16.  Aeon. 128. 130.  Ammon-phos.
 310.  Apoc.-andros. 467. 468.  Argent.-nit. 498.
    do.  Arlicularis.—Arg.-nit. 498.
    The  term arthritis is generally confined to gout, but we prefer to
 treat  in this place  of the principal inflammatory affections of the joints.
    In  acute synovitis the pain  is early and severe; it is constant and
 gradually increasing in severity ; it ultimately becomes intense ; there
 is swelling, also gradually on the increase, sometimes becoming great;
 the  skin' is red, tense, hot and sensitive ; the pain is severest in the
 interior of the joint, much aggravated by pressure, and altogether in-
 tolerant  of the slightest motion, so that a position is assumed in which
  the  parts affected are  most  relaxed  and pressure removed from the
  opposed  inflamed  surfaces ;  relief is  felt from this posture and it is
  maintained  as  much as possible, but the muscles about the joint are
  liable to spasms,  whereby  involuntary starlings  of the  limb occur,
  especially during the short and uncertain periods of disturbed sleep,
  and the pains are all much increased by these jerking motions.   The
  system  labors  under  inflammatory  fever of  a grave kind, which in-
  creases with the progress of  the disorder; finally, suppuration having
  occurred  there is a marked  aggravation of all  the  symptoms, both
  constitutional and local, and a succession  of rigors usually  ushers in
  the  exacerbation; the  fever  rises higher, and the system is propor-
  tionally more oppressed;  the swelling becomes larger and more tense ;
  the  pain  heat  and  feeling  of tightness are increased, accompanied
   with a deep-seated  throbbing, and  each beat of the pulse seems to
   augment the pain.   The superficial swelling becomes  more angry ; 
30
Index Raisonne.
 the fluctuation  within the joint  also changes its type, becomes less
 elastic,  and affords to the experienced touch a tolerably certain indi-
 cation of the presence of pus, and not merely of serum.  At one or
 more  parts  the  swelling  begins to point;  ultimately, the skin at the
 prominent points either gives way, or is opened artificially, the mat-
 ter is discharged, and the cavity of the joint is exposed to the exter-
 nal  air;  for  a  short  time the more urgent symptoms subside, by the
 relief from tension, but  very soon a second  aggravation, generally,
 ensues, even greater  than that which followed on the first formation
 of matter, the destructive process rages anew, accompanied by vio-
 lent constitutional disturbance, perhaps now of an irritative rather
 than  of the  inflammatory type of fever; this in its turn often gives
 way to hectic, and  the  system sinks under its burden.   Synovitis is
 generally  the result  of bruise or wound; if the joint be laid open,
 and the wound does not unite by simple adhesion, synovitis is inevita-
 ble.
   Synovial, or capsular rheumatism  must  not be mistaken for acute
 synovitis,  for the former is a far less serious disease than the latter.
 In capsular rheumatism the  pain does not last long before some de-
 gree  of swelling  is perceptible, with slight redness of the skin, and
 this swelling arises from the rapid effusion of  serum in the joint; the
 fullness and distension of the  synovial membrane  is tight and elastic,
 and  protrudes as it were between the spaces that intervene between
 the tendons and ligaments,  and fluctuation  is  often distinctly percep-
 tible.  So far, there are not many  distinguishing  features from acute
 synovitis,  but in  the  inflammatory affection  there is no tendency to
 suppuration, hence the  fever is either less intense from the beginning,
 or soon moderates after the joints begin to swell; the tongue  is less
 foul, and perhaps the patient sweats less than  in fibrous rheumatism,
 but his skin is less harsh and  dry  than in synovitis.   The whole  at-
 tack spontaneously becomes  stationary  or  tractable,  at the  very pe-
 riod when synovitis becomes more urgent and unmanageable.
   Capsular rheumatism in its  turn may be mistaken for simple chronic
 synovitis, in   which the  pain,  heat, &c. are  comparatively slight;
 swelling is the prominent  symptom, for the process of accumulation
 in the joint may be tolerably rapid in  its rise, yet peculiarly  indolent
 and painless; the superficial  soft  parts are  wholly uninvolved, the
 skin is not very hot, red or cedematous; the fluid effused is entirely
 serous and the whole disease is often regarded as a simple dropsy,
 and called Hydrops articuli.   But chronic synovitis is fraught with
 danger  by continuance ;  acute inflammation may  be  easily excited,
or the  chronic inflammation may extend to  the cartilages or  bones of
the joint;  the thinner portions of the synovial fluid may be absorbed,
a fibrinous or purulent deposit may gradually take its  place  both
within and without the cavity  of the joint;  the swelling, consequent-
ly, becomes more solid and less fluctuating, the joint more hot, painful
and more  abridged  in  its motion, and the constitutional irritation, be-
fore perhaps  slight, now becomes considerable, tending towards the 
Arthritis.—Ascites.
31
hectic type.  The disease is most common in those who have suffered
with the  venereal and mercurial poison; exposure to cold and wet,
aided perhaps by some slight bruise, or strain is its most common ex-
citing cause.
   With a little care chronic scrofulous synovitis need not be mistaken
for simple  chronic synovitis, nor for capsular rheumatism.  The scro-
fulous patients  usually evince more or less strongly the peculiarities
of the scrofulous cachexy; the  joint slowly swells, and has its  mo-
tion more or  less impaired, but little or no pain is experienced ; the
swelling is soft, doughy, somewhat elastic,  but totally devoid of any-
thing like true fluctuation, such as obtains in capsular rheumatism,
hydrops articuli and chronic synovitis ; the integuments are pale and
scarcely tense, and even pressure and manipulation are comparatively
well  borne.   In  this indolent condition the  joint may continue for
months, but gradually,  unless  relief be afforded, suppuration finally
supervenes,  followed by the usual  aggravations,  both general  and
 local.
   In chronic  scrofulous synovitis the membrane slowly and silently
 degenerates into a  gelatinous pulpy  substance, soft and of a whitish,
 or light grey color, the secretions from it becoming thicker and more
 opaque ;  it is an entirely different affection from the brown and dense
 degeneration of the synovial membrane, which slowly and insidiously
 changes into a pulpy looking substance of  darker hue and of greater
 thickness and extent; it is also of greater density and intersected by
 many  firm, fibrous  bands, somewhat after the manner of carcinoma.
 This brown intractable degeneration is most common  in adult females
 and shows itself externally as a gradual, soft, comparatively painless
 tumor  of the  joint, much like that of  the simple gelatinous degene-
 ration  or chronic  scrofulous synovitis; yet the swelling is more dif-
 fuse and less prominent,  as if the  diseased action had more deeply
 fastened upon the whole extent of the joint; it is also more decidedly
 elastic, often  simulating true  fluctuation very closely ; it is of a uni-
 form character, and has no peculiar bulgings dependant on the natural
 form  of the  joint;  the  uneasy sensations are greater, and increase
 more rapidly,  they are apt to be of a deep gnawing kind, gradually
 augmenting into smart lancinating  pains;  there is  an  obvious  con-
 comitant  cachexy, quite different from  the scrofulous, and somewhat
 similar to that which attends malignant disease ; there is sallowness oi
 hue, loss of flesh, strength and  spirits, and a modified hectic lever.

    AsciteS.-Acid-acet. 8.   Aeon. 124.  Apis 442. 443. 453. Apoc-
  cann. 484.                                       rt  .-,  /•  i i      i
    Ascites   The closed cavity within  which  the fluid of abdominal
  dropsy is confined, is kept moist during life and health by a continual
  serous secretion from its  surfaces, and it is kept merely moist, lor the
  fluid thus constantly secreted is as  constantly reabsorbed into the cir-
  culation   When dropsy of the abdomen  occurs, either the quantity
  of fluid exhaled  has  been augmented, the  absorption remaining the 
32                     Index Raisonne*.
same ;  or the absorption has been diminished, the  exhalation con-
tinuing the same;  or else the exhalation has been  increased, while at
the  same time the absorption was either lessened, or not proportion-
ately increased.   But  absorption  takes place both by the lymphatics
and the veins; the lymphatics absorb the more solid or albuminous por-
tions of the natural exhalations, while the veins absorb the serous fluid
exhaled from the  surfaces of the serous membranes.  In a large pro-
portion of cases of dropsy, the liquid collected is simply serous ; it is
not the liquor sanguinis, for it  holds no fibrin or albumen in solution:
in a  smaller class of cases, the contrary holds true.
   In the larger class of cases  we  require remedies, which act speci-
fically  upon  the  veins ; in the smaller upon the lymphatics.   In  an-
other simple class of dropsies mere debility is present; some persons
may  be  bled into a dropsy, or starved  or weakened into a dropsy;
these are genuine instances of dropsy from debility, but they  are rare,
and require only tonics, such as wine, spirits, China, Ferrum, nourish-
ing  diet, &c. to  cure them;  but  in a large number  of examples of
chronic or passive dropsy, debility is sooner or later added, often in an
extreme  degree, and  the  above remedies come in  play, in  the later
stages  of the disease, either alone, or as helps to other more  decided-
ly anti-hydropsical remedies.
   Simple debility of the veins, or  lymphatics, or of  the bloodvessels,
generally, is a comparatively rare affection  ; a thin and watery con-
dition of the blood, such as occurs in chlorosis, anaemia, &c. is more
common  ; the same tonic remedies, above alluded to, are required.
   A  much larger  number  of cases of chronic abdominal dropsy arise
from pressure upon the veins, more particularly the vena porta; this
pressure may arise from a tumor, such as, enlarged mesentericvglands,
cancer of the pylorus, cancer of the head of the pancreas, &c.;  but
far more frequently the pressure arises in the liver itself, when the
organ is  small, hard and contracted as in the so-called hob nail liver, or
granular liver, or cirrhosis; this  arises from chronic  thickening and
contraction  of Glisson's capsule,  which  is  an areolar tissue, that
accompanies the portal vein, hepatic artery and biliary ducts, and forms
a sheath around these vessels ; while the hepatic vein and its branches
are lodged in the proper substance  of the liver, without being invested
by Glisson's capsule ; hence thickening and contraction of Glisson's
capsule causes pressure  more especially upon the vena porta and  ob-
struction of the portal vein in the liver, hindering the return of  ve-
nous blood  from the intestines, followed by congestion or stagnation
in the  capillaries,  arrested venous absorption and mechanical transu-
dation of serous liquid.  Before the cirrhosis  of the liver is far enough
advanced to  cause dropsy unaided, but merely to predispose thereto,
the patient may be exposed to cold and wet, have  a  check of perspi-
ration,  and  as there is already considerable abdominal venous  plethora,
rapid effusion may take place in the abdomen, especially if the fever-
ish cold, produce  one  of  its most common effects, viz., scantiness of
urine;  under such circumstances  the patient who had merely been 
Ascites.—Asthma.
33
regarded previously as bilious, weak, or dyspeptic, or  what not, ra-
pidly becomes excessively flatulent, as he  thinks;  his abdomen be-
comes  more distended than common, although a considerable amount
of this  may have been  habitual with him;  his  breathing becomes
short and oppressed, especially on lying down or making any unusual
exertion, such as walking fast or going up-stairs; slight puffiness of
the ankles, and indistinct fluctuation will  be found, on careful ex-
amination.   These cases yield rapidly to treatment, if detected early,
and no  general  inflammatory irritation of the system, with more or
less (edematous pneumonia, pleurisy with effusion, and endo- or peri-
cardial  jmlogosis ensue.   Even  then, a few doses of Aconite and
Antimony,  or Mercurius and  Veratrum-viride, or Mercurius, Bryonia,
and Scilla, will allay this  storm, and the usual hydropic and diuretic
remedies will ensure complete present success.
   If Glisson's capsule be much thickened,  Muriate of Ammonia and
Hydriodate of Potash are the most important remedies, and will oc-
casionally  remove the dropsy, and  cure the capsular disease, unaided
by other remedies ; but often they will have to  be aided by China,
Arsenicum, Ferrum, Iodide of Iron, or the  Muriate Tincture of Iron,
or some other  so-called  tonic remedy, and,  as  frequently,  Apis,
Apocynum, Digitalis, Scilla,  &c, will be  required, as  intercurrent
remedies, when dropsical effusion or progressing debility form the most
serious complication.
   When no accidental occurrence  transpires, to  hasten the attack of
ascites,  the abdomen gradually enlarges,  flatulence becomes  more
troublesome, the breathlessness  gradually progresses, the difficulty
of lying down increases, the  urine becomes scanty, the  stools may be
clay-colored, the skin dry and harsh, &c.
   Hartmann regards Helleborus-niger as almost  specific in curable
ascites ; China he thinks the next most useful remedy, then Ferrum-
aceticum, Arsenicum,  Euphorbium-cyparissias, Solanum-nigrum, Pru-
nus-spinosa, Ledum.   Pulte  prefers Arsenicum  and Sulphur, in al-
ternation,  followed  by Apis-mdl.   Guernsey  prefers  Apocynum,
Apis,  and   Arsenicum, followed  by  Digitalis, Hellebore, Crotalus,
Dulcamara, or China, as the symptoms indicate.

   Asthma—Acid-benzoic, 14, 15.  Acid-hydroc, 33  Acid-nit 54.
 Acon^O.   Agar., 168.   Allium^., 206  Aljm, 229.  Ambra.,
049    Ammon.-carb., 276.   Ammon.-caust., 285,  287.  Gum-ammon.,
322.   Anac, 349.   Anis., 376.  Apis, 461, 462.

   Asthma is of various  kinds:  1st, The  simple spasmodic  asthma,
 which  is  a pure spasmodic  irritation of the muscular fibres of the
bronchial  tubes; these muscular  fibres  have been distinguished by
H^issessen and Laennec  in bronchial ramifications less than one line
across   This species is excited by trifling changes in the quality of
air bv indigestion, flatulence, mental  emotion, or some distant  irrita-
tion in  the system;  it usually passes off in  six  or eight hours.
                 c 
34
Index Raisonne.
   2d, The congestive spasmodic form, in which the patient usually has
fore-warnings, in the shape of languor, irritability, chilliness, oppression,
drowsiness, loss of appetite, &c, and  goes to bed chilly, ill, or un-
comfortable ; the chilliness of the surface makes the  blood  tend  to-
ward the susceptible lungs at  night, during the first sleep, when the
blood  is  fullest in quantity in  those  who  dine  late,  its movements
slow, and congestion towards internal  parts easiest; during sleep the
moderating influence of the will is also withdrawn from  the respira-
tory muscles, and those voluntary alterations in the rate of breathing
which are required  to  balance and correct the commencing derange-
ment of the pulmonary circulation, and which are prompted at once
during thes waking state, do  not  occur;  at  length, the  congestion
reaches that pitch which excites spasmodic contraction,  and a fit of
asthma rouses  the sufferer.  This process will  be clear to any one
familiar with the heavy and uneasy breathing  common to  most  sleep-
ing persons, when compared with  the  easy  breathing of the majority
of wide-awake  individuals    These  attacks are  rather more lasting
than the  simple spasmodic paroxysms, but  they generally do not last
many hours, unless  there be some  catarrhal, feverish, or rheumatic
irritation of the system.
   3d. The catarrhal variety.  This is by far the  most common ;  it
arises from ordinary catarrh or influenza of the air-passages, attack-
ing persons predisposed to, or  liable to paroxysms of asthma.  The
catarrhal element is usually overlooked by the patient, for the disease
falls at once upon the  susceptible  bronchial tubes, and the  ordinary
catarrhal affection of the eyes, nose, and throat  is  either altogether
wanting, or lasts so short a time that  it is usually overlooked  or for-
gotten.  A person  liable to asthma gets an  attack whenever he takes
cold, but is not  aware that he has taken cold.   These  attacks usually
last several nights and days, and will not yield to simple narcotic and
anti-spasmodic  remedies;  while  the pure spasmodic variety usually
subsides in the  morning, and the patient is  perfectly well in the day-
time, although he may  have another  attack at night.
   4th. The  emphysematous  variety.   In this form, the  patient has
chronic difficulty of breathing, both  by day and night; a  fit of flatu-
lence or indigestion, or a catarrhal attack will  produce severer attacks
than those  he is ordinarily subject to.  In  emphysema, the  air-tubes
and cells are dilated and feeble ;  the  chronic difficulty of breathing
arises  from want of contractility of the air-tubes and air-cells, and the
voluntary respiratory muscles  have  the greatest  part of  the labor of
expanding the  chest,  while the  air merely rushes  into  the  almost
passive lungs;  again,  the  air must be expelled  by  the  respiratory
muscles, almost unaided  by the  natural contractility of the  lungs.
During sleep, in emphysematous  persons,  the blood  collects  in un-
usual quantities in the  lungs, it is not properly  aerated, and, finally,
after a few hours' slumber, a  more  or  less severe attack of asthma
comes on ;  for the respiratory muscles and contractile fibres of the
air-tubes and lungs are thrown into a state  of  labor and spasm, in 
Asthma.—Asthenia.
35
order to restore the balance of the circulation, aeration, and respira-
tion.
  5th. The  chronic catarrho-emphysematnus  variety.   This is merely
a combination of chronic bronchitis and emphysema; there is always
more or  less cough, expectoration, and difficulty of breathing, all of
which are aggravated periodically or occasionally.
  6th. Cardiac asthma.
  Treatment.—In pure  spasmodic  asthma,  Ipecac,  Belladonna,
Stramonium, &c, are  the  most  important  remedies.  Watson says
he has often prevented  an  attack, when the  familiar preliminary feel-
ings have been present, by giving one-quarter or  half a grain of Ex.
Stramonii, just before going to sleep.   In  the severest cases, he says,
some preparation of Opium will have to be used, to give the agonized
patient some little relief, until other remedies remove the paroxysm.
   In the congestive variety, Ipecac, and Lobelia are the most  im-
portant remedies.  Watson  says, many persons are thrown  into  a
paroxysm  of dyspnoea if  they enter an apartment where  Ipecac, is
under preparation ; a  laboratory-man  at St. Bartholomew's Hospital
was obliged to fly the  place whenever Ipecac, was about.   Most per-
sons, he  continues, who have  had  much  experience  in druggists'
shops, are acquainted with similar examples, so that the  influence of
Ipecac, in  exciting fits  of  difficult breathing,  resembling  asthma, is
undoubted,  and  common to many constitutions.  We might as well
speak of Ipecacuanha-asthma, as of hay-asthma, which is a precisely
analagous affection ; yet, he says, en another  page, Ipecac  which is
so frequently the cause,  has  also been recommended for the cure ot
asthma.   I have seen  two very severe attacks, lasting three days, pro-
duced by Dover's powder. Wood says, that  Lobelia is the most useful
remedy which he has used;  sometimes it  is merely a palliative, in
others  it effects  absolute cures.  Hydriodate of Potash  dissolved in
an infusion of Senega, forms the basis of Whitcomb's celebrated remedy
for  asthma.  Nitric-acid and Hydriodate of Potash  had  been used
by physicians many years before Whitcomb's  remedy was so exten-
 sively advertised.

   Asthenia.—Acid-acet., 9.
   Asthenia 13 .defined  as want of strength, simple debility, or extreme
 debility  This term was employed by Galen and Brown to designate
 debility  of  the whole economy, or diminution of the vital  forces
   The simple asthenic constitution is  said to be rarely congenital, but
 more frequently acquired, in consequence of disease, excessive exer
 dons  or  dissipation.  It occasions a  constant sickness  or delicacy,
 without many objective symptoms, except deficient digestive powers
 ™^™7\esiem*ci*tLi every fresh attack of sickness, however
 slight, is rapidly followed by extreme  exhaustion.
   In death from asthenia, the pulse becomes very feeble and frequent,
 and  the muscular debility extreme,  but  the  senses  are  perfect, the 
36
Index Raisonne*.
hearing is sometimes even  painfully acute, and the intellect  remains
clear to the last.
  The  asthenic-ancemic constitution  is  frequently congenital, and as
frequently acquired by an injudicious mode of living, by chronic disease,
frequent haemorrhages, excessive exertions, miserable food,  frequent
child-births, prolonged lactation, excessive  grief, disappointment, or
misery.  When it  is congenital, the  body is slightly  developed, small,
delicate, &c  This constitution predisposes to many local  nervous
affections, especially gastric and facial neuralgias, indigestion, too fre-
quent and facile attacks of disease, so that a,cute, and otherwise slight
sickness often occurs,  and prove exceedingly obstinate and malignant.


                                B.
  Baldness.—Acid-fluoric, 19.  (See Alopecia, page 9.)

  Biliousness.—Aconite, 115, 123.  Agaricus.  Ammon.-inur.

  The  natural quantity of bile secreted every twenty-four hours, is
about three or four pounds;  of this, the whole of the fluid bile, and
at least seven-eighths, and perhaps fourteen-fifteenths of  the  solid
matter is again taken up by the absorbing vessels, on its road  from the
liver to the rectum.   It is clear, therefore, that it is  not a  mere ex-
cretion, and that the simple absorption of bile does  not cause bilious-
ness and  jaundice.
   It has  been found, by experiments on dogs  fed on meat only, that,
when  no bile was allowed to flow  into  the intestines, rapid decom-
position of the fleshy matters occurred;  there was continuous  rumbling
the  abdomen, secretion  of fetid gases, and of faeces smelling like
carrion, immediately  followed  with a very foul  breath.   When the
animals were fed on  bread only,  these symptoms ceased, the  fasces
and abdominal gases were sour, rather than putrid.   Hence, we may
conclude that bile acts on albuminous  matters, as  on  antiseptic, pre-
venting their putrid decomposition, and preserving  them safely,  to be
 exposed  as much as possible to the  absorbents  of the  alimentary
canal.  Bile also checks the excessive acid fermentation of vegetable starch,
so that it may  proceed  gradually, and  as  required  by the  digestive
 process.   It  has  also been found that  the greatest quantity of bile is
 naturally secreted twelve or fourteen hours after a meal; now, as both
 putridity and fermentation are most  likely to occur in  excess at a late
 period of digestion, we  have  here an  easy explanation  why nature
 furnishes the largest quantity of bile at that time.
   Although bile  prevents the putrefaction and  fermentation of albumi-
 nous  and starchy aliments, it does not digest  or solve them; indeed,
 since starch  has  saliva and pancreatic juice to digest it, and albumen
 gastric juice, why should the bile interfere?  But, bile does digest fat.
 In  dogs with biliary fistulas, only  1.56 of fat  was absorbed; if they
 were allowed to  lick up the bile, which flowed out of the fistula), 2.24 
Baldness.—Bilio us ness.
37
of fat  was digested;  while, in healthy,  uninjured  dogs, 11.1. was
taken up.  Hence, it is clear that, though some fat may be  absorbed
without  the  aid  of bile, yet, that a small addition of that  secretion
makes the quantity considerably greater, and that an unrestricted flow
of bile into the intestines increases the absorption of fat, five, six, or
seven-fold.
   Fresh flowing  bile is always neutral;  it only becomes alkaline after
mixing with the thickened contents of the gall-bladder, which con-
tain mucus.  The bile of carnivora is yellow in color, from  golden to
burnt sienna; in herbivora it is  green, from grass-green in rabbits, to
sea-green in  geese,  and olive-green in sheep.   These varieties of
color are partly dependent on the amount of oxygen admixed; for, by
an'artificial  addition of that element, the yellow  bile  may  be made
green, and the  green bile, when deoxidated by zinc, turns yellow.
We may conjecture, then, it varies in color somewhat, according to
the quantity  of oxygen brought to the liver  by the blood.  Acids also
turn the bile green.
   A full diet  increases not only the quantity of the bile, but also the
amount of solid material therein.  Flesh diet  increases the secretion of
 bile more than vegetables.  Fatty food, instead of increasing, as might
have been expected on theoretical grounds, the quantity of bile, extra-
ordinarily diminishes  it.  Water increases the quantity of bile  within
 an hour after it  is drank;  it probably merely dilutes and washes out
the bile already  formed more easily, and copiously.  Mercury, Muriate
 of Manganese, and Colchicum increase the  quantity of bile more  than
 any other medicines, and  they also produce a very great sanguineous
 congestion of the  liver.   Aloes,  Turpentine, and  Rhubarb empty the
 liver of its bile, and  increase the flow  into the intestines, but  render
 the liver pale.   Nux and Sulphur, in alternation, remove many cases
 of chronic biliousness.   Manganese deserves more attention than it
 has received.
   A large proportion of cases of  so-called biliousness, are not simple
 cases ofexcess of bile, but rather an excess of food and drink;  cases
 of combined gluttony, partial intemperance,  and much  laziness.   Too
 much stimulating food and  drink is taken, the stomach and bowels are
 loaded with  rich and badlv-digested food, too much blood is made and
 that of an unhealthy  quality, and too much bile  and  fat, also of an
 unhealthy nature.  If the  patient cannot  be induced  to reform his
 habits it is much better  to  give him somewhat active bilious and saline
 medicines-  let the excess be purged off, and the blood lessened in quan-
 tity, and thinned in quality, by getting the liver, kidneys, and skin to
 act freely   Then Nux, Bryonia, Sulphur, &c, will prove much more
 effectual'than when given without such preparatory treatment.
   In  ordinary biliousness, there is, generally, a partial retention ol the
 whole catalogue of  substances which  should  be  excreted  from the
 liver  bowels ''and perhaps kidneys, instead  of a complete retention of
 one constituent, the bile.   In general defective secretion from the liver
 and bowels there is a dinginess and darkness of complexion, but  none 
38
Index Raisonne.
of the yellow-green of jaundice, and  the stools are  scanty, usually
dark, hard, and dry, but not always clay-colored, as in simple jaundice.
   The skin gets greasy and opaque;  the face sometimes puffy and
bloated ; the lower eyelid especially sallow and discolored ; there is often
great sluggishness of body and apathy of mind, and often a miserable want
of decision and energy.  Digestion is  accompanied by a good deal  of
discomfort and  flatulence,  especially several hours after  eating; the
appetite, sometimes, does not suffer,  and  the  patients often  indulge
largely in  eating, and pronounce the first period after eating their most
comfortable time.  Alcohol and  fatty food are apt to disagree, and
sometimes are abstained from by choice ; attacks of bilious and flatulent
colic may occur, and  some disorders  closely bordering on  jaundice.
Nux, Sulphur, Mercurius,Colchicum, Bryonia, &c.;are useful remedies.
   Epithelial gastric catarrh is  often associated with biliousness, and
generally  mistaken  for it.  It is characterized  by a thick  yellow coat
on  the tongue,  an  incapacity of the  stomach  to digest its contents,
and  an  irritability of the viscus, which  tends  to reject, by vomiting,
these undigested  contents.  At the same time, although  the bile is only
formed in  its usual quantity, it  is drawn up, by the effort  of retching,
into the stomach  and thrown out with the food and mucus;  or else,
passing downward,  and not being absorbed by the mucous membrane,
it is excreted  in  the shape of bilious  stools.   The frequency with
which bile is  vomited, and  the  frequent appearance of large quantities
of bile in  the diarrhoea of  gastric catarrh, have acquired  for the dis-
order the  popular name of "bilious  attack."   It is  caused, possibly,
by an extension of  the catarrhal state to the duodenum, and, perhaps,
even to the gall-ducts themselves, and  thence to the whole substance
of the liver.   It is  likely that  there is an  increased secretion of mu-
cus from  the gall-ducts,  which mixes with the bile and makes it un-
suitable for reiibsorption from the intestinal canal, at the same time that
the absorption is  further impeded by the increased secretion of mucus
throughout the bowels.   The bile then regurgitates into the stomach,
and  excites vomiting,  or else  passes  away  by a diarrhoea.  These
cases are  best relieved by Pulsatilla, Ammon.-Muriat., Natrurn, Sic,
aided or not by gentle  laxatives."
   Chronic duodenitis is frequently mistaken for  simple biliousness and
jaundice, with which it is almost invariably associated.  In this disease,
there is pain more or less pronounced; accompanied by tenderness on
pressure,  and a sense  of constriction or  fullness, confined to a small
space, but sometimes occupying  the whole length of the duodenum,
extending down  from the  cartilage of the eighth  or  ninth  rib, in a
somewhat curved or crooked  course, toward  the right  side of the
umbilicus.  In some  cases, the pain, tenderness, and  constriction  in
this situation  are constant, and greatly aggravated  by taking  food or
irritating liquids ; in others, they are felt only after food, and are more
liable to occur  after  dinner than any other meal.  The pain is not
aggravated or excited  immediately after  food  is taken, but in from a
half, to one, or two hours,cr as soon as the chyme enters the duodenum, 
Biliousness.
39
and  the  pouring out of bile and  pancreatic fluid upon the irritated
mucous membrane commences, and is attended with flatulent eructa-
tions, and sometimes by slight nausea.  In some cases, the symptoms
cease  or decline  as soon as the  process  of duodenal digestion is
finished, in others, they continue for  several hours;  but, if the food
or drink  has  been very irritating or indigestible, they may last for
some time.
  The bowels are often confined  and irregular, but may be relaxed
and irritable ;  the motions are peculiar and characteristic of the disease.
In some  cases,  they are of the color  and  consistence of dirty paste;
in others, hard and clay-like, sometimes streaked with  black bile, or
formed  in parts, sometimes  altogether of bile, black and pitch-like,
yellow or green, and mixed  with, or surrounded with  mucus.   The
odor of the evacuations is  often peculiar; sometimes it is  faint  and
sickly, sometimes  highly offensive, and resembling that given off by
fish  or vegetables when putrefying.   In  some cases, these peculiar
states of the motions, with slight pain in the duodenum or in the right
lumbar region, are the only indications of the existence of the disease,
which is then almost certain to be mistaken, by ordinary physicians,
for simple bilious  derangement.   In one sense it is, however, a mis-
nomer to call this affection a simple and  pure chronic duodenitis, for
the  chronic phlogosis creeps along  the  biliary ducts by contiguous
sympathy and simple  progression, and finally a  large portion of the
secretory and  biliary portion of  the liver  becomes involved; still the
disease generally commences in the duodenum.
  The pain is rarely acute or strongly  marked, unless ulceration exists,
and then it may  be dull and boring;  sometimes the chief pain  is re-
ferred to the back, between the shoulders, and then may be mistaken
for  that  of perforating  ulcer  in  the  posterior wall  of  the  stomach.
The distress in the vicinity of the  margins of the false ribs often
consists of a feeling of tension or constriction, which is  worse to bear
than actual pain; it wears down the nervous powers, and renders the
sufferers irritable,  nervous, and melancholy, and often, from the great
bodily and mental depression which it excites, incapable of  exertion.
  On examining the right side of the epigastrium, some enlargement
and fullness, with tenderness on pressure, can generally be discovered,
especially after a full meal   This enlargement and fullness are often
mistaken for enlargement of the liver, with which, in fact, it is some.
times associated.  But simple duodenal distention is accompanied with
a clear sound on percussion, and, in the intervals of digestion, the en-
largement and  fullness always  diminish, and  sometimes  disappear.
These signs  are most valuable  when the liver is natural in size, or
rather smaller, as is sometimes the case.
  The appetite  is  generally  good  and digestion  rapid;  the  patient
makes no complaint immediately after food is  introduced into the
stomach, but as soon as chyle begins to pass into the duodenum, the
symptoms commence. If there be minute ulcerations scattered over the
mucous  membrane,  very sweet and  farinaceous  food, or very sweet 
40                      Index Raisonne.
 tea or coffee, or rough  sweet wines, especially after a full meal, will
 excite  or  aggravate the symptoms, exactly as sugar does  when  it
 comes  in contact with a decayed tooth.
   The tongue is often  dry and  flabby, coated  or streaked with white
 fur; the thirst, particularly  during digestion, severe;  yet  drinking
 freely  of liquids seems to  sweep the contents of  the  stomach more
 rapidly into the duodenum and add to  the distress.  Very cold liquids
 are said to give rise to severe headache,  which may last  from six  to
 twenty-four hours.  The skin is apt to  be  harsh and dry, often affected
 with psoriasis, sometimes with  prurigo, and occasionally with nettle-
 rash.   In  these cases, Arsenicum  is the most important remedy.
   Patients laboring under chronic  duodenitis are very  apt to have
 bilious  attacks, as the irritation spreads rapidly along the biliary ducts ;
 or these may  be thrown into a state of  spasm, by irritation, congestion,
 inflammation, or  ulceration  about  the  region  where the ductus  com-
 munis  empties  into  the  duodenum.   The  more  the  duodenum  is
 congested  or  inflamed, the more severe these bilious attacks become,
 and often last for several days ;  severe bilious headache is a constant
 accompaniment.   Nausea, retching, and vomiting may  occur;  the
 urine may be scanty, and loaded with  urates;  the bowels confined  or
 irregular;  the motions very deficient in bile;  increase of pain, tender-
 ness, and constriction about the duodenum ; the conjunctivae of ten become
 muddy, sometimes yellow, and the skin often assumes a jaundiced tinge.
 These  attacks may occur with  great  regularity once a week, or fort-
 night;  in females, often just before the menses;  but more frequently
 they occur at  irregular periods, excited  by irregularities of food  or
 drink, mental  emotions, exposure to cold and wet,  fatigue, constipation,
 &c.  When the spasmodic contraction of the mouth of the ductus-
 communis  is  very great, much difficulty is experienced  in getting
 evacuations from  the  liver  and bowels;  when it subsides, oil-like
fat is sometimes passed  from the bowels or vomited  up; it seems
 as if the bile detained  in the common or hepatic ducts undergoes a
 fatty degeneration.
   The  most useful remedies against chronic duodenitis are Colchicum,
 Conium, Mercurius, Aconite,  Phosphor., Agaricus,  and Cuprum.  In
 some instances, Tinct. Rad. Aconite may be applied freely over the re-
 gion of  the duodenum, several times a day;  or a plaster of Conium,
 Digitalis, or Mercurius ;  as severe burns (see page 58.) cause con-
 gestion, inflammation, or even ulceration of the duodenum, it may be
 homoeopathic to apply a small blister externally.

   Bites Of VeilOmOUS  Reptiles.—Ammon.-caust.,  281.   Anac, 339.
   Venomous bites may be divided into three  different  classes, e. g.,
 bites cf serpents, bites of spiders, and stings of insects;  but their treat-
 ment is so  similar, at least of the two  last, that they might almost be
 classed  under one head.  This  arrangement, of course, excludes the
 venomous bites of rabid animals, which, giving rise to a distinct and
 peculiar disease, hydrophobia, do  not  properly belong to this class of
 affections. 
Bites of Venomous Reptiles.
41
  Dr. Tomlinson  Fort favors the idea that the poison of the rattle-
snake, the viper, &c,  is the  same as that of stinging insects, (the
wasp, hornet, &c,) the only difference  being in the quantity of the
poison injected into  the flesh ;  and that, in a snake-bite, the danger
is very much in proportion to the size of the animal.  He has never
known death to occur  from the bite of a small snake of any kind.
Even the small variety of the rattle-snake, the ground rattle-snake, he
has never known to inflict a fatal wound, even on a small child.
  Though this may  hold good of the region  of  country of which Dr.
Fort writes, it  is  a  notorious fact  that, in the West Indies, some of
the most venomous and deadly reptiles are so small as frequently to
be overlooked in one's bed, and the bite of the tarantula spider, (Ara-
nea tarantula, Lycosa tarantula,)  an animal  much  .smaller  than any
snake, has frequently proved fatal.
  The poisonous snakes met with in the United States, are:
  1. The rattle-snake, (crotalus horridus,) of which, according to Fort,
there are  three species, all easily known by the  rattle in the tail.
This name, crotalus horridus,  is  also sometimes  used to designate the
 Cobra di capello, of  South America, but it is  more properly  the Colu-
 ber-nuja, of Linnaeus.
  2d. The viper, (Coluber-berus,)  of which  there are  four  varieties:
the common viper and the copper-head, which inhabit the uplands,
and the brown or blunt-tailed  moccasin and the cotton-mouth, both of
the latter amphibious, and  inhabiting small streams, swamps, and low-
 lands.
   According to Dr. Gilman,  (Philadelphia Journal of Homceopathy,)
 there are four distinct varieties of rattle-snakes, of which the crotalus
 horridus, and crotalus Kirtlandii are much the most numerous.   Of
 the moccasin-snake, as he calls the coluber, there are, he  says, two
 varieties, both of  them being quite as  venomous as the rattle-snake.
   The poisoning  apparatus  is,  he says, the same in  all varieties of
 snakes.   He describes it  as  •' a strong frame-work of bone, with its
 appropriate muscles,  in the upper  part of the head, resembling and
 being in fact, a  pair of jaws, but external  to  the jaws proper, and
 much stronger.  To these is attached, by a ginglymoid articulation,
 one or more moveable fangs on each side,  just at the verge  ot  the
 mouth, capable of being erected at pleasure.   These fangs are very
 hard, sharp, and crooked,  like the claws of  a  cat, and hooked back-
 ward with a hollow from  the base to near the point.   This hollow
 has been found divided by a thin bone, making  two.  At their base is
 found a small  sac,  containing two or three drops of venom, which
 resembles thin honey.  The  sac  is so connected with the cavity of
 the fang during its erection,  that a slight upward  pressure forces the
 venom into the fang at its base, and it makes its exit at a small slit or
 opening  near the point, with considerable force;  thus it is carried to
 the bottom of any wound made by the fang.  Unless the fangs are
 erected for battle, they lie concealed in the  upper  part of the  mouth,
 sunk between the internal and external jaw-bones, somewhat like a 
42
Index Raisonne.
penknife-blade shut up in its handle, where they are covered by a fold
of membrane which encloses them like a sheath—the vagina dentis.
There can be no doubt that these fangs are frequently broken oil" or
shed, as the head grows  broader, to make room  for new ones, for
within the vagina dentis of a very large crotalus horridus, which Dr.
Gilman dissected, he found no  less than five fangs on each side, in
all stages of formation.  The venom may be easily withdrawn by the
aid of chloroform, a few drops of which stupefies snakes.  They are
then to be seized by the neck, the vagina dentis held out of  the way
by an assistant, with  a pair of forceps, while the fang is erected and
gently pressed upward with a  pair of forceps.  The poison may be
caught in a little vial, or on a bit of lint.  After being robbed in this
manner, in two days  they  will be as highly charged as ever."
  A number of vigorous and healthy plants, inoculated with a lancet
charged with  the poison, were next day withered  and  dead, as  if
scathed  by lightning.  It is a significant  fact, that on  mixing the
poison, in order to preserve it, with two or three parts of alcohol, in
a short time it was found  to have lost its venomous properties ; but
no such result took  place after mixing it with.aqua-ammonia, spirits
of turpentine, oil of  peppermint, cinnamon, or cloves, nitric or sul-
phuric acid, &c
  The venom, though  elaborated by the  snake, is quite  as poisonous
to itself as to others. An experiment was made, of putting seven venom-
ous serpents together in one den ;  they were made to fraternize, and
lived amicably together.  A beautiful  pair  of  long-bodied speckled
snakes, known as king-snakes, known  to be fangless and venomless,
were introduced.  Some uneasiness  was observed  among the others,
but no attack  was  made upon  the king-snakes.  The next morning,
four of the venomous serpents  were dead;  one was still within the
coil  of the king-snakes, and the two others would  make no defence.
A large rattle-snake  seemed stupid  and indifferent  to  his  fate—he
could not be made to give warning or threaten with his rattles.   The
smallest king-snake was afterwards inoculated with the poison of one
of the  serpents  he had destroyed,  and he  died  immediately after.
Gillman's conclusions are as follows :
  1. That the venom of all serpents acts as a poison,  in a similar way.
  2. That  the venom  of some varieties  is far more active than that
of others.
  3. That a variety of the coluber, known as  the cotton-mouth, is the
most venomous serpent in Arkansas.
  4. That the venom of serpents destroys all forms of organized life,
vegetable as well as animal.
  5. That alcohol, if brought in contact with the venom, is, to a cer-
tain extent, an antidote.
  6. That serpents do possess the power of fascinating small animals
—that power being identical with mesmerism.
  7. That the blood  of small animals destroyed by the venom of ser-
pents, bears a close resemblance to that of animals destroyed by light- 
Bites of Venomous Reptiles.
43
ning or hydrocyanic-acid ; it loses its power of coagulation, and cannot
long be kept from putrefaction.
  The effects of a rattle-snake-bite usually-follow very promptly.  It
produces intolerable pain in an instant, sickness at the stomach, blind-
ness, pain in the region of the heart, and death.  Sometimes these
effects follow with almost instantaneous  rapidity ; but,  if the patient
lives a few  hours, intense and violent swelling  of the limb ensues;
and, if he lives a day, a violent fever follows, which sometimes de-
stroys life after the lapse of three or four days.
  Fort says, that for these awful  cases, we are in want of remedies,
notwithstanding every article  in the materia medica  has been tried.
Undoubtedly, the first thing to be done, if seen  instantly, is to remove
the poison by suction or excision.  Ammonia might be given, but he
should have more faith in the  liberal exhibition of whiskey or brandy.
But, if Bibron's Antidote were at hand, it would be, by all means, pro-
per to have  recourse to that;  for, from the  cases already published,
we may infer that, if not an  antidote, in the  full acceptation of the
term, it is, at least, very often successful.  It was discovered by Pro-
fessor  Bibron, and is composed  of " Potass.-iod., four  grains ; Hy-
drarg.-chlor.-corros., two grains ;  Bromine, five drachms.—Mix." Ten
drops, diluted with a tablespoonful  or two of wine or brandy, consti-
tute  a dose—to be repeated, if necessary.  To be kept in well-stop-
pered glass  vials.
  Surgeon Hammond, of the army, reports of it as follows :  Prof. Bi-
bron allowed a rattle-snake to bite him in the lips, cheeks,  &c;  he
took the antidote, and suffered no inconvenience.
  Case I.—A man was bitten in  the  index-finger by a large  rattle-
snake, (crotalus confluentus).   One dose of Bibron's Antidote arrested
the swelling, and  the symptoms disappeared.   Forty minutes  after,
they re-appeared.  The medicine was repeated,  and, in five minutes,
the pain and pulsation had ceased, and the finger regained its normal
appearance.
  Case II.—A very large rattle-snake was  made to bite  a young wolf.
Fifteen minutes after, the leg was much swollen,  with signs of uneasi-
ness, yawning, stretching, looking about, &c; increasing to  inability
to stand, drowsiness, and slight convulsive movements.  Now, thirty
minutes after the  infliction of the wound, six drops of the antidote
were given, with almost instantaneous disappearance of the symptoms.
  Case III.—On the following day, the same snake was made to bite
the wolf three times in  the space of five minutes.  Inability to stand,
gasping respiration, and  fixity of countenance ensued at once.  Some
delay occurred in getting the antidote  ready, and before it could be
administered all signs of life  had disappeared. Nevertheless, six
drops of the Bromine mixture  were given, and,  in one minute, respira-
tion again commenced,  and the heart could be  felt to  pulsate.  He
lived twenty-seven minutes, and then died  comatose.
  Case IV.—A dog, five months old, was bitten in the right shoulder.
Two ineffectual attempts were made to  administer the  antidote, but 
44
Index Raisonne.
the dog would not swallow.   The  third dose was  inhaled  into the
lungs.   By this time, he was perfectly senseless, and died in forty-five
minutes.
   Case V.—Forty-five minutes after, the same snake bit  another dog
of the same litter.  At the end of three minutes, the antidote was given,
and swallowed readily.   At the end of fifteen minutes, he seemed so
much worse that another dose  was administered.  The next morning
he was as well as ever.
   Case VI.—A  girl, aged fifteen, was bitten on the  back of  the finger
of the right hand.  In a few moments  the finger  became swollen and
bluish, and, when first seen, ten minutes after the receipt of the wound,
the fore-arm  had begun to swell, and  pain extended to  the elbow.
She was depressed and nauseated.  An elder sister had  sucked the
wound, from the first instant.   A free incision was made, down to the
bone, and two drops of the Bromine mixture given, as soon as the
articles could be procured;  and injected into the wound the Iodine
and Iodide of Potash.   She expressed herself relieved after the first
dose, and ultimately  recovered.  Some other cases  are reported, too
long to be embodied here, but all quite favorable to the efficacy of the
antidote.
   In many of  the severe cases, where death  is not the immediate re-
sult, the patient  may linger on for some days, suffering from grave
fever, and these cases  should be  treated  accordingly.   In a recent
wound, if the swelling is extensive and painful, it may be  bathed with
Aqua-ammonia, or Hartshorn.  Cloths  dipped  in warm  brandy and
water, have been recommended.  Sweet oil has  been  recommended
internally; but, if the patient  appear to be sinking, diffusible stimu-
lants should be  given at once, in full doses—brandy or whiskey are
probably the best.
   The bites of the smaller varieties of snakes, are not fatal; they get well
of themselves.   The pain is, perhaps, severe, and the  swelling great,
but, like the sting  of an insect, they appear  to run  their  course  in a
short time.  It is not uncommon for the part bitten to run on to morti-
fication, or give  rise to sloughing  and  extensive loss of substance.
But, whatever injury  follows, it is to be treated according to the general
indication, without regard  to its peculiar origin.   There is no evidence
that any portion  of the poison  remains in the  system.
   Bites of Spiders.—Fort thinks, that of the many different species
of spiders, there are comparatively few which  are poisonous.  In-
festing every house, tree, and bush, as they do,  they would be  dan-
gerous indeed were they all capable of inflicting a  poisoned wound.
Fort has seen but two  instances in which  the animal  was seen, and
these he describes with much care.  He says  the  wounds were in-
flicted by a variety of spider, common to our fields and woods, whose
bedy is of a shining black, with a bright red spot on the abdomen.  It
is about the size of a wild grape, or swan shot, with slender legs, slow
motion, and very feeble.  It spins its  web  in the open air, from  bush
to bush, much as do  many other varieties.  The spider was  described 
Bites of Venomous Reptiles.              45
 o him, in both cases, in language not to be mistaken, and he readily
recognized it.  Its  feebleness and  slow motion render it but little
dangerous, unless accident should bring them in contact with the body.
In both his cases, the spiders were thrown by accident into the bosom.
  The patients were both laborers—strong, active, young negro men,
laboring in the field. The symptoms were alarming and violent; pain
at the pit of the stomach, oppressed  and difficult  breathing, with
spasms of the muscles of the abdomen and back, so permanent and
rigid that the body could scarcely  be  bent.  The pain in the  part
bitten was slight, and the total absence of swelling  rendered it diffi-
cult to ascertain the exact spot on which the injury had been inflicted.
The symptoms of pain at the pit of  the stomach, and difficult breath-
ing came on in a few minutes.   One was bitten on the back, and  the
other on the  side, and, at the end  of two hours, when he first saw them,
he thought their symptoms  very alarming.
   When called to the first one, the  medical reviews were full of the
treatment with  Ammonia.  Time has  not strengthened  these claims.
 However, he gave a teaspoonful  of  Aqua-ammonia, as quickly as pos-
 sible.  Not  finding  him much better in half an hour, he cauterized the
place with lunar caustic.  Not being  able to  find the exact spot, he
 took a spot  as large as a dollar and  began rubbing it with the caustic,
 keeping  the part at  the same time moist, to dissolve it.  This process
 was continued  until it was evident that an eschar would form,  and, at
 the end of half an hour, the patient declared himself much better.   By
 the next morning, all symptoms of injury had disappeared, and, as soon
 as the eschar from  the caustic fell off and healed, he was well.
   The second case  occurred a year or two afterwards, and was treated
 in the same way, and with the same results.
   Stings of Insects.—The most formidable of the stinging insects
 is undoubtedly the  hornet;  but the  bee, wasp, &c, may produce very
 severe effects, if a number of them inflict their stings at  the same
 time.  In one of the departments of France,  some time since, a pair
 of farm-horses were stung to death  by  a swarm of enraged  bees, and
 numerous deaths have  undoubtedly occurred, among both adults and
 children  in the same way.
   The sting of a hornet is most to be dreaded about the head or eyes.
 Three or four on the face, have  almost instantly closed a man's eyes
 by the swelling which ensued;  and, in the case of a man stung on the
 ball of the eye, he  was frantic with pain for two hours, when the eye
 burst spontaneously, affording him some relief, but destroying the sight.
   A sting is also dangerous when  happening on the throat, in such a
 way that the swelling may impede respiration.  A lady came very
 near falling a victim, in this way, to the sting of a bee,  near the angle
 of the jaw.
   As cupping or suction is recommended  in the case  of the  bites of
 serpents, the same may be tried here, by pressing very strongly, over
 the place where the sting is supposed to have entered, a key or other
 small hollow tube.   On examining  it, after a moment or two, a drop of 
46
Index Raisonnt.
transparent fluid will be seen to have flowed from the wound.  Whether
this  be serum  from  the  blood,  or the  poison  which has  been
thrown into the wound, is as yet undetermined ; but, if it be done within
a few minutes of the time  when the sting is inflicted, no swelling will
follow, and the pain will shortly cease.   In  the case of bites of ser-
pents, a similar plan might be pursued with advantage—but it should
be immediate to be of any  use.
   Much relief will oftentimes be experienced, if, along with whatever
preparation may  be applied to the  sting, some preparation of Opium
be mixed.  Fort  has known almost immediate cessation  of the pain of
a wasp-sting  by  the instant application  of Camphor and McMunn's
Elixir.  Probably the  Opium would have been all-sufficient.

   Black Eye.—Ammon.-mur., 2D8.   Arnica.
   The ready production of ecchymosis about the eye  is due to the
superficial position of the bones of the orbit, and the looseness of the
skin about the eye-balls.  Watson says the employment, by pugilists,
of Bryonia-roots and Solomon's-seal, or of Rosemary and Arnica in-
fusions, has induced  medical men to recommend  these  applications;
but he insists that it is not a fact that prize-fighters can disperse black
eyes sooner than other  persons.   Under ordinary circumstances, the
blood in ecchymosis of the eye-lids is absorbed in two or three weeks ;
the swelling  subsiding, and the skin gradually losing its  livid color as
the absorption  goes on  ;  first becoming  brownish and  then  yellow.
Conium is more  homoeopathic than Arnica; and Hydriodate of Potash
is a more powerful absorbent than Muriate of Ammonia.   Leeches on
the injured part are worse than useless, they do not  imbibe the coagu-
lated blood, while they  add to the local  injury.   A  popular  remedy
are the bruised roots of  Black Bryony, or of Solomon's-seal; they are
beaten into a pultaceous mass in a mortar, and  re-applied every half
hour for three or four hours or more.  They cause a degree of redness
and swelling, the oedema which they excite diluting the effused blood,
and thus promoting its absorption.  According to this' view, Arsenicum,
which so specifically excites oedema of the eye-lids, ought to prove a
useful internal remedy.  Hammamelis  deserves attention.  If long
continued, Bryonia and Solomon's-seal produce too much  inflammation;
and, if the skin  is broken, they are too irritating to  be applied at all.
Pugilists, who are obliged to appear in public, sometimes contrive to
paint the discolored skin, from day to day, till the natural color is re-
stored.
   Sub-conjunclival  ecchymosis often occurs spontaneously in elderly
persons; in children, it  may arise from the concussions  of whooping-
cough.  It is very persistent, but need not excite the slightest anxiety
unless combined with much tumefaction.  Arnica  and Hammamelis
are the most reliable remedies.
   Ecchymosis of the eye-lids is sometimes symptomatic of counter-
fracture of the walls of the orbit;  the ecchymosis then increases slowly
for days, and is not attended by  any considerable swelling. 
Bladder, Irritability of.
47
  Bladder, Irritability Of.—Benzoic-acid, 14.  Alum, 227.

  The characteristic symptom of this disease is frequent micturition.
In the natural state, the  urine is voided from four  to six times in the
twenty-four hours, the quantity varying from thirty to forty-five ounces.
Urination generally occurs more frequently in the male, owing chiefly
to the smaller size of  his  bladder, and his consumption of  a larger
quantity of stimulating food and drink.
   In irritability of the bladder,  the urine is voided  every hour or two,
perhaps every few minutes, and the act is often attended with more or
less pain, spasm, and burning at the neck of the bladder and along the
urethra; the  urine may be perfectly natural,  or variously altered in
quantity or quality.
   Irritability sometimes  arises from congestion of the  neck of the
bladder, prostate gland, and seminal vesicles, and is then characterized
by a feeling of fullness in the perineum, almost uninterrupted micturi-
tion, and smarting of the neck of  the bladder, with a scalding sensa-
tion  in the urethra; these symptoms are  aggravated by exercise, by
the erect posture, exposure to cold, a full  meal, a few glasses of wine,
 &c   Canthurides is the most  homoeopathic remedy, but Digitalis is
 very useful.
    Irritability of the bladder  is  frequently induced by an altered state
 of the urine, which is often more or less acid, dark-colored, and strongly
 disposed  to become ammoniacal;  it is usually scanty,  often deposits
 a copious sediment of  mucus, and is speedily decomposed after  being
 voided.  It is often associated  with dyspepsia, constipation, capricious
 appetite, sour eructations, coldness of the extremities, dryness of the
 skin, soreness in the loins, neuralgic pains in various parts of the body,
 and burning in the urethra.  This form is most common in males, and
 those  disposed  to gout, rheumatism, or gravel.   Kali  and Colchicum
 are useful remedies.                                            .
    There  is a form of vesical irritability very common in young gins,
 soon after the age of puberty,  generally associated with spinal irrita-
 bility and disordered  menstruation.   The  extremities  are  apt to be
 cold* the  bowels  constipated,  tongue coated, appetite  impaired, and
 digestion languid and  difficult; the patient may also be flatulent, ner-
  vous  and  subject to  palpitations.   The slightest congestion  most
  trifling displacement,  or the smallest possible ulcer of the womb, has
  been known to maintain the bladder in an unsafe condition for months
  and years  the general health being in the  meantime perfectly wretched
  and life scarcely worth possessing.  A  four or  six weeks course of
  Arsenicum  Cantharides, or  Cocculus, will remove this affection with-
  out recourse to local treatment.   Diseases of the ovary or womb may
  cause irritability of the bladder.  It is singular that the local suffering
  is sometimes wholly confined  to the bladder, while the organ originally
  and mainly affected is free  from  irritation.   Pulsutdla, Digitalis, and
   Sabina, are useful remedies.
     In other cases, the complaint consists in an exaltation ol the nervous 
48
Index Raisonne.
sensibility of the mucous membrane of the bladder,  similar to that
which occurs in strumous ophthalmia and scrofulous photophobia, and,
of course, is most common  in the weak and scrofulous.  Belladonna
and Conium are useful remedies.
  In the confirmed  stage of stricture of the urethra, one of the most
constant  symptoms  is a frequent desire to void urine.   In females,
warty excrescences at the orifice  of the  urethra  generally produce
similar effects.   Stone, catarrh of the  bladder, inflammation or ulce-
ration of the mucous coat, gonorrhoea, venereal excesses, all may cause
it.  In boys, a  degree of irritation about the  bladder is sometimes
produced  by a long and  narrow prepuce, which prevents  the  ready
escape of the urine, in consequence of which the edges of the foreskin
become inflamed and sore, causing a  frequent desire to pass water,
accompanied with severe pain and even spasm.  Ascarides and tape-
worm will cause it; also mental emotion, grief, anger.  Too frequent
micturition will lessen the size of  the bladder, and  finally bring on
irritability.  Long-continued debility, exposure to cold and wet, or to a
very hot sun will induce it; the former checks the  secretion of the
skin, and  throws the  fluids back upon the kidneys, while  the latter
renders the urine scanty  and acrid.
  Gross has seen irritability of the  bladder disappear promptly under
the use of murialed Tincture of Iron ; he has found it most useful when
there was a weak, languid  state of the digestive organs, coldness of
the extremities, great  pallor of countenance, and an alkaline condition
of the urine.   China is said to  be  useful  when there is a frequent,
irresistible urging to urinate.
  Belladonna has been found most useful when the complaint is attended
with neuralgic  symptoms, or sharp, darting, or  shooting  pains in the
region of the bladder or pelvis.
  Balsam-copaiba is said to be particularly applicable when there is
an extension of gonorrhoeal inflammation, vesical catarrh, or organic
disease of the kidney.
  Gross has used Tinct.  Cantharides with marked advantage, in young
children and hysterical  girls,  when carried to the  extent of slight
strangury; as soon as this  effect passes off, there is generally a very
decided improvement, which, under the subsequent continuance of the
remedy,  in smaller doses, finally eventuates in a complete cure.  This
sounds quite homoeopathic
  Harlcem-oil has been used with happy effects, when everything else
has failed.  The Phytulacca-decandra was a favorite remedy with Dr.
Physick.  Turpentine is recommended when  worms are present, al-
though Santonine, Cina,  and Spigelia, may come in play.  Staphysa-
gria is useful when there is  ovarian irritation.   Cocculus, singularly
enough,  will relieve some cases attended with displacement  of the
womb.   A lengthened course of Arsenicum will cure those cases at-
tended with ulceration of the os uteri  and much leucorrhcea.  Digi-
talis ought to be used much more frequently than it is; it causes con-
stant desire to  urinate, especially at night. 
Bronchitis.
49
  Nitrate of Potash is a homoeopathic remedy; Gross says, when ad-
ministered for a long time as a duretic it seldom  fails to irritate the
neck of the bladder, and occasion frequent micturition.

  Bronchitis.—Acid-oxalic, 64.  Acid-phos.,73.  Aeon, 128.  Alum,
228.   Ammon.-carb., 274.  Ammon.-caust., 287.  Ant.-tart., 399, 414.
Apis. 462.

  Bronchitis  is  exactly similar in its nature to acute catarrh of the
nose, and we may infer, from the appearances of one, what they will
be in the  other.   At first, the nostril is dry and hot,  yet, though it is
dry, one cannot breathe through  it;  it is stuffed up, not with accumu-
lated mucus, but by the great swelling of the membrane; the part is
evidently red; it is tender  also, and  irritable; the contact of atmos-
pheric air, a little colder, or a little  less pure than common, will irri-
tate it.   After the unusual dryness the membrane begins to secrete a
thin serous fluid, having acrid'properties; by degrees, this thin serous
fluid  becomes  thicker and  less irritating, also more viscid, opaque,
and yellow; the swelling  of the membrane diminishes, it  becomes
less raw and  sensitive, the unnatural tumefaction of the membrane
entirely disappears, and, at length, the secretion resumes its natural
quantity;  for  the  mucous  membranes, in a state of health, are per-
fectly moist;  and the  exhalation of this moisture, to a certain extent,
and not beyond a certain amount, constitutes an essential part of their
healthy  functions.
   Healthy mucus  is composed—1. Of a transparent fluid, holding
 salts and mucine in  suspension ; 2. Of two kinds of suspended cor-
 puscules or cells.
   a. Epithelial cells,  of elliptical  shape, containing nuclei,  of elon-
 gated form and granular appearance.
   b. Mucous globules or corpuscules.  These are much less numer-
 ous than the epithelial cells in healthy mucus.
   Henle regards healthy  mucus as  being  the  product of the des-
 quamation  of the epithelium of mucous membranes ;  the desquamation
 occurring  consfantly  in  health, and being as constantly reproduced.
 We prefer to regard mucus as a secretion ; epithelium bears the same
 relation to the mucous membranes as the scarf-skin does to the  cuticle;
 perspiration does not consist in a mere exfoliation or desquamation of
 the scarf-skin, neither does mucus arise merely from the desquamation
 of the epithelium.
    Besides these two varieties of corpuscules, mucus,  under the mi-
 croscope, often presents a  granular appearance, which is regarded as
 indicative  of approaching precipitation of mucine.
    The  fluid which holds  these corpuscules in solution consists of
 water, like the serum of the blood,  holding in solution a certain num-
 ber of chemical constituents.
    Healthy mucus is chiefly composed of water, holding in solution
 the following substances :
                   D 
50
Index RaisonnL
  1. Mucine, which gives to  mucus its viscidity and special charac-
teristics ;  it is held  in solution  by free  soda.   Albumen is  never
found in healthy mucus.
  2. Free soda, lactate of soda, and chloride of sodium, the propor-
tions of which are increased in catarrhs.
  3. Phosphate of lime and silicia.
  4. Extractive matters.
  Diluted acetic, oxalic, and tartaric-acids dissolve the mucous globules;
the  mineral acids  do not.
  Lehmann says  it has not yet been determined whether the blood-
globules  take  part in the preparation of mucus as they do in most
other secretions,  and whether the mucus is formed solely from  the
constituents of the blood-plasma.
  In inflammatory mucus some of the albumen of the blood is poured
out.   Tn  purulent mucus, both albumen  and fat  are  discharged  in
abundance.
  We may sum up the history of  mucus and its modifications in  the
following table:
UNDER THE  MICROSCOPE.
Normal Mucus.	Morbid Mucus.	Muco-Pus.
1. Many epithelical cells. 2. Few mucous cells. 3. Fine granular appear-ance, due to precipita-tion of mucine.	1. Few epithelical cells. 2. Many mucous cells. 3. Fine granular appear-ance, due to precipita-tion of mucine. 4. Yellowish globules— larger than the mucous and verging on pus-globules.	1. Few epithelical cells. 2. Many mucous cells. 4. Numerous pus-globules.
MATTERS  HELD  IN SOLUTION BY WATER.
1. Mucus in tolerable quan-	1. Mucus in tolerable	1. A very small quantity
tity.	quantity.	of mucus.
2. No albumen.	2. Small quantity of al-	2. A large quantity of al-
	bumen.	bumen.
3. Free soda, lactate of	3 and 4. More salts and	3 and 4. More salts and
soda, chloride of sodium,	extractives.	extractives.
phosphate of lime.		
4. Extractive matters.		
	5. Small quantity of fat.	5. Fatty matters in abun-dance.
  It seems from the above as if catarrh was a species of albumenor-
rhagia, somewhat similar to that which occurs in albuminuria.
   Catarrh  arises in two ways: either from the application of cold air
to the mucous membrane; or else from cold, or cold and wet applied 
Bronchitis.
51
to the skin.   In the  latter case it is probable that some of the effuse
matters which should  be  thrown  off by the  skin  are  projected upon
the  mucous  membrane.
  In  bronchial  catarrh the  mucous  membrane is,  at first, dry, hot,
tumid, and  irritable; the  uneasy sensations, of which  it is the seat,
excite coughing; the chest feels  tight, stuffed, and constricted; there
may be  some hoarseness, and a  sense of roughness  and soreness in
the windpipe ;  a dry cough, which seems to arise from some irritation
about  the glottis; sometimes pains in the limbs  occur  like those of
rheumatism; the patient is thirsty,  and has lassitude.  Such attacks
are called catarrhal-rheumatic, and  it is very probable that bronchitis
is generally somewhat rheumatic in its nature.
  The syrnptoms and  importance of bronchitis vary, according as the
disease  is  seated in  the  larger, smaller, or capillary bronchi.  The
first is the most slight and manageable ; the  last  is  the  most severe
and dangerous, and  is especially  common in young children.
  Bronchitis of the  larger air-tubes is rarely attended with such vio-
lent symptoms  as  when  it attacks the minuter branches;  the fever
and dyspnoea are moderate, the  cough loud and deep, and the expec-
toration scanty and glairy at first, afterwards easy, profuse and mu-
 cous.   The percussion-sound,  in  all the varieties of bronchitis,  is
natural, and affords a ready mean of diagnosis  from pneumonia and
pleurisy, in which diseases more or less dullness  on percussion is al-
ways  present.  The hand, applied  to the chest, often detects rhonchal
vibration,  especially  if loud, sonorous rhonchus  be present.  In the
 first  stage  auscultation detects sonorous rhonchus, like  the  prolonged
 note  of  a bass-violin,  or the cooing of a dove; the louder the sounds
 the less dangerous the case.  When free expectoration comes on, the
 sonorous rhonchus  is intermixed  with a mucous  rattle  of large, scat-
 tered  and uneven bubbles.  As  a  general rule, except in phthisis, the
 larger the bubbles of  a mucous rattle in the chest the less dangerous
 the case.                                         .,        .    , -
    It is well to select remedies  which act specifically upon the skin
 and mucous membranes ;  of these Pulsatilla and  Stibium are the most
 useful   If the  fever runs  high, and  the chest  be  much oppressed,
 laraer'doses of Stibium should be given, and Aconite  or Veratrurn-
 viride may be required in  alternation; if the expectoration be thin and
 scanty  Bromide of Potash  and Kali-hydriodicuntwill  render it more
 thick and  copious; if it be too dense and profuse Arsenicum will
 render it thinner.   All these remedies exert a specific  and alterative
 action upon the mucous membranes.        , . .   .   ,       v.- i .i.
    The  more  common form of acute bronchitis is that in which the
 larger bronchi,  and those of the second, third, and  fourth orders are
  simultaneously  inflamed.  The  ordinary  descriptions  of the disease
  arT taken from  this variety.  There is often a burning-piercng pain
  beneath the breast-bone; a comparatively  great  oppression of the
  chest and difficulty of breathing,  yet the patient  is able to expand the
  chest' fully the cough is deep, metallic, ringing, dry  and hard; the 
52
Index Raisonne.
expectoration  is scanty in the first stage, often streaked with  small
threads of blood, saltish, transparent like the uncoagulated white of an
egg, glairy, and viscid; it is more stringy and viscid  in proportion to
the intensity of the inflammation, and  then may be drawn out into
threads like those of melted glass.  If expectorated after much cough-
ing, it will be  frothy, with unequal-sized large and small bubbles.
   In  the first stage of this variety the antiphlogistic remedies, such
as  Aconite, Stibium, and  Veratrum-viride, must be given, in larger
doses, and  more frequently repeated than in the milder forms, and the
catarrhal-rheumatic remedies,  like Pulsatilla, Kali-hydriodicum, &c,
can only be used after  some favorable impression has been made upon
the inflammatory symptoms by the antiphlogistic medicines.
   When the inflammatory fever abates or ceases, a remarkable change
in the expectoration  ensues;  or,  rather, when  those  changes in the
functions of the mucous membrane take  place which allow the in-
flammation  to subside, the expectoration  gradually loses  its transpa-
rency and  becomes  mixed with  yellowish-white or greenish opaque
masses, which increase more  and more, until they compose the whole
of the expectoration, which is then thick, consistent,  and muco-puri-
form,  though somewhat viscid and confluent.
   In some instances, bronchitis will linger in its first or dry stage, and
the symptoms  are very  severe, almost like a combination of spasmodic
asthma  with congestion of the lungs.  The patient is then generally
feverish, in  a state of extreme dyspnoea, sitting up  in  bed, from ina-
bility to lie down, laboring for breath, the face turgid and rather livid,
the nostrils working,  and shoulders elevated and heaving, scarcely
able to speak,  and in dread of  immediate suffocation.   Still this con-
dition is more  common in  capillary bronchitis than in  the second va-
riety.   Bromide of Potash, Hydriodate of Potash, or Muriate of Am-
monia, in alternation with reasonably full doses of Stibium, will bring
on expectoration, especially if aided by inhalations of quite warm water.
   The percUssion-sound remains clear in the second variety of bron-
chitis, and  this is of great importance ; for if, after three or four days
of fever, cough, hurried and laborious breathing, we find that the chest
sounds  clear, the great probability is that the  disease is bronchitis,
and not pneumonia  or pleurisy.   In  pleurisy, we  have dullness  on
percussion, and great feebleness or entire absence of respiratory mur-
mur in some portion of the chest; in pneumonia, we have dullness on
percussion,  and either  very fine crackling  sounds, almost  as small  as
those produced by  rubbing a  lock of hair between the fingers before
the ears, or like the  fine crackling of soda-water or champagne, or
else we hear the louder, smoother, clearer,  whiffing, bronchial breath-
ing;  in the  second  variety of  bronchitis, we hear sibilant or hissing
sounds, intermixed  with more or  less sonorous rhonchus, or a strange
admixture  of  chirping, whistling, hissing, and moderately  coarse
crackling, with louder sounds, such as cooing, droning, and  groaning.
We are also generally able to  hear some of the natural, gentle, breezy,
vesicular respiratory murmur ; and the more we hear of  this the less 
Bronchitis.
53
 dangerous the case ; the less we hear of natural respiratory murmur,
 and the more of sharp, hissing and sibilant rales, the more dangerous
 the attack ; the more the loud sounds of the first variety of bronchitis
 outroar the  sibilant and  natural respiratory murmurs the less danger-
 ous the case.
   Capillary bronchitis is a more serious disease than pneumonia; in
 fact it is at  the bottom of many cases of pnenmonia-notha.  The dys-
 pnoea  and oppression of the "chest is very great, the whole attack is
 of an  intense and severe character, and, unless quickly relieved, runs
 on to a fatal termination with great rapidity.  It resembles dry bron-
 chitis  of the second variety very much, but it is even more severe and
 dangerous than this; expectoration  is less easily brought about, and,
 when  it does occur, it blocks up the smaller bronchi and air-cells, and
 produces almost as much distress as  the dry stage; it is also very apt
 to be complicated with acute oedema of the lungs, and then the case is
 almost hopeless ; we  may  be able to relieve simple oedema  rapidly,
 but inflammatory oedema is most difficult to overcome. The percussion-
 sound, of course, remains clear.  The commencement of the attack
 is often marked by a very loud, rough respiratory murmur, resembling
 a great aggravation of the  natural respiratory  murmur;  this quickly
 changes to a dry, sharp wheezing, with sibilant rhonchus, hissing and
 whistling like  that in a case  of dry spasmodic  asthma;  we  can
 promptly  relieve  simple spasms, but inflammatory  turgescence  and
 spasms of the  capillary air-tubes is not so easily remedied.  In  ca-
 pillary bronchitis the sharp sounds are numerous and close together ;
 they  obliterate  the  natural  respiratory murmur, and when  they  are
 heard  all over  the  chest the  case   is a very serious one, for  severe
 capillary  bronchitis of both lungs is remarkable for the  rapidity with
 which collapse, extreme  prostration, and debility succeed to high fever
 and extreme dyspnoea.   It is natural  that it should  be so, for  almost
 every air-cell is obstructed, the oxygenation of the blood is much inter-
 fered with, and the patient dies, as it were, asphyxiated in his own im-
 pure venous blood.
   Depressing remedies  must be used  with great care, and only during
 the first  two or three days; still antiphlogistic remedies are impera-
 tively required.   Conium is a  valuable palliative,  relieving the diffi-
 culty of breathing better than  other remedies of this class, allaying
 irritation and spasm of the  capillary  air-tubes, and promoting absorp-
 tion of the fluids poured out into the  air-cells and small  air-tuhes  ; at
 first, it may  be given in alternation with Aconite, Stibium, or Veratrum-
 viride,wnld  the fever is somewhat controlled ; then  in alternation with
 Bromide of Potash, Hydriodate of Potash, or  Muriate of Ammonia;
and, finally, in alternation with Arsenicum.   It must be used liberally;
and, when  the  lividity, great  oppression, and  collapse  threaten,
Arsenicum may be given boldly.
  All the  fatal cases of bronchitis are probably complicated with this
severe capillary  disease.  When the inflammation is extended  and
intense, the  fever high, and the  labor of respiration great, and  the 
54
Index Raisonne.
 symptoms do not yield to treatment, the signs of impending suffocation
 begin  to  show themselves: the lips,  cheeks, and tongue assume a
 purplish  color; a livid paleness  takes the place of the  former  red
 flush; the expression  becomes more and more anxious; then the  de-
 lirium comes  on and rapid sinking.   These  signs indicate that  the
 circulation of the blood through the arteries is in a great measure venous,
 and venous blood acts as a poison when it so  circulates.  Profuse
 cold clammy sweats ensue, and the patient dies of apnoea ;  his breath-
 ing is  choked by the morbid secretion which occupies  the bronchial
 tubes,  small as well as large, and which he  has not strength enough
 left to cough up.
   This is  the  class  of cases in  which the inhalation of Oxygen is a
 useful palliative : when there is a livid countenance, delirium, hurried
 and laborious respiration, almost imperceptible pulse, and all the signs
 of  the rapid  approach  of death, by a mixture  of  coma  and apnoea, a
 few inspirations of  the gas will  redden the cheeks, the  artery will
 pulsate freely under the finger, consciousness will return, and some cough
 occur.  To administer the Oxygen, equal parts of Chlorate uf Potash
 and Peroxide of Manganese  are mixed together in a glass retort, and
 heated ; the disengaged gas may be passed through a column of water,
 and breathed through  a long flexible gutta-percha tube—from four to
 ten inhalations, two  or three times a day, will suffice.
   The good effects of  the inhalations must  be  kept up  by Arsenicum
 and Carbonate  of Ammonia, both of which exert a specific influence
 on  the bronchial mucous membrane.
   In  the  later  stages of acute  bronchitis,  a peculiar condition  of  the
 lung is apt to  result  mechanically, from obstruction of the air-tubes
 by  inspissated  mucus, followed by collapse of  a portion of the  lung.
 The mechanism of this collapse is very simple and intelligible.  Small
 portions of tough and sticky mucus are driven to and fro in the larger
 air-tubes during the alternate acts of respiration or in the  paroxysms
 of cough;  it may, and often does happen that, during inspiration, one
 of these pellets, forced strongly backward, in a tube which gradually
 becomes  smaller and  smaller, shuts up that tube and all the smaller
 branches that proceed  from beyond the place of the obstruction.  In
 expiration, the  plug  moves a little  outwards again, so  as to allow a
 part of the imprisoned air to escape ;  but, returning in  inspiration, it
 does not  permit any  fresh air to enter.   Repetitions of this process
 exhaust,  or nearly exhaust  the air  from the portion of the lung thus
 mechanically sealed up,  and the portion so exhausted becomes col-
 lapsed.
  Where  collapse of  the  lung takes  place to any extent during an
 attack  of  bronchitis, the  breathing  is  apt to become laborious; the
act of inspiration is  performed  with effort, difficulty, and distress,
while that of expiration is comparatively easy; the patient is unable
to lie  down ;  all the  muscles  accessory  to respiration are called in
play, yet little  air finds entrance.   This long-drawn, inadequate, ex-
hausting  inspiration is probably  peculiar to obstructive  bronchitis. 
Brightfs Kidney.—Bubo.
55
Some of the paroxysms of severe dyspnoea incidental to bronchial dis-
orders, and often so unhesitatingly ascribed to congestion of the lungs,
are doubtless owing to  casual changes in the position of portions of
tenacious mucus in the air-tubes.  A similar accident may sometimes
convert an apparently  slight attack of  bronchitis into a most perilous
and quickly fatal malady; a large plug of tenacious mucus may all at
once  enter and  stop  up the principal bronchus of one  or the other
lung; sudden and urgent dyspnoea ensues, and, unless  the plug be dis-
lodged, the patient may perish.   The symptoms are precisely similar
to those which arise when a foreign body gets down into the air-tubes.
The symptoms are marked, and the diagnosis easy; considerable dys-
pnoea comes on suddenly,  respiration quickly ceases to be audible
over  a  certain portion of the lung, yet the percussion-sound is clear.
   As the  muscular contractions of the  muscular tubes have frequently
a greater  share in promoting the expulsion of accumulated mucus than
the movements of respiration, it may be allowable to give Nux-vomica
or Strychnine, in sufficient doses to keep up a powerful spasmodic con-
traction of the  muscular fibres of the air-tubes.  Ammonia, by inhala-
tion, may be useful in  exciting cough and the expulsion of the offend-
ing body.—Peters.

   Bright's Kidney.—Aethusa,  155.   Allium-sat.,  209.   Apis, 464.
Apoc.-can., 486.  (See Albuminuria, page 7.)

   BubO.—Alum, 227.

   Although bubo comes  more commonly from syphilis than any other
affection, still it  may  arise  from a variety of causes; it  may also be
superficial or deep-seated, according as it is located in the superficial
or deep-seated inguinal glands or cellular tissue.
   The  superficial inguinal glands are above  the  fascia-lata, immersed
in a mass of subcutaneous  tissue and  fat, disposed below Poupart's
ligament and around the saphena vein, where  it is about to traverse
the crural ring and join  the  femoral.   They vary in number and size
in different persons, and hence, perhaps, one reason for the greater
tendency  to bubo in some  subjects.   The  more  internal  glands
receive the lymphatics of the scrotum, prepuce, and glans-penis in
the male; of the labia, nymphae, and clitoris in the female, and  of the
perinaeum in both sexes.  Hence, it is those glands of the superficial
plexus  which are seated nearest the median line which enlarge from
syphilis, gonorrhoea, phymosis, excoriations, or ulcers of the inner or
outer prepuce,  syphilitic warts or mucous tubercles on the scrotum or
nerinaeum abscess in the female labium, ulcerated piles, fissures or
fistulae of'the anus, ischio-rectal abscesses, &c.  Smart inflammation
of the inguinal glands has followed tying internal piles.
   The  inferior and central  superficial inguinal glands  receive  the
lymphatics of  the dorsum and  inner  side  of  the  foot, of the  front,
inner side, and  back of the leg, and surface of the thigh.  Hence, if 
56                      Index  Raisonn .
the surface of the foot, leg, or thigh be irritated, the lowermost of the
superficial inguinal glands will be affected, and this is often observed
in cases of suppuration beneath a corn or bunion, in diseases of the
toe-nail  or its matrix, in  fissures  between  the toes, in wounds, ery-
sipelas, or diffuse inflammation of the subcutaneous cellular tissue of
the foot or leg, after  blisters and ulcers of various sorts.  Indeed, if
the patient complains of bubo, and  the  lowermost  of the superficial
inguinal glands are enlarged, the surgeon  may presume that the cause
is in the lower portion of the leg, and not in  the parts of generation.
   The most  external of the  superficial inguinal  glands  receive the
lymphatics of the nates, and boils, or caustic issues about the buttocks
sometimes give rise to enlargement of them.
   The glands in the  middle  and outer side of the superficial plexus
are supplied  by the  superficial  lymphatic  of the hypogastric and
lumbar regions, and eruptions, sores, or boils on these parts sometimes
cause trouble in the middle portion of the superficial inguinal glands.
   The  deep-seated inguinal  glands vary more in number and  size
than  the superficial,  and are frequently absent.   They are  placed,
when they exist,  below  the  fascia-lata, and  beneath the saphenous
opening of the crural  canal.  The deep-seated lymphatics of the foot,
leg, ham, anterior, internal, and  external  parts of the thigh join the
deeper  seated inguinal  glands, or, in  case  of their deficiency, the
superficial ones.
   The  majority of cases of bubo arise from absorption of some  virus,
or  from  a  spreading irritation or  inflammation  of the lymphatic
vessels; but the inferent  or afferent vessels,  or the gland itself may
become strained or torn from pulling heavy  weights or riding restive
horses;  something may then be felt to snap in the groin, and a sup-
purating bubo may follow.
   The  mere exertion  and excitement of  coition  may produce simple
inflammatory enlargement of  a lymphatic gland, without the occurrence
of excoriation, gonorrhoea, or chancre.  And sometimes there maybe
an absorption of syphilitic virus, without any abrasion or ulceration of
the skin;  I have seen three cases of bubo  in  which there was
and never had been any  visible ulceration, all followed by secondary
syphilis.
   The  Syphilitic Bubo is of two kinds:   First, Specific, from ab-
solute absorption of  syphilitic virus, which  is  directly taken  up by
the lymphatic vessels, carried along them, and  deposited on their
sides ;  it then eats through the lymphatic vessels, and  acts on  the
cellular tissue of  the groin in  the same way as when introduced into
a mucous follicle on the glans-penis;  it produces a true chancre in
the groin, which  causes destruction of  the tissues, until  it appears at
the surface of the skin.  Inoculation of the secretion  of bubo has
clearly proved that a great  many buboes secrete  the syphilitic virus,
thus proving that absorption has  taken  place.   Ricord  gives a case
which proves this incontestably. In  a patient suffering under syphili-
tic bubo, attended with considerable suppuration, the external abscess 
Bubo.
57
  was opened ;  after the pus  had  been thoroughly evacuated from the
  cellular tissue, a  lymphatic gland  of considerable volume was found,
  presenting the feeling of fluctuation in  the centre; it was punctured,
  and the patient inoculated with the pus, and a characteristic syphilitic
  pustule was produced;  inoculation with  pus from the cellular tissue
  did not produce this  result.   Chancres situated  around the fraenum,
  meatus of the female, or at the anus, are seldom unattended by bubo.
  The treatment of this  form of bubo  is  exactly like  that  for a true
  chancre.
     Second, The syphilitic virus may not be absorbed, but give rise to
  an irritation or inflammation of a simple kind.  The treatment of this
  variety is mainly with Tartar-emetic, Conium, Aconite, and Veratrum-
v viride; in short, like that of simple inflammation.
     The Gonorrheal  Bubo is also of two  kinds:  the specific and
  irritative.  The majority of  cases are  of  the sympathetic or irritative
  kind, and are quite amenable to treatment.  The termination by resolu-
  tion is the  most common, that in suppuration  the least, while  that in
  induration  is  not an unfrequent  occurrence;  for, when an inguinal
  gland  is once enlarged  to  any size, it  regains with difficulty its exact
  natural dimensions.
     Scrofulous  Bubo.—The diagnosis of scrofulous bubo may gene-
  rally be made by observing that the swelling commences in the deep-
  seated glands; these, although small at first, may assume a very con-
  siderable size, and  may or may not suppurate.  Persons of a  scrofu-
  lous habit are particularly liable  to bubo, especially if they contract
  syphilis or gonorrhoea,  and the  tendency is to the affection of several
  glands together  or  in  succession ; it goes  through  its stages with
   characteristic dilatoriness ;  resolution is, of course, less frequent than
   in  the  healthy; induration is  very common,  and  suppuration  is
   common too.   When suppuration has occurred, a considerable swell-
   ing occupies the groin,  frequently irregular  upon its surface;  the
   skin is of a bluish  and variegated, or rather of a brick-dust red ; on
   pressure, the swelling  feels remarkably boggy, elasticity predominat-
   ing, however, in-one part, and cednmatous pitting in another.   Amidst
   the bogainess  and   tumefaction,  hard lumps may be  distinguished,
   evidently indurated  glands; the tenderness  is usually  inconsiderable,
   and the seeming amount of disease contrasts strongly with the general
   absence of pain.  If the  suppuration  has been recent, there are ulce-
   rated  apertures, of greater or less size, leading, perhaps, to an exposed
   gland -if the case  is  more ancient, these apertures may have closed
   completely or, what is more common, they may have ended in sinuses,
   eenerally leading to a diseased gland ;  and the sinus will not close
   securely until the morbid gland is cured, or has sloughed or suppurated
   away  The discharge, when there is any, is thin, and may be curdy.
   There is  a striking disposition to repeated and partial attacks of sup-
   puration ; the duration of this morbid state is always  prolonged, and
   may  last 'for a year or more.
      The scrofulous bubo must not  be mistaken for the  indurated syphi- 
58
Index Raisonne.
litic bubo.   In indurated chancre, there is a constant occurrence of
indurated glands in the  groin, and, in a diagnostic point of view, the
existence of  these  indurated masses is  very important.   When  a
chancre assumes the indurated form, several superficial glands become
enlarged to the size of horse-beans, generally most numerous on the
side on which the chancre  exists; the enlargement  is attended with
no pain,  but it has an  elastic feel, and the patient  says  he has no
bubo;  the  glands may  remain in this indolent state  a  long time,
showing no disposition  to  suppurate.   The  diagnosis  is  generally
simple enough when, together with  an indurated  sore  on  the penis,
we find several glands  in both groins  enlarged, which  have no ten-
dency to suppurate;  while, in inflammatory bubo, we  meet with en-
largement of  one gland  only, which  soon  hurries on  to suppuration.
The scrofulous buho is equally characteristic, and may often be recog-
nized at glance; it is voluminous, occupying the entire inguinal fossa ;
a large number of  inguinal  glands  are  simultaneously  affected ;  the
base is immoveable, and appears lost in  the iliac fossa,  or rather
appears continuous,  with a similar  affection  of  the glands  in  the
pelvis. If the  swelling bursts, it does so like other scrofulous tumors;
the pus is collected  in various little abscesses; their various orifices
do  not enlarge, but become  puckered, and present those  ill-shaped
cicatrices and  ill-conditioned sores seen in softened tuberculous glands.
  The Cachrctic  Bubo frequently results from the injudicious ad-
ministration of Mercury; it is characterized by the predominance of
the suppurative and ulcerative processes, and by  a marked tendency
to phagadaena  and sloughing.   When suppuration occurs, as it almost
always does, it is usually extensive;  the skin is blue and disposed to
be widely thinned and undermined; the cellular tissue is involved to
a greater  degree, the  absence of the limitations to abscess, which
occur  in a  healthy  person,  being marked ;  the  pain  is  frequently
severe, although it may be slight,  unless an opening be made early,
and often, in spite of every precaution, the skin ulcerates or sloughs
extensively.   A large cavity,  with sloughy-looking walls, and with
diseased glands, more or less exposed, is now laid open; granulations
arise  feebly and  irregularly,  ulcerating  or sloughing, perhaps, after
they are formed ; the  edges of the aperture may continue to ulcerate
and look picked or jagged;  or they may ulcerate in one  direction and
granulate in another.   The  surrounding cellular membrane still sup-
purates irregularly  or  sloughs, so  that sinuses  open  into  the  old
cavity, or fresh ulcerations  form in  the skin.   A patient in this state
is  liable  to  phagadaena  or  to gangrene, but the usual course is to
lapse into a  chronic state.   The cavity granulates to a certain extent,
its size being proportionately  diminished; but the  granulations are
unhealthy, dark, imperfectly organized, disappearing or even slough-
ing readily; the gland is often palpably diseased ; the discharge thin,
copious, and irritating;  the edges of the  sore  are  callous, or they
ulcerate  fretfully; the surrounding  skin bluish; the cellular tissue
thickened or  morbid  in some other  fashion.  This  state may persist 
Bubo.
59
for weeks or months, but, if properly treated, is  curable in a reason-
able time. The granulations then put on a healthy aspect; the diseased
structure of the gland is quickly absorbed, or removed by instalments
of ulceration or  of sloughing;  or the gland sloughs away bodily.
The diseased cellular tissue  is similarly  disposed of;  the sinuses
close or have to be laid open with the knife; and, at last, cicatrization
is complete.
  The symptoms of Inflammatory Bubo vary somewhat, according
as it is simple,  syphilitic, or gonorrhoeal.
   In syphilitic inflammatory bubo, the first appearance of the affection
is frequently the occurrence  of an  inflamed lymphatic vessel, com-
mencing at  the  chancre  and extending itself along the trunk of the
vessel to the  pubis, where  it  may terminate  and   form  a distinct
swelling, or may extend  itself to  one of the superficial  inguinal
glands.
   In other instances, there is no swelling of the lymphatic vessel, but
a gland,  connected  by its vessels with the part to which the venereal
poison had been previously  applied, becomes  a little enlarged  and
slightly painful on handling, so as to present a small  tumor about the
size of a filbert, situated under the skin, and moveable between it and
the subjacent parts.
   This moveable tumor  increases  in size, and becomes more fixed, in
consequence of the  disease  extending to the surrounding cellular
tissue ; the  motions of the leg become somewhat painful; the swelling
assumes an oblong rather than a rounded form; the skin is still move-
able over it, and of its  natural color; after a time, the skin  becomes
red, and  adheres to the surface of the tumor.  The bubo now increases
in size with rapidity; the pain becomes of a throbbing  kind; some
degree  of fever sets in with  it, accompanying  malaise, especially in
the evening.   The swelling becomes still more prominent, the skin
more red and shining, but the  tumor still feels hard and resisting; yet
soon this hardness  decreases, and  the swelling, which  was at  first
somewhat doughy, finally affords a distinct sense of fluctuation.  The
skin now commences to desquamate, so as to form scaly circles, and
afterwards  assumes a mottled,  livid appearance; the livid patches
quickly  acquire a deeper color, and often  become partially black, the
cuticle separates from  them,  and, giving  away, a  larger  or smaller
quantity of  thick yellowish-white  matter is discharged through  one
or more  small openings; these openings frequently present a ragged,
sloughy, ulcerated appearance, with a red edge, and with a white,
pulpy or porky substance on the inner  part of the  edge, as  if the
cavity of the bubo, or the surface of the ulcer from which the pus is
discharged  was lined or covered by a stratum of white, porky matter,
resembling that which  so frequently covers the primary sore on the
penis during its stage of ulceration.   The process of destruction thus
commenced" in the  integuments  covering the tumor extends  very
frequently, until  all  that part of  the  skin which had been rendered
very  thili is removed, and  until  the  bottom of the abscess  has  been 
60
Index RaisonnS.
so exposed  that the  diseased  part  presents  the  form of an ulcer,
somewhat resembling, on a large scale, the regular primary ulcer on
the penis.   The process of ulceration  ceases, in general, as soon as
the skin which  covered the  front of the  tumor has  been removed.
The ulcer is now quickly filled up by new granulations;  a narrow red
margin is formed, from the inner edge of which the new cuticle pro-
ceeds.   The regular bubo, if uninterrupted in its course, will occupy,
during its various stages, a somewhat longer period than that occupied
by the  regular primary ulcer  on  the  penis.   A  syphilitic bubo is, to
all intents and purposes, an actual syphilitic ulcer in the groin —Acton.
  The inflammatory gononhoeal  bubo  is characterized by the larger
quantity  of  merely serous fluid, or  of sero-purulent matter, which
forms, and which is much more readily absorbed under treatment than
ordinary pus, and infinitely more so than  syphilitic matter.   If sup-
puration ensues, a small ulcerated opening finally becomes visible,
the matter oozes out, the aperture extends usually in a linear direction,
and in that of  a  fold of the groin; or  several apertures  may form, or
two or more may coalesce.  The  matter is then discharged more freely,
but seldom freely enough, and the abscess may then either fill up, or
ulcerated openings in the  skin  may  continue, or  sinuses may form,
or the gland or the cellular tissue may undergo a decidedly morbid
modification of structure, which  must  be  removed before the whole
can heal soundly.
   It is but just to add that a large portion  of these bad effects are the
result of the recklessness and carelessness of  the patient;  the ma-
jority of them can be prevented  by judicious  treatment, and reason-
able self-denial on the part of the sick person.
   Compression  of buboes, which is so much recommended by some
surgeons, is often injurious;  it binds down the inflamed part, and the
effused  fluids, whether pus or serum, not being  able to come to the
surface, are forced deeply and laterally wherever they can penetrate.
   As regards  the  use of the lancet, it is  generally advisable, except
in scrofulous bubo, where small foci of pus are forming, and the cellu-
lar tissue is much involved;  these_cases  often  do better without,
than with lancing.  In  most  other cases,  an early opening is service-
able.  If the abscess  is small,  a vertical incision answers  best;  if
larger, it should be oblique,  forming  an  angle of  forty degrees, with
Poupart's ligament.   Sometimes, in a large  abscess, it is preferable
to make a small opening at each end, and pass a  seton through ; we
thus save much  integument, and avoid a large scar.—Acton.

   Burns.—Acacia, 5.   Acid-acet., 10.

   Burns and scalds arise from  the application of  fire, or  hot solid or
fluid  substances.  They vary in degree:  First,  Superficial inflam-
mation or erythema;   Second, More severe  inflammation, with rising
of the cuticle into blisters, resembling the vesication of a fly-blister
or that of vesicular erysipelas;   Third, More deeply penetrating  in- 
Burns.
61
flammation, attended with destruction of the cuticle and rete-mucosum,
followed by a phlegmono-suppurative  process, similar to that excited
by Tartar-emetic or Savine ointment; Fourth, Gangrenous destruction
to different depths, similar  to that  produced by the mineral  acids,
Arsenic, and other caustic substances.
   The  first  and  second varieties  require very little treatment, and
leave no  scars :  the third variety  leaves  white, glossy marks ; the
fourth variety leaves shapeless, hard, contracted, and tough, disfiguring
cicatrices.
   The  most  homoeopathic local treatment for the slighter  varieties is
the use of moderate  heat and  moisture, in the shape of comfortably
 warm slippery-elm,  bread-and-milk, or flax-seed  poultices, with  or
 without the  addition of a  small quantity of Cantharides,  Rhus, or
 Arnica; or thick cloths, wet with water, form a cleaner and more
 handy application.   Simple flour, or carded cotton  are said to be very
 useful  as protectees against the irritating effects  of atmospheric  air
 on the  tender or raw surfaces.  Many  homoeopathic  physicians  re-
 commend several coatings with a thick lather of castile soap;  this is
 only a  modification of the common empirical application  of sweet or
 linseed oil and lime water; but a drachm of good Magnesia, rubbed up
 in an ounce  of  simple cerate, forms a much more  elegant and useful
 salve.
   In the severer forms, far  more careful  internal  and external treat-
 ment is required.  The clothes of the patient should be removed with
 the greatest care; they should first  be soaked with warm water, and
 then cut through in  many places, so that  they will drop off, allowing
 the whole vesicles  to remain  unbroken, and the  loosened cuticle to
 remain in situ.   If the  patient be attacked with shivering, or remains
 cold and  collapsed, the system has  received a severe shock, which
 may terminate the patient's life by syncope, and warm brandy and water
 may be applied externally and given internally.   The same remedies
 may be used when imperfect or nervous reaction  results  to an exces-
 sive and incontrollable degree, the  patient  being inclined  to  sink
 exhausted under febrile tumult of  the asthenic kind  at an early
 period •  although Arsenicum is also a most  reliable remedy.   When
 the pain  is  intense, or there is a disposition to convulsions  or other
  spasmodic affections, or there be much sleeplessness, warm  tincture
  of  Opium may be  applied   externally, and  Opium given internally.
  It is quite certain that soothing the patient's  sufferings and dulling his
  nervous irritability are  most important indications in the constitutional
  treatment •  the advantage derived from sleep, even for a  short period,
  is very great, as during that time  the agony of the burn is forgotten.
  In some instances, Coffea will promote  sleep and allay nervous ex-

  01 iTsevere  burns and scalds, nausea  and vomiting very frequently
  occur  from the shock  and  prostration  of the system, and have to be
  treated  with stimulants.  But, in  the  higher degrees  of burns  and
   ^alds excessive reaction  may set in, when, on  account of  the dis-
SCc 
62
Index Raisonne.
turbed functions of the skin, and the changed  relations between the
skin and mucous membranes, that  of the stomach and bowels may
become disordered, and uneasiness, loss of sleep,  red, dry tongue,
nausea, vomiting, high nervous excitement, delirium, and the like
may come on.  In these cases, it  is supposed  that, from the sudden
stoppage of the functions of the skin, excessive  flow of  blood  may
take place to internal  parts, and congestion, or  even  inflammation of
the stomach and bowels may arise.   In some cases,  ulceration of the
duodenum  has been  found.   Habershon (see " Observations on Ali-
mentary Canal," p. 147.) says, after burns, the  mucous membrane of
the duodenum has been found greatly congested, and, in several cases
recorded by Mr. Curling, in the " Medico-Chir. Trans.,"it was ulcerated.
Habershon has seen congestion only; but Dr. Gull has reported a fatal
case of ulceration.   Arsenicum, Belladonna,  and Stibium are  the
most homoeopathic remedies, but Aconite, Veratrum-viride, and Hyos-
ciamus are often useful.
   Both burns and scalds are generally  dangerous, more in reference
to the part which is involved than  the extent of surface they injure;
although cases in which one-third  of  the whole body  is affected
usually prove fatal.   Still burns and  scalds on the  chest  and  belly
are far more dangerous  than on  the limbs, although  the injured part
be twice or thrice as extensive ;  and  children  who are badly burned or
scalded on  the chest  commonly die in  two  or  three days; in  a few
instances  they may live a week, but they rarely recover under ordi-
nary treatment. Convulsions may occur  in these severe cases ; but, if
they are to prove fatal in a  few  hours, the  patient generally, almost at
once, drops  into a state of  stupor from  which  he never after rouses,
and examination after  death shows the brain loaded with blood ;  or, if
life be  prolonged, effusion  of serum is  found on  the membranes and
in the  cavities of the brain, and less  commonly also in  ihe  chest.
These  facts would seem to point to the  homceopathicity of blisters to
congestion  and dropsy of the brain and chest.  In these cases, Opium
and Cantharides are the most homoeopathic remedies, although Helle-
bore may be required,  and Digitalis and Kali-hydriodicum may  prove
very useful.
   In other  cases, very copious and continued  suppuration may take
place,  and  exhaust  the patient.  Stibium is the most homoeopathic
remedy, although full diet, China, Nitric-acid,  and  Hepar-sulphur
may be required.   Suppuration is usually  established in  forty to fifty
hours,  and, previous to that time, the  patient usually suffers more or
less from febrile excitement, and cooling  drinks, with very light diet
are necessary.  But,  as soon as suppuration or the separation of the
sloughs commences, the patient must be supported  by easily digestible
broths  or  animal food, and ale, porter, wine-whey, wine, or spirits
may be required;  still care must  be taken  that  the patient is not
stimulated  too much.   In ordinary practice, it  not unfrequently
happens that a quickened pulse, heat of  the skin,  restlessness, and
flushing of the face  is thus caused ; the suppuration is checked or 
Cough.
63
suspended, and  effusion of water  on the brain, indicated by drow-
siness or stupor, or  irritation  of the  bowels and  watery purging set
in, all of which effects are very dangerous, and frequently destroy the
patient.  On  the other hand, if sufficient support be not given, typhoid
symptoms may come on, and the patient will sink rapidly.
  When there is much  gangrene and spachelus, Secale is the most
homoeopathic remedy, although Arsenicum and China are often useful;
yeast and charcoal poultices are frequently used, and a weak solution
of Chloride of Soda.— Peters.
                                c.

   Cough.—Acacia, 5.   Acid-benzoic, 14.  Acid-muriat.,  43.   Acid-
tannic,90.  Actea-rac, 14'^.  Allium-sat., 208.   Ambra.,249. Ammon.-
carb., 276.   Ammon.-carb.,  305.   Gum-ammon., 322.  Amyg.-amar.,
335.  Amyg.-dulc.,336.  Angust.-vera, 375.  Ant.-crud., 389.  Apis.,
461.

   Cough is a forcible expiration of the air from the respiratory ways,
and  may be  dependant  upon  any source of irritation within  their
limits:  be it an offending substance, as a foreign body or tubercle, or
simple irritation of the lining membrane of the bronchial tubes.  It is
produced by closing the glottis, and then making a sudden and strong
expiration.
   Watson  says that, to be  effectual, it requires the  admission  of a
certain  quantity of air, and  a  certain amount of muscular strength;
thus, a patient may be on the brink of suffocation, from a collection of
mucus in the windpipe, and be unable to expel  it, not from defect of
muscular power, but  because the lungs  cannot be sufficiently  inflated
beyond the mucus; an ample opening  in the trachea has enabled the
patient,  by  drawing a  long  breath, to  expel  the mucus through the
rima-glottidis.  Again, old and feeble  people, suffering from  chronic
bronchitis, doubtless, often die  suffocated,  from  a deficiency of mus-
cular strength to cough the phlegm up.
   But the  sensation which excites coughing may arise from  many
sources of  irritation :   slight irritation  about  the  glottis, a  long and
tickling  uvula, the inspiration of dust or irritating vapors, pressure of
any kind upon the  respiratory organs, may  all produce cough.   It
may be produced, also, by sympathy with another part, as in a stomach
cough.

   N. B.—As proper attention to my work on the "Principles and  Practice of
Medicine," the  fourth number of which is now ieady for delivery, will not allow
me sufficient time to carry out the " Index Raisonne," as I would like to, I
append here a  simple Index  to the "Materia Medica," as far as published.  I
most sincerely wish that some one else would take up the "Index Raisonne," and
continue it, either in the  sam« spirit  as the. commencement, or in some other more
usefnl manner,  if possible.  Such a work is much wanted, and some of the  drones 
64
Index Raisonne.
and grumblers in our school may here find useful employment.  In our ranks, as
in all others, perhaps, a few have to do all the work, while the majority amiably
play the part of the dog in the manger. they will not work themselves, and will
not let others work in a truthful and free manner.                  Peters.
  CalCUlllS,  Urinary.—Acacia, 5.   Acid-gallic, 25.   Acid-muriat.,
42.  Acid-nit., 53.  Acid-phos.,  72.   Acid-sulph., 84.  Actea-spic,
146.  Ammon.-carb., 273.   Ammon.-phos., 312.
  Colitis.— Acacia, 5.
  Cancer.—Acid-acet., 10.  Acid-nit., 52.   Acid-tannic, 89.  Arg.-
nit., 500.
  Cancer Of Stomach.—Acid-nit., 52.  Actea-spic, 146.
  Consumption.—(See phthisis.)
  Cataract.—Prus.-acid, 29.
  Cephalalgia.—(See also headache).   Acid-acet., 6.  Acid-fluoric,
19.  Acid-muriat., 38.  Acid-nit., 49.   Acid-oxalic, 60.  Acid-sulph.,
80.  Actea-rac, 140.  Agar., 164, 169.  Agnus-cast.,  172.  Alcohol-
sulph., 200.   Ammon-carb., 267,  268.   Arom.-spts.-ammon., 315.
Angust-vera,  370.   Anis, 376.   Ant.-tart., 420.   Apis, 447.
  Conjunctivitis.—Acid-acet.,  7.   Acid-tannic,  88.   Alum,  223.
Apis, 449.
  Carcinoma.—Acid-acet.,  10.   Acid-nit., 52.   Acid-tannic,  89.
Arg-nit.,  500.
  Constipation.—x*\cid-acet., 7.  Acid-benzoic, 13.   Acid-gallic, 25.
Acid-nit., 52.   Acid-tannic, 88,  89.    Actea-spic,  146.   Ammon.-
carb., 272.   Angust.-spur., 366.  Ant.-tart., 427.  Arg.-nit., 507.
  Cholera.—Acid-acet., 8.  Prus.-acid, 29, 30, 31.  Acid-nit., 52.
Acid-phos.,  72.    Acid-sulph., 83.   Aethusa,  154.    Alum,  225.
Ammon.-caust., 286.  August.-vera, 273.   Ant.-tart., 395, 426.
  Cholera  Infantum.—August.-vera, 372.   Ant-tart.-,  425.
  Colic—Altium-cepa., 205.   Aloes, 215.   Alum, 225.  Anis, 376.
Anth.-nob., 379.
  ColiCj  Renal.—Acid-benzoic, 13.   Aloes, 217.
    "    Painter's.—Acid-sulph., 82.  Alum, 225.
    "    BiliOUS.—Aethusa, 155.
  Catarrh.—Acid-benzoic, 14.   Acid-nit., 54.  Acid-tannic, 88, 90.
Aeon., 122.   Actea., 140.   Allium-sat., 206.  Alum, 222.  Alumina,
230.   Ammon.-carb., 274.  Ammon.-caust., 285.    Acid-nit., 285.
Gum-ammon., 322.   Anis, 376.  Ant.-tart., 421,  423.  Apis, 450.
Apoc-cann ,  490.
  Catarrh of Stomach.—Ammon.-mur., 300. 
Index Raisonne.                      65
  Chlorosis.—Acid-benzoic, 14.   Ammon.-caust., 287.
  Carbuncle.—Ant.-tart., 407.
  Cardialgia.  (See also  Gastralgia and Gastrodynia).—Acid-fluo-
ric, 21.  Prus.-acid, 30.  Acid-nit., 51.  Acid.-phos.,  71.   Amyg.-
dulc, 336.   Arg.-nit., 506.
  Cramp.  (See next page).—Amyg.-am., 332, 334.
  ( ariliaM olumnae, Rheumatism of.—Acid-fluoric, 23.
  Carditis, Rheumatic—Acid-fluoric, 23.
  Coup de Soleil.—Acid-fluoric, 24.
  Coma.—Prus.-acid, 28.   Aeon.,  117.   Agnus-cast., 173.  Ant.-
tart., 415, 421.
  Cramps.—Aeon.,  123.   Angust.-spur., 366.
  Congestion.—Prus.-acid., 29,  31.  Aeon., 113.
       "     of Womb.—Aloes, 218.
       "     of Bowels.—Aloes, 215.
       «     of Brain.—Aloes, 213.
       "     of Lungs.—Agar., 168.  Aloes, 219.
  Convulsions.—Acid-muriat., 37.  Allium-sat., 207.   Ammon-carb.,
259.   Amyg.-am., 332.  Arg.-nit., 504.
   Convulsions, Puerperal.—Amyg.-am., 332.  Ant.-tart., 412.
   Cancrum-OviS.—Acid-muriat., 39,  45.  Acid-nit.,  50.  Ammon.
carb., 270.
   Croup.—Acid-muriat., 40.  Acid-sulph., 81, 85.  Acid.-tannic, 88.
Aeon., 126.   Alum, 228.   Ammon-carb., 274, 289.   Ant.-tart., 435,
436, 437.
   Cornea, Ulceration  of.—Acid-nit., 49.
      «    Opacity  of.—Acid-hydroc, 29.   Acid-nit.,  49.   Acid-
sulph., 80.
   Cystitis, Chronic—Acid-nit.,  53.  Apis, 458.
   Cmsta-Lactea.—Acid-oxalic, 65.  Ant.-crud., 386.
   Coxalgia and Morbus-Coxarius.—Acid-phos.,  73.   Acid-sulph.,
85.   Arg.-nit., 498.
   Caries.—Acid-phos., 75, 75.
   Colica-Pictonum.—Acid-sulph., 82.   Alum, 225.
   Chemosis.—Aeon., 119.
   Chorea.—Actea-rac, 137,  138, 141.  Agar., 161,  162.   Ambra.,
245.   Ant.-tart., 412.
   CyrrhOSis Of Liver.—Aethusa, 155.  Apoc-cann., 483.
   Chillblains.—Alum, 229.
E 
66
Index Raisonne.
                               D.

   Diabetes.—Acacia, 5.  Acid-nit., 53.   Acid-phos.,  70,  72,  72.
 Acid-tannic, 89.  Allium-sat., 209.   Alum, 226. Ammon.-carb., 273.
 Ammon.-cit., 309.  Gum-ammon., 321.   Anac, 348.   Arg.-met., 500.
   Diphtheritis.—Alum,  227.   Ammon.-caust., 285.  Ant.-tart., 437.
   Diarrhoea.—Acacia, 5.   Acid-acet., 7.  Acid-benzoic, 13.   Acid-
 hydro., 31.   Acid-muriat., 42, 43.   Acid-nit.,  52,  52,  52,  53,  54,
 Acid-phos., 71.   Acid-sulph., 83, 86.  Acid-tannic, 88.  Acid-tartar.,
 93.   Aethusa, 154.  Agar., 166, 167.   Agnus-cast., 174.   Alcohol,
 196.    Alcohol-sulph., 201.   Aloes, 217.   Alum, 226.   Alumina,
 239.    Gum-ammon., 321.   Anac, 348.  Angust-vera., 372, 372.
 Ant.-tart., 440.   Apis, 456.  Arg.-chlor., 495.
   Delirium.—Acid-acet., 6.   Aeon., 116.   Agar., 164.  Ant.-crud.,
 386.  -
   Delirium of Typhus.—Acid-acet., 6.   Agar, 164.
      "     Tremens.—Agar., 158, 162, 164.  Ammon.-carb., 267.
 Ant.-tart., 395, 396, 411.
   Dyspepsia.—Acid-fluoric, 21.  Acid-gallic,  25.  Acid-muriat., 40.
 Acid-nit., 54.  Acid-oxalic, 62.  Acid-phos.,  71.   Acid-tannic, 88.
 Acid-tartar., 93.  Aeon.,  123.  Actea-rac, 140.  Agar., 166.  Agnus-
 cast., 171, 174.   Alcohol, 195.  Allium-sat.,  206,  209.   Aloes, 213.
 Alum, 224.  Ambra., 247.  Ammon.-carb., 270, 271.  Ammon.-caust.,
 286.  Ammon.-cit., 309.  Gum-ammon., 320.  Angust-vera.,  370, 372.
 Anis, 377.  Anth.-nob., 379.  Ant.-crud., 388.  Apis, 452.  Apoc-
 acid, 466.
   Dropsy.—Agnus-cast., 171, 172.   Allium-cepa., 203.   Allium-sat.,
 206.  Ammon-acet., 254.  Ammon.-mur., 295.  Gum-ammon., 321.
 Angust-vera., 369.  Anthris.-cer., 381.   Ant.-tart., 407.  Apis, 442.
 Apoc-cann., 483.   Aralia-his., 491.  Arg.-nit., 500.
   Dropsy, Post-Scarlatinae.—Acid-acet.,  8.  Apis, 445.
   Drowsiness.—Acid-muriat., 44.   Agnus-cast., 173.   Ant.-crud.,
390.  Ant.-tart., 420.
   Dislocations.—Ant.-tart., 406.
   Dysentery.—Acid-nit.,  53.   Acid-sulph.,  83.   Acid-tannic, 89.
 Acid-tartar., 93.   Aeon.,  125.  Aethusa, 155.   Aloes, 217.  Alum,
 226.  Alumina, 239.   Gum-ammon., 321.   Angust-vera., 369, 369,
 373.  Anth.-nob., 380.   Ant.-tart., 426.  Apis, 457.    Arg.-chlor.,
495.                                                    *

   Despondency.—Acid-phos., 68.   Aeon., 116.   Agnus-cast., 171,
172.  Ambra., 245.
   Dysuria.—Acid-phos.,  72.   Acid-tannic, 89.  Ammon.-mur., 295.
 Apis, 458.

   Debility.—Acid-phos.,  71.   Alcohol, 193.   Ambra., 250. 
Index Raisonne.
67
  Dysecoia. — Aeon., 119.   Allium-sat.,  207,  209.   Aloes, 213.
Ambra., 246.  Gum-ammon., 319.
  Dizziness.—Agar., 164.  Anis, 376.
  Dyspncea.—Allium-sat., 210.   Angust.-spur., 367.
  Dysmenorrhea.—Alumina, 240.  Ammon-acet., 254.  Anth.-nob..
380.  Apis, 443.   Aquil.-vul., 490.  Arg.-iod., 496.


                               E.

  Epistaxis.—Acacia, 5.  Acid-acet., 6.   Acid-gallic,  25.   Acid-
muriat., 39.   Acid-phos., 69.  Acid-tannic, 88.  Aeon., 119.  Agar.,
165.  Alum, 222.   Ammon-carb., 269.  Ant.-tart., 422.
  Enlarged Prostate.—Ammon.-mur., 295, 304.
  Eye, Inflammation About.—Acid-nit., 49.  Apis, 449, 450.
    "   Affections of.—Acid-tannic, 88.  Aeon.,  119.   Aethusa, 153.
Agar., 165.   Gum-ammon., 319.  Angust.-spur., 364.   Apis, 449.
  Eye, Lime in.—Acid-acet., 6.
  Eczema.—Acid-acet., 10.   Acid-muriat., 38, 39.   Acid-nit., 49,
55.   Acid-phos., 69, 70.  Acid-sulph., 87. Anac, 340.  Ant.-crud.,
386.  Ant.-tart., 410, 423.  Apis, 446.
  Epilepsy.—Prus.-acid, 34, 34, 36.   Aethusa,  150,  Agar, 162.
Ambra., 252.  Ammon.-caust., 280, 284.   Amyg.-am., 332.  Anagall,
351.   Ant.-tart., 412.  Arg.-chlor., 495.   Arg.-nit., 512.
  Erysipelas.—Acid-nit., 49.   Aeon., 121.  Adeps, 148.   Ammon-
carb., 260, 266.   Ammon-caust., 282.  Anac, 339, 340.   Ant.-tart.,
411.   Apis, 449, 450, 451.
  Elephantiasis.—Acid-nit., 55.
  Exostosis.—Acid-oxalic, 64.
  Eruptions.—Acid-phos., 76.   Allium-sat.,  207.  Ant.-crud., 386.
Ant.-tart,, 400.
  Ectropium.—Acid-sulph., 80.
  Erythema.—Ammon.-carb., 266.
  Ephelides.—Acid-sulph., 87.
  Enteritis.—Aeon., 124.  Apis, 455.  Hydroc-acid, 466.
      "      Chronic.—Agar., 167.
   Enlargement of Liver.—Agar., 167.  Alcohol, 197.
   Emissions  Of Semen.—Agnus-cast., 171. ♦ Ant.-tart.,  438. Arg.-
 nit., 498, 500.
   Eructations.—Alumina, 230. 
68                    Index Raisonne.

                              F.

   FavUS.—Aeid-acet., 6.
   Foot-Sweat, Suppression of.—Ammon.-mur., 308.
   Fistula-Lachrymalis.—Acid-fluoric, 20.  Apis, 449.
   Fistula in Ano.—Acid-nit., 53.
   Flatulence.—Acid-fluoric, 21.    Acid-muriat.,  42.    Agar.,  166.
Alcohol-sulph., 201.  Aloes, 213   Ammon-carb., 270, 272.   Aneth.-
foen., 353.  Anth.-grav., 354.  Angust.-vera, 372.
   Fatty Degeneration.—Ammon.-mur., 308.
   Fevers.—Prus.-acid, 35.   Acid-oxalic, 65.  Acid-tartar., 93.  Aeon.,
113,116. Agar., 163.  Allium-sat., 208. Ammon-acet.,254. Ammon.-
caust.,  282.  Ammon.-mur., 291.   Angust.-vera, 369.   Anth.-nob.,
378.  Ant.-tart., 414, 415.
   Fever, Inflammatory.—Aeon.,  113.   Ammon.-acet.,  254.   Ant.-
tart.
   Fever, Bilious.—Ammon.-mur., 293.   Angust.-vera,  369.   Ant.-
tart., 415, 416.
   Freckles.—Acid-muriat.,  39.   Acid-sulph., 87.
   FrOSt-Bites.—Agar., 164, 169.
   Febris-Mucosa.—Ammon.-mur., 292.
   FlUXUS-MucOSa.—Ammon.-mur., 300.

                              G.
   Gastritis.—Acacia, 5.  Acid-muriat., 40.  Acid-oxalic, 62.  Acid-
sulph., 82.   Aeon., 123.  Ammon.-mur., 290.  Apis, 455.
   Gastritis, Chronic—Agar., 167.  Ant.-crud., 388.  Ant.-tart., 424.
   Gastralgia.  (See also Gastrodynia and Cardialgia).—Acid-acet.,
7.  Acid-fluoric, 21.   Aloes, 211.
   Glanders.—Ammon.-carb., 266.
   Gathered Breasts.—Acid-acet., 9.
   Gonagra.—Arg.-nit., 498.
   Gangrene.—Acid-acet.. 10.
   Gout.—Benzoic-acid, 16.  Acid-nit., 53.  Aeon., 130.  Ammon.-
phos., 310.   Anag.-arv., 351.  Hydroc-acid, 467, 468.
   Gonorrhoea.—Acid-gallic, 26.  Acid-hydrochlor., 32.  Acid-nit., 54.
Acid-sulph., 84.   Acid-tannic, 89.   Agnus-cast.,  175.   Alum, 227.
Alumina,  230.    Ammon.-mur.,  295, 304.   Gum-ammon., 321.
Apoc-acid., 466.   Arg.-nit., 500.
   Gleet.—Acid-sulph., 84.   Acid-tannic,  89.  Alum, 227.  Ant.-tart.,
438. 
                    Index Raisonne.                      69

  Gastrodynia.   (See also Gastralgia and Cardialgia).—Acid-prus.,
30.  Ammon.-caust., 286.
  Glossitis.—Acid-oxalic, 61.  Apis, 452.
  Gastromalacia.—Acid-oxalic, 62.  Acid-sulph., 82.  Arg.-nit., 505.
  Gums, Affections of—Acid-phos., 70.   Alum, 224.
  Gastric Fever.—Acid-phos., 76.  Ant.-tart., 415.
  Glandular Enlargements.—Agar., 162.   Ammon.-mur., 294.

                              H.
  Haemorrhage*—Acacia,  5.   Acid-gallic, 24, 39.  Aloes, 213.
Alum, 222.   Ammon.-carb., 259.   Ammon.-caust., 281.
   Haemorrhage   from  Bowels. — Acid-nit.,  52.   Acid-tannic,  89.
Alum, 226.
   Haemorrhage,  Uterine.—Acacia, 5.   Acid-acet., 8.  Acid-sulph.,
84.  Aloes, 218.  Alum, 227.  Ammon.-mur., 296, 305.  Apis., 460.
Apoc-cann.,  486.
   Haemorrhage,  Vicarious.—Aloes, 212.
        «        Nasal.—Acid-acet, 6.  Acid-gallic, 25.  Alum, 222.
        "        Bronchial.—Acid-acet., 8.
        "        Pulmonary.—Acid-acet., 9.
   Headache.  (See also Cephalalgia).—Acid-acet, 6. Acid-muriat.,
38.   Aeon.,  117.   Amoracia, 245.
   Haemoptysis.   (See also Pulmonary Hajmorrhage).—Acid-acet., 9.
Acid-phos., 74.  Agnus-cast., 171.   Alum, 222.   Ammon.-mur., 307.
Amyg.-amar., 335.   Ant.-tart., 435.
   Hydrocele.—Ammon.-acet., 254.  Ammon.-mur., 304.   Gum-am-
mon., 321.
   Hospital  Gangrene.—Acid-acet., 10.
   Hffimatemesis.—Acid-fluoric, 21.  Acid-gallic, 25.  Acid-nit., 51.
Acid-tannic, 88.   Alum, 222, 225.
   H»morrhoidS.-Acid-fluoric, 22.  Acid-muriat., 42.  Acid-tannic,
89.   Aloes, 217.   Gum-ammon., 321.
   Hvdrothorax.—Acid-fluoric, 22. Acid-sulph., 85.  Ammon.-carb.,
276.   Apis,  442, 448, 462.   Apoc-cann., 484.
   Hypochondriasis.  (See also Melancholy)-Prus.-acid 28.  Acid-
muriat., 38.  Aeon., 116.   Agnus-cast., 172.  Aloes, 211.   Anth.-
nob., 380.
   Hnnninff-Couffh.—Prus.-acid, 33.  Acid-nit., 54.  Acid-tannic, 90.
Album?satg,  21™  Alum,  228.  Ambra, 249.  Ammon.-mur., 305.
Ant.-tart., 436.   Arg.-iod., 496.
   Herpes.—Prus.-acid, 34.   Acid-muriat., 38, 39, 43.  Apis, 446.
     «    Circinatus.—Ammon.-caust.,  284.
     *i    Labialis.—Acid-phos., 70. 
70                     Index Raisonni.

  Hypertrophy Of Heart.—Prus.-acid, 35.  Aeon., 113.
  Hydrocephalus.—Acid-muriat., 38.  Ant.-tart., 420.  Apis, 447.
  Hiccough.—Acid-muriat., 40.  Acid-sulph., 82.
  Hepatitis.—Acid-muriat., 41.  Acid-nit., 52.   Aeon., 124, 125.
  Hoarseness.—Acid-muriat., 43.
  Hectic.—Acid-muriat., 45.    Acid-oxalic,  65.   Acid-phos., 76.
Agar., 162.  Ammon.-carb., 266.
  Hysteria.—Acid-phos., 68.   Agar., 161.  Ambra., 247.  Ammon.-
caust., 280.  Amm.-spts.-arom., 315.  Anthemis-cotula., 377. Anth.-
nob., 380.
  Hydrarthrns.—Ammon.-caust., 288.   Ant.-tart., 409.
  HyperemesiS.—Acid-tannic, 88.
  Hematuria.—Acid-tannic,  89.  Alum,  222, 226.   Ammon.-mur.,
304.
  Heart, Disease of.—Aeon., 113.
    "    Dilatation of.—Alum, 221.
  Hemia, Strangulated.—Aeon., 124.  Ant.-tart., 426.
  Herpes-Zoster.—Aral.-mu., 491.

                               I.
  Insanity.—Acid-acet., 6.  Aeon., 116.  Ant.-tart., 419.
     "    Puerperal.—Ammon.-carb., 267.   Ant.-tart., 419.
  Itch.—Acid-acet., 11.  Acid-sulph., 87.  Actea-rac, 144.  Adeps.,
149.
  Inanity.—Anac, 340.
  Incontinence Of Urine.—Acid-benzoic, 14.  Agnus-cast.,  175.
Alum, 227.  Angust-spir., 366.
  Intoxication.—Ammon.-carb., 271.
  Irritability, Nervous.—Fluoric-acid, 18. Aeon., 116.  Actea-rac,
137.
  Impotence.—Acid-fluoric, 22.  Acid-phos., 73.  Agnus-cast., 171,
175.
  Insomnia.—Acid-fluoric, 24.  Prus.-acid, 34.  Ambra., 250.  Arg.-
met., 499.
  Ileus.—Prus.-acid., 31.
  Intermittent Fever.—Acid-nit., 55.    Agar., 162.   Agnus-cast.,
171.  Allium-sat., 208.  Alum, 229.  Ammon.-carb., 266.   Ammon.-
mur., 292.   Amyg.-amar., 333.   Angust-spec,  362.   Angust-vera.,
369. Anth.-nob., 378, 379.  Ant.-crud., 385.  Ant.-tart., 414. Apiol.,
441. 
Index Raisonni.
71
  Induration of Testis.—Alumina, 230.
  Inflammation.—Aeon., 113, 114.   Ant.-tart., 413.
       **        of Labia.—Apis, 458.
  Icterus.—Aeon., 115.
  Influenza.—Ant.-tart., 420, 421, 437.  Apoc.-and., 466.
  Iritis.—Aeon., 119.
                              J.
  Jaundice.—Acid-phos., 71.  Aeon., 115.  Ammon.-mur., 293.

                              L.
  Lichen.—Acid-acet., 10.  Acid-muriat., 39, 43.  Acid-sulph., 87.
Ant.-crud., 386.  Ant.-tart, 410.  Apis, 446.
  Lepra*—Acid-acet., 10.   Ammon-carb., 266.
  Laryngitis, Strumous.—Acid-benzoic,  14.  Ant.-tart., 437.
       **     Chronic.—Acid-benzoic, 14.   Acid-fluoric, 22.  Acid-
nit., 54.  Acid-sulph., 80.   Apis, 461.   Arg.-met., 501.
  Lachrymation.—Acid-fluoric, 20.
  Leucorrhcea.—Acid-gallic, 26.  Acid-muriat., 43.   Acid-nit., 54.
Acid-phos., 73.  Acid-sulph., 84.  Acid-tannic, 89.  Alum, 227. Alu-
mina, 230.   Ambra., 248.  Gum-ammon, 321.  Ant.-tart., 439.   Apis,
450.
  Lithiasis.—Acid-phos., 72.
  Lead-Colic—Acid-sulph., 82.
  Lumbago.—Aeon., 129.
  Labor.—Actea-rac, 137, 142.   Ant.-tart., 406, 439.
  Liver, Torpidity of.—Aloes, 211, 214.

                              M.
  Mania.—Acid-acet,,  6.  Aeon., 116.  Agar., 164.  Aloes,  211.
Alum, 222.   Anag.-arv.,  351.  Ant.-tart., 418.
  Meningitis.—Ant.-tart., 414.
  Mammary Abscess.—Acid-acet., 9.
   Mammae, Inflammation of.—Ant.-tart., 437.
   Mumps.—Ammon.-acet., 254.
   Moles.—Acid-acet., 10.  Acid-nit., 10.
   Mouth, Ulceration of.—Acid-benzoic, 12.
   Malarious Fever.—Ant.-tart., 415, Apoc-cann., 466.
   Muscae Volitantis— Acid-fluoric,  19. 
72                        Index Raisonne.

  Maculffi-IIepaticffi.—Ant.-tart., 423.
  Menorrhagia.—Acid-gallic, 26.   Acid-tannic, 89.   Agnus-cast., 171.
Alum, 221, 227.   Alumina, 240.   Ammon.-mur., 255.   Apoc-cann.,
486.
  Melancholy.—Acid-muriat., 38.   Acid-phos., 68.   Agnus-cast., 172.
Aloes, 211.
  Mesenteric Glands, Enlargement of.—Phos.-acid, 71.   Ammon.-mur.,
294.  .
  Mercurial Erythism.—Ammon.-carb., 267.
  Metrorrhagia.—Acid-phos., 73.   Agnus-cast., 175.
  Measles,—Adeps, 148.   Ammon.-carb., 260, 266.
  Milk, Absence of.—Agnus-cast., 171.  Anis, 376.
  MuscBB-Volitantes.—Aloes, 213.
                                 N.
  Night-Sweats.—Acid-acet., 8.  Acid-sulph., 85, 85. Acid-tannic, 90.
Ambra., 250.  Ammon.-carb.,  283.
  NSBVUS-Matemus.—Acid-acet., 10.  Tinct.-ferrum.-muriat., 10.  Acid-
nit., 10.  Alum, 229.
  Nephritis.—Acid-gallic, 25.  Ant.-tart., 414, 438.
  Nephritic Colic.—Acid-benzoic,  13.
  Nipples,  Cracked.—Acacia, 5.  Borax, 5.   Benzoin, 5.  Acid-benzoic,
15.
  Neuralgia.—Prus.-acid, 32.  Aeon., 120,  129.  Agar., 166.  Ammon.-
carb., 276.  Angust.-spur., 367.   Anth.-pyreth., 380.  Ant.-tart., 421.
Arg.-nit., 506.
  Nenralgia  Frontalis Intermittens.—Angust.-spur.,  558.
  Nervous Palpitations.—Prus.-acid, 35.  Ambra., 249.
      "   Irritability.—Acid-phos., 68.  Acid-tannic, 90.
  Your " Index Raisonne" I like very much.  It is a multum in parvo.
                          Very truly yours,                 C. Neidhahd.
  I am sorry you give up the " Index Raisonne ;" although I thought its commencement
premature, I soon found it very interesting and valuable.  Do set  Dr. Snelling or some
one else to work on its continuance.     Very sincerely yours,    W. H. Holcombe.
  Many of our readers will doubtless be glad to learn that arrangements have been made
with Dr. W. Faulkner Brown, of this city—long an associate of Dr. John F. Gray—to
continue the " Index Raisonne."  Sufficient copy is already in  hand to make it certain
that it will appear in the next number of the Journal.  Every capable physician is en-
treated to furnish him such assistance as they can.  The publication of the above simple
Index will enable all to  take part who wish to.  Dr. Snelling and myself will also render
all the aid in our power.                                           Petebs. 
Calculus,  Urinary.
73
  CalCUlUS, Triliary.—Acacia, 5.  Acid.-gallic, 25.   Acid.-munat.,
42.   Acid.-nit.,53.   Acid.-phos.,72.  Acid.-sulph., 84.   Actea-spic
146.   Ammon.-carb., 273.   Ammon.-phos., 312.

  Calculus is a solid or organized concretion, found in various parts
of the body—in the biliary ducts,  gall-bladder, liver, articulations, &c
   Urinary calculi have their origin in the kidneys,  from whence they
are carried by the ureters to the bladder, where,  if they remain, they
become the nuclei for  other deposits.  The diatheses most  favorable
to the formation of calculi  are the lithic and phosphatic
   The deposits of the lithic diathesis are yellow, red, or lateritious, or
perhaps pink deposits of lithate of ammonia, or there may be formations
of red gravel, or crystals of lithic  or uric acid  Dr. Bird says : " Uric
acid  is of more serious importance than most other elements of cal-
culous formations, not  only from its constituting  a  large proportion of
all  urinary calculi, but, even when they are chiefly composed of other
ingredients, the deposits are, in the great majority  of cases, composed
of  uric  acid."*   We have also the deposits of uric or  xanthic  oxide,
which closely  resemble and are often mistaken for  those of uric acid.
They are distinguished by the following tests :t

          URIC OXIDE.                           URIC ACID.
 1. Dissolves slowly in nitric acid, with-  1. Dissolves readily in nitric acid, with
    out evolutions of bubbles of gas.         effervescence.
2. A  nitric solution leaves by evapora-  2. Nitric solution leaves by evaporation
    tion a yellow residue.                  a pink residue.
3. Soluble in strong sulphuric acid, and  3. Is precipitated by water from its so-
    not  precipitated on the addition of      lution in  concentrated sulphuric
    water.                               acid.
 4. Its solution in liq. potass, is not dis-  4. Hydrochlorate of ammonia  precipi-
    turbed by hydrochlorate of ammo-      tates it, combined with ammonia,
nia.
                                        from its solution in liquor potass.
5.  Precipitated  uncombined when  a  5. A current of carbonic acid gas throws
    current of carbonic acid gas  tra-      down from the alkaline solution an
    verses its solution in potass.            acid urate of potass.
6  Insoluble in a solution of carbonate  6. Readily soluble in  a dilute solution
    of potass.                            of carbonate of potass.
7.  Ignited in a tube does not yield urea.  7. When ignited yields urea as one of
                                        its products.

   In the  phosphatic diathesis we have white gravel, or crystals of
the phosphate of magnesia and ammonia, or the phosphate  of lime.
   The triple phosphate, or fusible calculus, so  called  from its  easy
fusibility before the  blow-pipe, is, next to  uric acid, one  of the  most
often  met with.   It  is  very  irregular  in  shape,  sometimes  being a
complete cast of the  pelvis and calyces of  the  kidney, at other times
regularly oval, and  sometimes almost  circular.  Its shape probably
depends upon its  position  in  the  kidney,  or whether  it  has  passed
down the ureter before becoming of any considerable size.
   We have also calculi of the oxalate of lime, or the mulberry calculus,

        * " Bird on Urinary Deposits," p. 139.               t Ibid.
                   F 
74                     Index Raisonne.
usually found in young persons ;  and also the fibrinous calculus of Dr.
Marcet, which, Dr. Bird says, " Differs from other concretions, and
must be regarded as a portion of dried inspissated albuminous matter
exuded from an irritated  kidney, rather than  as a calculus  produced
under circumstances  at all analogous to those of other concretions."
The kidneys, uterus, bladder, prostate gland, or  urethra may  contain
calculi, but they are most commonly found in  the bladder, sometimes
loose, and very frequently  encysted ;  sometimes  only one  may be
found, but upwards of one hundred have been discovered existing at
the same time in one  subject.
   As the calculus passes down the ureter  the  patient experiences
great pain, frequently desires to pass  his water, but is  generally un-
able to  do so, except a few drops at a time, which are very high-
colored and often  mixed with blood.  We find also  febrile symptoms,
nausea, vomiting, eructation, and frequent spasmodic retraction of the
testicle.
   The most reliable means  we have for diagnosticating stone in  the
bladder is the introduction  of the  " sound,"  which is  moved about
until it touches the stone, when a metallic sound is conveyed by the
instrument.   If the " sound  " does not readily come in contact  with
the stone, the finger may be  introduced into  the rectum, and, pressing
the lower  part of the bladder  upwards, the " sound" may thus  be
brought in contact with the stone.
   We  have  also,  as diagnostic signs, irritability of the  bladder, fre-
quent desire  to urinate ; sometimes the stone falls upon the orifice of
the urethra, causing sudden  stoppage of the stream.   The patient will
always experience great pain in the neck of the bladder, and in  the
glans-penis.
   Calculi are of the greatest possible variety in form, but  generally
are more or less ovoid ; sometimes they appear to  have been divided
into segments, which is probably caused by  the attrition of one calcu-
lus against another.   The  relief of  calculus, in the more  advanced
stages, comes properly within the sphere of the surgeon, rather than
the physician.  If the stone cannot be extracted or dissolved, it will
generally be  found necessary to have recourse to lithotomy.
   Much may be done before the stone is fully formed, if  we discover  a
tendency to such formations, and here it becomes the duty of the physi-
cian to  treat the  diathesis; if a strumous diathesis  be  subjected to
prompt and  energetic  treatment, the formation  of tubercles  may be
prevented.   So, if  we are  able to treat in time a patient with calcu-
lous diathesis, we may possibly prevent the formation of stone.
   Bird recommends acids, to hold the phosphatic salts  in solution,
and thinks highly of nitric acid, because it  does not deteriorate diges-
tion, but is rather beneficial on account of  its tonic properties.   Par-
ticular  attention should be  had to  the skin; warm clothing, flannel,
leather  waistcoats, silk shirts,  and friction are  highly  necessary
wherever a  gouty or calculous taint exists.  The  vapor bath is very
beneficial, such as the Oriental bath, which is used throughout Rus- 
Cancer.
75
sia, Turkey, Egypt, and Persia, and which has  been introduced here
by Mr.  Culbertson ; it removes a large  quantity of albuminous  and
other excrementitous matters from the skin.   Dr. Bird thinks that the
exemption from urinary calculi which the sailors in the English navy
enJ°y (lhe number  of  cases being about one in  thirty-four thousand)
to be entirely  attributed to their sleeping in a sort of vapor bath.
   Great care  should be used to preserve  the healthy functions of the
digestive apparatus.  Moderate and judicious exercise should be en-
joined ;  for lazy luxurious habits tend very much to develop calculus
and  its  attendant maladies.
   It is also beneficial to wash out the bladder by injections of warm
water, when phosphatic alkaline urine exists;   and  it will be found
that  the  secretion of mucus and the phosphates  will be diminished by
this  treatment.
   The   remedies most useful are Aeon., Canth.,  Scill., Nux-vom.,
Opium,  Puis., Kali-carb.;  these remedies will  allay the irritation  of
the bladder and the accompanying pain.   Lycopodium is indicated by
pain  in  the kidney,  the ureter, painful  emission  of  urine, frequent
heartburn, mucus in  the throat, and haemorrhoids.   Cannabis-sat.  is
also of  great use, as are also  Sulphur, Uva-ursi, and Graphites.  Cal.-
carb. and Cal.-phos. have also been recommended, but these remedies
appear  to be isopathic rather than homoeopathic, and would, perhaps,
only add stone to stone  in an  already morbid structure.   Colchicum
is, perhaps, a very good remedy where we have a lithic-acid diathe-
sis to deal with, and, as we have  before said, we should, in the treat-
ment of this disease, always bear in mind the diathesis.—Browne.

   Cancer.—Acid.-acet., 10. Acid.-nitric, 52.  Acid.-tannic, 89. Arg.-
nit.,  500.

   Cancer is  a disease often arising from hereditary predisposition,
generally occurring in the middle  or more advanced stages of life ;
beginning with  a  local hardness,  which afterwards softens in the
centre,  infects the adjoining parts, and finally contaminates the whole
system.
   Cancer, which means, in the Latin language, a crab, receives its
name from the  claw-like  spreading of the veins.   It is also called
carcinoma (tcapKivoic,  a crab),  which term is by some restricted  to
the primary or initiatory stage, usually denominated schirrhus (oKip-
poc, a piece of marble ; a hard tumor), but by  others the  word car-
cinoma is applied to the ulcerating or opening stage.
   The  textures of  cancer, as given by Boyle, are:
   1. The chondroid or cartilagiform.
   2. The hyaloid, or vitriform.
   3. The lorinoid, or laediform.
   4.  The bunioid, or napiform.
   5. The encephaloid, or cerebriform.
   6. The colloid, or gelatiniform. 
76
Index Raisonne.
   7. The compound cancerous, the mixed cancerous, and the super-
ficial cancerous.
   Dr. Watson makes three species of cancer:
   1. Schirrhus, which is remarkable for its hardness ; it is as firm as
cartilage.   The exposed surface has a glistening watery appearance,
the color is white or gray, or bluish-white.  Though this semi-trans-
parent mass runs opaque, intersecting bands of a fibrous appearance.
   2. The encepholoid, so named from its brain-like appearance, which is
a cerebriform  mass, transversed  and circumscribed by fibrous septa.
"In both these species of cancer there  is a contained and a contain-
ing element."
   3. Colloid cancer, which presents the appearance of small portions
of greenish yellow  transparent  gum or jelly, arranged  in  regular
cells ; and  is sometimes called alveolar cancer.
   Cancerous tumors, occurring in  any part of the  human bod}-, may
multiply in  other  parts ;  even after their extirpation in one part they
may occur again in  another, with more alarming symptoms than be-
fore.  Sometimes  the ulceration  lays open  large  blood-vessels, and
the malady is  brought to an end by fatal  haemorrhage.  Sometimes
vital parts are  slowly disorganized, and again the  patient sinks under
the wearing influence of the malady.   It may attack almost any organ
of the body, the eye, the lips, the face, the stomach, intestines, liver,
kidneys, lungs, mammae, uterus, testicles, and even the bones.  The
mamma, the uterus, the stomach, the liver, and the testicle seem most
obnoxious to its ravages.
   There have  been  numerous opinions concerning the origin of this
disease.  Some have thought it  to be a peculiar depravation of  the
nervous fluid,  others have  supposed the  existence of a  hydatiform
body (hydates  carcinomatosa), but its  origin is a matter of great  ob-
scurity.   This much we know, that it is in consequence of a diathesis
either hereditary or acquired.  We cannot better discuss this subject
of its proximate cause than in the words of Dr. Watson :
   " The mode in  which cancer  originates  is uncertain; the modes
in which it  spreads  and  multiplies itself are better understood.   An
individual tumor may enlarge by the progressive insinuation of the can-
cerous matter into the intestices of the neighboring tissues, which thus
fostering upon it, it consolidates.  The disease may be communicated
by inhibition, from  one organ to another which  is near or in contact
with it.   But how does  it occupy at the same time, or in quick  suc-
cession, several separate and distinct organs?  This is a  question of
the greatest interest and importance, and it admits of a distinct reply."
   Cancer often makes its appearance in a single spot on the surface
of the  body ;  in the female  breast, for instance.   We see and feel it
while it is  yet small, and  while  the general health of the patient
seems to be otherwise perfect.   By degrees the  tumor increases,  and
at length softens  in  some  places ; the glands of the  axilla  become
swollen, hard, painful, and  filled  sometimes with cancerous matter ;
the tumor breaks perhaps through the skin, and presents the shocking 
I
                             Cancer.                          77

appearance of " open cancer;" the general health gives way, and the
skin assumes a st*»w-colored tint.  During  this  process, unless  the
patient dies prematurely, or the original disease is removed by a sur-
gical  operation, cancerous tumors form  in one or in several of the
internal organs, and give notice of their presence by appropriate symp-
toms.  There is an original morbid growth, and there are subsequent
morbid growths ; a primary tumor and secondary tumors, and the lat-
ter are caused  by the former.   This is a most important fact, if indeed
it be true.
  Now  Muller has discovered, by means of the  microscope, and his
discovery has been confirmed  by other  observers, that the contained
matter in the  several species or varieties of cancer consists of mi-
nute  cells, with nuclei attached to their walls,  and of granules  still
more  minute, which are supposed to be the  rudiments of new  cells.
It  is  (apparently) by the  amplification  of these  granules into  cells,
and by the development of nuclei into other cells, and by the growth
and evolution of young cells, which, in  some instances, are included,
generation after generation, on  the  parent  cells,  that  the  original
tumors enlarge and extend themselves ; and it is  by the transference
of certain of these  cells and  granules from the original tumor that a
crop  of secondary tumors is sown in remote parts of the body.   The
cells, and probably the granules also, are endowed with a power of
self-increase and propagation whenever they find  a fitting soil.  Pos-
sessing,  like  plants,  an inherent vitality of their own, they merely
require, in order to germinate, to be placed in contact with some  liv-
ing tissue, wherewith they may form vascular connections, and where-
from they may draw  the  materials for their nourishment.  Cohering
together, for the  most part, with  but little force, they are easily de-
tached from the  parent mass.  It is a matter of fact that the secon-
dary tumors form most rarely and most rapidly when the primary tumor
is of  a soft  kind;  and that, when they succeed to scirrhus, it is after
the process of softening has commenced  on  the original  hard struc-
ture.  These germs—which present in  their form and mode of gene-
ration striking analogies with those of some of the lower animals, as
well as  with those of plants—these germs  are carried  through  the
lymphatic vessels to absorbent glands in the vicinity of  the  primary
growth:  from a cancerous breast, for example, to the glands of the
axilla ; but there can  be scarcely any doubt that the blood is the main
channel  by which  the  seeds  of this dreadful malady are conveyed
from its first to its subsequent sites, and thence, perhaps, if life  con-
tinue  long enough, to  tertiary creations.    The gross matter of cancer
is often to be found in the veins  that proceed from the primary tumor,
nay,  in  large venous trunks at a  distance ; so that some distinguished
pathologists have too hastily conjectured that  it may originate in the
veins.   We  are  all aware  that  foreign substances, circulating
in the blood, stop or are entangled more often in some organs than in
others.   Minute globules  of mercury, when the  metal has been in-
troduced into  the veins, are found strewed through the substance of 
 78                     Index Raisonne.

 the  lungs  and  of the  liver.   Pus, received into  the blood in phle-
 bitis, is arrested, and forms scattered points  of inflammation and ab-
 scess in the same  organs, and it is in the liver  and lungs that sepa-
 rate tumors of secondary cancer are most commonly met with.  If this
 be the true theory of secondary cancerous formations,  it is  scarcely
 to point out  the  urgent  importance  of the  rule  which prescribes
 to the surgeon the most complete extirpation of  the primary tumor, at
 the earliest possible period of its existence.
   The  disseminated cancer-germs are not scattered to this  organ or
 to that, to  the lungs or to the  liver, indiscriminately  or by chance.
 Their distribution  bears a  certain relation, as  you may readily con-
 ceive, to the situation of the primary disease.   Since the blood, in its
 return from  the stomach, the intestines, the rectum, passes through
 the portal system of veins before it reaches the  lungs, you would ex-
 pect that the cancer-cells conveyed from these parts would be stopped in
 their journey through the capillary vessels  of the liver—and it is so.
 A few, in very rare instances, pass on, to lodge and grow in the lungs.
 Again, the  blood from the breast goes direct to the vena-cava, and the
 lungs are the first  to receive and  entangle whatever seeds of disease
 it may carry ; for what is true  of the cancer-germs  is true of pus also,
 and of other morbid materials.   The pulmonary capillaries, however,
 are more easily  permeated by  such matters than the hepatic.   Some
 of the germs pass through them and enter the general circulation;
 and the liver as  well as the lungs become  contaminated ; and  germs
 may thus settle in other  parts.   In these facts  we see one reason why
 cancerous  growths  are more often met with  in the liver than  in any
 other organ of the  body.   Primary cancer of the  kidney is, in like
 manner, apt to be disseminated through the medium of the vena-cava,
 and  we might  expect  the cancer-germs from  the uterus would take
 the same course, and affect the lungs earlier and more  often than the
 liver.  But this is not always  the  case.  The liver  is liable to be
 secondarily affected from malignant  disease  of the womb, and Dr.
 Budd gives the explanation of this apparent  anomaly.   The rectum
 and the hemorrhoidal veins, which return the  blood to the venee-portm,
 very  frequently  become implicated in  the uterine  disorganization.
 Fortunately, cancer of the uterus, which is a fearfully common disease,
 is not so  often  disseminated  as cancer of  the stomach or  of the
mamma.
   The  origin of primary cancer is involved in  much  obscurity.   It
seems, however (and this, after  what has  just  be  stated, one  might
 expect), that the  germs of the disease  are  capable of being trans-
ferred from one human being to another, and  even to an animal of a
 different species.   Langenbeck injected cancerous matter, just taken
from a living body, into the veins of  a dog.  After some  weeks the
dog began to  pine  away, and was then killed,  and cancerous growths
were found in its lungs.  Several instances have occurred—I  myself
know of two—of cancer of the penis  in men whose wives labored 
Cancer.
79
under cancer of the uterus.   Here  it is presumable  that cancerous
germs, received upon a delicate and  vascular  surface, and  suffered,
perhaps, to  lodge there through neglect of cleanliness, might fasten
on the part, take root as it were, and grow.  One very curious circum-
stance connected  with this  subject  is, that the  frequent contact of
common soot seems to have the power of  producing cancer.  There
is a form of carcinoma, affecting chiefly the scrotum, and familiar to
surgeons  as the  chimney-sweeps'  cancer.  A  case is  recorded of
a cancer of the same variety occurring in the  right hand  of a  gar-
dener, who for years had been in the  habit of sprinkling soot over his
flower-beds with his hands.   There  are not wanting, then,  plausible
grounds for the  hypothesis that cancer may be introduced, in some
way which eludes observation, from without ; that cancerous growths
are  strictly parasitic,  and independent of the body, excepting so far
as they derive their pabulum  from its juices.   The difficulties in-
volved in this supposition are not greater (as we shall hereafter  see)
than those that hang over the  source  and origin  of certain entoza
with which the body is liable to be infested.  But whether this hypo-
thesis  be true, or whether cancer-cells and germs are merely morbid
elements of the native  tissues  of the body, developed  by some per-
verted energy of the  formative process, remains yet to be determined.*
  As  we have  before said, cancer, like tuberculosis, is undoubtedly
an  hereditary malady, but it seldom  shows itself before the age of
thirty.  Women are  more liable to become victims  of this malady
than men, particularly if they have never been pregnant.   The  lym-
phatic seems to be the temperament most obnoxious to this disease.
Mental anxiety, sorrow, bad  air, unwholesome  diet, exhausting  and
laborious occupations, and  an unhealthy  locality  are  predisposing
causes of this  malady.  The exciting causes  are various : a blow,
improper diet,  abuse of  spirituous  liquors, pressure, or any external
injury.
  The diagnosis  of this disease  is  important, for  scirrhus may be
mistaken for simple induration  resulting from  chronic inflammation,
and vice versa.   The best means of  diagnosis, where the disease is
not unmistakably defined, is undoubtedly the microscope.
  When we come to  consider  the  treatment of this truly malignant
disease we  are indeed appalled ;  perhaps  there has been  no other
disease the  treatment of  which has been such a source of gain to the
quack, and so unsatisfactory to the conscientious practitioner ; indeed
we  may almost positively say  lhat the more extensively  a disease
is advertized as curable  the more certainly will it  be  found to be
incurable.
  With even the evangel of modern medicine—" Similia  Similibus
Curantur"—sounding in our ears we stand aghast, for where have we
a remedy for the disease which has been fully proved ?  and we are,

           * Watson's " Practice."  London, 1857.  pp. 213-16. 
80
Index Raisonne.
 alas, reluctantly forced to turn to the glittering knives of the surgeon
 for relief.  But the disease may be palliated, and, after the extirpation
 of the tumor, its recurrence may possibly be  prevented.  The reme-
 dies which seem to be indicated according to their pathogeneses are :
 Ars., Aser., Bellad., Conium, Carb.-veg.,  Caust., Phos., Petrol., Ar-
 senic, Iod.? Nux-vom., Calendula, and Cicuta.  Remarkable success
 has  been obtained from the use of Vibernum  ; and  we should think
 that, if soot will cause  cancer, Kreasote ought to be homoeopathic to it,
 or even  soot itself.  Viburnum has been found of very great service
 in the  treatment  of  cancer, and of the  cancerous diathesis.  The
 particular treatment of cancer of the various organs we  shall  consi-
 der hereafter, and more at length.
   Cancer of the Lip.—We seldom find  cancer  of the  upper lip;
 the disease usually attacks the lower lip, and may  commence  by in-
 filtration of scirrhus,  presenting the characteristics of this formation
 throughout a limited extent of the lip, and apparently underneath the
 skin  at its junction with  the mucus surface.   After a time the inte-
 guments give way, a  thin viscid fluid is  discharged, and  a scab is
 formed, which is reproduced as soon as  it falls off, or is torn away.
 After the  ulcerative process  begins, the formation  of regular scabs
 ceases, and we have fungous formations arising from a scirrhus basis.
 These  are seldom of  the encephaloid  species, but are usually indu-
 rated.
   We frequently find a small rounded tumor, resembling a shot in size
 and color,  immediately beneath the integuments covering the vermil-
 lion of the lip, rolling under the finger  when  pressed upon.  In the
 beginning this  species is  generally painless ;  frequent handling irri-
 tates  the tumor, and  growing rapidly it  soon adheres to the surround-
 ing parts.  Frequently we find a firm immovable lump of considerable
 size imbedded in the lip;  gradually it  approaches the surface, ulce-
 rates, and  throws out a fungus of dark-red color.   We  also find  a
 chocolate-colored warty excrescence, which is continually casting off
 scabs.  The ulceration may extend over the entire cheek, or even to
 the sternum.   The disease is more frequent among males than females.
 Venereal ulcers  of the lower lip, with an indurated base, are often
 mistaken for  true  scirrhus, and an operation  determined upon, after
 which the  patient  recovers, and is then told by the operating surgeon
 that he has been cured of cancer ;  great  care  should therefore be
 taken to distinguish between cancer and syphilitic ulceration, for the
 syphilization of our day is progressing  rapidly.  Lupus  may also be
 mistaken for cancer.   Superficial ulceration may sometimes be con-
 trolled by cauterization with acid solution of the Nitrate of Mercury
 or the Chloride of Zinc ; but, where the ulceration is deep, cauteriza-
tion is of little use.  The use of the  knife sometimes  hastens  the
 fatal termination of the disease, but sometimes cases of true scirrhus
 have recovered after excision of the tumor.
   Cancer  of  the  Gums.   "Epulis."—This  form  of  cancer  is
usually of the scirrhus species, sometimes, but very rarely, encepha- 
Cancer.
81
loid.  We find it more frequently in the lower than in the upper jaws;
it usually begins as an infiltration of the gums, progresses  slowly, and
the tuberculated nodule is soon the result.   This scirrhus formation is
dense, imperfectly vascular, and abounds in fibriform substance.   The
tumors vary in size ;  we often find them as large as a walnut and fre-
quently not as large as a pea.   Ulceration takes place, and is followed
by  a profuse discharge, which has usually a foetid, disgusting odor.
The sore progresses and frequently we find  profuse  haemorrhage.
The patient complains of lancinating pain; mastication is interfered with,
and very often the disease attacks the  bone.   We distinguish between
this  malady and productions which are often found near carious teeth
by its density, tuberculated shape,  pale color, local suffering, and gene-
ral history of  the case.
  Cancer of the Tongue.—Cancer of the tongue is a very com-
mon disease ;  it  is  almost always of  the scirrhus species.   It may
commence as a small circumscribed, somewhat knotted and irregular
tumor, situated in the anterior part of the  tongue, midway between
the raphe and the edge, but rarely  extending beyond the mesial line ;
or we may have a small excrescence, which in some instances becomes
pedunculated; or in some few cases cancerous deposition complicates
simple  ulceration, produced, for example, by the contact of a carious
tooth, and  in  very rare cases  we  find an erectile tumor  the  seat of
such deposition.   The mass ulcerates—the fungous formations some-
times attaining very large dimensions—assuming the cauliflower shape.
The progress of the disease is  fearfully rapid.  Generally the  patient
complains of an aching  sensation, with sharp pangs in the direction
of the ear.
  The discharge is very troublesome, not only because the patient is
constantly obliged to  expectorate, but  it also,  at night, accumulates in
the throat, theieby  causing  coughing and other  disagreeable symp-
toms.   Articulation, mastication,  and deglutition are very much inter-
fered with, and often become impossible, so that the patient  may
eventually be  reduced to starvation.   We distinguish cancer of the
tongue  from  simple induration by its situation, by the general health
of the patient, and by absence  of pain in  the latter case.   Syphilitic
ulceration with induration is very likely to be mistaken for this dis-
ease, but  the  syphilitic  ulcer  furnishes but  comparatively little dis-
charge, and has not the firm everted edge and sprouting fungi of the
cancerous  species.   The history of the case must  be carefully exa-
mined.   The  ulceration  produced by  dyspepsia has not  the  hard
basis of cancer.
  The treatment  of these forms of cancer is not generally very satis-
factory.   Arsenic is an important remedy, and is indicated where we
have tumors with a fatty base,  and hard roll-like margins,  surrounded
by a dark-red areola,  with a hectic flush  on  the cheek.  It is  indi-
cated in very malignant ulcers, which  spread  rapidly, bleed  easily,
and which show that  they are  the  outward  sign of a deeply-seated
cachexia, rather than the  result of some external injury.   If we have 
82                     Index Raisonne.
" Burning swelling in the nose, with  pain on  contact;  tumor in the
nose ;  ulceration  of the  nostrils, high  up, with  discharge  of foetid
ichor;  wart-shaped  ulcer on  the cheek; dry  cracked lips, brown
streak  on the lips, as if burned;  bleeding of the lower  lip; ulce-
rated eruption around the  lips ;  cancer-like  eruption  on  the  lower
lip, with thick crusts, hard  pod-shaped  edges, with  burning  pain,
particularly  when the parts  become cold, and with  a  cadaverous
bottom ; spreading ulcer on the lip, painful in the evening,  when in
bed, with tearing  and smarting in the daytime during motion, which
is worse  when  touching  the ulcer in  the  open  air;  disturbing
the night's  rest;  corrosion of the  edge of  the tongue, in  front,
with smarting ; the tongue  is blackish and cracked,"—Arsenic, Hel-
muth says, is  indicated.  Practitioners of the dominant school  have
noticed that Mercury frequently aggravates the disease ; if this be so
it may be a  proof of its  homceopathicity, and  it may be of service,
especially if there  be any syphilitic combination; but, if the  carci-
noma  arises from syphilitico-mercurial disease, it would be well to
employ Nitric-acid  or the  Chlorate  of  Potass.    Conium is an im-
portant remedy, particularly where we  have  a scrofulous diathesis.
Silicea is indicated  by erysipelatous  blotches, suppurating glandular
swellings, scirrhus  indurations, scurfs and ulcers of the nose, cracked
skin, and indurations of the face and upper lip; sponge-like ulcer on
the inner side of  the lower lip; burning itching  around the mouth;
eruption ;  swelling of the upper lip and gums, very painful to the touch.
Gold  is also recommended where there is  dryness of the fauces ;
painful blister on the tongue, accompanied with burning pain ;  deep
ulcer within the buccal cavity, with inverted edges and blackish base.
Also when the disease is  complicated  with  syphilitic or mercurial
symptoms,  Sulphur  revives the activity of the  organism, and in
some cases  acts as a very good adjuvant.  But the remedy which has
proved most  effective is the Viburnum-prunifolium, or Black  Haw.
Cases pronounced to be a true cancer, by the first surgeons and physi-
cians in the country, have  been entirely cured  by this remedy ; and
it may be that we have at last found  an  agent which, if taken in time,
shall  effectually  break up  the  cancerous diathesis, and give back
health to many who now suppose themselves doomed to a cruel death.
Tobacco has been known to cause, or rather to excite  cancer  of the
lip and mouth, and  might be a remedy for the  disease when  it has
been the exciting cause in the first instance.—W. Faulkner Browne.

   Cancer of  the Stomach and (Esophagus.—Acid.-nit., 52.  Actea-
spic,  146.
   Cancer of the oesophagus occurs generally at the upper end of the
canal, behind the larynx, most rarely at  its middle part, but sometimes
it occupies  the  entire length and circumference.  The formation of
 cancerous matter is usually preceded by pyrosis,  hiccough, and occa-
sional  pain in the fauces.   Sometimes  the tumor is perceptible ex-
 ternally, and is  mistaken  for an enlarged thyroid gland.   After the 
Cancer.
83
 disease has somewhat advanced,  deglutition becomes almost impos-
 sible, and the greater  portion of each mouthful of food regurgitates.
 The malady is accompanied with pain, which  in  some  instances in-
 dicates the seat of the morbid formation, but generally the pain is re-
 ferred to  the entire length of the canal, or is felt in the back, in the
 shoulders, or in the arms.  When the patient swallows, he frequently
 experiences severe shooting pains along the fauces to the base of the
 skull, and along the  eustachian  tube to the ear.   Constant hiccough
 usually accompanies the other symptoms.   As  the  fatal termination
 approaches there  is  often  an apparent improvement in the  patient,
 marked remissions of the attacks of dysphagia, and it is  difficult even
 for the physician  to credit the approach of death, which generally
 ensues from inanition.   Patients suffering with cancer of the oeso-
 phagus are liable to severe  haemorrhage.   Life may also be short-
 ened by  perforation of the diseased tube with effusion  of  the  in-
 gesta into  the mediastinum, causing  an abscess in that region, or a
 communication may be established between the oesophagus and the
 larynx, trachea,  bronchi,  pleura, or  lungs.   In our  diagnosis  we
 must distinguish this disease from spasmodic stricture—a rare affection,
 but one which may simulate the  symptoms of carcinomatous contrac-
 tion.   Spasmodic  contraction of the  diaphragm,  by producing tight
 embrace of the lower end of the  oesophagus, may also  simulate this
 disease.   The easy passage of the  probang and the health of the
 patient  will readily distinguish dilatation and sacculation of the oeso-
 phagus.   Phthisical  dysphagia, depending on  disease of the  larynx,
 and causing spasmodic  stricture, is easily distinguished by signs of
 pulmonary tuberculization.
   Cancer  of the Stomach.—This very common disease is  asso-
 ciated  with cancer in other parts of the body, or, as is sometimes the
 case, is the solitary evidence of the diathesis.   The  contents  of the
 abdomen, rather  than of the thorax,  pelvis,  or cranium, are  more
 likely to be affected coincidently with cancer of the stomach.   When
 the disease is of the colloid  species, the omenta  are  most likely to
 become affected.
   The most common form of gastric cancer is the colloid.  We also
 quite  frequently meet the milt-like variety of the encephaloid,  and
 sometimes the scirrhus.   The pylorus is the part of the stomach most
 obnoxious to the disease ; next in order is the cardiac orifice, then the
 greater, and lastly the lesser curvature.  The special seat  of the can-
 cerous  formation  is  the sub-mucous  cellular membrane.   The intra-
 muscular  coat and peritoneal tissues, may also undergo infiltration ; but
 the mucous membrane offers great resistance to the encroachments of
 the disease.   It is very usual to find thick viscid mucus, stained with
 a brownish-red color, in some abundance, in the interior of the organ;
 it  may be present  either before or after the ulcerative  process  has
 begun, the discoloration  in the former case being  caused by simple
 transudation of blood; the mucus may also be  stained of an almost
 black hue ;  the acidity of the gastric juice will explain this fact.   In
some cases the size of the stomach is  unaltered, while at other times 
I
84                     Index Raisonne.

it is so much enlarged that the greater curvature almost reaches the
os-pubis ;  while in a third class of cases it is contracted and reduced
in bulk and capacity.  This disease is more common among males than
among females ; its duration is shortest when the morbid  production
occupies the cardiac orifice ;  longest  when it is seated in  the body of
the organ.   Dr. Walshe, from whom  we have taken the greater part
of this paper, says, " Authors have commonly recognized three periods
in the progress of the malady, and, although the arrangement is some-
what artificial,  it is  not without foundation  in  clinical observation.
a. During the first of these periods various dyspeptic symptoms exist:
the  tongue is pale ;  the mouth clammy and disagreeable in the morn-
ing ; the appetite variable and impaired ;  digestion laborious and slow,
and sometimes, it is said so curiously perverted, that food, which in the
healthy state would inevitably cause indigestion, passes through the sto-
mach without causing particular annoyance ; a sensation of weight and
fullness is felt at the epigastrium,  or even actual  pain, but  very rarely
any severity ; this region  is  slightly tender under pressure ; gaseous
eructations, either foetid and  acrid, or free from smell, occur during di-
gestion ; vomiting is rare, but the ejection of a small quantity of glairy
fluid from the stomach in  the morning is  among the  most constant
signs of the affection in this  stage ; flatulence  and constipation tor-
ture the patient; the  constitution may begin to sympathize, and the
peculiar tint of skin exhibit itself  to a slight  degree.   b. By-and-by
the  severity of  the epigastric pain  increases, the appetite fails com-
pletely, foetid eructations occur more frequently; constipation and fla-
tulence become constant and obstinate ;  vomiting occurs  with fre-
quency, and the matters vomited  may be discolored in  various ways ;
succussion of the epigastrium causes a  gurgling noise ;  by careful
manual examination and percussion a tumor may be  discovered  in
connection with the stomach; the general symptoms more and more
distinctly assume the  cancerous type,  yet the  pulse  may remain tran-
quil,   c.  Finally, the  intensity  of all  these  symptoms  increases ;
obstinate constipation alternates with'attacks of colliquative diarrhoea;
the  pain becomes unendurable;  hiccough adds to the sufferings  of the
patient, and almost  everything  swallowed is  productive of vomiting;
all physical strength is annihilated; the pulse becomes feeble and almost
filiform—attacks of  syncope are  not uncommon; the skin dry and of
marked cancerous tint; the face pinched and worn, and  expressive
of anguish and moroseness.  Eventually the patient perishes in a state
of perfect marasmus.   Some of these symptoms require close analysis."
Here he goes on to give the numerous  variations from these symptoms,
for which we must refer the reader to his work.*
  He then proceeds :  " Cancer of the stomach does not  give rise to
ascites ; but, should the omentum become  implicated  in  the disease
(as  is most common in cases  of colloid),  that symptom  is commonly
induced ;  general dropsy sometimes eventually follows.  *  *  *
  " It follows clearly, from what  has been said, that the nature of the

           * " Walshe on Nature and Treatment of Cancer." 
Cancer.
85
symptoms and the cause of gastric cancer vary with the parts of the
organ affected.   The distinction  maintains  itself  even to the close  of
life.   Thus, when the cardia is affected,  death  occurs  by inanition,
precisely  as  in  cases of  oesophageal  cancer;  the  advance of the
cachexia  cuts off individuals in  whom the orifices  are free ;  or it
is not uncommon, as has  been remarked by M.  Ferrus. when a state
of  contraction of the pylorus has been removed by ulcerative destruc-
tion, for life to be  abruptly terminated by wasting and incontrollable
diarrhoea.   The course of cancer,  instead of being uniformly progres-
sive, may be  intermittent.  Although, in  some instances, cessation of
suffering  and functional disturbance  may be ascribed to the influence
of  some happy system of treatment, yet it is in the  great majority of
cases the result  of  a spontaneous  process,  the nature of which is un-
known.   It is conceivable that, in  certain  instances, the detachment
and conveyance from the stomach of fungous vegetations, blocking up
the pyloric orifice,  may, by  liberating that  orifice, cause the removal
of all symptoms dependent upon its obstruction ;  but this explanation
will by no means hold invariably good.   Be this  as  it may, the physi-
cian should never lose sight of the fact that, in  many recorded  cases
of gastric cancer, the suspension of symptoms (especially in the early
periods of the malady) has for a time been so complete that the dis-
 ease  was suspected  to  have been misunderstood,  and to have been
 really nothing more than nervous  or irritative dyspepsia.    *    *   *
 The malady  occasionally runs a latent course.    *    *    *   A num-
 ber of very different  affections have occasionally been mistaken for
 cancer of the stomach, and vice versa.   The  most practically impor-
 tant of these affections are gastrodynia and chronic gastritis."
    The chief points of distinction may be enumerated as follows :
     GASTRODYNIA.


Tongue variable, but often pale
  and pitted at the edges.
Eructations frequently of air,
  without disagreeable smell.

Appetite  depraved,  iregular,
  capricious.
Sensations sometimes of heat,
  sometimes of cold, in  the
  stomacli; thirst not common.
Solids more  easily digested
  than liquids.
Though the labor and suffering
  of the  process be great, di-
  gestion in completed in the
  end.
Pain  variable ; occurs in ir-
  regular paroxysms ; is often
  relieved by ingestion of food
  or pressure.
Epigastric  pulsation not un-
  common.
Never runs a completely latent
  course.

Simple chronic vomiting (with
  or  without gastrodynia) is
  CHRONIC GASTRITIS.


Tongue dry, red, contracted,
  smooth, shining, or saburral.
Eructation  not a prominent
  symptom.
Sensation of heat in the sto-
 mach ; thirst.
   GASTRIC CANCER.
      {Early period.)

Tongue pale or natural.

Eructation of air, more or less
  fetid, sometimes horribly so,
  a prominent symptom.
Appetite diminished, or even
  totally suppressed.
These symptoms not observed.
Digestion
 pleted,
               Liquids more  easily digested
                 than solids.
imperfectly  com- Digestion not properly effected.
Epigastric pain not very severe,
  and scarcely ever felt when
  the stomach is empty ; is in-
  creased by pressure.
Is not observed.

Never completely latent.
Epigastric pain may be agoniz-
  ing, the lancinating charac-
  ter sometimes marked, often
  increased by pressure.
Is not observed.
                        May for a variable time be com-
                          pletely without local symp-
                          toms.
Vomiting of sudden and severe Vomiting of sudden and severe
 character,  sometimes  the   character is never the first 
86
Index Raisonne.
   especially  frequent  in  fe-   very first symptom; occurs   symptom; it occurs generally
   males, and is almost confined   irregularly  before  or after   early in the morning, subse-
   to persons affected with hys-   eating.  "                  quently at variable periods
   teria.                                               alter eating, or at periodical
                                                     intervals.
 Vomitingofcoffee ground look- Coffee-ground  looking matter    The matters vomited are at
   ing matter does  not occur,   sometimes vomited; but this    first glairy, then half-digested
   unless from accidental and   is rare and exceptional.       food,  then coffee-griund  or
   rare haematemesis.                                    soot-like.
 Bowels  continually  consti- Irritation, colic, and diarrhoea  Bowels habitually  and obsti-
   pated, but not obstinately so.   frequent from  extension of   nately constipated ;   occa-
                            infiammation 10 intestine.     sional severe diarrhoea.
 Febrile action accidental and Evening fever  not uncommon. Fever absent.
   rare.
 In females the chlorotic tint is Violent  discoloration of the Straw-colored tinge may be
   often present.               lips, conjunctiva, and face,   obvious.
                            <tc, often present.
 Often accompanied  with vari- Not so attended.             Not so attended.
   ous nervous  or  hysterical
   symptoms.
 Hypochondria   occasionally Hypochondria is not caused by Hypochondria is not among the
   present.                    chronic gastritis             effects of gastric cancer. (?)
 Is more frequent than the other Is rarer even than cancer.     Is much more rare than  gas-
   two affections.                                       trodynia.
 Is more common  in  women Is of equal frequency in both  Occurs more frequently in men
   than men.                  sexes, probably.             than women.
 May exist in very young per-  Occurs at all ages.           Is excessively rare before age
   sons (e. g., aged 15).                                   of 30.
 Is often heriditary.           Is not heriditary.            Often runs in families.
 Is rarely refernble to any dis- Is often  referrible to some dis-  Is rarely, if ever, referrible to
   tinct local exciting cause.      tinct local exciting cause.      local agencies.
 Is relieved or cured by stimu- Is relieved or cured by anti-  Is not cured, but is relieved by
   lant, tonic, and  anodyne   phlogistic treatment.         special treatment.
   treatment.


   But, although this array of distinctive character looks  most satisfac-

 tory on paper,  it must be confessed that, even after due  consideration

 of them all at the bedside, doubts  will sometimes  still  remain in the

 observer's mind.   As cancerous disease  advances, as  the epigastric

 region becomes the seat of tension, and  of gurgling noise under pres-

 sure, as  the patient vomits  periodically profuse  quantities of coffee-

 ground matters, the diagnosis  becomes more and  more certain.

   The diet of the patient should be carefully watched, his food should

 be taken  at regular hours in small  quantities, it should be well masti-

 cated, and only those  articles of diet should  be  allowed which are

 known to  agree with the  patient.   On this subject  we can  give no

 rule ; for what  will be readily digested  by one will cause great  pain

 to another.   The  principal remedies  which seem to be indicated  for

 this   disease   are    Viburnum-prunifolium,   Arsenicum,   Conium,

 Kreasote,   Secale-cornutum,   Artemisia-vulgaris,   Baryta-carbonica.

 Acid.-hydrocyanicum  or  Laurocerasus  will  sometimes relieve  the

 vomiting and nausea.   Nux-vomica is frequently indicated when we

 find flatus,  constipation,  and  vomiting.   Belladonna  is frequently of

 service, and Walshe says that " a  Belladonna  plaster to the  epigas-

 trium affords  much  comfort  to  many patients.   Rough ice,  allowed

 to melt in the mouth, and  the application of ice in bladders to  the epi-

 gastrium, will also," he says, " relieve the nausea and  vomiting."  The

 medicines  at the head  of  this  article,  Acid.-nitric, and Actea-spic. are

frequently indicated.   But, with all  our medicines, and all our skill, we

can  do little more than alleviate this  distressing malady.

                                     W.  Faulkner  Browne, M. D. 
Cancer.
87
   Cancer of  the  Uterus.—We have hitherto traced the ravages of
this almost hopeless malady with sad hearts, but now we are  forced
almost to utter despair;  for we find a disease, not only  painful  to  the
patient, but also rendering her an object of loathsome pity to those
around her suffering couch, from which  she is only to be removed by
the  kind hand of death.  The study of this malady is, indeed, inte-
resting to the pathologist, but the therapeutist must (if he be an honest
man) acknowledge his inability to contend with it.  Still, it is neces-
sary, in  our preparation of the " Index Raisonne," to glance  at the sub-
ject, for  cancer of the uterus is  a  disease  very frequently  met with,
and one  from which scarcely any age can claim  exemption.
   Schirrus of the uterus  is an exceedingly rare disease.   "Fungoid
or medullary cancer is  by far the  most  common; next in  frequency
may be  classed the epithelial varieties  of the  disease, if, indeed, it
may not be more  correct,  as  some men  of high authority  believe, to
'refer them to a separate category,  distinct  from genuine cancer."*
Next in  order, and probably almost as rare  as  schirrus, is the  colloid
or alveolar variety of this disease.  Rokitansky thus describes schirrus
of the uterus:  "On a careful examination! one  may discover  in  the
 midst of the tissue of the portio-vaginalis another structure, recognizable
 by the  different shade of white of the fibres composing it, and which,
 though closely tracked, intersect each other in every imaginable direc-
 tion, while the small interstices between them are  filled by a transparent
 matter, of a pale yellowish-red or greenish color.  This new structure
 is infiltrated into the uterine substance without any distinct limits, ex-
 tending further in one part than in  another, and here and there heaped
 up in a  greater quantity, thus producing the enlargement of the  portio-
 vaginalis, the  uneven  undulated character, and  the well-known indu-
 ration of its  substance."!
    " Uterine cancer is more commonly solitary than associated.   There
 can be no question that the womb ranks among those organs less prone
 than certain others (for instance, the mammae and  testes) to  contami-
 nate distant  viscera      *     *     *    *     Propagation  of the
 disease  to the  adjacent  structures, by simple  infiltration, and  also
 lymphatic contamination, is, on the  other hand, common in  uterine
 cancer.   Hence, it follows that  uterine  cancer  is  commonly  pri-
 mary,   and  possessed of  comparatively  slight   tendency  to  con-
 taminate  the  system  generally.   Of  affection  of this  organ,  the
 stomach being the  primary seat of disease, I have  observed, and  in a
 previous  chapter mentioned an example; some few  others, too, are
 on record.  The disease  originates  by far the most frequently in the
 cervix.   *    *    *   *    f ne diseased formation generally continues
 limited  to the cervix or its immediate neighborhood, before ulceration
 commences.  When this change occurs, infiltration spreads  upwards
 in proportion as the erosive destruction of the neck advances.   While
 the disease advances in the uterus the ordinary changes pursue  their
* West's " Diseases of Females," p. 33G.
t Ibid, p. 338. 
88
Index  Raisonne.
 course in the surrounding textures.   The organ becomes more or less
 fixed, from infiltration of those textures with simple exudative matter,
 or from  the  extension of the cancerous deposition amid them.  The
 propagation of the disease to the vagina commonly commences  with
 the anterior wall (a fact supporting the opinion of those who maintain
 the priority of invasion of the anterior lip of the os); it thence proceeds
 to the septum, the bladder, and urethra ;  or, attacking first the poste-
 rior  paries of the vagina, exercises its ravages in the neighborhood of
 the rectum.   In other cases, the cellular  tissue around is  especially
 affected ; the broad ligaments,  Fallopian  tubes, and even the ovaries
 becoming implicated along with  their investing cellular structure "
   '•  Local peritonitis, following a slow  and insidious course, is a com-
 mon morbid state  in uterine cancer.  Adhesions in various  directions
 are  met with ;  the omentum has been found, by different observers,
 adherent  to the uterus, a condition to which Dr. Montgomery invites
 attention.  Cruveilhier, who has particularly studied the condition of
 the lymphatic system in this disease, states that the pelvic  glands are
 most always  implicated;  two of these, situated at the upper part of
 the sciatic notch,  being most frequently, and often solely affected.
   "The lumbar glands are much more rarely diseased (a fact already
 noticed by Boyle), and are often enlarged  and red, without containing
 a  particle of carcinoma;  the inguinal glands  do  not suffer, unless
 when the disease  extends  to the external genitals or  orifice of the
 vagina.  Andral has found  the diseased matter in  the parietes of the
 thoracic  duct; Hahnemann  traced it along the lymphatics  from  the
uterus to that  tube.
   " The matter contained in the  intervening lymphatics was precisely
 similar to that appearing in the  uterus ; their walls were  thickened,
 but their lining membrane perfectly transparent and smooth, the matter
 easily removable,  and  the  valves perfect.  Such implication of  the
 thoracic  duct must, however,   be  rare.   I have  found  it  perfectly
 healthy in seven  or  eight  cases, expressly examined with reference
 to this point, and M. Cruveilhier, who habitually opens the tube in
 cases of uterine cancer, has never known  it so affected but once."
                Mott Haven, Westchester Co., N. Y.,'December 21, 1859.

  Dr. Peters, Dear Sir:—In the last number of the Journal you say that I
was at one time an associate of Dr. Gray.  Now, as this  may be misunderstood
by many of your readers, who  may infer that I  intend  to give a resume of Dr.
Gray's clinical experience, I hope you will permit me  a few words of explanation.
  I was at one time a student of Dr. Gray's, and to him I owe all the  knowledge of
homoeopathy that I have ;  but I never was his associate, and cannot give either his
views or experience.
  In my preparation  of the " Index Raisonne'  I  shall aim rather at a careful
compilation from the best authorities than the production of an original paper.

                   Very truly,  yours,     W. Faulkner  Browne, M. D. 
Cancer.
89
  " In the ordinary progress of events uterine cancer is  early  at-
tended with  very clear and  obvious  functional  disturbances, and the
symptoms thus  caused have commonly been described in connection
with two stages of the disease—that preceding, and that following ul-
ceration.  I will follow this plan, sanctioned as it has been by general
approbation, guarding the practioner against  too unlimited confidence
in the invariable justness of the  division into these stages, by referring
especially to some of the more striking deviations from the common
character and sequence of symptoms.
  " First Stage.—Occasional uneasiness  or dull pain in the uterine
and sacral regions, especially in the erect posture, during menstruation,
or for a period varying from  a few hours to some days after sexual
intercourse ;  a dragging sensation in the inguinal and lumbar regions,
accompanied with a feeling of  weight and distention of  the hypogas-
trium, or  at  the perinaeum and  anus ;  irregularity in the quantity,
quality, and  frequency of the  catamenial  discharge   in women still
menstruating, or  haemorrhage  (commonly attributed  by patients to a
return of that function) in women of more  advanced age ; leucorrheal
discharge, of whitish  or yellowish color  and moderate consistence,
without fcetor, and becoming red under excitement, or giving place to
a slight  effusion of pure blood  after  sexual  congress ; trifling irrita-
bility of the  bladder, or more rarely of the rectum;  states sometimes
accompanied  with slight  difficulty in voiding  the contents of  those
viscera, and pruritus more or less distressing of the labia and adjoining
parts,—form the usual train of local symptoms in the early period of the
disease. The urine may, at this juncture, have already become alkaline
from nephritic irritation, and its impregnation with some ropy catarrhal
matter (pus or muco-pus  altered by an alkali) is not  excessively un-
common.  The proneness of the female for the generative act varies.
   "By manual  examination of the hvpogastrium nothing unusual is
discovered, in the greater number of cases.   If extensive hypertrophy
of the body coexist with the cancerous infiltration of  the neck of  the
organ, a tumor corresponding in size to  the  degree of this  change
may (in thin persons especially) be detected after the bladder has been
emptied ; and, by a careful percussion (which is rarely in this stage
too  painful a process to be satisfactorily employed), dullness of sound
commensurate with the size  of the tumor may  be recognized.   Exa-
mined per vaginam, the lips of the  cervix  are  found hardened  and
thickened more or less extensively, and  sometimes  tender  to  the
touch.                                 .          .   .
   " The orifice is unnaturally open, sometimes sufficiently so to permit
the point of the  finger to be pushed on to the cavity of the body ; and the
 cervix not uncommonly lower  down than is usual.  The enlargement
 of  ihe lips is rarely equable ;  it is much more common to find one or
two  rarely more, irregular elevations, separated by fissures.  ••   * *
 If  the  cervix  be pressed between two fingers  a slight  flow of blood
often follows, and this  may be  accompanied with a crepitating feeling.
Observed  through the speculum, the cervix appears  tense, tumid, ir-
                  G 
90
Index Raisonne.
regularly tuberiform, and fissured, and of  a dull white color; in the
latter particular the contrast with the surrounding tissues is sometimes
strikingly marked.  In  less common cases the color of the cervix is
dirty brownish-red.
  "Second  Stage.—At a variable period the second stage commences,
and is usually marked  by a change in the constancy, intensity, and
character of the pain.  It becomes more or less habitual, acquires the
lancinating character and extreme severity.   Generally situated in the
uterine region, and shooting along the broad and round ligaments, this
pain is sometimes replaced by sharp pangs in the course of the sciatic,
crural, or obturator nerves,  recurring, it may be, at fixed periods of the
day—pangs that have, according to the  testimony of  Boyle,  been  in
certain instances so violent as  to induce  ' cerebral  fever.'  Such ex-
treme results as these are,  however, rare,  though the intensity of pain
sometimes, beyond  a question, shortens  life by exhaustion.  These
neuralgiae may be attended with the debility and inability to move  of
ordinary sciatica.   The excretion of urine and  faeces grows more and
more painful and difficult;  alternate diarrhoea and constipation some-
times distress the  sufferer ; in rare instances insuperable  obstruction
is induced  by pressure of enlarged glands on  the bowels.   Perfora-
tion  of either, or more  rarely of both  the  adjacent  hollow viscera  at
length takes place, announced first, in the case of the rectum, by the
passage of  flatus through the vagina ;  the latter  canal is now converted
into a cloaca for the reception of the uterine discharges, and the vesical
and intestinal excretions. Haemorrhage may or may not meanwhile have
become of  more and more  frequent recurrence ; the quantity of  blood
lost on each occasion does not uniformily  increase ; on the contrary,
as the frequency of haemorrhoids augments, its  amount often lessens
(precisely  as is observed in the haemoptysis of  phthisis and of pulmo-
nary cancer), while, in  other  cases,  females merely fancy the  early
attacks  the most  severe, because  they  attract more  attention than
subsequent  ones.   The vaginal discharge now commonly  acquires
the cancerous fcetor, and  a dirty white or greenish color, is thin and
serous (in some cases perfectly watery), sometimes mixed  with blood,
or, especially where encephaloid fungi have sprung  up.  with shreds
or lumps of  cancerous matter.   Its  acrid properties  are usually  so
marked that its contact with  the vulva,  perinaeum, and folds of the
thighs causes excoriation  of  those  parts, and furnishes additional
cause for  the pruritus  felt in the former situation.   The discharge,
however, sometimes continues  trifling  for a  time  after ulceration
has set  in.     *    "'    "::"     "'    *   *    ""'    *    *    *  *   *
Viewed  through the  speculum, the diseased surface exhibits the dif-
ferent characters of cancerous destruction."   At advanced periods of
the  malady the use  of the  speculum is very dangerous, and may
cause a rupture of the  vagina.
  " The general symptoms are usually well marked in uterine cancer
—the cancerous  facies and straw-colored tint of the skin   particu-
larly so.   Loss  of sleep,  failure of  strength,  and emaciation  make 
Cancer.
91
rapid progress.   The  digestive and  gastric disturbance  is extreme ;
almost constant nausea and inability to retain even the lightest food in-
crease, in some cases,  the general distress, and end occasionally in ob-
stinate and uncontrollable vomiting.    *    ""*    "*    *   '"'
The mental condition  of these sufferers, though great, is not habitually
so extreme  as their helplessness of condition and the agony endured
might lead  us to  anticipate.  The  influence of the uterus on the
encephalon  becomes  particularly obvious in the  insane ;  the ravings
of such doubly afflicted persons frequently turn on sexual intercourse.
   " At no age can  females be said to  be exempt from the chances  of
uterine cancer.   Five hundred and  twenty-nine cases,  collected by
Boivin and  Duges, and Dr. Lever, may be  arranged as follows, in re-
spect of age :
	number of oases per				DENT	OCCURRING
GO		AT	EACH AGE.			
W						
o						
<	Total Cases Observed,		120.	Total Cases Observed, 409.		
	(Levee.)				Boivin, Duges.	
Under 20						2.93
20—25				}		20.29
25—30	3.30					
30—35	15.00			\		24.93
35—40	10.83					
40—45	20.00					25.91
45—50	20.00					23.22
50—55	13.30			1		1.71
55—60	14.16					
60—65	.83			\		.97
65—70	1.00					
70—75	.83					
  " Of the causes of uterine cancer nothing special is  known.   M.
Cruveilhier, whose opportunities of observing  the disease among the
ae-ed inmates of the SalpStriere have been considerable, emphatically
avows that neither dissoluteness nor chastity, sterility nor fecundity,
healthy pregnancies or the  contrary, the  habit of suckling or of con-
signing the duty to others, regular  or  irregular menstruation, the oc-
currence or not of abortion, an active and laborious or an inactive and
listless life, hereditary influence, temperament, scrofula, syphilis, leu-
corrhoea the excess of polypi or of fibrous tumors, appear  to exercise
the smallest  influence on the  development of uterine cancer.   And
this'statement  is  (with the single exception of influence of hereditary
taint) but the echo of general experience.''"";
   Dr  West gives the  following  tables, which may not be uninterest-
ing- in connection with  the  mooted question as to  the relative  fre-
quency of uterine cancer in single and married women.

               * Vide  "Walshe on Cancer," pp. 443—456. 
92
Index Raisonne.
NUMBER OF	Pregnancies	Number of	Children	Number of		Abortioni	
WOMEN.	to Each.	Women.	to Each.	Women.		to Each.	
12	1	13	1	26		1	
12	2	11	2	16		2	
8	3	14	3	7		3	
2	4	6	4	4		4	
9	5	12	6	3		5	
12	6	11	6	1		7	
11	7	10	7	1		11	
7	8	6	8				
6	9	7	9				
4	10	1	11				
9	11	3	12				
6	12	2	13				
4	13	2	14				
2	14	1	17				
1	16	1	18				
1	18						
1	20						
1	24						
109		107		5	8		
Number of	Number of	Number of	Issue of Last	Date of Symptoms
Pregnancies.	Children.	Abortions.	Pregnancy.	of Cancer.
3	3		Live child.	10 Months.
7	6	i		6
12	12			6
4	3	i		Immediately.
10	7	3		
9	9			
2	1	1		
6	2	4		
7	5	2		
11	10	1	Abortion at 5th month.	
7	6	1	Abortion at 1\ months.	it
  The treatment of this malady must partake of a palliative character ;
curative  treatment  is  almost, if not absolutely impossible.   When
ulceration sets in, perfect  cleanliness must be preserved; the  parts
should be frequently sponged, and vaginal  injections  employed ; that
of Lugol's solution may be found useful.   Warm or tepid  water injec-
tions, medicated with  astringent or anodyne  preparations, may also
give relief.   Haemorrhage  should be  treated with Secale-cornutum,
ice-water injections, Plumb.-acet., Gallic-acid, Tincture Fer.-chlor., Sic.
  The following homoeopathic remedies have been recommended, and 
Cancer.
93
may  sometimes  be useful: Arsenicum-alb., Conium.-mac,  Carbo-
animal., Viburnum-prunifol., Platinum, Kreosote.

   Cancer Of the  Mamma.—We  find  cancerous affections of the
mamma in both sexes, but it is of comparatively rare occurrence in the
male, while in the  female it is  the most common of the organic dis-
eases of the breasts.   It is either solitary or associated.  When asso-
ciated with other cancers it is usually primary.
   Scirrhus is most common.   Encephaloid is  sometimes found, but
rarely; and we seldom find the colloid variety of the disease.
   Generally it is the left breast which is affected.  " In cases where
both organs are affected, the disease  attacks one consecutively to the
other.  Sometimes  the two breasts  are connected by indurated ab-
sorbents,  or a chain of small cutaneous scirrhi.
   " Proper scirrhous tumors do not exceed an orange in size, but in-
filtrated masses of  the disease acquire greater dimensions."
   The local morbid changes  are enlargement of the glands, obstruc-
tion and  distention of the  veins, induration of the adjacent cellular
membrane, and  cancerous infiltration of the skin.
   The atrophous and hypertrophous forms of the breast are both found.
In subjects of advanced age the breast is usually atrophied.
   The lymphatic system suffers at an  early stage of the disease, and
the axillary, supra-clavicular, and post-sternal glands are those usually
affected.
   The pain is of the average severity, and is likely to be more severe
at  the menstrual period.   Occasionally there  is  a discharge  of  a
quantity of blood or sero-sanguineous fluid by the nipple.   This flow
of blood is said, in  some  cases, to be  sufficiently abundant to replace
the menstrual discharge at the critical period ; but the catamenia may
continue  almost till the close of life.  The disease  is frequently ac-
panied with distressing thoracic symptoms—cough, oppression of the
chest, and dyspnoea.
   Sir Astley Cooper believed  that scirrhus of  the breast would ge-
nerally take from two to three years  in growing, and from six months
to two years afterwards in destroying life.  As a general fact, scirrhus
of the breast makes the slowest progress when  developed in old age.
   " Encephaloid of the breast  runs an average course  of from six to
twelve months,  according  to the estimate  of Velpeau.  It is distin-
guished from scirrhus not only by its instrinsic character, but by being
less disposed to become adherent to the deep-seated parts, less prone
to cause  enlargement of the axillary glands, and by the less amount
of pain it causes previous to ulceration.
   » In the majority of fatal cases  death occurs  before the total de-
struction of the mamma; in others the ulcer extends from the axilla
to the lower border of the  pectoralis muscle, or even downwards to-
wards the flank, while its base is formed by the thickened pleura and
ribs.                                   ...       .      .
   " The  discharge of haemorrhages occurring from time to time reduce 
94
Index Raisonne.
the patient's vital powers to the lowest ebb, and she sinks at last under
the influence of cachexia alone.  Death is, however, not uncommonly
accelerated by inflammatory effusion into  the  pleura.  Aged women
who die from causes independent of their cancer  frequently perish
from pneumonia.
   " Although no single character suffices to distinguish a scirrhous
tumor  from certain  other  diseases to which  the  mamma is  liable ;
yet a combination of the signs described will usually ensure tolerable
certainty of diagnosis.  If a hard  moveable tumor, free from pain, of
a small size, insensible under pressure, but  becoming painful a short
while  after manipulations, and, having originated  without apparent
cause,  has existed in the breast of a female, aged thirty, or upwards,
for a certain period—say  from  six months to a year—the probability
is  strongly in favor  of its being cancerous.   This probability will
amount to  a positive certainty  if either previously to or  at the end
of this  period lancinating periodic pains, alternating with'perfect free-
dom from suffering, supervene, and haemorrhage occur from the nipple,
while the disease resists local antiphlogistic and discutient measures.
*   *    *    '"   *"'    *   *   '•''   The signs of encephaloid growth
in the breast, if combined  in any number, can rarely mislead."*
   This disease is to be carefully distinguished from: neuralgia of the
breast, atrophy of the breast, with induration,  accumulation  of cal-
culi in  the  lactiferous ducts, which is an excessively rare condition,
simple  chronic  induration,  chronic   abscess,  fibrous   tumors,  en-
cysted  accumulations  of  fluid blood,  tuberculous  accumulations,
which,  however,  are  extremely rare,  cysts,  cysto-sarcomatous
tumors.  Syphilitic ulceration  in this  region  has  sometimes  passed
for cancerous.
   For  particulars  on the  diagnosis of cancer of the breast we must
refer the reader to Walshe's admirable work, from which we have
compiled this article.
   Treatment.—The  medicines  supposed to be  homoeopathic  to this
disease are, Cham., Arnica, Arsen., Bryonia, Clematis, Conium, Krea-
sotum,  Carbo-animalis, Carbo-veg., Phosph., Bell.   That  these  medi-
cines may and will prove beneficial in alleviating the symptoms which
they indicate we have  no doubt; but, as to  their curing  a confirmed
case of cancer of the breast, we must say we have  very little faith in
their efficacy.  Viburnum-prunifolium may also prove beneficial.
   The surgical  treatment of this disease does not come within  the
scope  of this paper ;  and as  to  the propriety of removing these
tumors  by  pressure, cauterization, or  amputation, we must refer  the
reader  to the  numerous surgical works which treat of this  subject.
But this much may be said, the treatment, medical or surgical, must
not be  delayed.   The safety of the patient depends upon early and
energetic treatment.
   Too  much care  cannot  be observed  in the regulation  of the parti-
cular habits and diet.
* Vide " Walshe on Cancer," pp. 467-485. 
Catarrh.
95
  Catarrh.—Acid.-benzoic, 14.   Acid.-nitric,  54.   Acid.-tannic,
88, 90.   Aconite, 122.  Actea, 140.  Allium-sat., 206.   Alum., 222.
Alumina,  230.  Ammon.-carb.,  274.   Ammon.-caust., 285.   Acid.-
nitr.,  285.   Gum-ammon.,  322.  Anis,  376.  Ant.-tart., 421, 423.
Apis, 450.  Apoc-cann., 490.

   Catarrh is an inflammation of the mucous membrane.  The term,
in common parlance, is restricted to the mucous membrane of the nos-
trils, trachea,  and bronchial tubes.  It may be caused by exposure to
damp or wet weather, sudden changes in the atmosphere, the want of
proper  clothing, insufficient protection of the feet, exposure to drafts
of cold  air;  or it may exist as an epidemic, when it is usually known
as influenza, so called from  the supposed influence of the heavenly
bodies in causing this disease.   This  idea is, however, now generally
discarded—men being now too wise to believe that the heavenly bodies
were made  either  to " rule" the days, or  " to be for signs  and for
seasons;" but this  much  may  be  said, if terrestrial influences may
cause such variations in  the tides as are  attributed to them, there is
no reason why they  may not also bring about variations  in the atmo-
sphere  and  the forces which are  about our earth, or as  to cause de-
vastating epidemics,  and, perhaps, after  all, we  may not be so much
wiser in this  matter than our superstitious  forefathers.
   This  disease, appearing in its epidemic form, has been more  fatal
in its results  than is generally  supposed—devastating Italy to such a
degree that it was called "the plague."  In other countries of  Europe,
and in our country, it has often numbered its victims by thousands.
In 1840, during the Harrison and Tyler campaign, it commenced in
Maine, and followed the course of the Atlantic border, and, from the
fact that it seemed to follow Mr. Tyler in his journeyings, was called
the "Tyler grippe."
   There are  but few persons who  have not  been more or less incon-
venienced by catarrh, but some seem peculiarly obnoxious to it, and
more particularly those of a scrofulous diathesis.
   The symptoms  vary  with the intensity of the disease;  some per-
sons experiencing but slight inconvenience, such as, sneezing slight
headache, and obstruction of the nose, which symptoms are  often  re-
lieved  by a glass of hot whiskey punch before  retiring   Others are
made quite  sick;  the  inflammation  extends to the throat,  trachea,
 bronchial tubes, and even the  lungs;  the  patient gets  better, goes
 about his ordinary business, and, perhaps, in a short time, his physician
 informs him that tubercles have begun to form in his lungs.
   Diagnosis.—We  have  more or less  fever, obstruction  of the a.r-
 Dassag°es;  sneezing; unusual   languor;  pains in  the  head, back,
 limbs  bones; a bruised feeling all  over the body; chilliness,  fre-
 nuentiy alternating  with  flushes of heat; burning heat in  one part
 and chilliness in another;  severe  dry cough;  hoarseness and scrap-
 ing  in the  throat; throbbing,  bursting headache; headache in  the
 frontal region, very  severe over the  eyes, so that sometimes it would 
96
Index Raisonne.
seem as though the eyes would burst from their sockets; frequently
we have  neuralgia of the second branch of  the fifth pair of nerves.
In the more aggravated  form  of influenza we also have complete
prostration of  strength, drowsiness, general  chilliness, rheumatic
pains, vertigo, photophobia, plentiful  coryza, dry shaking cough, nau-
sea,  sore throat, swelling of the parotid glands, and foetid sweats. The
patient suffers with great thirst, anorexia, is ill-humored, fretful,nervous,
and  feels generally disagreeable to himself and those around him.
   Therapeutics. — As we have before said, catarrh frequently terminates
favorably in a day or two without  the administration of any medicine ;
but it usually has its  course  of about nine days.  At about the third
day we have a white mucous discharge of more or less tenacity ;  about
the fifth or sixth a yellow, purulent, or muco-purulent discharge ; and
about the ninth day, if the  disease has been  properly treated, it is
terminated by resolution.  The homoeopathic  remedies, in addition to
those mentioned  above, are  Arsenicum, Arnica,  Bellad.,  Bryonia,
Coffea,  Camphora, China, Dulcamara, Ipecac, Iodine, Euphrasia,
Sulphur,  Phosphorus,  Mercurius, Pulsatilla, Rhus, Stibium,  Spongia,
Kali-hydriod.,  &c
  The following  treatment  will generally  be found  of  service :
When the attack  first  comes on give Stibium, 1  ; if there is much
fever, alternate  with Aconite.  It may also be necessary sometimes
to alternate the Stibium with Bellad. or Nux-vomica ; or, if there is
much inflammation of  the  eyes or schneiderian  membrane, with Eu-
phrasia.   Towards the close Arsenicum may be substituted  for Sti-
bium with benefit.   If there still remains an irritation about the throat,
Bellad. and Protiod. Merc, will  usually complete  the cure.  Bryo-
nia will  be found  useful  where we find  rheumatic pains  about  the
chest or in the scapulae ;  severe headache  increased by motion.  But,
for the general  treatment  of  this  disease,  Stibium  or Arsenic are  the
main remedies, giving such other remedies in  alternation as the symp-
toms shall indicate.
   Chronic Catarrh is  usually very difficult to cure ; Arsenic or
the  Iodide of Arsenic may sometimes be used with benefit, and  fre-
quently great  service  may be obtained from  a persevering use of
Nitric-acid.

  Cardialgia<—Acid.-fluoric, 21.  Prus.-acid, 30.   Acid.-nitric,  51.
Acid.-phos., 71.  Amyg.-dulc, 336.   Arg.-nit., 506.
   Vide "Gastralgia" and "Gastrodynia."

  Carili<£-Calunm£e,  Rheumatism of.—Acid.-fluoric, 23.
   Vide " Rheumatism."
  Cephalalgia.— Acid.-acet.,6.   Acid.-fluoric,  19.   Acid.-muriatic,
38.  Acid.-nitric, 49.   Acid.-oxalic, 60.   Acid.-sulph., 80.  Actea-
rac,  140.   Agar., 164, 169.  Agnus-cast., 172.  Alcohol-sulph.,200.
Ammon.-carb., 267, 268.   Arom.-spts.-Ammon., 315.  Angust.-vera,
370.  Anis, 376.   Ant.-tart., 420.  Apis, 447^
   Vide "Headache." 
Carcinoma.—Chloros is.—Cholera.
97
  Carcinoma.—Acid.-acet.,  10.    Acid.-nitric, 52^   Acid.-tannic,
89.  Arg.-nit., 300.   Vide "Cancer."

  Chlorosis.—Acid.-benzoic, 14.   Ammon.-caust., 287.
  This  disease  is so  named from the Greek word  XAwpoc, which
signifies  green, and  it is frequently called the "green sickness."   It
is generally brought on by a depraved condition of the nervous sys-
tem and digestive organs.   At about the age of fourteen, or when the
first  menstruation  ought to  take  place, we find  it obstructed;  the
patient is pale, frequently the complexion is of a livid greenish hue ;
she complains of weariness and debility ; she has headache, anorexia,
flatulent  distention  of the abdomen; sometimes she is  troubled with
looseness of the bowels, at other times she is constipated.   She is
often troubled with  palpitation of  the  heart  and dyspnoea;  a harsh
troublesome  cough,  sometimes  accompanied with a  bloody expecto-
ration ; and her  parents will often come to the physician, in great fear
that  their  daughter  is  hopelessly afflicted with disease of the heart
or consumption.   Dyspepsia and hysteria love to keep company with
chlorosis, and by no  means lessen the apprehensions of the frightened
friends.  The young patient seeks delicate morsels  of food, as chalk,
slate-pencils, and the like.   The  legs frequently become oedematous.
Sometimes we find leucorrhoea.
   The remedies which seem to be  indicated in  this disease are:
Pulsatilla,  Ferruin,  Bryonia,  Sulphur, Calcarea-carbon.,  Sepia, Phos-
phorus,  Ignatia, China,  Nitric-acid,  Aurum-murial.   The  patient
should be given nutritious food ; exercised freely in the open  air;  bathed
in cold water, or, if it be found that she cannot bear cold water, tepid
water may be used.  After  bathing she should  be  well rubbed with
the palm of the hand or a coarse towel.  Ferrum-iod. will generally
be found beneficial  as  a  constitutional remedy, and  also the  Hypo-
phosphites of Soda, Lime, Iron, and Polassa.  After the general  health
has been restored, in a great  measure,  by those means, if the menses
are still retained, Asclepias, Collinsonia, Secale, or some other emena-
gogue may be administered.

  Cholera.—Acid.-acet., 8.  Prussic-acid, 29,  30, 31.  Acid.-nitric,
52.  Acid.-phos., 72.  Acid.-sulph., 83.   /Ethusa,  154.   Alum, 225.
Ammon.-caust., 280.  Angust.-vera, 273.  Ant.-tart., 395, 426.

  Cholera  Morbus.—The  exciting cause of this disease is usually
indigestible food, unripe fruit, suppression of the perspiration from
sudden exposure, the drinking of ice water when over-heated, &c
  The attack comes on with a feeling of nausea and griping; then
we have  purging and vomiting, often accompanied by  coldness of the
limbs and bodv; cramps.  Sometimes the evacuations  are of a  bilious
character;  sometimes  thin, watery, and fetid.  The pulse is weak,
II 
98
Index Raisonne.
and  sometimes scarcely perceptible.  We also frequently find con-
siderable tenesmus.
  The remedies indicated are Veratrum, Ipecac, Chamomilla, Cam-
phor, Arsenicum.

  Colic, IMenstmal  (Dysmenorrhoea). —Alumina,  240.   Ammon.-
acet., 254.   Anth.-nob.,  380.  Apis-mel., 443.   Aquil.-vul., 490.
Arg.-iod., 496.

  Why this affection is called "menstrual colic" we never have been
able  to find out; that the colon, or indeed any  part of the intestinal
canal, has anything to do with it is hardly to be supposed; we there-
fore prefer the  name now generally  used, dysmenorrhea, or  painful
menstruation.   We may divide the  disease  into four varieties: the
neuralgic, the congestive, the rheumatic or gouty, and the mechanical.
  The word neuralgia is a favorite term with many physicians;  it is
a sort of asylum ignorantia,  a convenient word  to conceal paucity of
ideas ; when they find a patient suffering intense pain in some parti-
cular part of the body, and they are unable to determine the  true
nature  and cause of  the suffering,  they say,  " Oh, it's neuralgic;"
which  frequently is equivalent to saying, " It's a pain."   So with dys-
menorrheea, it would be very easy to  say that all forms of painful men-
struation were  neuralgic, as  they are  all painful and are accompanied
with more or  less of nervous  symptoms.   But what  is neuralgic
dysmenorrhea ?
  The seat of the pain in this form of painful menstruation is in the
nerves of the uterus—it may be, perhaps, that the nerves themselves,
or some  part of the nerve tissue is diseased ; and we might  enlarge
upon this subject, but  we have not the  time or space in the  " Index
Raisonne" to discuss  whether it be the neurolemna or the nerve sub-
stance which is affected, and practically it makes but little difference.
Frequently the  nerves may  not be diseased, the dysmenorrhoea may
not be idiopathic, but may  be  sympathetic.    The uterus,  being  a
most sensitive organ,  its nerves, at the monthly crisis, readily sympa-
thize in the general nervous debility  or nervous derangement.
  Neuralgic dysmenorrhoea usually  occurs in females whose sexual
system has been of tardy or the imperfect development. The pain comes
on a day or two  previous to menstrual flux,and reaches its climax during
the first thirty-six hours of that period.   Generally it is  most severe
in the pelvic  and uterine  regions, but it is also felt in the back and
loins ;  frequently the patient will complain of  pain in the groin, which
shoots down the inside of the thighs.  The pain comes on in parox-
ysms and sometimes is so intense as to resemble labor pains or severe
colic, from which, probably,  the term  menstrual colic is derived.   The
abdominal surface is very tender, so  as not to bear the slightest pres-
sure  ; but the hand or Auger-ends, gently passed over the  hypogastric
region, will  sometimes ^ive great relief.  This we know is  also the
case in  severe cases of neuralgia of the  second branch  of the fifth 
Colic, Menstrual.
99
pair :  when the patient cannot even bear a pocket handkerchief laid
lightly on the temples, he will be greatly soothed by the gentle  pass-
ing of the hand or fingers over the  temporal  region.  Whether this
be animal magnetism or not we cannot say, but we know that it is so.
  The  patient, in neuralgic dysmenorrhoea, frequently  complains  of
intense headache ; the stomach is disordered ; there is nausea, and
sometimes vomiting.   As might be expected, we frequently find hys-
terical  symptoms, but this  is by no means always  the  case.  That
this form of dysmenorrhoea is of  nervous  origin is proved by the fact
that anything that produces sexual erethism will bring on neuralgia of
the uterus, in these patients, at other times than the menstrual period.
Sexual congress is very painful, and the pain of parturition is intense.
However, women with this form  of the disease seldom conceive.

   Congestive   Dysmenorrhea.—Of ihis form of the disease  Dr.
West says: " It  has been termed congestive from the peculiar circum-
stances that attend it.  Unlike the purely neuralgic variety, it is less
frequent at the  commencement  of sexual vigor  than as an acquired
condition at a  later period in life.  A  sense of  weight about the
pelvis, and a tendency to  haemorrhoidal affections,  generally exist in
the intervals between the menstrual  periods;  and these symptoms
increase considerably a  few days  before  the discharge comes on.
During  the first twenty-four or thirty-six hours of each  menstruation
the discharge  in general  is but scanty, and the pain  is very severe.
 At the  end of  this  time, however, sometimes sooner, the discharge
becomes abundant; and as the blood flows the pain abates, and then
 ceases  altogether.   The  congested womb ached till  nature bled it;
just as the  head aches when the brain is congested, till ihe cupping-
 glasses or leeches have relieved the  over-charged cerebral vessels.
 Sometimes, in  these cases, the  menstrual  flux at  no time  becomes
 abundant, and  consequently the  relief  which  nature gives is partial.
 *    *    *    *    *     In  some instances  of this form of dysme-
 norrhoea not only is  the  amount of blood  lost at a  menstrual  period
 insufficient to relieve the congested womb, but  is absolutely as well
 as relatively scanty."  Sometimes, as  Dr. West says, the  discharge
 will  cease, and then come on  again, mingled with coagula.  Now this
 is an interesting fact, for we know that, ordinarily, the menstrual fluid
 will  not coagulate, and  formerly it was on this account denied to be
 blood ; but this  form of  dysmenorrhoea furnishes a  solution to the dif-
 ficulty, for these coagula, according to  the same distinguished author
 whom' we have before  quoted, are due  " to the blood having been
 poured out so  slowly as  to  allow of its  coagulating in the  uterine
 cavity ;  an occurrence  prevented during  healthy menstruation by its
 comparative rapid flow into the vagina, where its fibrine is at once dis-
 solved by the  acid secretion of that canal, and its coagulating property
 destroyed."  In this form of the disease we frequently find, inter-
 mingled with  the discharge, filaments  or shreds of membrane, and in
 some cases a  distinct membrane is thrown off which exactly  corres- 
100
Index Raisonne:
ponds  to the shape of the cavity of the uterus, so as to form a com-
plete cast of it.   Concerning this membrane and these strips of mem-
brane there has been much discussion ;  many authorities, following
Dr. Dewees, maintain that it was a pseudo-membrane, the product of
inflammation, and that the pain was to  be attributed to the effort of
the uterus  to throw it  off.   Dr. West,  on  the  contrary, maintains
that, " During menstruation, the  epithelium of the uterine  cavity is
thrown off in greater or less abundance ;  while an examination  of the
membrane suffices  to  show that  what had  occurred in  its formation
and development is  merely an exaggeration of the procesa»which, to
a less degree, takes place at every menstrual period.   The membrane
is  smooth  on one  surface, rough, almost villous, on the other, and
presents  the remains of  numerous dilated uterine  glands; characters
that  prove  it to be the analogue of  that decidua which, under the
physiological stimulus of conception, passes  through  a more com-
plete development to serve important  purposes.   I need scarcely say
that it  is not a matter  of indifference, in a practical point of view,
whether  or not you entertain correct opinions with reference to the
structure of this membrane.   To regard it as a layer of plastic lymph,
similar to that which is  poured out in croup, at once  suggests the em-
ployment of antiphlogistic measures,  such as experience would  by
no  means  justify.   Reasoning,  however, even  independent of  the
actual observation to which  I  have appealed, would suffice to show
the fallacy  of this opinion.   It is utterly inconceivable that a mucous
membrane,  so inflamed  as to  become the seat of deposits of lymph,
should in a few days return  to a perfectly healthy condition, and yet
periodically undergo the same intense  inflammation, issuing in the
same deposit, and this with no serious injury to its functions and no
permanent  change of  its structure."
  The third variety of this disease is dependent on the gouty or rheu-
matic diathesis. Sometimes  wet feet or "a cold" is referred  as the
cause of  the  trouble ;  at other times the disease comes  on  gradually
and with apparently no exciting  cause.   We  frequently find lithates
in the urine ; the skin is hot and the pulse frequent.   The seat of tha
pain is in the muscular tissue.  Sometimes the pain is very severe in
the back, sometimes it is in the pelvis, sometimes it resembles sciatica.
The  menstrual period  is succeeded  by profuse leucorrhoea,  which
sometimes  lasts till the return of the  catamenia.  This form of dys-
menorrhoea is closely in its character and in its symptoms to the con-
gestive form.   We  now come to the fourth variety of this disease—

   Mechanical Dysmenorrhea, by  which  is usually meant pain-
ful menstruation, attributable to some  mechanical impediment, either
in the neck of the  womb or  at the internal  or external os-uteri.
Sometimes  it  may be  caused by ulceration or inflammation  of the
cervix, and very often it is  attributable  to  imperfect uterine develop-
ment—the  cervix being too narrow, or the os itself being too small.
   Dr. West says;  " If  the operture be  so  small as  scarcely to allow 
Colic, Menstrual.
101
this to tike place [the escape of the blood, drop by drop, from the os
uteri] menstruation may be rendered very painful; and, just as when
stricture of the urethra exists, the  bladder and ureters, and kidneys,
become irritated and disturbed in the performance of their functions.
So it is quite  conceivable  that a similar state of the cervix-uteri may
exert the  same influence on the functions of that organ, and render
the menstrual flux scanty in quantity and  morbid in character, as the
consequence of the difficulty in  its discharge."  It  is  his  opinion,
however, that the narrow cervix is only a part of  the evil, and that it
is a  consequence  of an undeveloped state of the organ.  Whether
this be so or not we do not attempt  to  decide.  Very many respect-
able authorities differ from  Dr. West on this subject, although his argu-
ment seems to us to be clear and to the point.
   Treatment.—In the purely neuralgic form of this disease the treat-
ment at the time of the attack must be  palliative ;  we  must pursue
very  much the same  course that we  would  for neuralgia anywhere
else,  giving Quinine, Aconite, Belladonna, Opium, Phosphorus, Verat-
rum,  Platina, Pulsatilla,  Ignatia, Nux-vomica, Hyoscyamus, Cannab.-
indica, &c.   The patient  may also be  placed in a  hot  hip  bath, of
either very hot water or of hot mustard  and  water, or a local vapor
bath may be given.   It will also be found  advantageous to inject warm
water into the rectum at the time of the attack, and indeed it will be
found of great service to do so a day or two before menstruation takes
place.  Applications of  Ether or Chloroform  to the  hypogastrium, or
injected per rectum and vagina, will often give relief.  Dr. West advises
the  internal administration  of Ether, in a draught containing half a
drachm of the compound  Spirits of Ether and  fifteen  minims  of
Chloric Ether.  The unguentum Belladonnas, rubbed  on the hypogas-
trium, may also be of some  service in  many cases.   During the in-
terval between the catamenia the general health of the  patient should
be attended to, and, if the cause of  the  neuralgia can be discovered,
the treatment should  be directed towards its  removal.   Appropriate
remedies, such as Quinine, Iron, Ignatia, Cannabis-indica, Nux-vomi-
ca, and Belladonna, should be administered.  The patient should daily
use the tepid sitz  bath, and  the  back and abdomen  should  be well
rubbed by the hand of another person.   The  patient  should also take
a proper amount of exercise in the open  air, be regular in her habits
of eating and sleeping, avoiding excitement, late hours, and indiges-
tible  food.
   Treatment of Congestive Dysmenorrhceu.—Dr. Wesjt advises deple-
tion and the administration of Ipecac, until its nauseating effects  are
produced.   The  remedies which are  best, suited to  this form of  the
disease are  Aconite,  Belladonna, Pulsatilla, Secale-cornut., Sabina,
and Ipecac.; but, more especially, Collinsonia-canadensis, which seems
to have a specific effect in nearly all cases of dysmenorrhoea, and  in
all forms  of  it.  The  hot  hip  bath  may  be used with advantage, and
also injections of warm water.  Warm cloths applied to the abdominal
region  will frequently give relief.   If the patient, desires hot whiskey
                 I 
102
Index Raisonne.
or gin she should not be forbidden them, even though the practitioner
does run the risk  of breaking  his fragile Hahnemannian creed.  If
there be much gastric derangement it may be well to alternate Ipecac.
or Nux-vomica with Collinsonia.
   Treatment of Rheumatic or Gouty Dysmenorrhcea.—In the interim
between  each  menstrual  period the treatment  should  be directed
against the  rheumatic or gouty diathesis.  The sitz bath and friction
of the  back and abdomen will also  be found  beneficial.  During the
attack the treatment must be similar to that  in the other forms of the
disease.  In this,  as in other forms, Collinsonia or Asclepias  are to
be relied on ; Pulsatilla and Cocculus are also important remedies.
  For  the  mechanical form of dysmenorrhea  the treatment must be
mechanical dilatation of the os-uteri, either by bougies, ung. Bellad.,
or a surgical operation.
  Although  it is convenient in books to classify diseases in  a tabular
form, we do not always find that the disease corresponds to the  books.
So, in the  case  of this disease, we frequently  find more  than one
form of the  disease existing in  the  same person.  The other  organs
of the body  also sympathize with the uterus, and we often have  pal-
pitation of the heart, gastric derangement, headache, &c  Frequently,
before  the  menstrual period comes on, the  breasts become swollen
and painful.   Dr. Dewees  says that where this occurs the disease is
more easily  cured than when it does not occur.  Leucorrhoea is  a
common sequel to painful menstruation, and we have seen cases where
there was a black muddy discharge for several days after menstruation
had ceased.   Dysmenorrhoea is a disease that requires careful  and
patient treatment,  and the  practitioner who  is too modest (?) or too
indolent to carefully examine and inquire into every particular of the
case is justly to be censured.

  Colic,  Flatulent.—Allium-cepa,  205. Aloes, 215.  Alum,  225.
Anis, 376.   Anth.-nob., 379.
   This disease is characterized  by severe griping pains in the bowels,
particularly  in the  region of the umbilicus and  along the course of the
colon; the pain is not increased by pressure ana there is  no fever,
and so it  is generally easy to distinguish  it from peritonitis or enteritis.
The pain is spasmodic ; between the spasms, which come on suddenly,
the patient enjoys  comparative ease.  The flatus often causes a rum-
bling noise in the intestines, which  troubles the patient considerably.
At first there is, a feeling of distention in the pit of the stomach, soon
followed  by  pain,  which increases in  violence,  during which  the
patient tosses about pressing his hands  upon his abdomen.   Wind is
frequently passed,  both from the mouth and  the anus.  Very often
there is diarrhoea and vomiting.
   The causes  of  this complaint are many.   Sometimes it will be
caused by the patient taking cold ; at other times, when over-heated,
it may be caused by a copious draught of cold water; it may also be 
Colic, Bilious.—Colica Pictonum.
103
brought on by eating too freely of acid fruits, or by indigestible food ;
the pains come on an hour or two after ihe indigestible food has been
taken.   Sometimes it  passes  into the bowels  in  an imperfectly di-
gested  state, and then the pain does not come on so soon and is felt
in the  region of the umbilicus.
   Prognosis.—Generally favorable, unless inflammation sets in.  The
disease sometimes produces a  paralytic state of the bowels, resulting
in habitual costiveness.
   Treatment.—When the stomach contains irritating food it should be
emptied by emetics; when it has passed out of the stomach a cathar-
tic should be given.   We  are aware that many of our homoeopathic
friends will hold up their hands in holy horror at this suggestion, but
we cannot help it : common sense teaches us that when there is a
foreign substance irritating the intestinal canal that foreign substance
should be got rid of.  Warm fomentations will be found useful.  The
remedies  to be  relied  on are :  Colocynth, Nux-vomica,  Pulsatilla,
China, Cocculus, Carb.-veg.,  Belladonna, Sulphur, Chamomilla, To-
bacco, Veratrum, Ferrum, Ipecac , Nitric-acid, Phos., Zinc, Opium,
Plumb., and Mercurius.  If the colic be caused by worms, which is fre-
quently the case, the  proper remedies are : Santonine or Cina  (very
strong), Spigelia, Mercurius, Ruta, Sabadilla, Terebinth, and Kreosote.
Brandy is a valuable palliative in this disease.

   Colic, Bilious.—iEthusa, 155.
   This disease is called  bilious  colic from the bilious vomiting and
other  symptoms, showing functional derangement of the  liver.   The
patient complains  of headache, anorexia, bitter taste  in  the mouth,
and thirst.  The colic  pains  are  very acute;  at first pressure  gives
relief,  but the abdomen  grows tender to the touch  as the disease ad-
vances.   In this  disease we  have a good deal of bilious vomiting,
after which the  pain  abates temporarily.  The bowels are generally
torpid and immovable.  On  the  second or third day the eyes  and
skin become yellow, and we occasionally have tremor, numbness, and
paralysis of the arms in this disease.
   Causes.—This complaint occurs most  commonly in  the  autumn,
and is frequently brought on by marsh miasmata.
   Treatment.—If there be any irritating substance in the bowels they
should be  evacuated.   Merc-dulc. is chiefly to be depended on ;  Po-
 doph.-pelt,  and  Nux-vom. are valuable  remedies;  so also Colocynth,
 Chamomilla, and  Bryonia.   The  warm bath is a  useful auxiliary.
 Great care must  be had concerning the  diet during convalescence,
 and very  cold  drinks  must be avoided.  When  acid exists in the
primie-vnB, give Nitric, Muriatic, or Sulphuric-acids.

   Colica Fictonuiu (Painter's Colic).   Acid-sulph,82.  Alum,225.
   This disease comes  on gradually, preceded by symptoms of gastric
 derangement, anorexia, constipation, foul eructations, languor, Iran- 
104
Index Raisonne.
 sient pains in the abdominal  region,  usually about  the  umbilicus.
 There are remissions of pain, but, unlike other kinds of colic, there
 is no decided intermission.  We have occasionally paralysis of some
 of the voluntary muscles.   The bowels  are constipated, and cannot be
 moved without difficulty.   Some  authorities  are  of the opinion that
 constipation is caused by the loss  of contractile power in the intes-
 tines, or else the failure of the intestinal mucous membrane to secrete
 mucus.   The  disease  frequently  assumes  a  chronic form, producing
 wasting and paralysis of the fore-arms, and this  often remains after
 the disease  has been cured.  One  attack of  the  disease is very apt
 to predispose  the patient  for another.   M. Andral  considers colica
 pictonum  a neurosis in which the spinal marrow  and abdominal
 plexuses of the  great sympathetic seem to be the seat of lesion.
  The  principal cause of  this  disease  is exposure to  the  poison of
 lead.  The  writer had under his treatment, a short time since, a man
 suffering  with this disease, who  had been exposed to the combined
 poisonous effects  of lead,  mercury,  gold, and several other metals.
 He was a porcelain painter, and was  necessarily exposed to the fumes
 of these metals in his business.   Alumina, Platinum, Nux-vomica,
 Colocynth, Merc-corros.,  and the usual  remedies, seemed to give but
 little relief;  he was rapidly sinking into a collapse state.  Brandy was
 now given him, a tablespoonful  every  half-hour; the  pulse rose and
 became stronger, and he slept quietly under the influence of Codeine,
 and  from that  time his convalescence was rapid.
  Treatment.—The medicines proper for this  disease are:  Merc-
 dulc, Merc.-corr., Nux-vom.,  Opium,  Codeine,  Morphine,  Sulph.,
 Bellad., Alumina, and  Platinum.  It would be  well to give a warm
 bath, with injections of warm water  while the patient is in the bath.
 Sulphuric-acid has been recommended'as a preventive of lead poison-
 ing,  paralysis, «Sr.c.  Electro-galvanism  is a valua'ble  remedy for the
 subsequent paralysis.
  In concluding the subject of colic, we would  remind our  readers
that  the common  Bed-bug  has  been recommended  by respectable
homoeopathic authorities for "colic  terminating in emissions of flatu-
lence ;" and the North American Skunk for pressure in the stomach
with colic.

  Cholera Morbus.
  Diagnosis.—Nausea, succeeded by griping, purging, and  vomiting;
frequently there is  coldness of the extremities, and  sometimes of  the
whole body.   There is also great thirst, cramps in the legs  and arms,
difficult and hurried respiration, spasms of  the abdominal muscles, shrink-
in"  of the features, and  a  hollow expression  about the eyes.   Pulse
is frequent, weak,  and  very often scarcely perceptible.   There is a
great deal of tenesmus, and the evacuations are thin, watery, bilious,
and offensive.   The vomiting is  often   bilious, and  there  is also,  in
many cases, bilious diarrhoea ; vomiting of acid matter, colic pains  in