A 
MANUAL 
OP 
THERAPEUTICS. 
RICHARD .lyjGHES, 
Jj.B.C.P. ED. (EXAM.), m!b.C.S. ENGL. 
LONDON: 
HENRY TURNER & CO., 77, ELEET STREET, E.C. 
AND 74, NEW BOND STREET, W. 
MANCHESTER: 
41, PICCADILLY, AND 15, MARKET STREET. 
1869. J. K. ADI.ARD, MTMTER, BARTHOLOMEW CLOSE. PREFACE. 
Much of wliat I have said in preface to the first 
part of this work is applicable also to the present 
volume. I have, moreover, in the “ Introductory ” 
Letter of the following series explained the prin- 
ciples which have guided me in this, the therapeutic 
pprtion of my undertaking. I have a very few words 
to add in this place. 
I have strictly kept before me the object I ori- 
ginally proposed, viz. to supply a manual of Homoeo- 
pathic practice suitable “for students and beginners.” 
I have written for these, and not for men of stand- 
ing and experience. I have attempted to put in a 
compact and accessible form those applications of 
remedies to disease which general consent has 
stamped as classical. These are the alphabet and 
grammar of Homoeopathic practice : the student 
must learn them, and cannot acquire the knowledge 
of them by chance or instinct. The practitioner of 
standing, on the other hand, is ever endeavouring 
to overflow and pass over these well-beaten boun- 
daries. He is seeking for remedies for diseases 
hitherto neglected, for more accurate adaptations of 
the medicines he has already learnt to apply, for new 
weapons from the great armoury of Nature where- 
with to make his strokes more effectual. For him 
I have indeed a suggestion here and there: but I VI 
PREFACE. 
have not his wants primarily in view. The develop- 
ment of the Materia Medica on the one side, the 
increased knowledge of disease on the other, are 
what he needs : and these things are beyond my 
present scope. But if I can make the study of 
Homoeopathy less bristling with difficulties, and the 
early attempts at its practice less tentative and hap- 
hazard, I think I shall have done good service. We 
should have been a larger band than we are, were it 
not for the many would-be students who have been 
repelled and the many beginners who have fainted 
and turned back for lack of a guide. 
If the present volume shall meet the kindly 
reception accorded to its predecessor I shall have 
every reason to be content. 
Brighton; February, 1869. CONTENTS. 
Letter page 
I. Introductory 1 
II. “ SlMILIA SlMILIBUS” 13 
III. The Dose and its Repetition—Change and 
Alternation of Medicine—Auxiliaries— 
The Duties of the Homoeopathic Phy- 
sician 27 
IV. Blood Diseases. 
Plethora—Anaemia—Scurvy—Purpura... - 43 
V. Blood Diseases (continued). 
Scrofulosis—Tuberculosis— Cancer 51 
VI. Blood Diseases (continued). 
Gout—Rheumatism—Rheumatic Gout— Gonor- 
rhoeal Rheumatism 58 
VII. Blood Diseases (continued). 
Febricula—Typhus—Typhoid—Relapsing Fever 
— YellowFever—Plague—Malignant Purpuric 
Fever 68 
VIII. Blood Diseases (continued). 
Ague—Remittent Fever—Bilious Remittent 79 
IX. Blood Diseases (continued). 
Variola— Varicella—Rubeola 87 
X. Blood Diseases (continued). 
Scarlatina—Rotheln—Dengue—Miliaria 95 
XI. Blood Diseases (continued). 
Hydrophobia— Glanders—Malignant Pustule— 
Syphilis—Sycosis 104 
XII. Diseases of the Nervous System. 
Cerebral Meningitis—Phrenitis—Softening of the 
Brain—Apoplexy 114 
XIII. Diseases of the Nervous System (continued). 
Mania — Melancholia—Dementia — Idiocy — 
General Paralysis of the Insane—Hypochon- 
driasis—Delirium Tremens 124 
XIV. Diseases of the Nervous System (continued). 
Headache— Vertiqo—Insomnia—Injuries of the 
Head 133 VIII 
Letter page 
XV. Diseases of the Neryofs System (continued). 
Spinal Meningitis—Myelitis—Spinal Congestion 
—Spinal Irritation—Spinal Haemorrhage— 
Softening, Induration, and Atrophy of the 
Cord—Concussion of the Spine—Paralysis... 142 
XVI. Diseases of the Neryofs System (continued). 
Epilepsy—Tetanus 151 
XVII. Diseases of the Neryofs System (continued). 
Chorea — Catalepsy — Hysteria — Neuralgia — 
Local Spasms 161 
XVIII. Diseases of the Eye. 
Inflammation of the Lids—Spasmodic and Para- 
lytic Affections of the Lids—Tarsal Tumours 
—Inflammation of the Lachrymal Sac—Fistula 
lachrymalis— Conjunctivitis simplex—Oph- 
thalmia neonatorum—Gonorrhoeal Ophthal- 
mia — Purulent Ophthalmia — Diphtheritic 
conjunctivitis 175 
XIX. Diseases of the Eye (continued). 
Strumous Ophthalmia—Rheumatic Ophthalmia 
—Arthritic Ophthalmia—Syphilitic Ophthal- 
mia 185 
XX. Diseases of the Eye (continued). 
Pterygium— Corneitis— Corneal Opacities—Iritis 
—Mydriasis— Choroiditis— Cataract—Glau- 
coma — Retinitis—Amaurosis—Asthenopia— 
Hemeralopia—Diplopia—Myopia and Pres- 
byopia—Photophobia—Photopsia and Chro- 
matopsia—Strabismus 192 
XXI. Diseases of the Ear. 
Frysipelas aurium — Eczema aurium — Otitis 
externa— Otorrhoea—Polypus aurium—Exos- 
toses of the Meatus — Inflammation of the 
Membrana Tympani — Throat Deafness — 
Otalgia — Inflammation, Hypertrophy, and 
Rigidity of the Tympanic Mucous Membrane— 
Anchylosis of the Tympanic Ossicles—Caries 
of the Mastoid Process—Nervous Deafness— 
Tinnitus aurium 204 
XXII. Diseases of the Digestive Organs. 
Ulcers of the Mouth—Cancer of the Lips— 
Glossitis—Ulcers, Syphilis, and Cancer of the 
Tongue — Odontalgia —Parulis —Ptyalism— 
Parotitis 216 
XXIII. Diseases of the Digestive Organs (continued). 
Angina— Tonsillitis— Chronic Angina—Diph- 
theria 223 
CONTENTS. CONTENTS 
IX 
Letter page 
XXIV. Diseases op the Digestive Organs (continued). 
Gastritis— XJlcer of Stomach—Cancer of Stomach 
—Gastrodynia 236 
XXY. Diseases of the Digestive Organs (continued). 
Acute Dyspepsia — Chronic Dyspepsia — Pain 
after Food —Aridity — Heartburn— Water- 
brash—Flatulence— Vomiting—Hcematemesis 245 
XXVI. Diseases of the Digestive Organs (continued). 
Inflammation and Spasmodic Stricture of the 
(Esophagus— Enteritis—Intestinal Ulceration, 
Cancer, and Haemorrhage—Enterodynia 255 
XXVII. Diseases of the Digestive Organs (continued). 
Diarrhoea—Dysentery—Cholera 261 
XXVIII. Diseases of the Digestive Organs (continued). 
Constipation—Intestinal Obstruction—Hernia . 272 
XXIX. Diseases of the Digestive Organs (continued). 
Haemorrhoids—Fissure of Anus—Prolapsus ani 
Fistula in ano—Worms — Peritonitis — 
Ascites 279 
XXX. Diseases of the Digestive Organs (continued). 
Diseases of the Pancreas—Hepatic Congestion— 
Hepatitis Cirrhosis of the Diver — Acute 
Atrophy—Fatty, Amyloid, Pigmentary, and 
Cancerous Degeneration of the Liver—Jaun- 
dice— Gall-stones 289 
XXXI. Diseases of the Respiratory Organs. 
Nasitis — Coryza — Influenza — Hay fever — 
Ozaena—Epistaxis—Polypus narium—Laryn- 
gitis—Aphonia 297 
XXXII. Diseases of the Respiratory Organs (con- 
tinued). 
Bronchitis — Dilatation of the Bronchi — Em- 
physema—Asthma 306 
XXXIII. Diseases of the Respiratory Organs (con- 
tinued). 
Pneumonia—Pulmonary Abscess and Congestion 
Hcemoptysis — Pulmonary Apoplexy — 
(Edema Pulmonum 316 
XXXIV. Diseases of the Respiratory Organs (con- 
tinued). 
Phthisis Pulmonalis—Pulmonary Syphilis and 
Cancer 323 
XXXV. Diseases of the Respiratory Organs (con- 
tinued). 
P leurisy — Hydrothorax — Empyema—Pneumo- 
thorax—Pleurodynia—Injuries of the Chest... 330 X 
Letter page 
XXXVI. Diseases op tee Circulatory System. 
Diseases of the Heart: Palpitation, Hyper- 
trophy, Dilatation, Patty Degeneration—Angina 
Pectoris—Pericarditis — Endocarditis —Chronic 
Valvular Disease 338 
XXXVII. Diseases of tiie Circulatory System (con- 
tinued). 
Arteritis, Aneurism, and Atheroma — Phlebitis 
and Varicosis—Pyaemia—Angioleucitis—Inflam- 
mation and Hypertrophy of the Spleen—Leuco- 
cythcemia—Disease of the Supra-renal Capsules— 
Bronchocele—Exophthalmic Goitre 346 
XXXIX. Diseases of the Urinary Organs. 
Albuminuria, from—Nephritis—Granular Dege- 
neration—Amyloid Degeneration—Patty De- 
generation—and other causes 355 
XL. Diseases of the Urinary Organs (continued). 
Albuminuria—Chylous Urine —Diabetes —Poly- 
uria—Gravel—Azoturia 368 
XLI. Diseases of the Urinary Organs (continued). 
Penal Congestion—Suppression of Urine—Hcema- 
turia—Pyelitis—Penal Cancer and Tubercle— 
Cystitis—Irritable Bladder—Strangury—Reten- 
tion of Urine—Stone—Cancer of the Bladder— 
Stricture of the Urethra 378 
XLII. Diseases of the Male Sexual Organs. 
Orchitis —Sarcocele—Irritable Testicle—Neural- 
gia Testis—Impotency— Sterility— Spermator- 
rhoea — Hydrocele — Varicocele—Petraction of 
the Testicles—Prostatitis—Gonorrhoea—Balani- 
tis—Soft Chancre—Epithelioma of Penis and 
Scrotum—Inflammation of Scrotum 387 
XLIII. Diseases of the Female Sexual System. 
Ovaritis—Ovarian Neuralgia—Ovarian Dropsy 
■—Menorrhagia—Amenorrhoea — Chlorosis — In- 
frequent and Vicarious Menstruation—Dysme- 
norrhcea 399 
XLIV. Diseases of the Female Sexual System (con. 
tinued). 
Uterine Congestion —Hysteralgia — Endo-metritis 
— Cervico-metritis — Leucorrhoea — Peri-uterine 
Hcematocele— Uterine Displacement—Polypus— 
Fibrous Tumour—Cancel—Hydrometra 411 
CONTENTS. CONTENTS. 
XI 
Lettee page 
XLV. Diseases op the Female Sexual System (con- 
tinued). 
Vaginitis — Vaginismus — Vulvitis—Acute Labial 
Abscess—Pudendal Cancer—Pruritus Pudendi— 
Nymphomania—Vascular Tumour of the Urethra 
—Sterility—Chronic Mammary Tumour—Irri- 
table Tumour of the Breast—Mammary Scirrhus 424 
XLYI. Diseases op the Female Sexual System (con- 
tinued). 
Disorders of Pregnancy: Mental Disorder, Head- 
ache, Sleeplessness, Tooth-ache, Salivation, Vomit- 
ing, Heartburn, Cravings, Constipation, Diar- 
rhoea, Cough, Dyspnoea, Irritation of Bladder, 
Albuminuria, Uterine pain, Mammary pain, 
Lumbar pain, Pruritus, False pains—Miscarriage 431 
XLV1I. Diseases op the Female Sexual System (con- 
tinued). 
Disorders of Parturition: Mal-presentation, 
Rigid os uteri, Deficient pains, Excessive pains, 
Retained Placenta—Post-partum Hcemorrhage— 
Puerperal Convulsions 440 
XLVIII. Diseases of the Female Sexual Organs (con- 
tinued). 
Disorders of the Puerperal State: After-pains, 
Torn Perinceum, Retention of Urine, Hcemor- 
rhoids, Morbid Lochia, Constipation, Diarrhoea— 
Puerperal Fever—Puerperal Insanity—Disorders 
of Lactation: Milk Fever, Deficient Milk, Painf ul 
Suckling, Weaning, Over-lactation, Mastitis— 
Phlegmasia alba dolens—Critical Age 448 
XLIX. Diseases of the Skin. 
Erythema — Erysipelas — Urticaria —'Roseola — 
Eczema —Herpes— Scabies—Pemphigus—Rupia 
—Impetigo—Ecthyma—Lichen—Prurigo—Pity- 
riasis — Psoriasis — Lepra —Lupus—Elephan- 
tiasis 458 
L. Diseases of the Skin (continued). 
Warts — Molluscum — Acne — Sycosis menti — 
Alopecia—Plica Polonica — Favus—Furuncle— 
Carbuncle—Whitloiv—Disease of Nail Matrix 
— Ulcers—Pruritus 467 
LI. Diseases of the Locomotiye Organs. 
Myositis —Myalgia — Cramps —Muscular Rheu- 
matism—Periostitis —Nodes—Ostitis— Caries— 
Necrosis—Neuralgia of Bone—Mollities Ossium 
— Synovitis — White Swelling — Arthralgia— 
Bursitis—Ganglion 475 XII 
CONTENTS. 
Letter page 
LII. Diseases op Children. 
Rachitis—Remittent Fever—Hereditary Syphilis 
—Acute Hydrocephalus—Chronic Hydrocepha- 
lus— Convulsions—Infantile Paralysis 486 
L1II. Diseases of Children (continued). 
Stomatitis —Aphthae—Cancrum Oris —Stammer- 
ing—Morbid Dentition—Diarrhoea— Co lie—Pro- 
lapsus Ani—Tubercular Peritonitis 496 
LIV. Diseases of Children (continued). 
Laryngismus Stridulus — Pertussis — Croup — 
Proncho-pneumonia 505 
LY. Diseases of Children (continued). 
Strumous Adenitis—Tabes Mesenterica—Fnuresis 
nocturna and other Urinary Difficulties—Leu- 
corrhaea —Noma Pudendi —Intertrigo—Crusta 
Lactea —Porrigo Capitis —Strophulus —Ring- 
worm — Cephalhcematoma — Neevus — Hernia— 
Mastitis—Icterus—Scleroderma—Trismus 515 
LVI. Casualties—Miscellaneous. 
Wounds—Contusions—Strains—Rums and Scalds 
— Chilblains —Stings —Fractures —Sunstroke— 
Fmotional Disturbances—Atrophy —Gangrcena 
Senilis—Conclusion 523 LETTER I. 
INTRODUCTORY 
My dear 
It is now some time since I wrote you my last 
letter on Pharmacodynamics. In its concluding 
sentences I promised ere long to enter with you 
upon Therapeutics,—to tell you what Homoeopathy 
can do for the manifold forms of disease, and how 
it does it. That it is necessary I should thus take 
up the subject from the side of disease, you have 
already found in working with my former letters. 
You have wished that I had affixed to them a clinical 
index, noting against the various maladies of the 
human frame the medicines I had mentioned as 
useful in their treatment. Indeed, you have se- 
riously thought about compiling some such index 
for your own use, did I not speedily provide you 
with a fuller guide to practice. I will therefore 
delay no longer to redeem my promise: and will 
begin at once to write you a series of letters on 
Therapeutics. 
Let us distinctly understand what it is I propose 
to do for you in the following letters. You do not 
want me to write you a treatise on the Practice of 
Physic. You know disease as well as I do. I can 
1 2 
INTRODUCTORY. 
tell you nothing about the history, the diagnosis, 
or the pathology of its various forms but what you 
know already, or at any rate may acquaint yourself 
with by consulting the authorities on your book- 
shelves. You will meet me half-way here: and I 
may spare myself the travel over the familiar road. 
What you want to know is this. Here is a recog- 
nised malady. You have been accustomed to treat 
it in such and such a way, and with such and such 
success. Has Homoeopathy discovered how to treat 
it better? How far shall you be justified in any 
given case in dispensing with measures which, how- 
ever rude, are tried, and trusting unreservedly to 
the action of specific medicines? The question is a 
fair, and indeed an imperative one for you to put. 
The law of similars, relating as it does solely to 
the dynamic action of medicines, has obviously 
limitations inherent in its own nature. It is 
farther only capable of application to practice 
when similarly acting medicines have been disco- 
vered. There may be diseases therefore which lie 
beyond its possible range. Still more likely is it 
that there are diseases which have not yet come 
within its practical range. Accordingly, our first 
step must be to inquire what Homoeopathy can 
do—as compared with the capabilities of Old 
Physic—in each malady that comes before us. 
And next you will require to know what are the 
specific remedies with which success has hitherto 
been obtained : and how far they need supplement- 
ing by auxiliary means. 
To answer these questions, from a survey of 
Homoeopathic literature and from my own expe- INTRODUCTORY. 
3 
rience, will be my only and sufficient task. I 
shall say no more upon the nature of the various 
diseases than is necessary for their identification, 
that we may know we are thinking of the same 
thing. Confining ourselves thus to their prognosis 
and treatment, we shall save an infinity of time 
and space : and shall be devoting our energies to 
what are really the only points on which your adop- 
tion of Homoeopathy requires you to have fresh 
knowledge and modified views. 
In executing such a work, moreover, I shall be 
doing something for you which you will not find in 
any volume now extant. The few manuals of 
general therapeutics which the Homoeopathic school 
has produced are framed upon a much more ambi- 
tious scale. They aim at being complete Treatises 
on the Practice of Medicine, and at superseding, 
for Homoeopathic students and practitioners, the 
ordinary text-books. Shall I confess that this 
“ vaulting ambition” of theirs seems to me to 
“ overleap itself 
And fall on the other side” ? 
Can they describe like Watson, or compile like 
Aitken ? I have not seen the recent works of 
Bahr and Kafka : but I have before me Laurie’s 
“ Elements of the Homoeopathic Practice of Phy- 
sic,” Hartmann’s “ Acute and Chronic Diseases and 
their Homoeopathic Treatment,” and Marcy and 
Hunt’s “ Homoeopathic Theory and Practice of 
Medicine.” Dr. Laurie’s book was probably useful 
once : but it is imperfect in the extreme. It omits 
numerous forms of disease: and in recommending 4 
INTRODUCTORY. 
medicines rarely tells us whether the choice is made 
on a priori considerations, or from actual expe- 
rience. Hartmann, garrulous, credulous, yet prac- 
tical, is out of date;—his pathology is obsolete, and 
his nomenclature barely intelligible. Of Drs. 
Marcy and Hunt’s attempt I have spoken at large 
in vol. xxiii of the ‘ Brit. Journ. of Horn.,’ p. 475. 
I regret that I cannot recommend a work which 
must have cost its authors so much pains. 
The truly valuable therapeutical literature of our 
school consists in the clinical records scattered 
throughout its periodicals, or brought together in 
the collections of Riickert and Beauvais (Roth): and 
in the monographs we have on special forms of 
disease. To these I shall make copious reference 
as I go on. I shall also occasionally mention the 
text-books, when their treatment of any subject is 
instructive. My letters will thus serve as an index 
to our therapeutic literature at large : so that under 
its guidance you will be enabled to read up the 
most that has been written on any malady which is 
demanding your special attention. 
In making a classification of diseases for my 
purpose, I have not aimed at any striking novelty. 
Before the appearance of Dr. Russell Reynolds’ 
“ System of Medicine” I had already adopted his 
division of maladies into “ General” and “ Special.” 
I have ventured, however, to call the general dis- 
eases “blood-diseases”—grouping them accordingly; 
and have omitted from their number all which more 
obviously belong to the disorders of particular 
organs. Such are mumps, diarrhoea, dysentery, 
and cholera,—which I place among the diseases of INTRODUCTORY. 
5 
the alimentary canal and its associated glands : and 
influenza and hooping-cough, which I relegate to 
the sphere of respiratory disorders. I have also 
introduced the diseases of certain organs,—as the 
eyes, ears, bones, and joints,—which are usually 
supposed to belong to Surgery, but to which Ho- 
moeopathic Medicine has much to say. The result 
has been the following grouping, which will at least 
be practical and intelligible, and which I think omits 
no morbid state of importance. 
I. BLOOD DISEASES. 
Plethora. 
Anemia. 
Scurvy. 
Purpura. 
Scrofulosis. 
Tuberculosis. 
Cancer. 
Gout. 
Rheumatism. 
Rheumatic Gout. 
Gonorrhceal Rheumatism. 
Febricula. 
Typhus. 
Typhoid. 
Relapsing Fever. 
Yellow Fever. 
Plague. 
Epidemic Cerebro-spinal 
Meningitis. 
Ague. 
Remittent Fever. 
Variola. 
Varicella. 
Measles. 
Scarlatina. 
Rotheln. 
Dengue. 
Miliaria. 
Hydrophobia. 
Glanders. 
Malignant Pustule. 
Syphilis. 
Sycosis. 
II. DISEASES OF THE NERVOUS SYSTEM. 
Diseases op the Head. 
Meningitis. 
Phrenitis. 
Softening. 
Apoplexy. 
Mania. 
Melancholia. 
Dementia. 
Idiocy. 
General Paralysis of the 
Insane. 
Hypochondriasis. 6 
INTRODUCTORY. 
Diseases of the Head—con- 
tinued. 
Delirium Tremens. 
Headache. 
Vertigo. 
Insomnia. 
Injuries of the Head. 
Diseases of the Spinal 
Cord. 
Meningitis. 
Myelitis. 
Congestion. 
Irritation. 
Haemorrhage. 
Softening. 
Induration. 
Atrophy. 
Concussion. 
Paralysis. 
The Neuroses. 
Epilepsy. 
Tetanus. 
Chorea. 
Catalepsy. 
Hysteria. 
Eeuralgia. 
Local Spasms. 
Diseases of the Lids. 
Inflammation of the Eye- 
lids. 
Spasmodic and Paralytic 
Affections of the Eye- 
lids. 
Tarsal Tumours. 
Diseases of the Lachrymal 
Apparatus. 
Inflammation of the Lach- 
rymal Sac. 
Fistula lachrymalis. 
The Ophthalmia. 
Conjunctivitis simplex. 
Ophthalmia neonatorum. 
Gonorrhoeal Ophthalmia. 
Purulent Ophthalmia. 
Diphtheritic Conjunctivi- 
tis. 
Strumous Ophthalmia. 
Rheumatic Ophthalmia. 
Arthritic Ophthalmia. 
Syphilitic Ophthalmia. 
III. DISEASES OF THE EYE. 
Diseases of the Conjunctiva. 
Pterygium. 
Diseases of the Cornea. 
Corneitis. 
Opacities. 
Diseases of the Iris. 
Iritis. ♦ 
Mydriasis. 
Diseases of the Choroid. 
Choroiditis. 
Diseases of the Lens. 
Cataract. 
Diseases of the Vitreous. 
Glaucoma. 
Diseases of the Retina. 
Retinitis. 
Amaurosis. 
Asthenopia. 
Hemeralopia. 
Diplopia. 
Myopia. 
Presbyopia. 
Photophobia. 7 
Diseases of the Retina— 
continued. 
Photopsia. 
Chromatopsia. 
INTRODUCTORY. 
Diseases of the Oculab Mus- 
cles. 
Strabismus. 
IV. DISEASES OF THE EAR. 
Diseases of the Extebnal 
Eae. 
Erysipelas aurium. 
Eczema aurium. 
Diseases of the Extebnal 
Meatus. 
Otitis externa. 
Otorrhoea. 
Polypus. 
Exostosis. 
Diseases of the Membbana 
Tympani. 
Inflammation. 
Diseases of the Eustachian 
Tube. 
Throat-deafness. 
Diseases of the Tympanum. 
Otalgia. 
Inflammation of Mucous 
Membrane. 
Hypertrophy and Rigidity 
of ditto. 
Anchylosis of Ossicles. 
Diseases of the Mastoid 
Cells. 
Caries. 
Diseases of the Inteenal 
Eae. 
Nervous Deafness. 
Tinnitus Aurium. 
V. DISEASES OF THE DIGESTIVE ORGANS. 
Diseases of the Theoat. 
Angina. 
Tonsillitis. 
Chronic Angina. 
Diphtheria. 
Diseases of the (Esophagus. 
Inflammation. 
Spasmodic Stricture. 
Diseases of the Stomach. 
Gastritis. 
Dicer. 
Cancer. 
Gastrodynia. 
Acute Dyspepsia. 
Chronic Dyspepsia. 
Diseases of the Mouth. 
Ulcers of the Mouth. 
Cancer of the Lips. 
Diseases of the Tongue. 
Glossitis. 
Ulcers. 
Syphilis. 
Cancer. 
Diseases of the Teeth. 
Odontalgia. 
Parulis. 
Diseases of the Salivaby 
Glands. 
Ptyalism. 
Parotitis. 8 
INTRODUCTORY. 
Diseases of the Stomach— 
continued. 
Pain after food. 
Acidity. 
Heart-burn. 
Water-brash. 
Flatulence. 
Vomiting. 
Hcematemesis. 
Diseases of the Intestines. 
Enteritis. 
Ulceration. 
Cancer. 
Haemorrhage. 
Colic. 
Diarrhoea. 
Dysentery. 
Cholera. 
Constipation. 
Intestinal Obstruction. 
Hernia. 
Haemorrhoids. 
Fissure of Anus. 
Prolapsus Ani. 
Fistula in Ano. 
Worms. 
Diseases of the Peritoneum. 
Peritonitis. 
Ascites. 
Diseases of the Pancreas. 
Pancreatitis. 
Cancer. 
Diseases of the Liter. 
Congestion. 
Hepatitis. 
Acute Atrophy. 
Cirrhosis. 
Fatty Degeneration. 
Amyloid Degeneration. 
Pigmentary Degeneration. 
Cancer. 
Jaundice. 
Oall-stones. 
VI. DISEASES OF THE RESPIRATORY ORGANS. 
Nasitis. 
Coryza. 
Influenza. 
Hay fever. 
Ozaena. 
Epistaxis. 
Polypus Narium. 
Laryngitis. 
Aphonia. 
Pronchitis. 
Bronchiectasis. 
Emphysema. 
Asthma. 
Pneumonia. 
Abscess of Lung. 
Pulmonary Congestion. 
Haemoptysis. 
Pulmonary Apoplexy. 
(Edema Pulmonum. 
Phthisis Pulmonalis. 
Pulmonary Syphilis. 
Pulmonary Cancer. 
Pleurisy. 
Hydrothorax. 
Empyema. 
Pneumo-thorax. 
Pleurodynia. 
Injuries of the Chest. INTRODUCTORY. 
9 
VII. DISEASES OF THE CIRCULATORY SYSTEM. 
Diseases of the Heart. 
Palpitation. 
Hypertrophy. 
Dilatation. 
Fatty Degeneration. 
Angina Pectoris. 
Pericarditis. 
Endocarditis. 
Chronic Valvular Disease. 
Diseases of the Blood-ves- 
sels. 
Arteritis. 
Aneurism. 
Atheroma. 
Phlebitis. 
Varicosis. 
Pyaemia. 
Diseases of the Absorbents. 
Angioleucitis. 
Diseases of the Spleen. 
Splenitis. 
Hypertrophy. 
Leucocythcemia. 
Diseases of the Supra-renal 
Capsules. 
Addison’s Disease. 
Diseases of the Thyroid 
Gland. 
Bronchocele. 
Exophthalmic Goitre. 
VIII. DISEASES OF THE URINARY ORGANS. 
Diseases of the Kidney. 
Nephritis. 
Granular Degeneration. 
Amyloid Degeneration. 
Fatty Degeneration. 
Albuminuria. 
Chylous Urine. 
Diabetes. 
Polyuria. 
Gravel. 
Azoturia. 
Congestion. 
Ischuria. 
Hcematuria. 
Pyelitis. 
Cancer. 
Tubercle. 
Diseases of the Bladder. 
Cystitis. 
Irritable Bladder. 
Strangury. 
Retention of Urine. 
Stone. 
Cancer. 
Diseases of the Ubethka. 
Stricture. 
IX. DISEASES OF THE MALE SEXUAL ORGANS. 
Diseases of the Testis. 
Orchitis. 
Sarcocele. 
Irritable Testicle. 
Neuralgia Testis. 
Impotency. 
Sterility. 
Spermatorrhoea. 10 
INTKODUCTOIIY. 
Diseases of the Testis—con- 
tinued. 
Hydrocele. 
Diseases of the Spermatic 
Cord. 
Varicocele. 
Detraction of the Testicles. 
Diseases of the Prostate 
Gland. 
Prostatitis. 
Diseases of the Penis and 
Scrotum. 
Gonorrhoea. 
Balanitis. 
Soft Chancre. 
Fpithelioma. 
Inflammation of the Scro- 
tum. 
Diseases of the Ovaries. 
Ovaritis. 
Neuralgia. 
Dropsy. 
Disorders of Menstruation. 
Menorrhagia. 
Amenorrhcea. 
Chlorosis. 
Inf requent Menstruation. 
Vicarious Menstruation. 
Dysmenorrhoea. 
Diseases of the Uterus. 
Congestion. 
Hysteralgia. 
Undo-metritis. 
Cervico-metritis. 
Leucorrhoea. 
Peri-uterine Hcematocele. 
Displacements. 
Polypus. 
Fibrous Tumour. 
Cancer. 
Hydrometra. 
Diseases of the Vagina and 
Pudenda. 
Vaginitis. 
X. DISEASES OF THE FEMALE SEXUAL SYSTEM. 
Vaginismus. 
Vulvitis. 
Acute Labial Abscess. 
Cancer. 
Pruritus. 
Nymphomania. 
Vascular Tumour of Ure- 
thra. 
Sterility. 
Diseases of the Mammj;. 
Chronic Tumour. 
Irritable Tumour. 
Scirrhus. 
Disorders of Pregnancy. 
Miscarriage. 
Disorders of Parturition. 
Post-partum Hemorrhage. 
Puerperal Convulsions. 
Disorders of the Puerperal 
State. 
Puerperal Fever. 
Puerperal Insanity. 
Disorders of Lactation. 
Phlegmasia alba dolens. 
Critical Age. INTRODUCTORY. 
11 
XI. DISEASES OF THE SKIN. 
Exanthemata. 
Erythema. 
Erysipelas. 
Urticaria. 
Roseola. 
VESICULE. 
Eczema 
Herpes. 
Scabies. 
Pemphigus. 
Rupia. 
PUSTULE. 
Impetigo. 
Ecthyma. 
PAPULE. 
Lichen. 
Prurigo. 
Squame. 
Pityriasis. 
Psoriasis. 
Lepra. 
Tubercule. 
Lupus. 
Cheloid. 
Elephantiasis. 
Diseases of the Papilla. 
Icthyosis. 
Warts. 
Diseases of the Sebaceous 
Glands. 
Molluscum. 
Acne. 
Sycosis menti. 
Diseases of the Hair Fol- 
licles. 
Alopecia. 
Plica Polonica. 
Favus. 
Mis cellaneous. 
Furuncle. 
Carbuncle. 
Whitlow. 
Diseases of the Nail-ma- 
trix. 
Ulcers. 
Pruritus. 
XII. DISEASES OF THE LOCOMOTIVE OKGANS. 
Diseases of the Muscles. 
Myositis. 
Myalgia. 
Cramps. 
Muscular Rheumatism. 
Diseases of the Bones. 
Periostitis. 
Nodes. 
Ostitis. 
Caries. 
Necrosis. 
Neuralgia. 
Mollifies Ossium. 
Diseases of the Joints. 
Synovitis. 
White Swelling. 
Arthralgia. 
Eursitis. 
Ganglion. 12 
INTRODUCTORY. 
XIII. DISEASES OF CHILDREN. 
Blood Diseases. 
Rachitis. 
Hereditary Syphilis. 
Infantile Remittent Fever. 
Diseases of the Neetous 
System. 
Acute Hydrocephalus. 
Chronic Hydrocephalus. 
Convulsions. 
Infantile Paralysis. 
Diseases of the Digestive 
Oegans. 
Stomatitis. 
Aphthae. 
Cancrum Oris. 
Stammering. 
Morbid Dentition. 
Diarrhoea. 
Colic. 
Prolapsus Ani. 
Tubercular Peritonitis. 
Diseases of the Respieatoey 
Oegans. 
Laryngismus Stridulus. 
Pertussis. 
Croup. 
Broncho-pneumonia. 
Diseases oe the Cibculatoey 
System. 
Strumous Adenitis. 
Tabes Mesenterica. 
Diseases of the Ubinaby 
Oegans. 
Enuresis Nocturna. 
Diseases of the Genital 
Oegans. 
Noma Budendi. 
Diseases of the Skin. 
Intertrigo. 
Crusta Lactea. 
Porrigo Capitis. 
Strophulus. 
Ringworm. 
Miscellaneous. 
Cephalhcematoma. 
Ncevus. 
Hernia. 
Mastitis Neonatorum. 
Icterus Neonatorum. 
Scleroderma Neonatorum. 
Trismus Neonatorum. 
XIV. CASUALTIES. 
Wounds. 
Contusions. 
Strains. 
Burns and Scalds. 
Chilblain. 
Stings. 
Fractures. 
Sun-stroke. 
Emotional Disturbances. 
XV. MISCELLANEOUS. 
Atrophy. 
Oangrcena Senilis. LETTER II. 
“ SIMILIA SIMILIBUS.” 
Before entering upon the main subject of the 
present volume, viz. the Homoeopathic treatment of 
the various forms of disease, there are several pre- 
liminary questions on which we must come to an 
understanding. The chief of these is, What is 
Homoeopathy ?—wherein does it essentially consist ? 
what does it include and what exclude? and what 
are your duties and limitations now that you are 
avowedly practising under its banner ? To the 
consideration of this group of questions I shall 
devote the present letter. 
Homoeopathy is, pi'imd facie, the treatment of 
disease by medicines selected according to the rule 
“ similia similibus curentur ” “ let likes be treated 
by likes.”* The “like” (o/uoiov) here spoken 
of is explained by Hahnemann as opposed both to 
the “ different ” (aAAotov) and to the “ contrary ” 
(Ivavriov). Thus :—a case of disease is before us. 
* I prefer this putting of the motto—which is indeed Hahne- 
mann’s original formula—to the affirmation “similia sitnilibus 
curawtur” usually adopted at the present time. I have no desire 
to quarrel with the Latinity of the latter : though the use of “euro” 
in the sense of “ cure” is at least unfamiliar. But in the present 
state of our knowledge I think it wiser to state our principle as a 
rule of Art than as a law of Science. 14 
“similia similibus.” 
We are not to consider what processes of evacua- 
tion, revulsion, and such like, will benefit, and pre- 
scribe our remedies accordingly. Nor are we to 
think what drug will act in an opposite direction to 
the symptoms present, and accordingly give Strych- 
nia for paralysis, aud Opium for sleeplessness. Our 
inquiry should rather be—what drug is capable of 
producing upon the healthy body a morbid condition 
similar to the one before us? The presence of 
sleeplessness will suggest a medicine capable of 
banishing natural sleep, as Coffee: while Opium 
will be indicated rather in conditions of sopor— 
as in fevers—similar to that which it commonly 
induces. 
But now of this “similarity” itself the question 
arises, wherein does it consist ? This is a point 
which has exercised the minds of our best men from 
Hahnemann downwards. For the opinions of the 
master and his early disciples I refer you to Dr. 
Dudgeon's “Lectures on Homoeopathy.” Later 
deliverances on the subject are the essays “ On the 
Various Actions of Medicines” and on “ Contraria 
Contrariis” by Dr. Madden in the 8th and 25th 
vols. of the ‘British Journal of Homoeopathy,’ on 
“ the Homoeopathic and Allopathic Use of Specifics ” 
by Dr. Drysdale in vols. xxiv—xxvi, on “ Similia 
Similibus Curantur” by Dr. Elb in vol. xxvi, and 
on “ Organopathy ” and “ The Anatomical Basis of 
Therapeutics’’ by Dr. Sharp in the ‘Monthly 
Homoeopathic Review ’ for 1867—8. To these I 
must add Dr.Carroll Dunham’s treatise on “Homoeo- 
pathy the Science of Therapeutics.” You will do 
well at your leisure to read what these able thinkers “ SIMILIA STMILIBUS.” 
15 
have taken the pains to set down upon the point 
before us. For the present I shall endeavour to 
express what I myself understand by our thera- 
peutic rule, and by the “ similarity ” of which it 
speaks. 
For this “ similarity,” then, I take the first 
requisite to be that it be real and not merely 
apparent. It will not do, because a medicine has 
caused a sense of weakness and weariness in the 
lower extremities, to set it down as homoeopathic to 
paraplegia. When the prover of a drug has expe- 
rienced from its action a cough with stitchings in 
the side, he must not infer that he has found the 
simile of pleurisy or pneumonia. However nume- 
rous the varieties of diseases thus named, however 
unique in some respects each individual instance of 
their occurrence, there are in all certain essential 
elements, certain peculiar pathological changes. 
That a medicine shall be capable of causing these 
changes on the healthy body is the primary requi- 
site to its homoeopathic relationship. 
Now how is it to be ascertained that this essen- 
tial similarity between disease and drug exists? 
Hahnemann answers, by finding that the “ totality 
of symptoms” in each coincide. Exception has 
been taken to his statement; but I imagine that it 
is based on some misconception of what he means by 
“ symptoms.” He could not wish to limit the term 
to those phenomena which appear on the surface, 
and strike the uneducated eye. At any rate, that 
is not what we mean by symptoms now. We know 
that very often the same surface symptom belongs 
to two or more utterly distinct conditions of the 16 
“ SJMTLIA SIMILIBUS.” 
body, while the symptoms which distinguish these 
conditions do not lie on the surface, and can only 
be ascertained by more profound research. They 
are still symptoms; for every disease is only a 
group of symptoms or appearances. But they need 
the pathologist to discover them ; bringing as he 
does to his aid all the resources of science (the 
stethoscope, the microscope, the speculum, the test- 
tube), and thus seeing not only all that the others 
see on the surface, but all that lies beneath the sur- 
face as well; so that he can distinguish where they 
could not, and the ojuoiov to them would be the 
aXXoTov to him. In Hahnemann’s day, indeed, 
pathology could hardly be said to exist as a science. 
But his doctrine is the same. Obtain all the symp- 
toms you possibly can, both in proving your medi- 
cines and in examining your patients; then, in 
prescribing for an individual case, select that remedy 
which corresponds most nearly to the totality of the 
symptoms present. 
The symptoms, then, on whose presence the com- 
parison of disease and drug is to be effected, are all 
that can be ascertained, both subjective and objec- 
tive, both surface and deep. If all which constitute 
the disease are to be found in their due proportion 
and sequence in the pathogenesis of the drug, the 
similarity we desiderate must be considered to be 
established. Such a simile is Strychnia to tetanus, 
Cannabis Indica to catalepsy, and Hydrocyanic Acid 
to the epileptic paroxysm. It cannot be objected 
with justice that from such a comparison diagnosis 
is excluded. If diagnosis means the perception of 
the precise seat of the malady, and of the exact “ SIMILIA SIMILIBUS.” 
17 
morbid alteration which is going on therein, then 
it is indeed often necessarily excluded, whether as 
regards disease or as regards drug-action. Who 
will tell us what Catalepsy is? Yet it is a definite 
condition, and the Indian hemp has been observed 
to produce it. But diagnosis more properly means 
the clistinguishment of one form of disease from all 
others which resemble it: and the very means of 
effecting such distinguishment is a consideration of 
what symptoms are present and what absent. 
Nor should it be affirmed that such a method of 
finding the simile makes the prescriber “liable to 
overlook the distinction between idiopathic and sym- 
pathetic affections; between symptoms which arise 
from diseases of the organs they are connected with, 
and those which are the effect of sympathy with 
some other diseased organ.”* Such a mistake 
would be due to his own ignorance or carelessness,— 
not to any fault in his method. How do we dia- 
gnose between vomiting of cerebral and of gastric 
origin except by considering all the symptoms pre- 
sent, and observing their proportion and sequence ? 
If we have done the same with our drug-symptoms, 
we are not likely to select “ inappropriate remedies” 
in any given case. 
A signal merit in this method of arriving at the 
true simile is that it ensures that the likeness shall 
be specific, and not merely generic. All things are 
like each other in some points, but differ in others. 
All diseases are departures from health: but some 
are miasmatic, some diathetic, some “ dietic.” All 
the miasmatic diseases are febrile; but some of the 
* Dr. Sharp on * Organopathy.’ 18 
“ SIMILIA SIMILIBUS.” 
fevers are intermittent, some continued, some erup- 
tive. Again, the eruptive fevers resemble each other 
in possessing an exanthem, but differ according as 
this is of the character of measles, scarlatina, or 
small-pox. Then there are certain well-recognised 
varieties of each of these diseases, in which the 
characters essential to each exist with certain dif- 
fering modifications or concomitants. Lastly, each 
individual case of either small-pox, measles, scarla- 
tina, or any other disease, has its own peculiarities 
which distinguish it from every other case. Now 
the method by totality of symptoms provides for 
this individualization, alike of disease and remedy. 
If fully followed out, the medicine will correspond 
with the malady, not only in the generic lesion we 
call pneumonia, phthisis, dysentery, and so on, but 
in the specific characters assumed by it in the 
variety we are observing, or in the individual 
patient before us. These specific differences cannot 
be accidental: they are parts of an organic whole. 
If they are not found in the medicine as well as in 
the disease, the former so far falls short of that 
perfect similarity which is required to ensure per- 
fect success. 
The method by totality of symptoms, moreover, 
has the advantage of meeting every conceivable 
case. It is only a portion of the great world of 
disease that has yet been so accurately surveyed 
that it can be mapped, and planned, and fitted with 
names. For such concrete maladies only can speci- 
fics be allotted beforehand. Beyond their range 
lies a terra incognita of derangements the most 
diverse, complex, and varying, which as yet defy “ SI MI LI A S1MILIBUS.,J> 
19 
classification and nomenclature. To cases of this 
kind the symptomatic method is the only one 
applicable. I knew not the significance of the 
occurrence, in a patient convalescing from parturi- 
tion, of urine loaded with lithates, debility, low 
spirits, anorexia, copious sour perspirations, and 
persistent aching of the mammae. But I found 
all these symptoms (save the last) in the patho- 
genesis of Causticum: and selected that remedy 
accordingly, with amply satisfactory results. 
Hitherto I have been vindicating the scientific 
accuracy and practical adaptability of the Ilalme- 
mannian method. Such vindication is necessary if 
we would not disown those early successes which 
made the fortune of Homoeopathy so rapidly. But 
as you read what I shall hereafter write to you, you 
will see that it is rare indeed that a complete paral- 
lelism of symptoms exists between diseases and their 
remedies. But few medicines have been exhaustively 
proved : and the form in which the early provings 
have been handed down to us renders any rational 
comparison of their symptoms with those of disease 
out of the question. You will find us led to the 
simile—sometimes by a mere hint in the patho- 
genesis, sometimes by the evidence of a post- 
mortem examination, sometimes by the usus in 
morbis reflecting light upon a group of symptoms 
otherwise meaningless, sometimes by that usus in 
morbis alone. But I would have you observe that, 
by whatever pathway reached, it is the true simile 
which is obtained. That is, we have found the 
medicine which is in specific relationship with the 
disease,—with the part affected, and with the 20 
“ SIMILIA SIMILIBUS.” 
manner of its affection. Baptisia effects as defi- 
nite an extinguishment of gastric as does Aconite 
of simple fever: but the application of the former 
was obtained from merely empirical sources, while 
that of the other was a pure induction of Hahne- 
mann’s from the symptoms of his proving. 
Let me enlarge a little farther on this head. I 
have spoken of the necessity of considering the 
sequence of symptoms. This applies especially to 
those symptoms called “primary and secondary.” 
Thus, the initial chill and the subsequent burning 
heat of fever are apparently opposites; and it would 
seem that a medicine which would be homoeopathic 
to the rigor would be antipathic to the calor. But 
observation teaches us that the chill and the heat 
are but successive expressions of the same morbid 
condition: experiment even proves that the tem- 
perature is rising while the patient is still shivering. 
So far, then, from a different medicine being re- 
quired for the two stages, it is essential that the 
one medicine which shall control both shall be 
capable of causing both, as indeed Aconite does. 
It is the simile of the two series of phenomena 
because it is in specific relationship with the vas- 
cular nerves, and with that disorder of their 
regulating function in which simple fever consists. 
The same thing is true of what are known as 
“alternating symptoms.” We know Nux vomica 
as one of the remedies for constipation, and Mer- 
eurius for diarrhoea. But we find looseness of the 
bowels no rare symptom in the pathogenesis of 
the former, and constipation in that of the latter. 
If we are puzzled, observation of disease soon “ SIMILIA SIMILIBUS.” 
21 
explains the difficulty. That same irritable state 
of the intestinal fibre which in the adult induces 
constrictions which impede free evacuation, in in- 
fants leads to impatience and frequent emptying 
of the canal. While in chronic hepatic disorder it 
is no uncommon thing for the patient to complain 
that his bowels are sometimes unduly confined, and 
sometimes quite as deranged the other way. In 
alternating symptoms, then, as in those called 
primary and secondary, the relationship of simi- 
larity on the part of the medicine is with the 
underlying condition capable of producing either 
or both. 
Ilcnce “ contraria contrariis ” is often as true 
phenomenally as “ similia similibus,” and a no less 
certain guide to the right medicine. I do not mean 
to imply by this that mere antipathic power on the 
part of a drug qualifies it for a place among our 
remedies. Such means will sometimes meet tem- 
porary emergencies: but they have ever been found 
wanting in the treatment of prolonged and recurring 
disorders. Dr. Madden's Bromide of Potassium may 
have so quenched the acute erotic irritation of his 
patient that the sympathizing brain had time to 
recover from its mania. But the use of this drug 
in epilepsy, so much belauded at present, is to my 
mind a most unsatisfactory practice. By its dead- 
ening influence on the nervous centres it suspends 
the paroxysms for a while. But with its discon- 
tinuance they nearly always return ; and the patient 
must either live upon the drug all his lifetime, with 
evils yet untold developing under its use, or must 
takv. off the repressing influence only to see the 22 
e< SIM ILIA SIMILIBUS.” 
fits returning, perhaps with renewed vigour after 
their temporary suspension. The adoption of the 
antipathic method, as such, is moreover rarely prac- 
ticable. Very few morbid states have any contraries. 
Can you tell me the opposite of gout or of scrofula, 
of typhus or of erysipelas? But the great bulk of 
the opposites are really not contrary but comple- 
mentary one to another. Spasm and paralysis, 
hyperesthesia and anesthesia, contraction and dila- 
tation of blood-vessels, sopor and insomnia, consti- 
pation and diarrhoea may succeed one another or 
replace one another or even co-exist in the same 
patient. They are but varying expressions of a 
sub-vital condition of an organ or of the general 
system,—the variation in the expression being 
governed by laws as yet little known to us. 
And so we arrive at the conclusion, that the true 
contrary of ofxoiog is not Ivavnog but dAAotoe, not 
opposite but foreign.* If a medicine have no spe- 
cific relationship to the part affected, Homoeopathic 
therapeutics have nothing to do with it. If it have 
such relationship, we shall not be deterred from 
giving it by an apparent contrariety between the 
symptoms induced by the drug and those present in 
our patient to-day. The opposite and comple- 
mentary symptoms may appear to-morrow. When- 
ever, indeed, as in tetanus or post-diphtheritic 
paralysis, in lead-colic or cholera, experience tells us 
that the symptoms set uniformly in one direction, 
it is necessary for the simile that the effects of the 
* Just as the true contrary of love is not hate, hut indifference. 
Love and hate both imply an interest in their object, and are often 
(in the lower grades of the former) interchangeable. “ SIM1LIA SIMILIBUS.” 
23 
medicine should point the same way. That is, the 
kind of affection, as well as the part affected, must 
coincide in the disease and the drug respectivel}r. 
This is still more important when we come to dis- 
criminate between the specifically different derange- 
ments which may affect the same organ. That a 
medicine acts on the liver, and sets up simple in- 
flammation therein, does not prove it homoeopathic 
to acute yellow atrophy. The tormina, tenesmus, 
muco-sanguineous stools, and post-mortem ulcer- 
ations of dysentery, must be reproduced in the 
pathogenesis, if a power of inflaming the mucous 
membrane of the large intestine is to constitute 
any drug a remedy for this disease. You will see, 
therefore, that I cannot coincide with Dr. Sharp’s 
revived “ Organopathy,” or adopt an exclusively 
“anatomical basis of therapeutics.” Specific re- 
lationship between drug and disease must include 
character as well as locality. But what I aim at 
showing is that specific relationship, thus under- 
stood, is the fundamental fact on which Homoe- 
opathic therapeutics are based. I believe, indeed, 
that in the Divine order of Nature there is a pre- 
established harmony between disease and drug- 
action,—between the idiopathic derangements of 
the organism and the action of poisons upon it: 
that there is no pathological condition, however 
peculiar or complex, which is not producible also by 
some drug, known or unknown. When every sub- 
stance in the mineral, vegetable, and animal king- 
doms capable of affecting the body shall have been 
proved upon it, and its full effects ascertained, then 
the ncaling art will not be far from perfection. In 24 
“ SIMILIA SIMILIBUS.” 
the mean time mag is venenum magis remedium. 
The polychrests will be those which correspond to 
the greatest number and variety of morbid states, 
or to those of most frequent occurrence. The minor 
medicines will fill up gaps in those of wider range, 
or will occupy niches which, if left without special 
tenants, would be weak points in the therapeutic 
edifice. 
We return to our rule “ similia similibus curen- 
tur.” It appears now in the light of a guide-post 
towards the true object of our search, specific re- 
lationship. We may use it either a priori, as when 
we study the pathogenesis of a medicine to ascertain 
to what idiopathic diseases it is likely to correspond: 
or a posteriori, when in viewing a case we consider 
what medicine causes the group of symptoms we 
have before us% In either case the rule is our guide 
to the discovery of specifics. That they may be dis- 
covered in other ways is obvious. Sometimes, as I 
have mentioned, by the rule “ contraria contrariis 
curentur,” as when Ilyoscyamus was given for cere- 
bral excitement because it sometimes causes sopor. 
Sometimes purely empirically, “ by the merest 
chance,” as we say, of which Cinchona bark in ague 
is a notable instance. I only claim for the rule 
“ similia similibus” the first place as an instrument 
for this discovery :—its title thereto being that more 
specifics have been found by its means in the last 
fifty years than have rewarded other modes of re- 
search for the preceding five thousand. Aconite in 
simple fevers, Arsenic in those of a typhoid type, 
Belladonna in inflamed throat and erysipelas, Bryonia 
and Khus in rheumatism, Calcarea in the mal-assi- “ SIMIL1A SIMILIBUS.” 
25 
milative derangements of childhood, Camphor and 
Yeratrum in cholera, Chamomilla in nervous ere- 
thism, Coffea in sleeplessness, Colocynth in colic,— 
I could go on for a page enumerating the specifics 
already discovered by this potent instrument. That 
more and more will come to light as its materials 
increase, and its application becomes more sound 
and thorough, I firmly believe : until at last every 
possible variety of disease shall have found its 
suitable remedy. Then, and not till then, will 
Hahnemann's “ Novum Organon'5 cease to be 
necessary, for its work will have been accom- 
plished. 
This is the future of medicine to which I look. 
The “ perfecting of the Materia Medica” of which 
we so often hear I regard as only a means to an end; 
and in proportion as that end is attained the need of 
any Materia Medica.whatever becomes less and less. 
Few of us now ever consult the pathogeneses of 
Aconite or Belladonna, of Arsenic or Camphor. We 
know all their specific relationships : any fresh appli- 
cations they may yet receive will be only extensions 
of those already established. Pathology is every 
year pushing her outworks farther and farther on. 
The chaos of disease is steadily being brought into 
order, and its almost infinite varieties are being dis- 
tinguished and ticketed and classified. As each new 
species comes into light it will be our task to assign 
to it its specific remedy; and if more than one medi- 
cine corresponds to its symptoms, we must consider 
what are the varieties of the disease to which each 
belongs. We shall thus be building up the great 26 
tc SIMILIA SIMILIBUS.” 
edifice of specific therapeutics of which the law of 
similars I take to be only the sqaffolding. 
To note, from time to time, the progress of this 
building, and to make suggestions for its best pos- 
sible extension ; to set down such specific treatment 
as has become classical, and to indicate the directions 
in which to look for more,—this is a work which 
needs to be done. The following pages, however 
feebly and imperfectly executed, will at least be 
wrought in this spirit and with this aim. If, be- 
sides helping yourself and others who may see 
them, they contribute anything, however humble, 
to our knowledge of true specific relationships, I 
shall not have toiled at them in vain. 
I have devoted so much space to the consi- 
deration of the meaning of our fundamental law, 
that I must defer to another letter the various ques- 
tions which arise as to its due application. LETTER III. 
THE DOSE AND ITS REPETITION CHANGE AND ALTER- 
NATION OF MEDICINES AUXILIARIES THE 
DUTIES OF THE HOMOEOPATHIC PHYSICIAN. 
} ou are now in the presence of a case of dis- 
ease. You are possessed, either through some pre- 
vious adaptation of remedy to malady, or from a 
comparison of your patient’s symptoms with the 
Materia Medica, of the similar medicine you 
require. But several questions have yet to be 
settled before you use it : and one of the first 
which will arise is that of the dose in which it is to 
be administered. 
You have probably already learnt that while all 
practitioners of our school are agreed upon the prin- 
ciples on which the remedy should be chosen, they 
are widely divided as to the quantity in which it 
should be given. It would be of little use for me 
to add my individual opinion to the multitude 
already existing. But you will have to make up 
your own mind upon the subject: and I can at 
least supply you with some of the data on which 
your judgment must be formed. 
The history of the “ homoeopathic dose” is as 
follows. When Hahnemann first began to pre- 
scrib' medicines according to the rule “ similia 
similibus,” he gave them in the usual quantities. 28 
THE DOSE AND ITS REPETITION. 
It is not surprising that his patients* symptoms, 
even though ultimately removed, were often in the 
first instance severely aggravated. It needs no ar- 
gument to show that the ordinary doses of Arsenic, 
against which even a healthy stomach needs to be 
shielded, would increase the irritation of one already 
inflamed. So Hahnemann found, and he reduced 
his doses accordingly. At what stage of this re- 
duction he found that fractional quantities of a small- 
ness hitherto undreamt of exercised a potent influ- 
ence I cannot say. But once satisfied of the power 
of infinitesimals, he adopted them with enthusiasm 
as a part of the new system of medicine he was in- 
augurating. He regulated their preparation bv a 
fixed scale of dilution,—the centesimal. With this 
he boldly pushed on till at the 30tli dilution he had 
reached decillionths. Here he paused, and appears 
to have wished to draw at this point a “ hard and 
fast line/* In his ‘ Chronic Diseases* he recom- 
mends all medicines to be given in the 30tli dilu- 
tion, thus advancing to that point the many con- 
stituents of his £ Materia Medica Pura’ to which he 
had there assigned the I2th, 9th, or 3rd potency, or 
even the mother-tincture, as most suitable. With 
the exception of a suggestion in the preface to the 
proving of Thuja that such a drug might with 
advantage be raised even to the 60th, he seems 
himself to have kept to the 30th as an ultimatum. 
But his disciples were more Wilkesite than Wilkes 
himself. A few of them, amongst whom Trinks is 
eminent, declined even to follow the master, and 
used only the first two or three of the dilutions of 
his scale. But the more enthusiastic pushed on THE DOSE AND ITS REPETITION. 
29 
until the 200th had been reached, nor indeed paused 
there. You will find an account of the doings of 
these “ high-potency men” in Dudgeon's ‘ Lectures 
on Homoeopathy.' They have nearly died out in 
Germany, and have found very few representatives 
in France or England. But in America the school 
has taken a fresh start. 'With a number of prac- 
titioners there the 200th is considered a low potency, 
suited for common use : while the 1000th forms a 
new unit from which to start, and we hear of cures 
being wrought by the 71 iq dilution, which means 
the 71,000th ! 
I must leave you to satisfy yourself, if you care 
to do so, as to the claims made on behalf of these 
“ high potencies.” They are altogether outside the 
range of the Homoeopathy into which I am endeavour- 
ing to help your induction. I shall do more for you 
if I tell you how the dose question stands and has 
stood in this country, which is (with the exception 
above named) a fair representative of all others in 
this matter. 
The converts made to Homoeopathy in Great 
Britain seem to have started from about the level of 
the ‘ Materia Medica Pura.' The earliest practice 
on record in English literature exhibits the medium 
dilutions—the 12th to the 3rd—chiefly in use, the 
30th also being pretty frequently administered. 
But a tendency soon displayed itself to descend 
rather than ascend the scale. The writings of Dr. 
Drysdale* and Dr. Maddenf and the cases recorded 
* ‘ Brit. Journ. of Horn.,’ vol. vi, p. 1. 
t Ibid., vol. xi, p. 1. 30 
THE OOSE AND ITS HE PETITION. 
by Dr. Henderson* exhibit the march of this pro- 
gress. Now almost all British practitioners have 
joined it. A few remain behind, and protest loudly 
from their desolate eminences. But while some, 
and those not of least eminence among us, have 
even reached the mother tincture as the most suit- 
able dose, there are few of us who in our ordinary 
practice go above the 2nd and 3rd. There are 
indeed advocates for a more extensive range of dose, 
who believe that different medicines require to be 
given in very different dilutions, and that different 
dilutions of the same medicine often subserve very 
different purposes. Drs. Madden and Bayes are 
the chief defenders of this position in our present 
literature ; and with them I humbly range myself. 
But for your part you will do well to adopt as a 
general rule the dilutions from the 2nd to the 6th. 
When the evidence concurs and preponderates 
strongly, as in the case of Chamomilla, of Lachesis, of 
Lycopodium, in favour of the higher dilutions,—or 
as in that of Camphor, of Aconite, and of Baptisia 
on the side of the lower, you will feel bound to 
follow it. In other cases the range I have suggested 
will be found tolerably safe. 
I have carefully refrained from prejudicing you, 
either in these or in my former letters, on the ques- 
tion of dose. WTien writing to you upon our 
medicines, I have mentioned whether the higher or 
lower potencies have been most in favour, or whe- 
ther success has been claimed from different sides 
for both. In now discussing the treatment of dis- 
eases, I shall only name the potency of the medi- 
* * Brit. Joura. of Horn.,’ vols. viii, ix, &c. THE DOSE AND ITS REPETITION'. 
31 
eines I recommend when it is with the dose, as well 
as with the remedy, that the experience has gained. 
You will thus be put in a position to try, as all 
of us have had to try, the question for yourself; 
and the result at which you arrive will at least be 
your own, and not borrowed at second hand from 
another. 
For the bibliography of the dose question 1 refer 
you to Dr. Dudgeon's “ Lectures on Homoeopathy" 
(Lect. xiv, xv), and to the following papers in the 
‘ British Journal of Homoeopathy.' 
Dr.Drysdale, “ Critical Examination of the Dose," 
vol. vi, p. 1. 
Dr. Black, “ Remarks on Posology,' vol. vii, 
p. 224. 
Dr. Madden, “ On Infinitesimals," vol. xi, p. 1. 
Ibid., “ A few more words about the 
Dose," vol. xix, p. 293. 
And in the ‘ Annals,' Dec. 1867, on “ The Dose,'’ 
by Mr. Edward T. Blake, with the Discussion. 
You will observe that with us the question of 
dose is that of the “ potency," not of the number 
of drops or grains. The latter is of little conse- 
quence, so far as quantity is concerned. But if 
there be anything in the principle of minute sub- 
division as extending a given quantity over a wider 
area,* and if it be so that a number of spermatozoa 
are requisite for the impregnating impulse, it would 
seem probable that several drops of the higher dilu- 
tions at least would make more impression than 
* See Doppler’s observations in he Essay of Dr. Samuel Brown 
in the “ Introduction to the Study of Homoeopathy ” by Drs. Drys- 
dale anu Bussell. 32 
THE DOSE AND ITS REPETITION. 
one. I generally act upon this theory: but I have 
nothing positive to bring forward in the way of 
results. 
2. You have now selected your medicine and 
determined upon its potency. The drops of tincture 
you prescribe will of course be mixed with water, 
and the grains of trituration suspended in the 
same vehicle or put dry upon the tongue. The 
next question which will arise will be as to the fre- 
quency of the repetition of the dose. It is strange 
that there should be any difference of opinion on 
this subject. You will almost instinctively do what 
the great mass of our practitioners do; i. e. give the 
medicine once or twice a day in chronic diseases, 
and in acute diseases from every four hours to every 
fifteen minutes according to the rapidity of the 
morbid process you are combating. But you will 
find that while the latter practice is almost universal, 
and in cholera at any rate received the sanction of 
Hahnemann himself, it is otherwise with chronic 
diseases. The master and his immediate disciples, 
and in the present day those among us who call 
themselves specially by his name, advocate in such 
cases the plan of giving one dose, and “ allowing it 
to act” for a length of time. A certain “ duration 
of action” is assigned in the ‘ Materia MedicaPura* 
and the ‘ Chronic Diseases* (on what grounds I 
know not) to each medicine : and the practitioner 
is considered impatient if within this period he 
repeats his dose. Twenty-four hours is the shortest 
of these durations : and a week, thirty, forty, fifty 
days are not uncommon. 
Now I am not going to condemn such a mode of CHANGE OF MEDICINES. 
33 
practice out of hand. On the contrary, I think it 
worthy of investigation. But I must assert that it 
has yet to he established upon experimental grounds. 
There is no evidence for the long duration ascribed 
to the action of certain medicines. There is a dif- 
ference among the Hahnemannians themselves as 
to whether the high or the low dilutions act the 
longest. Prof. Hoppe has argued the subject very 
ably from their point of view in the ‘ Brit. Journ. 
of Horn./ vol. xx, p. 269. But while we may 
grant him that in recent disturbance of the organ- 
ism a single medicinal impression may rectify the 
disordered balance, and set going the processes 
which lead back to health, it seems more likely 
that in disease of some standing a steady and 
regular repetition of such impressions at not too 
long intervals would effect most good. At any rate 
cures are frequently wrought in this way; so that 
if the repetitions are needless, they are harmless. 
I recommend you, therefore, for your own part, 
to follow the ordinary mode of proceeding. But it 
is right that you should be aware of the existence 
of this doctrine and practice; and I see no reason 
why you should not test it in cases where you 
really know something of the length of action of 
the medicine, and can watch closely the patient’s 
symptoms. 
3. And now as to continuing your medicine. 
Are you to expect, when you have once chosen the 
simillimum of your patient’s condition, that he will 
be cured by that one remedy alone ? That he 
should be so cured is perhaps the ideal and the ulti- 
mate goal of the Homoeopathic method. But it is 34 
CHANGE OF MEDICINES. 
certainly not practicable at present. In chronic 
disease, even though the starting-point should have 
been in one organ, by degrees other organs have 
become involved, and probably the blood and ner- 
vous system have deviated from the healthy stan- 
dard. A number of elementary morbid states are 
concurring to make up the concrete disease before 
us; and it is by no means certain that, even if you 
can discover the primary lesion, you can destroy 
the branches by your cuttings at their root. Very 
often, too, (the tendency of modern pathology is to 
say nearly always*) the disorder has begun in the 
system at large before it has localised itself in any 
particular organ. Hence your treatment of chronic 
disease must generally be the unravelling of the 
coils of a complicated knot, and you will require 
more than one medicine in its course. Carefully 
review your patient’s symptoms from time to time, 
and if any improvement which has resulted from 
his present medicine has come to a pause, consider 
whether any other seems more suitable. Only do 
not be too ready to make a change. Keep the 
ideal before you, even though at present it be un- 
attainable. You may sometimes, if the symptoms 
still point to the original remedy, change its potency 
only, ascending from low to high, or (still better, 
as I think) descending from high to low. The 
medicines to which your first study of the case, if a 
thorough one, conducted you should be adhered to 
as firmly as possible throughout its treatment. 
* See Dr. Gull’s * Address on Medicine/ before tlie British Medical 
Association, 1868, and the last Edition of Aitken’s ‘ Science and 
Practice of Medicine/ passim. CHANGE OF MEDICINES. 
35 
In acute disease we may approach more nearly 
to the standard. In many cases we are able to 
oppose the whole group of symptoms with one medi- 
cine, and see them melt away under its sole influ- 
ence. The number of diseases which admit of 
being thus dealt with is continually increasing : and 
they form some of the most satisfactory parts of our 
practice. Nor are all the exceptions truly such. 
For instance, when diseases have well-marked 
stages—as meningitis, typhoid fever, hooping-cough 
—it is no departure from the specific ideal to have 
a different medicine allotted to each stage. And the 
conformity is complete when the medicines for the 
different stages show a power of curing the disease 
then and there before it goes any farther. So, for 
instance,—while pertussis is a catarrh with a cough 
violent out of proportion to the inflammatory irri- 
tation, Aconite and Ipecacuanha precisely cover it, 
and will every now and then extinguish it. But 
when it becomes a pure spasm, it has passed the 
reach of these remedies, and Drosera, Belladonna, 
Corallia and such like take their place. The same 
holds good of Baptisia and Arsenicum in the first 
and second stages of gastric fever, and is familiar to 
you in the relation of Mercury and Iodide of Potas- 
sium to primary and secondary syphilis. Recognising 
this principle of stages, and carefully allotting our 
remedies to varieties, I think we may in acute disease 
make the single medicine the rule rather than the 
exception.* 
* Upon this subject you should read a paper by Dr. Neville 
Wood (‘ Annals,’ vol. i, p. 316), with the discussion at the British 
Homoeopathic Society which followed its reading. 36 
ALTERNATION. 
4. The above question borders closely upon that 
of alternation, on which I now desire to say a few 
words. 
What are you to do when no one medicine covers 
all your patient’s symptoms ? In chronic disease I 
think there can be no hesitation about the answer 
to the question. You should give the medicine 
which corresponds to the symptoms of greatest 
weight, and let it play its part before you bring 
any other to bear. The adoption of a different 
course would lead to confusion, certainly in the 
results of your practice, and probably in the organ- 
ism of your patient. Save in a few instances, 
where the exception is warranted alike by reason 
and experience, the rule is never to give more than 
one medicine at a time in chronic disease. 
But again acute disease gives a different aspect 
to the question. There is often no time to wait 
till the effect of one medicine is exhausted before 
you give the other; nor can you stay with your 
patient to watch the fitting hour for the change. 
So that upon the ground of practical expediency 
only we are sometimes driven to alternate, since we 
are unwilling to mix. Then again there are the 
cases brought forward by Dr. Bussell, in which two 
morbid processes, as variola and typhus, run their 
course in the system at the same time. This, 
which in Hahnemann’s day was thought impossible, 
necessitates a modification of the rigidity of his rule 
to give only one medicine at a time; and encour- 
ages us further to believe that two medicinal actions, 
as well as two diseases, can work side by side with- 
out interference. Nor are there wanting other in- ALTERNATION. 
37 
stances in which the use of more than one medicine 
at a time seems justifiable. The pathological pro- 
cess we call dysentery finds its pi’ecise analogue in 
Mercurius corrosivus ; and very often this medicine 
alone is all that we require. But sometimes the 
fever, sometimes the tormina, sometimes the haemor- 
rhage, sometimes the tenesmus—are so severe, that 
an alternating remedy suited to the predominant 
trouble seems to have a raison d’etre, and is cer- 
tainly useful. So when hooping-cough becomes 
complicated with bronchitis,—it would hardly be 
wise to omit your remedy for the neurosis because 
you have to give one for the phlogosis: and so you 
must alternate. 
All these cases are very different from the slipshod 
practice of alternating two medicines as a matter of 
course; or because you think them equally well 
indicated, and cannot choose between them. This has 
but to be mentioned to be condemned. Alternation 
should always be practised—not “under protest,’* 
but—as an exceptional proceeding. The exception 
is in part practical only, and may disappear with 
advancing knowledge. As we often supersede two 
opposite half-truths by some deeper whole truth 
which embraces them both, so in many instances in 
which we now alternate two medicines one may be 
discovered which shall cover all the symptoms. I 
think, indeed, that we often alternate unnecessarily 
as it is. But I am disposed to believe that to some 
extent alternation is founded on principle ;—that 
there are (the illustrations are Dr. Madden’s) double 
stars in the firmament of medicine, compounds which 
are themselves radicles in therapeutic chemistry. 38 
AUXILIARIES. 
I do not refer to such medicines as Hepar sulphuris, 
which is a compound of Sulphur and Calcarea. 
The combination here is chemical, and it has been 
proved as a simple drug. The “ binary Homoeopathy” 
of which I speak is vital and not chemical : the 
reactions of the medicines are not one with another, 
but with the organs whose different tissues they 
influence. I will only hint at this now : it is an 
inquiry which needs working out. But just to 
indicate what I mean — I can hardly conceive a 
medicine more homoeopathic to the fever of measles 
than Aconite, and evil always results from its sus- 
pension ; and yet you must alternate other medicines 
with it if you want to relieve the coryza, the bron- 
chitis, or the diarrhoea from which your patient may 
be suffering. 
For further suggestions towards the basing of occa- 
sional alternation on fixed principles I refer you to 
the papers of my friend Dr. Drysdale in the 4<th 
volume of the ‘ Annals/ p. 3. 
5. Next to the dose and alternation, the most 
moot question in our ranks concerns the employ- 
ment of (so-called) auxiliaries. Now I cannot help 
thinking that much of the feeling which leads to 
the use of this term is unhealthy, and needs cor- 
rection. But there is a right use of it, and a right 
thought about it, which may be stated as follows. 
Let us suppose a practitioner of traditional medi- 
cine first embracing the Homoeopathic doctrine. He 
feels, as Dr. Bussell expresses it, “that a sudden 
sunshine has been spread over his practice; ” he is 
conscious of the possession of many new therapeutic 
agents, and of a key to the discovery of many more. AUXILIARIES. 
39 
But does he therefore abandon all the means he has 
hitherto learnt to use ? He would be very foolish 
were he to do so. On the contrary, he erects his 
new building within the walls and under the cover 
of the old. He begins by treating selected cases 
with his novel remedies, leaving unchanged the 
great bulk of his practice. As he learns confidence 
and experience he pushes his Homoeopathy farther 
on, and lets his former expedients drop more and 
more into the background. At last the latter have 
become the exception and the former the rule of 
his practice, and the term “ Homoeopathic ” becomes 
justly applicable to his position and mode of treat- 
ment. 
Now as with the individual practitioner, so with 
the whole school which follows the teaching of 
Hahnemann. We have no doubt in our minds that 
likes are cured by likes. But this is quite a differ- 
ent thing from affirming that likes cure all diseases 
without the aid of other means. How far this latter 
is true can only be decided by trial; and Homoe- 
opathic practice, regarded scientifically, is a vast 
experiment towards the decision of the question. 
In the case of many—I may say most—diseases it 
has already answered it in the affirmative. In some 
few the reply is already negative. But in the 
remainder the experiment is still proceeding, the 
question still being asked : and when here we use, 
as we must use, some of the resources of the old 
school, we should acknowledge to ourselves and at 
large that they are extraneous auxiliaries. You will 
find ipstances of what I mean in several of the 
letters I shall write to you. 40 
DUTIES OF THE HOMCEOPATHIC PHYSICIAN. 
But this is quite a different thing from styling 
everything beyond the specific medicine we admi- 
nister an auxiliary, and using such “ under protest/* 
and with a sense of imperfection and need of apo- 
logy. It seems to me that such a state of feeling is 
unhealthy and even demoralizing. Drug-giving, 
however important, is surely not the beginning and 
the end of the physician’s duty. He has to adapt 
to his patient all natural forces and circumstances 
within his control,—heat and cold, light and air 
and water, rest and exercise, food and stimulus. 
He has to remove mechanical obstacles, and neutral- 
ize chemical infections. To call the measures— 
surgical, hygienic, hydropathic, as the case may 
be—by which he effects these ends auxiliaries, and 
to imply that they lie outside the ordinary path of 
medicine is, I conceive, an error of the most per- 
nicious kind. I should be very sorry for you to 
enter upon Homoeopathic practice with the thought 
that all your knowledge and command of natural 
influences were henceforth to be laid aside. How 
far you can do without bleeding and blistering may 
be a question : but that you can regard these others 
as needless is an unwarrantable expectation. 
6. In what I have just been saying about auxi- 
liaries I have touched upon the subject of the 
position and duties of the Homoeopathic practitioner. 
You will see that the common assumption as to the 
limitations to which he has bound himself has no 
foundation in fact. In becoming an Homoeopathist, 
he has not ceased to be a physician. “ Christianus 
nomen, Catholicus cognomen/* said S. Augustine; 
and so with us. Our name is physician, homceo- DUTIES OP THE HOMOEOPATHIC PHYSICIAN. 
41 
pathic is but an addendum. We are priests of the 
one Catholic Church of Medicine, though the pre- 
vailing majority would fain deny our orders and 
invalidate our sacraments. They force ns into a 
sectarian position: * but they shall not inspire us 
with a sectarian spirit. We claim our inheritance 
in all the Past of Medicine, and our share in all its 
Present. We assert and use our liberty to avail 
ourselves of every resource which the wit of man 
has devised or shall devise for the averting of death 
and the relief of suffering. We know of no obli- 
gation superior to the paramount one of doing our 
best for our patients. 
But while desirous of impressing this primary 
truth upon you, I would remind you that you have 
duties as “ Homoeopathicus ” as well as “ Physi- 
cianus.” Duties to your patients, for they seek your 
aid as such : duties to the Method itself, whose 
name you adopt, and whose advantages you enjoy. 
These duties belong to your share in carrying out 
the great experiment of which I have spoken. 
Except in instances where large experience has 
pronounced it insufficient, give Homoeopathy pure 
and simple a fair trial. Do not aim at a premature 
and presumptuous eclecticism. It is much to have 
cured the case in hand. But it is much more to 
have cured it upon a simple method which, satis- 
factory in itself, admits of application to other cases 
and by other hands. Do not be content with saying 
“ I don’t know whether it is scientific practice or 
not; all I know is that my patients get well under 
* See the capital paper on “ Science and Sectarianism,” by Dr. 
Dudgeon, in the ‘British Journal of Homoeopathy’ for July, 1868. 42 
DUTIES OF THE HOMCEOPATII1C PHYSICIAN. 
it.” If your treatment be not scientific,—that is, 
methodized—it perishes with yourself, and benefits 
only the few individuals who come under your care. 
Eut every cure wrought upon principle is an acces- 
sion to the Healing Art, and leads to consequences 
immeasurable. We want diligent workers at our 
Method, at its theory and its practice;—men who 
love it for its own sake as truth and knowledge, 
apart even from its usefulness to mankind, still more 
from its value in putting fees into their own pockets. 
Among such workers—and these letters teem with 
names of them—I hope that you will take your 
place. If I shall have helped you, not merely to 
practise Homoeopathy, but to practise it in this 
spirit, I shall not have written for you in vain. LETTER IY. 
BLOOD DISEASES. 
I begin the group of blood diseases with those 
which involve a quantitative change only in 
the composition of the vital fluid. These are 
Plethora, Anaemia, and (less certainly) Scurvy. 
Together with the last named I associate Purpura, 
on the ground of their phenomenal resemblance, and 
for want of a better place. 
Plethora 
is a morbid condition which may be dismissed in a 
very few words. I take it to be very rarely met 
Avith now-a-days; and, Avhen present, to result 
from the transgression of obvious physiological 
laws. Its treatment must accordingly be purely 
hygienic and dietetic, and no place for dynamic 
remedies can be with any plausibility assigned. If, 
however, a case should come before you in which 
the patient really does “ make blood too fastif, 
in spite of spare diet and active exercise, the symp- 
toms of plethora still persist, you Avould naturally 
and rightly administer minute doses of some pre- 
paration of Ferrum* 
* My friend Dr. Hutchinson suggests that the pseudo high 
health resulting in the Styrian peasants and the Vienna horses from 44 
ANiE MIA. 
Ansemia 
presents a wider field for inquiry. In one form 
indeed in which it occurs it is just the correlative 
of plethora, both as to cause and as to treatment. 
I mean when it results from deficiency of air, 
light, and suitable food, and from other depressing 
causes. The only rational and permanently suc- 
cessful treatment of such cases must be the removal 
of the depressing cause or the restoration of the 
lacking sanantia. I cannot doubt, however, that 
the administration of Iron as a dietetic agent is of 
great benefit here. It certainly quickens the im- 
proved sanguification which proper diet and hygiene 
are favouring. But without these it can be 
nothing more than a temporary stimulant; and I 
see many objections to its use. 
There is another simple and intelligible form of 
anaemia; that resulting from excessive or long-con- 
tinued losses of blood. I need hardly remind you of 
the value of China in these cases. But this 
remedy goes no farther than the exhaustion con- 
sequent upon the haemorrhage. Again we turn 
gladly to the well-tried Iron to help the generous diet 
we prescribe to make blood as speedily as possible. 
The direct feeding of the impoverished blood by 
the metal is here a plausible hypothesis enough. 
But perhaps the most common form of anaemia 
is that which comes before us in connexion with 
disordered menstruation. A glance at the young 
woman who enters our consulting room gives us the 
eating Arsenic is a plethora of this kind: and infers the homoeo- 
pathicity thereto of this medicine ANAEMIA. 
45 
whole group of symptoms. The catamenia absent, 
or retarded, scanty, and pale ; frequent palpitation ; 
breathlessness on slight exertion; debility, anorexia, 
and low spirits—make up the patient’s story; to 
which our examination adds the anaemic murmur 
in the neck, the waxy puffy skin, and the exsan- 
guine mucous membrane. Now what is the 
relation between the anaemia and the catamenial 
disorder ? It is common now to say that these 
patients do not menstruate because the ovaries find 
no blood upon which to drawr. But very often the 
history of the case is this. A young woman in fair 
health gets a chill while menstruating, and the 
flow is checked. When the next period comes 
round, nothing is seen. Coincidently with this the 
general health fails, and the symptoms of anaemia 
develop themselves.* If now under dynamic 
remedies (of which Pulsatilla is the chief) the cata- 
menia are restored, pari passu the anemia departs. 
I must not follow up the pathological inquiries 
which such facts suggest. Their bearing upon 
treatment is pretty obvious. While you can hardly 
do anything but good by giving your chalybeate food 
as heretofore, Homoeopathy enables you to strike 
at the root of the matter by her specific remedies 
* Compare the following case related by Trousseau. “ This 
young girl is seventeen years old; she has menstruated regularly 
until this last time, when on her taking a cold bath on the last day 
of her menstrual period, the menses were immediately suppressed, 
and she shortly afterwards felt an acute pain in the region of the 
left ovary. Within a few days she had palpitation of the heart, got 
out of breath easily, and complained of disordered digestion and of 
vague pains she had become chlorotic.”—(‘ Clinical Lectures/ by 
Bazire, Lect. XVII.) 46 
ANAEMIA. 
for deficient menstruation. These will be considered 
in their proper place. For the present let me 
illustrate what seems to me the true plan of treat- 
ment for such cases by one of my own. It appears 
in the f British Journal of Homoeopathy/ vol. xxiv, 
p. 328. 
“ Emily G—, set. 16, consulted me at the Dis- 
pensary on January loth, 1866. In the previous 
February she had caught cold whilst menstruating, 
and the flow had prematurely ceased. She had 
seen nothing since; and had been growing weaker 
and weaker. She wras very pale, and complained 
of breathlessness, palpitation, headache, &c.; in a 
word, she was thoroughly anaemic. I ordered her 
to take two grains of the Ferrum redactum of the 
British Pharmacopoeia once daily with a meal. 
“ January 22nd.—No change. Continue Ferrum. 
“29th.—Feeling much bctterin health. Continue. 
“February 5th.—Much better and stronger, and 
colour returning; but no catamenia. 
“Gave Pulsatilla 12, 6, and 3, in succession; 
each dilution for two days; a drop three times 
a day. 
“ 11th.—The catamenia reappeared on the 8th 
(i. e. while taking the 6th dilution), and were fair 
as to colour and quantity. She feels and looks 
quite well.” 
You may say, perhaps, that the catamenia w ould 
have returned in time of their own accord when 
once the blood had regained its normal richness 
under the influence of the chalybeate. It may he 
so. But read the very similar case in Professor 
Hughes Bennett's f Clinical Lectures ’ (p. 890 of 3rd PURPURA. 
47 
Ed.). It is said to have been dismissed "cured.” 
But after two months’ treatment by Iron, tonics, 
generous diet, and rest, the catamenia had not 
appeared. 
Scurvy 
is a typical instance of a disease resulting from 
pure dietetic causes, and requiring pure dietetic 
treatment. Professor Simpson seems to think he 
has made a point against Homoeopathy when he 
has argued that lemon-juice cures scurvy, but is 
incapable of producing it. The argument is really 
altogether wide of the mark. Lemon-juice is only 
a convenient form for supplying certain necessary 
constituents of our food, the absence of which 
induces the condition we call scorbutic. It plays 
no essential part in the treatment of scurvy. It 
is generally sufficient to place the sufferers on the 
full diet of a hospital, comprising as it does fresh 
meat and vegetables, and milk : and nothing more 
is required for the cure. 
Purpura 
must, I suppose, be discussed here, as it lias been 
styled "land scurvy.” But I am convinced that 
the resemblance is phenomenal only. In purpura 
there is none of that excess of fibrin in the blood 
which analysis demonstrates to exist in scurvy, and 
which shows itself in the plastic deposits which 
sheath the muscles and mat the cellular tissue of 
scorbutic patients. Nor is there in the majority 48 
PURPURA. 
of cases of purpura any history of deficiency in the 
fulness or variety of diet. It seems to me a morbid 
condition sui generis, developing itself under very 
various circumstances. I have gone somewhat into 
its pathology and causation in a paper on the subject 
in vol. xxvi of the fBrit. Journ. of Homoeopathy/ 
p. 60. Keferring you thither for details, I sum 
up here the conclusions arrived at as to its treat- 
ment. 
Purpura appears under two forms, the febrile, 
and the simply haemorrhagic. The febrile variety 
itself differs as it is sthenic or asthenic. Of sthenic 
febrile purpura I have cited instances in my paper, 
and have noted the repute of venesection, purgatives, 
and low diet in its treatment. With us the place 
of the first two would be taken by Aconite, which 
accordingly promises to be its most suitable remedy. 
Of purpura with asthenic fever I have given two 
cases from Homoeopathic literature. Both were 
severe; and both recovered under Sulphuric Acid 
and Arnica. I confess myself, however, quite un- 
able to see the homoeopathicity of Sulphuric Acid 
to the morbid condition here present. Its use 
seems a relic of old-school traditions rather than an 
induction from the law of similars; and it is diffi- 
cult to conceive of the “ astringent ” action of the 
drug being exerted in the 1st and 2nd dilutions, 
which were those used in the cases cited. The 
claims of Arnica, indeed, deserve more respectful 
attention. The petecliiae of Purpura are unques- 
tionably so many bruises (the term “ ecchymoses ” 
is common to both) : only in this case the extrava- 
sation results from morbid change from within, and PURPURA. 
49 
not from mechanical violence from without. The 
influence of Arnica over the latter is probably not 
merely local, but dynamic and specific. It “ deter- 
mines ” (in old-school language) “ to the surface,” 
and so favours haemorrhages : but there is nothing 
like purpura, simplex or haemorrhagica, in its patho- 
genesis. A better remedy than either of these for 
asthenic febrile purpura would seem to me to be 
found in Mercurius. This poison unquestionably 
causes ecchymoses and haemorrhages : and the 
second of the two cases cited reads so like an 
example of acute hydrargyrosis that I wonder Mr. 
Willans did not treat it with Mercurius through- 
out. Arsenicum, too, must not be forgotten; it 
is homoeopathic alike to the prostration and the 
petechiae. 
Of the non-febrile variety of purpura, where the 
haemorrhage is all in all, the only instance I know 
of in our literature is a case in the ‘American 
Homoeopathic Review’ for June, 1865. The symp- 
toms rapidly subsided when, after six days’ increase, 
on the seventh a high dilution of Phosphorus was 
administered. The choice of the medicine was 
determined by the haemorrhagic symptoms ascribed 
to it in Hahnemann’s pathogenesis. There is no 
doubt that the abundant ecchymoses observed in 
the subjects of poisoning by Phosphorus closely 
resemble the symptoms of purpura. But unfortu- 
nately the weight of evidence is against these 
symptoms being primary. They seem to occur 
only in connexion with the peculiar morbid changes 
induced by Phosphorus in the liver. They point 
to the purpuric symptoms which characterise yellow 50 
PURPURA. 
fever and acute hepatic atrophy, rather than to the 
idiopathic disorder. Still I do not hold the ques- 
tion as settled :* and we do well to keep Phosphorus 
in reserve in the treatment of our present malady. 
A more promising candidate for the place of 
specific remedy for this form of purpura is Hama- 
melis. A case is recorded in Dr. Hale’s “New 
Remedies/’ in which the administration of this 
remedy rapidly dissipated purpuric symptoms super- 
vening upon varioloid. I have myself, since writing 
the paper referred to, cured very speedily with it a 
case in which blood had been largely extravasated 
under the skin and was passing in the urine. The 
anti-hmmorrhagic virtues of Hamamelis are so con- 
siderable, that I am disposed to credit it with 
much power over the morbid condition we are 
considering. 
* Compare p. 56. LETTER Y. 
blood diseases (continued). 
Our discussion of purpura has been a digression. 
It has led us away from the quantitative derange- 
ments of the blood, requiring mainly dietetic treat- 
ment, which we were studying in plethora, anaemia, 
and scurvy. We now return to our direct line of 
march, and come to the cachexies,—struma, tuber- 
culosis, rachitis, cancer. Here we have quantitative 
derangement, but something more; dietetic treat- 
ment, but something more. Let us first take 
Scrofulosis. 
Using this term in its distinctive sense, as 
excluding all tubercular developments, we mean 
by it that condition of the system in which the 
lymphatic glands take on an indolent form of 
inflammation, and there is a general tendency to 
eruption and ulceration on the part of the skin and 
mucous membranes, and to disease of the bones and 
joints. The various local manifestations of scrofula 
will come under discussion in their proper place. 
As regards the treatment of the general diathesis, 
there is no doubt that the most important part in 
it is played by hygienic and regiminal measures. 
In these I need not instruct you. But I must add 52 
TUBERCULOSIS. 
to the resources they afford us one medicine at 
least, which Homoeopathy has given us wherewith 
to combat the strumous diathesis. This is Sulphur. 
Some of the local manifestations of scrofula,— 
especially the cutaneous eruptions and the ulcera- 
tions,—will yield to this remedy alone : and there 
are none in which its exhibition will not aid the 
medicines more specifically related to the affected 
part. But it is the diathesis itself at which we 
aim in giving Sulphur : and if this be borne in 
mind, there will be no difficulty in assigning it its 
due place in the treatment of scrofulous disorders.— 
Calcarea, also, has probably some control over the 
scrofulous cachexia; and ought to be preferable to 
Sulphur when the bones and joints are affected. 
Tuberculosis 
I must regard as a diathesis distinct from the 
strumous, although frequently associated therewith. 
I would suggest that, if the view he correct 
which regards tubercle as a product of mal- 
assimilation, the link between the two diatheses 
may lie in the mesenteric glands. Certainly the 
most important medicines for tuberculosis are those 
which influence the assimilative process. Of these 
the chief (perhaps the only ones) are Calcarea and 
Iodine. In the common use of Calcarea we have 
another bond of connexion between the two 
cachexise. I think this medicine most suitable 
when the disorder of nutrition is functional rather 
than organic. Iodine, on the other hand, seems 
to correspond to the pre-tubercular engorgement CANCER. 
53 
of the parts liable to be affected.* But however 
this may be, it is certain that these two medicines 
have more power than any others to modify the 
tubercular diathesis. I need hardly say that the 
dietetic and hygienic treatment of this cachexia is 
not less important and indispensable than that of 
the strumous. The introduction of the fatty ele- 
ments of diet, especially in the form of the animal 
oils, has both reason and experience in its favour : 
and the Iodine contained in cod-liver oil cannot 
but be in most cases in which it is administered a 
remedy truly homoeopathic to the symptoms. 
Leaving llachitis till we come to the Diseases of 
Children, I now have to essay to tell you what 
Homoeopathy can do for that terrible diathesis we 
style 
Cancer. 
I begin by referring you to our recent literature 
bearing on the subject. This comprises a series of 
cases by Dr. von Viettinghoff, in the ‘ Brit. Journ. 
of Horn./ vol. xvii, p. 53,—and another by Drs. 
Maclimont and Marston in vol. xxi of the same 
Journal, p. 611 : with an account of the virtues of 
the Hydrastis Canadensis in the treatment of the 
disease contained in various papers by Dr. Bayes 
in vol. iii of the ‘ Annals’ and vols. xix and xx of 
the ‘British Journal.’ To these I may add a 
remarkable case of Fungus Hsematodes of the 
uterus by Dr. Quin in the ‘Annals,’ vol. i, p. 177. 
* The chemical combination of the two medicines, in the form of 
the Iodide of Lime, has lately been suggested by Dr. Meyhoffer, 
and bids fair to be an excellent remedy. 54 
CANCER. 
The general impression one gains from reading 
the observations referred to is that Homoeopathy 
has remedies which materially improve the general 
health of cancerous patients, and which, by their 
elective affinity for the parts affected, tend in a 
greater or less degree to restore their healthy nu- 
trition. I cannot say that I see evidence of any 
specific relationship between these medicines and the 
carcinomatous diathesis, so that the one can fairly 
be expected to neutralize the other. Nevertheless, 
when you have done all you can by healthy living 
and generous diet, by iron and by cod-liver oil, to 
improve the general health of these subjects (and 
how much may be done in this way has been well 
shown by Mr. Weeden Cooke) you will find in our 
constitutional remedies the means of doing some- 
thing more. The chief of these is Arsenicum. 
Under its use, in varying dilutions, you will seldom 
fail to observe an increase in strength, a better oxy- 
genation of the blood, and a healthier performance 
of the functions in patients affected with cancer. 
The lancinating pains, moreover, which annoy the 
affected part are frequently relieved by this medi- 
cine. Sometimes, where the general condition is 
characterised by great torpor, Carbo may be a better 
medicine even than Arsenicum; as in a case men- 
tioned by Drs. Marston and Maclimont (p. G33). 
The animal charcoal is generally used ; but I sus- 
pect that the vegetable product would act quite as 
well. 
Approaching cancer from another side, there 
are certain remedies to which we are led by the 
form of the disease present. Thus “ epithelial CANCER. 
55 
cancer” has been, by the investigations of histology, 
identified with such growths as warts and condylo- 
mata under the common title of “ epithelioma.” 
Analogy would accordingly lead us to administer 
and apply Thuja in these cases, and to expect from it 
some, at least, of the power for good it manifests 
over the less malignant growths of the same order. 
Under this head it seems we are to group the 
cancers of the lip, tongue, and scrotum, and the 
“ cauliflower excrescence” of the os uteri. Perhaps 
Ur. Quin’s case in the ‘ Annals/ though styled by 
him “ fungus hsematodes,” was really cauliflower 
excrescence; and here Thuja was strikingly bene- 
ficial. Epithelial cancer of the lip, however, is so 
markedly under the control of Arsenic, that I should 
feel indisposed to resort to any other medicine. 
Its external use in the form of ointment (say gr. v 
of the 3rd dec. trituration to $j of lard) is here 
advantageously conjoined with its internal adminis- 
tration. I should recommend the same treatment 
for “ cancer scroti.” The other forms of cancer 
afford little indication for treatment. Nevertheless, 
when the encephaloid or melanotic growths assume 
a fungus-like form, the power of Thuja over vas- 
cular as well as epithelial growths may be brought 
to bear with advantage. The celebrated case of 
Badetzky is possibly an illustration of its virtue. 
I say, possibly: because the part taken by the 
medicine in the cure (the fungus grew from within 
the orbit) has been questioned. You will find the 
narrative of the case, with criticism and defence, 
in the first vol. of the c Brit. Journ. of Horn.’* 
* Since writing the above a cure of presumed encephaloid cancer 56 
CANCER. 
The third factor which guides us in our choice 
of remedies for cancer is the part affected. The 
elective affinities which we have ascertained to 
belong to our medicines are here brought into play 
with good effect. Thus Conium, which acts so 
powerfully upon the breast, lias not unfrequently 
arrested the progress of mammary scirrbus (see 
cases in ‘Brit. Journ. of Horn/ vol. xvii, pp. 70-72, 
vol. xxiv, p. 497, and in Teste, sub voce Conium). 
Aurum, which is our great osseous medicine, has 
cured cancer of the antrum and of the nasal and 
palatine bones (‘Brit. Journ. of Horn.,5 vol. xvii, 
p. 59, and preface to proving of Aurum in the 
‘Chronic Diseases’). Arsenic and Phosphorus, 
which cure so many gastric diseases, seem occasion- 
ally to have influenced for good a cancer of the 
stomach (‘Brit. Journ. of Horn./ vol. xii, p. 173, 
vol. xii, p. 321). And Dr. Bayes sums up the facts 
which exhibit the action of Hydrastis as follows :— 
“ My experience has thus led me to infer that the 
remedial sphere of Hydrastis is confined to the 
arrest and removal of scirrbus in its early stage, 
and chiefly when its situation is in a gland, or in 
the immediate vicinity of a gland. It therefore 
appears probable that Hydrastis bears no specific 
relation to cancer, but that its true sphere of action 
is on the glands and skin, and in virtue of its 
has been put on record (‘ Brit. Journ. of Horn.,’ vol. xxvi, p. 658). 
The remedy was Phosphorus: to which the prescriber was led, fol- 
lowing Dr. Constantine liering, by the symptom in Hahnemann’s 
pathogenesis, “ Slight wounds bleed freely.” I have already, when 
speaking of Purpura, discussed the relation of Phosphorus to hae- 
morrhagic conditions. The present case, whatever its nature, is in 
favour of its claims in this direction. CANCER. 
57 
specific action upon the glands, it enables these 
active eliminants to cast out the morbid matter in 
its early stage.” The same action on the glands is 
probably the ground of the virtues, such as they are, 
of Carbo animalis in discussing cancerous tumours. 
While the specific influence of Secate on the uterus 
accounts for what is said in the Report of the 
Leopoldstadt Hospital. “ In cancer of the womb 
Secale was of most service ; it soon removed the 
accompanying violent sacral pains and diminished 
the discharge.” 
Of cancerous disease of particular organs I shall 
speak in their proper place: and then will come 
before us the important question as to how far our 
additional resources warrant us in recommending 
our patients to abstain from surgical measures. LETTER YI. 
blood diseases (continued). 
We are still in the region of “ diatheses” when 
from Scrofula and Cancer we pass to Gout and 
Rheumatism. These diseases, moreover,—especially 
the latter—form a link between the chronic altera- 
tions in the composition of the blood with which we 
began, and the various forms of its acute poisoning 
which will soon come before us. 
Gout 
has, so far as I am aware, no Homoeopathic 
literature whatever. You will feel with me that this 
is somewhat ominous as respects our means of deal- 
ing with it. I must say that my own experience of 
the malady confirms this unfavorable impression, at 
least as regards the acute attack. I have tried all 
the remedies which seemed indicated or have been 
recommended,—Aconite, Ledum, Pulsatilla, Arnica, 
Bryonia, Sabina, in various dilutions: but have 
never been able to trace any decided effect to their 
use. The attack has seemed to run its protracted 
course of remissions and relapses much as if Nature 
had been left to take her course. If the author of 
the r Nullity of Homoeopathy5 had taken gout for 
his theme, I fear that no answer could have been GOUT 
59 
given to his charge. Perhaps some of my colleagues 
have had better success: but if so, I wish they 
Avould come forward and tell us how they have 
obtained it. 
In the mean time, I must recommend you to 
adhere to your Colchicum, whose power of giving 
relief is unquestionable. Moreover, although the 
associations of the medicine are Allceopathic, its 
character is far more of the Homoeopathic order. It 
is admitted now that its evacuant operation is needless 
to the obtaining of its soothing effects. Watson, 
indeed, calls it “ an anodyne but he must be 
speaking of the result of its administration, not of 
its modus operandi. It has confessedly no stupefy- 
ing power over the brain, or benumbing action on 
the nei’ves. It seems, therefore, to be one of those 
remedies which are classed as ic specific. ’ I claim 
all such remedies for the school which inscribes 
“ o/uoioq ” as opposed to “ liWolog ” on its portals. 
That Colchicum has never produced anything like 
the gouty paroxysm I must admit. Put I cannot 
feel that in using it in its treatment I am treating 
disease in a manner different from that which I 
ordinarily follow. 
In adopting Colchicum, however, as the remedy 
for the gouty paroxysm, Homoeopathy may do some- 
thing towards removing those inconveniences which 
beset its administration in the old school. Besides 
the depressant and drastic effects which result from 
over doses, it is alleged by your therapeutists that 
its use “ renders the disposition to the disease still 
stronger in the system.” Probably all these bad 
effects might be averted by a reduction of the dose. 60 
GOUT 
We want to give just as much as is necessary to sub- 
due the local pain and inflammation, and no more. 
I cannot yet affirm that our usual dilutions will 
avail to answer this purpose. I would advise you 
for the present to give Colchicum in gout in the 
manner suggested by Dr. Chas. Phillips for the ad- 
ministration of Morphia as a general anodyne. Put 
twenty drops of the mother tincture into a six ounce 
mixture, and let the patient take a teaspoonful 
every 5, 10, or 15 minutes, according to the in- 
tensity of the pain, until it subsides. Should it 
recur in the same joint, or attack others, let the same 
course be pursued. In the interim you may be 
giving any medicine which may seem homoeopathic 
to the general condition, having especial regard to 
the digestive organs. Pulsatilla, Nux Vomica, and 
Mercurius, are the remedies most frequently indi- 
cated: and sometimes the state of the circulation 
requires Aconite. What I think of still greater im- 
portance is the promotion of free elimination, as by 
remaining in bed and drinking copiously of fluids. 
I confess, moreover, that I have not got over my 
penchant for chemical remedies: and am given to 
mixing potash with my patient’s drink. 
When you have got your patient through his acute 
attack, you have to combat the morbid diathesis 
whose existence it reveals. There seems no doubt 
but that in gout the radical fault lies in the primary 
digestion. I need add nothing to what men like 
Watson and Garrod have written on the diet and 
regimen necessary for patients thus affected. I can 
only add my testimony to the paramount importance 
of this part of the treatment, and refer you to the GOUT 
61 
writings of my friend Dr. Acworth* as enforcing 
with abundance of argument and illustration the 
same truth. But here Homoeopathy comes to help 
us with its array of anti-dvspeptic medicines. I 
cannot enumerate these, or define the place of each. 
Every case must be treated as an individual, and the 
remedy be selected according to the character of the 
digestive derangement present. In confirmed gout 
Dr. Acworth states that he has seen much benefit 
from the administration of Sulphur: and the fre- 
quent determination of the poison to the skin in 
the form of psoriasis or eczema adds force to his 
recommendation. 
You will probably be asked whether we have any- 
thing in our Materia Medica which will avert the 
gouty paroxysm, if taken on the appearance of its 
premonitory symptoms. Sometimes the anti-dys- 
peptic medicine suitable to the case will seem to do 
this: thus I know of one case in which Pulsatilla, 
in the 12th dilution, appears to answer the purpose. 
But I am a little sceptical as to the relation of cause 
and effect. For the premonitory symptoms of a 
gouty paroxysm mean, I take it, that uric acid is 
already in excess in the blood. It seems much more 
rational under such circumstances to adopt elimi- 
native measures,—to take a Turkish bath, drink 
plenty of fluids, and eat sparingly of animal food— 
than to guard the parts affected against the skir- 
mishings of a poison which is threatening to make 
an assault in full force upon the joints. 
Of the various gouty neuralgia and inflammations 
* You will find Dr. Acworth’s papers in the ‘ Brit. Journ. of 
Horn.,’ vols. xv, p. 177; xvii, p. 83; ‘ Annals,' vol. iv, p. 481. 62 
RHEUMATISM. 
I can only confirm the experience of your own men 
that, once certain of their arthritic nature, you can 
combat them more effectually with Colchicum than 
with any other medicine. Several of those affections 
—especially the pleurodynia, angina, and oph- 
thalmia—are figured pretty plainly in its patho- 
genesis. “ Gout in the stomach,” I take to be, in 
nearly every case, a neurosis of the solar plexus. Its 
danger would then be analogous to that of a blow on 
the epigastrium or the rapid drinking of cold water 
when heated—viz. inhibition of the heart’s action 
conveyed along the splanchnic nerves. Nux Mos- 
chata has some reputation in our school in the 
treatment of this alarming complication. I should 
be disposed to give it in doses large enough to pro- 
duce its stimulating effects. 
Rheumatism 
occupies a very different place from gout both in 
our literature and in our practice. We have some 
capital medicines for it: and Dr. Russell,* Dr. 
Black,f and Dr. HenriquesJ have written instructive 
papers upon its treatment. You will also find 
statistical accounts of the cases of rheumatic fever 
treated in the Leopoldstadt Hospital in Wurmb 
and Caspar’s “ Clinical Studies/’§ in the ‘ Brit. 
Journ. of Horn.’ vols. xix and xxii, and in the 
‘Annals/ vol. iv. 
* ‘ Clinical Lectures on Rheumatism,’ &c. (Leath and Ross.) 
f c Brit. Journ. of Horn.,’ vol. xi, p. 216. 
If Ibid., vol. xii, p. 35. 
§ Ibid., vol. xi. RHEUMATISM. 
63 
I believe with Dr. Russell that there are two 
medicines, and two only, which positively neutralize 
the rheumatic poison in the blood. These are 
Aconite and Bryonia. It is usual to give these 
two drugs in alternate doses, or one during the day 
and the other during the night. I myself prefer 
to distinguish their spheres of action, where practi- 
cable. In the acute sthenic rheumatic fever I 
would give Aconite, in the 1st or 2nd dec. dilution, 
every two hours. In sub-acute cases, with less 
circulatory excitement; or where, after the subsidence 
of the fever, the pains continue, I would substitute 
Bryonia * I think you will have reason to be well 
satisfied with this treatment: and will not hanker 
after the flesh-pots of Egypt in the shape of the 
alkalies with which you have been hitherto ac- 
customed to saturate your rheumatic patients. 
It is a more difficult question whether our specific 
treatment secures for the heart that same measure 
of immunity which is claimed for the alkaline 
method. In a paper “On the Chemical Treatment 
of Disease/’ which I read before the British Homoeo- 
pathic Society in 1865, I argued the negative of 
this proposition (you will find the paper in the 4th 
vol. of the ‘Annals’). So many of my esteemed 
colleagues, however, at the time and afterwards 
expressed their dissent from my conclusions that, 
in deference to their judgment, I have refrained 
from carrying them into practice. You will read 
the discussion on my essay, Dr. Black’s paper “Am 
* Dr. Bayes speaks strongly of the superiority of the 12tli and 
18th to lower dilutions of the drug here: and the cases appended 
to the Austrian proving confirm his opinion. 64 
RHEUMATISM. 
I a Ifomceopathist or a Physician ?” with tlie dis- 
cussion following it,* and the review of ray paper in 
the f Monthly Homoeopathic Review’ of December, 
1865, and then make up your mind for yourself. 
Whether we adopt the chemical treatment or 
not, we shall certainly do well to bed our patients 
in flannel and blankets, so as to allow no linen to 
touch their skin. If in spite of all our precautions 
cardiac complication should occur, the treatment 
must be that which I shall describe when I come to 
the affections of the heart. The occurrence of other 
inflammations in the course of rheumatic fever need 
not lead us to change our Aconite and Bryonia. 
To pleurisy, pneumonia, peritonitis, and even to 
arachnitis these grand medicines are as suitable as 
they are to the general rheumatic condition itself. 
I have only to add as regards acute rheumatism, 
that there cannot be the least objection to applying 
to the affected joints the warm alkaline and opiate 
epithems recommended by Fuller and Watson. I 
have seen the most speedy relief follow their use, 
and I should be sorry to deprive a patient of the 
benefit they afford. 
In chronic rheumatism a much larger number of 
medicines has to be brought into play. There is 
here little or no toxaemia: and we have to combat 
the rheumatic poison in the sphere of the tissues or 
organs it has affected. The chief remedies we 
have to consider are Bryonia, Rhus toxicodendron, 
Rhododendron, Ledum, Pulsatilla, Dulcamara, Kali 
Hydriodicum and Bichromicum, Mezereum, Phyto- 
lacca, Mercurius, and Sulphur. The indications 
* ‘Annals, vol. iv, p. 385. RHEUMATISM. 
65 
for the choice of these remedies are derived from 
their pathogenetic effects: and I have generally- 
given them in my previous letters on Pharmaco- 
dynamics. Bryonia is good where there is local 
heat and swelling, however little the constitution at 
large sympathises therewith. The pains are in- 
creased by motion. Rhus is preferable in the 
“ passive” or “cold*’ form of chronic rheumatism; 
where the fibrous tissues—tendons, fasciae, sheaths 
of nerves, &c.—are affected rather than the synovial 
membranes; and where the pains, although increased 
on first movement, by continued motion are relieved. 
The rheumatic pains of Rhododendron are very- 
similar to those of Rhus; they affect the muscles 
chiefly, and are characteristically worse in stormy 
weather. Ledum is good where the small joints 
are affected, and where there is much general cold- 
ness. Pulsatilla has a special action on the synovial 
membranes of the knee, ankle, and tarsal joints: 
but is more frequently indicated in rheumatic gout 
(iq. v.) than in genuine rheumatism. Dulcamara is 
valuable where a sub-acute or chronic rheumatic 
condition is traceable to continued exposure to a 
damp atmosphere : there is a good case of the kind 
in the ‘ Brit. Journ. of Horn.,’ vol. xxiii, p. 642. 
Kali Hydriodicum and Bichromicum, Mezereum, and 
Phytolacca (perhaps also Guaiacum), are the remedies 
for periosteal rheumatism; I cannot well distinguish 
between them. Mercurius, both Corrosivus and 
Solubilis, in low potencies, proved very efficacious 
in some cases recorded by Dr. Yeldham in the 3rd 
and 4th vols. of the ‘Annals.* Aggravation of the 66 
RHEUMATIC ROUT. 
pains at night, and profuse sweats which afford no 
relief, are classical indications for this medicine. 
Where the general rheumatic diathesis is very 
well marked, the continued use of Sulphur is usually 
of great benefit. 
Rheumatic Gout. 
This little-understood disease,—the “ rheuma- 
toid arthritis” of Garrod, the “ chronic rheumatic 
arthritis’* of Dr. Robert Adams—is, I apprehend, 
totally distinct from either gout or rheumatism pro- 
per. With Dr. Fuller, I have nearly always met 
with it in the female sex, and in them always asso- 
ciated with menstrual derangement. Accordingly, 
its remedies are taken from the list of uterine medi- 
cines. They are the following,—Pulsatilla, Sabina, 
Ruta, and Caulophyllum. Pulsatilla is specific 
where the catamenia are scanty; where the knee, 
ankle, and tarsal joints are most affected ; and where 
the patient’s disposition is that characteristic of this 
medicine. Sabina and Ruta—the former espe- 
cially—correspond to cases where menorrhagia 
exists. Caulophyllum has been several times found 
curative where the joints of the hand were specially 
affected. 
It is only in comparatively recent cases that 
striking results can be expected. Our failure to do 
much in cases of long standing is quite accounted 
for by the morbid anatomy of the disease, which 
reveals extensive destruction of the articular car- 
tilages. GONORRHOEAL RHEUMATISM. 
67 
Gonorrhoeal rheumatism 
is, I take it, much the same thing in the male 
sex as the disease last mentioned in the female. I 
can say nothing as to its treatment. I have only 
had one case under my care, and this seemed little 
influenced by any of the medicines I used. How- 
ever, the patient made a good and complete recovery, 
which is more than occurs in many cases. Perhaps 
there is some specific virtue in the liquid Biniodide 
of Mercury (prepared by mixing bichloride of mer- 
cury with iodide of potassium) which Dr. Fuller 
lauds so highly in the treatment of this disease. 
Sarsaparilla (of course in the potencies) is said 
by some Homoeopathists to exert an influence over 
gonorrhoeal rheumatism. LETTER VII. 
Blood Diseases (continued). 
From rheumatic fever we pass naturally to 
“ fever” proper. In the present letter I shall dis- 
cuss the treatment of the “ continued fevers,” It 
is scarcely necessary for me to say to you that I 
assent to the now generally received division of these 
fevers into typhus, typhoid, relapsing, and febricula. 
To these British types of fever, I think we should 
add yellow fever, plague, and epidemic cerebro- 
spinal meningitis. 
Let us begin with 
Febricula. 
I have seen a good deal of this at Brighton. It 
yields immediately to Aconite. Indeed, if the criti- 
cal “ defervescence” has not taken place within 
twenty-four hours of the administration of this 
medicine, I conclude that I have gastric fever to 
deal with, and change to Baptisia. 
Dr. Bussell, who gives a case of this disorder in 
his clinical lectures on Fever (hereafter referred to), 
mentions its identity with the “ ardent continued 
fever” of India, and suggests the trial of Aconite 
therein. 
Of tlie true epidemic— TYPHUS. 
69 
Typhus, 
on the other hand, I cannot speak from personal 
experience. It never appears, I believe, in Brighton. 
Nor have those of our practitioners who inhabit the 
great towns which it chiefly visits given us their 
experience in its treatment. The only exception is 
Dr. Bussell (in this, as in so many ways, much 
lamented) whose volume of c Clinical Lectures’ 
contains two on “ Lever,” giving an account of 
thirty cases treated at the London Homoeopathic 
Hospital in 1861, nearly all of which were true 
typhus. 
I can add nothing to the knowledge you already 
possess relative to the general management of ty- 
phus. The important question is,—have we any 
medicines capable of curing, that is, of cutting short, 
the disease ? Dr. Bussell thinks we have : but I 
cannot see that his cases bear out his inference. It 
seems to me that he hardly allows sufficiently for 
the now well-ascertained fact, that in cases of re- 
covery from typhus, the crisis takes place naturally 
between the twelfth and the seventeenth day. Now 
as far as can be made out, none of the cases treated 
by Belladonna, Bryonia, and Bhus, showed any 
decided change for the better earlier than the twelfth 
day of the illness. Arsenicum wras given in one 
case only, on the ninth day; and on the thirteenth 
day the report is “ seems much better; tongue is 
getting moist; skin cool.” When this improve- 
ment began is not noted ; but as the case was 
pretty severe, this looks more like a curative action 
than anything recorded in the other cases. 70 
TYPHUS. 
Considering, then, the general applicability of Ar- 
senic to typhoid conditions, I should recommend 
you, if you have to treat an epidemic of true 
typhus, to try whether this medicine has any cura- 
tive power over the malady, as shown by a shorten- 
ing of its duration. If it fails to accomplish this 
you must be content to treat the disease. This 
you may sometimes do best by giving medicines 
suitable to the general condition. Thus, if the 
symptoms of nervous prostration predominate, much 
benefit may be expected from Phosphoric acid: 
while if the blood-poisoning is most manifest, Mu- 
riatic acid wdll display corresponding powers. If 
either the adynamia or the toxaemia, however, be 
excessive, Arsenicum will probably be better than 
either. In other cases the local complications may 
demand your chief attention. When the cerebral 
symptoms are more than the “ cry of nerve for 
healthy blood,” they require and yield to Bella- 
donna : and the extreme sopor which marks. the 
height of the disease often needs a few doses of 
Opium. The pulmonary affections of typhus nearly 
always find their best medicine in Phosphorus • 
which would also oppose the “ typhous softening of 
the heart” of authors, this being an acute fatty 
degeneration. Convulsions occurring in the course 
of typhus are, I suppose, invariably uraemic: and 
require the treatment of that affection. If the 
blood can be relieved of its “ perilous stuff,” it will 
probably be wise to direct the whole stress of 
your medicinal treatment upon the kidneys. The 
only other complication I can mention here is 
inflammatory swelling of the salivary glands and the TYPHOID FEVER. 
71 
areolar tissue about the neck. Dr. Russell had two 
cases of this kind in the hospital. One died, Bel- 
ladonna 1 having been given in vain; in the other 
the swelling was immediately checked by the 1st 
trit. of the Biniodide of Mercury. 
The results of such treatment of typhus, under 
good general management, will probably be highly 
satisfactory. Of the thirty cases treated in the 
London Homoeopathic Hospital in 1864, two only 
died, one from these glandular swellings, and one 
from convulsions. No uncomplicated case was 
lost. 
I pass now to the enteric or 
Typhoid fever. 
Let us quite understand what we include under this 
name. There can be no question about its embrac- 
ing the “ abdominal typhus” of France and Ger- 
many, and the continued intestinal fever, with rose- 
spots and diarrhoea, well-known in the hospitals of 
this country. The only question is about “ gastric 
fever.” Dr. Russell appears to think this an inde- 
pendent form of pyrexia. “ I mean by this term” 
he writes, “ a non-infectious, continued fever, which 
has no regular course ; in which there is no erup- 
tion, and which is not attended with diarrhoea 
or any intestinal affection.” He thus distinguishes 
it from typhoid : and farther on he characterises it 
as “ a fever which, having many points in common 
with typhus, differs from it in this, essentially, that 
the pain in the head is much more intense, and does 72 
TYPHOID FEVER. 
not tend to pass into delirium.” I can only say that 
I have never seen such a fever ; nor is it recognised 
by the latest writers on the subject—Jenner, Mur- 
chison, Aitken. I use the term “ gastric fever,” 
as less alarming, to designate the ordinary endemic 
low fever I meet with in my practice. But I 
know well that if the symptoms are not checked 
in the first stage, diarrhoea will set in, and with 
the dry tongue, the tympanitis, and the deli- 
rium will manifest unmistakeably the “ typhoid” 
condition. 
I have implied in what I have said that this fever 
is capable, under certain circumstances, of being cut 
short. It seems a bold assertion : but I have been 
making it over and over again for some years past, 
and it has never been disproved. Dr. Madden, 
Dr. E. M. Hale, Mr. Harmar Smith, and Mr. Free- 
man have each contributed several cases in which 
the abortive power of the Baptisia tinctoria (which 
is the medicine I recommend) is plainly shown. 
The only contrary testimony is that of my friend 
Dr. Yeldham ; and as it is the result of a single 
observation only, I think he will allow me to say 
that it goes for very little. I refer you to my re- 
marks on Baptisia in my letters on Pharmacody- 
namics for farther information : and will only add 
here that when you can catch a case of typhoid 
fever within the first five days, before the signs of 
localization in the intestinal glands have appeared, 
you may fairly expect to cut short the disease. 
Give a drop or two of the 1st dec. dilution of Bap- 
tisia every two hours, and a critical defervescence 
may be expected in two or three days at the utmost. TYPHOID FEVER. 
73 
Baptisia is to this fever what Aconite is to the 
effects of a chill. 
If, however, when you see your patient, the 
tongue has become dry; and the ochre-yellow stools, 
copious and frequent, and the distended and tender 
abdomen, with its gurgling on pressure, tell that the 
intestinal glands are inflamed, you are too late for 
Baptisia. The grand remedy now is Arsenic. It 
has no abortive power; and it does not, as I shall 
presently argue, influence the affected glands. But 
it powerfully controls the general intestinal catarrh 
on which the diarrhoea depends; and by its influ- 
ence upon the adynamia and toxaemia it sustains 
the whole frame. I have never needed any other 
medicine for fully developed typhoid; and I have 
very rarely lost a case. I have thought it right, 
however, to prepare myself and you for cases in 
which the typhous deposit in the intestinal glands 
gives trouble in its elimination. Ulceration— 
showing itself by re-accession of the febrile phe- 
nomena, with increase of diarrhoea, abdominal pains 
and tenderness, and glazed tongue; and sloughing, 
indicated mainly by haemorrhage, are the forms of 
trouble I refer to. I cannot think Arsenic homoeo- 
pathic to these conditions, though in one case of 
poisoning there was found enlargement of Peyer’s 
glands at the lower part of the jejunum, with 
tendency to ulceration. In typhoid fever, how- 
ever, these glands are affected in concert with 
the other parts of the blood-making system,—the 
mesenteric glands and the spleen : and are not 
merely irritated iu sympathy Avith the intestinal 
surface. 74 
TYPHOID FEVER. 
The three medicines to which I look to help me 
here are Mercurius, Iodium and Terebinthina. Iu 
favour of Mercury is its general glandular influence 
and control over ulceration, and some cases by Dr. 
Petroz of Paris, which you will find in the c Brit. 
Journ. of Horn./ vol. xxiii, p. 636. The black sul- 
phide (Ethiops mineral) wras the form of the drug 
used: the dilution was the 12th. Iodine has yet 
stronger physiological evidence in its favour. In a 
case of slow poisoning of an animal, conducted by 
Dr. Cogswell, the following appearances were pre- 
sented post-mortem. “ The lining membrane of the 
intestines, for about three feet from their origin, 
was remarkably vascular; oval spots, about the size 
of a chestnut, then began to occur at every three 
inches, on the side opposite to the mesentery; a 
similar spot at the junction with the colon was two 
or three inches in length, and wras expanded at its 
lower termination over the whole circuit of the gut. 
These spots were not injected, and were composed 
of little aggregated eminences with black points in 
the centre, separated from one another by white 
cellular bands. They appeared to consist of the 
agminated glands enlarged, as sometimes noticed in 
the early progress of fever” (f Prize Essay on Iodine,5 
p. 34). I may add that iodine was considered by 
the late Mr. Aston Key to have a specific influence 
upon the ulcerative process. Its action upon the 
mesenteric glands must also be taken into account. 
Turpentine is of repute in our school for intestinal 
haemorrhage occurring in typhoid fever. Dr. 
Wood’s observations, cited in my remarks on Tere- 
binthina (Pharmacodynamics, p. 531), point to its RELAPSING FEVER. 
75 
exerting a direct influence over the morbid process 
going on in the glands. 
With one or other of these remedies (to which 
the continuous wet compress to the abdomen may 
be added with advantage) I think we shall control 
the intestinal mischief of typhoid. Cerebral or 
pulmonary complications must be met as in typhus. 
Suspicious chest symptoms appearing during con- 
valescence will generally yield to Tincture of Sulphur; 
or, this failing, to Iodine, or Phosphorus if any 
inflammation be present. 
It is only fair to tell you that the treatment of 
typhoid now sketched is not that of the Homoeo- 
pathic school at large, but is a crotchet of my own. 
For the remedies commonly used, I refer you to 
our abundant literature on the subject, especially 
to Dr. Fleischmann's Deports of his Hospital in the 
‘ Brit. Journ. of Horn./ vols. iii-vi, and to Drs. 
WArmb and Caspar's ‘Clinical Studies' in vol. 
xii of the same journal. There is also a special 
‘ Treatise on Typhoid Fever and its Homoeopathic 
Treatment' by Dr. Bapou: this I have not seen. 
I have not much to say about 
Relapsing Fever. 
Our best account of it is from Dr. Kidd, who 
treated it in Ireland in 1847. His original narra- 
tive is in the ‘ Brit. Journ. of Horn.,’ vol. vi: but 
in the ‘ Annals/ vol. iv., you will find from his pen 
a review of his former opinions and experience in 
the light of later knowledge. His success, under 
very disadvantageous circumstances, was great: and 76 
YELLOW FEVER. 
his recommendations as to treatment come accord- 
ingly with authority. Bryonia is his chief medi- 
cine : and its thorough homoeopathicity to the 
symptoms is very apparent. Dr. Kidd thinks also 
that something may be done towards preventing 
the relapses by giving Nux Vomica a day or two 
before they are expected,—the patient being kept 
in bed and carefully dieted. 
If there is anything more to be said, it is that 
Aconite, though not curative, might fairly be 
expected to relieve the fever during the first two 
or three days; and that the Eupatorium perfoliatum 
is an alternative to Bryonia well worth bearing in 
mind. 
Yellow Fever 
must, I think, be classed in this category, as its 
nosological name “ typhus icterodes ” implies. It 
is a disease which you will probably never have to 
treat; hut for the sake of completeness I must say 
a few words upon it here. 
The fullest account extant of the Homoeopathic 
treatment of yellow fever is an article by Dr. Hol- 
combe in the 3rd vol. of the ‘North Amer. Journ. 
of Homoeopathy/ In the section on the disease 
in Marcy and Hunt’s “ Practice ” his statements 
are collated with those of other observers : but you 
had better read his original paper, which is very 
able. His treatment was general and symptomatic. 
Camphor was given when the primary chill was so 
severe as to remind the observer of the choleraic 
collapse (“algid form” of Lyons). Aconite and PLAGUE. 
77 
Belladonna controlled the reaction; after which 
Ipecacuanha or Bryonia were generally required by 
the gastric symptoms. If the case ran on into the 
typhous condition, Arsenicum and Lachesis were 
given ; and, if “ black vomit ’’ supervened, Argentum 
Nitricum. Sometimes Cantharis was called for by 
the condition of the urinary organs, which it speedily 
modified for the better. Under such treatment 
Drs. Holcombe and Davis had, in 1016 cases, only 
55 deaths,—i. e. a mortality of 5'4 per cent. 
Attempts have since been made to discover 
medicines having a more direct relation to the 
essential nature of yellow fever, so as to exercise a 
control over it in its inmost seat. Those which 
promise best to answer this description are the 
serpent-poisons (especially Lachesis and Crotalus) 
and Phosphorus. I refer you to my observations 
on Crotalus and Phosphorus for the grounds of the 
selection of these medicines. The latter certainly 
corresponds to the jaundice, the haemorrhages, and 
the albuminuria of yellow fever in a most striking 
manner: and I am not surprised to hear from 
Rio de Janeiro that it has done great things iii an 
epidemic occurring there. 
Plague, 
also, appears to be a malignant typhus, characterised 
by carbuncles and engorgements of the lymphatic 
glands. Homoeopathy has no practical knowledge 
of its treatment. 
The last of these continued fevers I shall men- 
tion is the epidemic cerebro-spinal meningitis, 78 
MALIGNANT PURPURIC FEVER. 
whose manifest toxtemic nature and petechial effu- 
sions have led to its being known as “ spotted 
fever,” or 
Malignant purpuric fever. 
In a paper in the 23rd vol. of the £ Brit. Journ. of 
Horn./ p. 386, I have gathered together all that was 
then known of this malady. It has since appeared 
in and about Dublin, and a case or two has been 
observed in this country. You will see that the 
Homoeopathic treatment of this malady has always 
had large comparative success: but it is as yet too 
little fixed to enable me to set it down here. LETTER VIII. 
blood diseases (Continued). 
The study of the acute toxsemise we have just 
left has brought us so entirely into the sphere of 
fevers in general, that I cannot quit it without con- 
sidering the intermittent and remittent types of 
fever in connexion with those called “ continued.” 
I believe, indeed, that the seat of these latter fevers 
in the system is as different as is their causation 
and mode of propagation from those of the con- 
tinued fevers. I doubt if they can be called blood- 
diseases at all. But it seems on the whole more 
convenient to consider them here, than to treat of 
them under the head of disorders of the nervous 
system, to which pathologically they belong. 
The “ malarious,” “ paludal,” or “ litoral fevers” 
of which I have to speak are intermittent fever, or 
ague; remittent fever; and “ bilious remittent ” or 
malarious yellow fever. 
Ague. 
About the treatment of this disease there ought 
surely to be little difference between us. The 
power of Cinchona over the intermittent paroxysm 
was the Newton's apple which led Hahnemann to 
Homoeopathy. At the present day, Dr. Latham 80 
AGUE 
cites it as tlie cardinal instance of the “ cure” as 
distinguished from the “ treatment ” of disease.* 
It has been shown that “ the disappearance of ague, 
as a cause of mortality, exactly coincides with the 
introduction of Cinchona Bark into general use in 
this country/’ so that while between the years 1653 
and 1660 there died in England of ague 10,466 
persons, in the corresponding septenary period 1733- 
1740 the deaths from this cause were only thirty- 
one.f Quinine confessedly answers every require- 
ment of a homoeopathic remedy; it acts singly, 
directly, in small doses, and in virtue of the principle 
of similarity. 
I cannot, therefore, account for the prejudice 
which seems to exist in the minds of many of my 
colleagues against this medicine. To its indiscrimi- 
nate use I should object as strongly as any one. I 
refer you to my former remarks sub voce Quina for 
the development of this subject. I repeat here that 
“in recent, uncomplicated agues, showing the regu- 
lar series of chill, heat, and sweat, and unmarked 
by any special phenomena, Quinine is pretty well 
infallible.” It is sometimes objected that it only 
“ suppresses the paroxysms ” and does not really 
cure the disease. But in the recent cases of which 
I speak the paroxysm is the disease : in its repeated 
recurrence lies all secondary evil which may occur. 
Take possession of the vascular nerves with your 
Quinine, and the malarious poison finds no other 
point of attack. Hence, I take it, the prophylactic 
power of the drug,—which is rather better esta- 
* * Brit. Med. Journ.,’ Aug. 17, 1861. 
f Bussell’s * Clinical Lectures,’ p. 355. AGUE 
81 
Wished than that of Belladonna against scarlatina, 
and rests on the same ground. 
The only point remaining for discussion is the 
mode of administration. Shall we give the Quinine 
during the fever, or only in the apyrexia ? and shall 
we administer it in one full dose, or in repeated 
small quantities ? For the first, I would recom- 
mend that the Quinine he not begun until the 
sweating has set in : mainly for this reason, that so 
much relief can be given during the cold and hot 
stages by the administration of Aconite. This 
precious medicine gives us here all the benefit which 
in Watson’s lectures we find ascribed to blood- 
letting,—a remedial measure which he nevertheless 
wisely shrinks from recommending. As to dose, I 
see no reason to depart in the present instance from 
our wonted method. I find that two or three grains 
of the 1st dec. trituration taken every three or four 
hours during the intermission seldom allows more 
than one recurrence of the paroxysm. The large 
abortive dose is sometimes at least followed by bad 
consequences,—as in a well-narrated case by Dr. 
Hirsch of Prague in the f Brit. Journ. of Horn.,’ 
vol. xxv, p. 406. Remembering, farther, the tem- 
porary nature of the immunity secured by the anti- 
periodic remedy, we do well to continue its use, in 
less frequent doses, for a week or so after the 
appearance of the last paroxysm. 
The treatment I have now sketched is that of a 
typical case of ague. That variations will be re- 
quired in individual cases I do not doubt. During 
the paroxysm itself Belladonna, Ipecacuanha, or 
Yeratrum may be indicated by the symptoms even 82 
AGUE 
more strongly than Aconite : and the two latter, 
with Nux vomica, Ignatia, and Pulsatilla have pro- 
bably some anti-periodic virtues of their own. 
Where they seem thoroughly homoeopathic, then, to 
the concomitant symptoms they might be continued 
into the apyrexia, instead of changing to Quinine. 
Drs. Wurmb and Caspar cured 17 cases out of 27 
with Pulsatilla, 14 out of 30 with Nux, 10 out of 
14 with Veratrum, 4 out of 12 with Ignatia, and 6 
out of 9 with Ipecacuanha. My own experience 
concurs with that of Fleischmann and Bussell in 
thinking that Nux vomica and Ipecacuanha in 
alternation most frequently control the impure 
intermittents which come under our treatment in 
non-aguish districts. You may even have, in 
obstinate cases, to wander farther in the Materia 
Medica in search of the specific remedy. Dr. Bayes, 
in his admirable paper on Ague in the second 
volume of the ‘ Annals/ narrates two cases which 
resisted all his efforts until he hunted for and found 
the simillimum of the first in Phosphoric Acid; of 
the second, in Eupatorium perfoliatum. 
In admitting the necessity of occasionally de- 
parting from the Quinine treatment of ague I am 
but following in the steps of your own therapeutists. 
Sir Thomas Watson, in mentioning supplementary 
remedies for this disease, frequently has to say—as 
of Arsenic, black cobweb, piperine, and Zinc—that 
they have succeeded where the sulphate of quina 
has failed. It is admitted, therefore, that bark is 
not always the specific remedy for ague. But 
Homoeopathy has this great advantage that she can 
with tolerable certainty foresee when Quinine will AGUE 
83 
fail, and select from the other anti-periodics the one 
most likely to succeed. The law of similarity 
enables her to do this. You cannot see it better 
carried out than in the ‘ Clinical Studies ’ on Inter- 
mittent Fever of Drs. Wurmb and Caspar, translated 
in the ‘ Brit. Journ. of Horn./ vols. xii. and xiii. 
The precision of their selection of the remedy and 
the rapidity of their cures are beyond doubt or cavil. 
It is especially with reference to the treatment of 
chronic intermittents that those valuable Studies 
should be consulted. In these Quinine is hardly 
ever of use. As I have said “ If it breaks up the 
paroxysms for a while, they always return: and if 
its use is pushed, a medicinal cachexia is added to 
that already induced by the disease.” Drs. Wurmb 
and Caspar confirm Hahnemann’s dictum that in 
these cases the condition of the patient in the in- 
terval is a more important guide to the selection of 
the remedy than the phenomena of the paroxysm. 
“ If, during the employment of a remedy, the 
cachectic state should remain unchanged, while the 
paroxysm decreases in force, the medicine should be 
continued for some time, then another should be 
chosen, even if the former one should have entirely 
subdued the paroxysms. The diminution of the 
cachectic state is the most certain sign that the 
suitable remedy has been chosen, and its use should 
not be discontinued, even if there should be a more 
frequent recurrence of the paroxysms; the cure is 
certain if the remedy be not changed.” 
By far the most important of the medicines re- 
quired for chronic intermittents is Arsenic. Drs. 
Wurmb and Caspar echo from our ranks the praises 84 
AGUE 
lavished upon it by Boudin. “The symptoms*' 
they say “ of chronic poisoning by Arsenic exhibit 
a surprising similarity with those of the cachectic 
condition induced by an intermittent; it like- 
wise possesses in so high a degree the property 
of producing periodical exacerbations, that it ex- 
cels all other medicines/’ The special indica- 
tions for it they epitomise thus—“ One stage 
absent; heat burning ; rapid prostration; torpid 
weakness; dropsical swellings; cachexia; abuse of 
Quinine.” But they add “ It will often cure when 
other remedies selected with the greatest care have 
failed.” It appears to answer equally well in their 
infinitesimal doses (15th dilution) as in the hun- 
dredths of a grain prescribed by Boudin. After its 
administration there were no paroxysms in 4 cases, 
in 4 cases only 1, in 4 more only 2, in 4 but 3 : 
while in the remaining 4 cases cured by it the 
numbers were 4, 4, 5, and 8 respectively. 
After Arsenic, Nalrum Muriaticum seems to be 
in most repute (especially in America) for chronic 
intermittents. Dr. Peai’son states that it is indi- 
cated by “bilious vomiting before and during the 
chill, with great thirst, and sores on the lips or 
corners of the mouth.”* But I would especially 
refer you to my remarks on Cedron (f Pharmacody- 
namics,’ p. 206) and the authorities there cited. In 
two cases of chronic “ chills” which have come under 
my care the curative action of this medicine has 
been most satisfactory. 
In the course of this paper I have mentioned 
our chief authorities upon the treatment of Ague. 
* * United States Med. and Surg. Journal,’ vol. i, p. 203. REMITTENT FEVER. 
85 
You will also find many cases and remarks bearing 
on the subject in the American Homoeopathic jour- 
nals generally;—the malady being of frequent 
occurrence in that country. 
Remittent Fever, 
of malarious origin, is of course a totally different 
tiling from the well-known “ infantile remittent ” 
which will come under our consideration as one of 
the diseases of childhood. It is just a severe ague 
whose intermission is so imperfect as to cause it to 
be designated a “ remission ” instead. I know it 
only from the description given of it in books :* 
and, in the absence of any Homoeopathic literature 
bearing upon it, must content myself with suggest- 
ing the remedies most likely to avail. 
Of even more importance than in intermittents 
must be the treatment adopted during the attack. 
“ The first and most immediate object of treatment” 
writes Aitken “ is to reduce the force and frequency 
of arterial action during the paroxysm.” We know 
too well the power of Aconite to effect this end to 
need the spoliative venesections advised by the 
Indian writers. With the rule to begin Quinine 
as soon as remission shows itself I have no quarrel. 
I would only suggest that in the asthenic form of 
the fever not unfrequently Arsenic might be pre- 
ferable. And the remarkable power of Gelseminum 
over remittent feverish states observed in cooler 
* I speak especially of the articles on it in Ait ken’s c Science and 
Practice of Medicine ’ and in the * System of Medicine ’ edited by 
Dr. Russell Reynolds. 86 
BILIOUS REMITTENT. 
climates makes it worth a trial in the fevers we are 
now studying, where the symptoms do not run high 
enough to require Aconite. If the gastric irrita- 
bility be very marked, a few doses of Ipecacuanha 
may do good service. 
Bilious Remittent 
appears to differ from simple remittent only in the 
implication of the liver in the attack. It is some- 
times called “ malarious yellow fever,” from the 
resemblance of its symptoms to the contagious 
toxaemia so properly named. Dr. Neidhard, more- 
over, finds Crotalus as useful in this fever as in 
the true typhus icterodcs (‘ On Crotalus in Yellow 
Fever/ &c.). He gives it in the 1st, 2nd, and 3rd 
triturations. This is all I have to tell you about 
the Homoeopathic treatment of the disorder in 
question. LETTER IX. 
blood diseases (continued). 
In the present letter we shall consider the treat- 
ment of the acute exanthemata,—Variola, Varicella, 
Rubeola, and Scarlatina. 
Variola. 
Let me begin by saying that as regards vaccination 
we are thoroughly at one with you and with every 
one who understands the subject. Statistics at 
large demonstrate the extensive immunity from 
the disease secured by this invaluable prophylactic: 
and no one who has had the opportunity of com- 
paring the unmodified small-pox with that form of 
it which ordinarily appears in vaccinated subjects 
can do otherwise than bless the name of Jenner. 
Some, indeed, have thought that the efficacy of 
vaccination is an illustration of the law of similars. 
It is said, I know, that the relation of the cow-pox 
and small-pox poisons is rather one of identity : and 
that the immunity of the vaccinated results from 
their having really had a mild but effectual attack 
of variola itself. But what of the effect of vacci- 
nating one who has caught small-pox before the 
eruption appears,—or of introducing vaccine and 
variolous matter at the same time into the same 88 
VARIOLA. 
individual ? The same modifying influence is 
observed, so that the patient has varioloid instead 
of variola. This could hardly be, were the two 
poisons identical, differing only in energy. In the 
face of these facts, and of certain others which I 
have adduced in a paper on “ The Present Doctrine 
of Vaccination ” in the ‘ Brit. Journ. of Horn./ April 
1868, I submit that the ordinary theory needs re- 
considering : and that a modification in our direc- 
tion seems likely to be required. 
Of the treatment of small-pox as modified by 
vaccination—varioloid—it is unnecessary to say 
much. You will give Aconite for the primary 
fever in which you will be called to your patient: 
but I doubt if you will see much change in it until 
the eruption begins to appear. You may then by 
way of precaution give Tartar Emetic every three 
or four hours, until the sudden decline of the symp- 
toms on the fourth or fifth day tells you that no 
farther medication is necessary. 
It is altogether different when your patient, un- 
protected by vaccination, has become infected by 
genuine small-pox. If you see the case early 
enough, i. e. before there is any sign of eruption, 
an attempt should be made to convert tbe disease 
even yet into varioloid. You may introduce your 
cow-pox lymph by vaccination in the usual manner:* 
or you may give it internally as a medicine in 
Homoeopathic dilution. You will smile at this 
latter suggestion : but let me ask you to read the 
* But see Mr. Marson’s remarks (cited in my paper already 
referred to) as to the latest period at which this proceeding will be 
effectual. VARIOLA. 
89 
experiments of Severin, Schneider, and Norman 
Johnson in the ‘ Brit. Journ. of Horn./ vols. xxiv, 
171, and xxv, 340. You will there see that vaccine 
lymph, even in infinitesimal doses, when taken into 
the stomach will develope the cow-pox vesicles with 
their concomitant fever. Vaccination from the vesi- 
cles thus produced has succeeded perfectly. Drs. 
Pulte, Hummel, and Bayes—to speak of no others 
—have used “ Vaccinine ” internally in the treat- 
ment of small-pox, and testify to its great value. 
It should probably not be used stronger than the 2nd 
or 3rd dilution, as the effects of the pure substance 
taken in this way have proved very violent. 
I have no personal experience of this treatment; 
and the theory would lead us to suppose it effectual 
only if begun quite early. I should certainly adopt 
it in the pre-eruptive stage, instead of making vain 
attempts to reduce the fever by Aconite. But when 
the pock has once appeared, I think our best means 
of modifying the future progress of the disease to 
be the use of Tartar Emetic. My experience quite 
concurs with that of Dr. Liedbeck of Stockholm* 
and Dr. Ludlam of Chicagof that this medicine 
exerts a real abortive control over the variolous 
process. I cannot better illustrate this than by 
citing a case of the disease treated by the latter 
physician. 
“ Frank —, aged six years, a fine healthy boy, 
the child of German parents, had never been vacci- 
nated. I had promised to vaccinate him as soon 
as it was possible to procure a little good virus. 
* ‘ Brit. Journ. of Horn.,’ vol. vii, p. 475. 
f ‘North Amer. Journ. of Horn.,’ vol. xii, p. 567. 90 
VARIOLA. 
Meanwhile he contracted the small-pox. The papu- 
lar stage was well-defined. One could not mistake 
the shot-like pimples beneath the skin. The vesi- 
cles were formed, and in due time most of them 
became umbilicated. The eruption was thick, but 
yet distinct in its location, suggesting to an experi- 
enced eye that, when the pustular stage should set 
in, the case would assume the confluent form. All 
the attendant symptoms, the odour of the breath 
and of the exhalations, the swollen eyelids and 
features, the sore throat and salivary symptoms 
were equally pronounced. The little fellow was 
really ill with genuine small-pox. We prescribed 
Tartar Emetic, 3rd dec. trituration, of which he 
was to have a dose every three hours. 
“ When the period arrived at which the serous 
fluid contained in the vesicles should have become 
turbid and purulent, it was remarked that no such 
change took place. Some of the vesicles burst, but 
the majority of them disappeared by desiccation and 
desquamation. Pus was not formed, and the third 
stage was not developed. The cutis vera was not 
seriously implicated, and did not slough away; 
consequently even upon the most exposed portions 
of the face and extremities there wras no 1 pittingi 
at all. The child recovered without any of the 
ordinary sequelse of severe small-pox, as ophthalmia, 
chronic diarrhoea, &c. During the whole course of 
the disease he took no other medicine than Tartar 
Emetic.” 
If you have not had the opportunity, or have 
failed, to modify the disease in these earlier stages 
by Yaccinine or Tartar Emetic, you must treat the VARIOLA. 
91 
fully developed pock according to the symptoms. 
Where itching and swelling are the most prominent 
features, Apis will give much relief. If the sup- 
purative fever presents no malignant character, 
Mercurius seems its most suitable remedy; and is 
highly praised by Rapou and Hartmann. Where 
typhoid or putrid symptoms appear, it will be 
necessary to give Arsenicum or Lachesis. 
A few words now about the complications and 
sequelee of variola. Sudden retrocession of the erup- 
tion, with collapse, is best treated by repeated doses 
of Camphor. The Tartar Emetic you will be giving 
covers so well all the respiratory affections likely to 
occur that it will rarely be necessary to change it. 
The post-variolous ulceration of the cornea seems 
to call for Mercurius Corrosivus as its most likely 
remedy. The tendency to the development of 
numerous furuncular abscesses which often appears 
Hartmann has checked with Phosphorus or Calcarea. 
Teste suggests Sulphur for this and most other 
sequelae of the disorder. 
The whole treatment of variola laid down by the 
last-named physician is curious enough to merit 
citation, especially as he strongly asserts its practical 
value. If the patient is seen before the first pus- 
tules have made their appearance, Zincum 30 is to 
be given, and “ will in all probability arrest the 
development of the eruption.” In the eruptive 
stage Mercurius corrosivus 30 and Causticum 30 
should be administered,—two or three doses of the 
latter in the morning, and the former at the same 
intervals in the after part of the day. These 
remedies “ will abridge more than one half the 92 
VARICELLA. 
whole duration of the disease, and prevent second- 
ary symptoms.” Lastly “when the disease pur- 
sues an irregular course; when the eruption exhibits 
a tendency to disappear from the surface ; when the 
pustules, instead of being transparent, or yellow, 
are green, purple, or black ; when the blood with 
which they are filled announces a decomposition of 
this fluid, and threatens the approach of putrid 
symptoms, it is not to Arsenicum that we should 
have recourse, but to Sulphur/’ 
There are two other medicines which have been 
credited with an abortive influence over variola. 
These are Thuja and the Sarracenia purpurea. Thuja 
was recommended by Yon Boenninghausen, on the 
strength of its being the specific remedy for the 
analogous “ grease ” of horses. He states that it 
causes the early drying up of the pocks without 
pitting ; and also acts as a temporary prophylactic, 
like Belladonna for scarlatina. Some cases have 
lately been published in America in which its use 
was attended with very satisfactory results. The 
evidence for and against the Sarracenia purpurea is 
given at length by Dr. Hale in the article on the 
medicine in the 2nd Ed. of his “ New Remedies 
to which I must content myself with referring you. 
Varicella 
hardly merits a place in a manual of therapeutics. 
Aconite may be given during the fever: and Apis 
is useful if, as often happens, there is much itching 
with the eruption. 93 
KUBEOLA. 
Rubeola. 
I use this term, with Watson, as equivalent to 
morbilli; and not, with Aitken, to designate the 
hybrid between measles and scarlatina. The chief 
medicine in the treatment of measles is Aconite. 
It is noted by all writers of the fever which accom- 
panies this exanthem that, unlike that of small-pox, 
it does not subside on the occurrence of the erup- 
tion, but rather increases. Aconite should therefore 
be given from the commencement, and continued 
throughout the disease. Dr. Ozanne, who has 
given an interesting account in the 6th vol. of the 
‘Brit. Journ. of Homoeopathy ’ of an epidemic 
observed by him in Guernsey, writes thus on this 
point. “ I had remarked, that after giving the 
Aconitum either for twenty-four or forty-eight 
hours, and producing a fall of 30 or 40 pulsations 
per minute, on replacing it by Pulsatilla the pulse 
frequently rose again from 80 pulsations per minute 
to 90 or 100, its strength and fulness gaining in 
proportion, whilst the heat of the skin and the 
restlessness at night, together with the peculiar 
harsh and troublesome cough, continued or increased, 
and this at a period (the fourth or fifth day after the 
first appearance of the exanthem) when all these 
symptoms of febrile excitement ought to have sub- 
sided.” He therefore gave Aconite more persistently, 
and with the happiest results. 
While Aconite is thus the main remedy for 
measles throughout, I am persuaded that much 
benefit is obtained from alternating with it medi- 
cines suitable to the local disorders present. Thus 94 
RUBEOLA. 
for the conjunctival and nasal coryza of the first 
two or three days Euphrasia is invaluable. A little 
later the catarrh of the digestive canal calls for 
Pulsatilla, which is a medicine of high repute in 
measles. If, together with this latter condition, 
the laryngeal cough is very troublesome, I must 
agree with Dr. Lippe in thinking Kali bichromicum 
the most homoeopathic remedy. Nor should I rely 
less upon it if actual laryngitis should occur, though 
Spongia and Bromine would be possible alternatives. 
If bronchitis or broncho-pneumonia supervene, 
Phosphorus will generally give you every satisfaction. 
But more on this point when we come to the dis- 
eases of the chest. 
The malignant form of measles (morbilli graviores), 
now happily so rare, does not seem to have been 
observed by Homoeopathic writers. But I have 
not unfrequently seen great danger occur from the 
imperfect development or retrocession of the eruption. 
In these cases I have seen the best results from 
Ammonium Carbonicum (1st) or Camphor. Bryonia 
is recommended by Hartmann and Teste for recalling 
the eruption, especially where the chest suffers most 
from its retrocession. 
The sequelae of measles, notably its ophthalmia 
and pulmonary mischief, are best treated by Sul- 
phur. 
I have bestowed so much space on small-pox and 
measles that I must devote a separate letter to that 
still more important exanthem, scarlet fever. LETTER X. 
Blood Diseases (continued). 
Scarlatina 
is unquestionably one of the most important dis- 
eases with which we have to deal. Its great fre- 
quency both in town and country, its high mortality, 
and the variety of its forms, complications, and 
sequelae invest it with alike practical and scien- 
tific interest. You will be eager to know what 
Homoeopathy can do in its treatment, and how she 
does it. 
In the first place, you will expect me to tell you 
something about the reputed prophylactic virtues of 
Belladonna. That the probabilities are in its favour 
must be admitted, I think, when we consider the 
parallel instance of Quinine in ague. Belladonna 
covers the whole field of the invasion of the scarla- 
tina poison; pre-occupy the ground with its in- 
fluence, and the enemy finds no point of attack. 
If now you will read the testimonies collected by 
Dr. Black in the 1st vol. of the ‘ Brit. Journ. of 
Horn. ’ (p. 129) or by Dr. Dudgeon in his ‘ Lectures 
on Homoeopathy/ you will see that there is an 
immense body of evidence from all sources in its 
favour. That results of an opposite kind have been 
obtained I know well. But two considerations 96 
SCARLATINA. 
In the “ scarlatina anginosa” you will have begun 
with Aconite and perhaps Belladonna: but very 
soon you will find that the state of the throat 
demands special remedies. You will have either 
swelling or ulceration as the prominent symptom 
present; and your remedies must be selected 
accordingly. For the former condition I have been 
disappointed in Baryta Carbonica, which I was led 
to use from its value in quinsy: but we have a 
capital medicine for it in Apis. For the ulceration, 
often so destructive, which obtains in scarlatina, we 
have an excellent and most homoeopathic remedy in 
Mercurius (see f Pharmacodynamics,’ p. 397). These, 
then, are the chief medicines for scarlatina anginosa : 
you may keep up your Aconite or Gelseminum in 
alternation with them if you please. 
And now of that frightful disease which we call 
ff scarlatina maligna.” We usually first recognise 
it in the general nervous toxication which charac- 
terises its primary invasion. The obvious indication 
here is to get the poison to the skin: for which 
purpose Dr. Hamilton strongly recommends Currie’s 
cold affusion and subsequent wrapping in blankets. 
Hartmann praises Camphor, assiduously adminis- 
tered. When the oppression of the brain is the 
most prominent symptom, Cuprum Aceticum and 
Zincum are of high repute among us. I refer you 
to the papers of Dr. P. P. Wells on “ Scarlatina” 
for the scarlatinal fever, considering this hardly sthenic enough for 
Aconite. In one case with which I am acquainted the fever assumed 
the remittent type so characteristic of this drug,—the rash receding 
and reappearing with the remissions and exacerbations. Gelseminum 
was given here with manifest advantage. 97 
SCARLATINA. 
in the ‘ American Homoeopathic Review/ vol. iv, 
for comments on this morbid condition, and sug- 
gestions as to additional remedies—as Hydrocyanic 
Acid, Tabacum, Lachesis, and Ailanthus—likely to 
meet it. 
If the patient rallies from the primary shock, the 
symptoms of a malignant toxsemia develop them- 
selves. Here the grand medicine is Arsenic, on 
which you had best rely to the exclusion of all 
others. Our American colleagues place much reli- 
ance on Lachesis here. I have no experience with 
it; but its pathogenesy would point to its applica- 
bility to those cases where, as Watson puts it, “the 
system is re-inoculated from” the ulcerated and 
gangrenous throat. 
Hr. Wells, in the continuation of his papers on 
“ Scarlatina” in the 5th vol. of the ‘American Ho- 
moeopathic Review/ speaks of “inflammation of 
the brain and its membranes” as not unfrequently 
occurring in scarlatina, and describes the character- 
istics of its remedies, notably Belladonna and 
Sulphur. I suspect that the complication is a very 
rare one. Laryngitis, also, is happily unfrequent : 
Spongia or Bromine might touch it when occurring. 
The “ post-scarlatinal dropsy” forms a connecting 
link between the complications and the sequelae of 
scarlatina. I mean that it seems now ascertained 
that renal implication, as shown by albuminuria, is 
no accident of this exanthem, but of its essence and 
constant. This requires no treatment: but it is 
otherwise when it results subsequently in acute 
desquamative nephritis and dropsy. Several medi- 
cines are in repute for this malady. I am glad to 98 
SCARLATINA. 
Iii the “ scarlatina anginosa55 you will have begun 
with Aconite and perhaps Belladonna: but very 
soon you will find that the state of the throat 
demands special remedies. You will have either 
swelling or ulceration as the prominent symptom 
present; and your remedies must be selected 
accordingly. For the former condition I have been 
disappointed in Baryta Carbonica, which I was led 
to use from its value in quinsy: but we have a 
capital medicine for it in Apis. For the ulceration, 
often so destructive, which obtains in scarlatina, we 
have an excellent and most homoeopathic remedy in 
Mercurius (see f Pharmacodynamics,’ p. 397). These, 
then, are the chief medicines for scarlatina anginosa : 
you may keep up your Aconite or Gelseminum in 
alternation with them if you please. 
And now of that frightful disease which we call 
<f scarlatina maligna/5 We usually first recognise 
it in the general nervous toxication which charac- 
terises its primary invasion. The obvious indication 
here is to get the poison to the skin: for which 
purpose Dr. Hamilton strongly recommends Currie’s 
cold affusion and subsequent wrapping in blankets. 
Hartmann praises Camphor, assiduously adminis- 
tered. When the oppression of the brain is the 
most prominent symptom, Cuprum Aceticum and 
Zincum are of high repute among us. I refer you 
to the papers of Dr. P. P. Wells on “ Scarlatina55 
for the scarlatinal fever, considering this hardly sthenic enough for 
Aconite. In one case with which I am acquainted the fever assumed 
the remittent type so characteristic of this drug,—the rash receding 
and reappearing with the remissions and exacerbations. Gelseminum 
was given here with manifest advantage. SCARLATINA. 
99 
in the ‘ American Homoeopathic Review,’ vol. iv, 
for comments on this morbid condition, and sug- 
gestions as to additional remedies—as Hydrocyanic 
Acid, Tabacum, Lachesis, and Ailanthus—likely to 
meet it. 
If the patient rallies from the primary shock, the 
symptoms of a malignant toxaemia develop them- 
selves. Here the grand medicine is Arsenic, on 
which you had best rely to the exclusion of all 
others. Our American colleagues place much reli- 
ance on Lachesis here. I have no experience with 
it; but its pathogenesy would point to its applica- 
bility to those cases where, as Watson puts it, “ the 
system is re-inoculated from” the ulcerated and 
gangrenous throat. 
Dr. Wells, in the continuation of his papers on 
“ Scarlatina” in the 5th vol. of the ‘ American Ho- 
moeopathic Review,’ speaks of ‘‘inflammation of 
the brain and its membranes” as not unfrequently 
occurring in scarlatina, and describes the character- 
istics of its remedies, notably Belladonna and 
Sulphur. I suspect that the complication is a very 
rare one. Laryngitis, also, is happily unfrequent : 
Spongia or Bromine might touch it when occurring. 
The “ post-scarlatinal dropsy” forms a connecting 
link between the complications and the sequelae of 
scarlatina. I mean that it seems now ascertained 
that renal implication, as shown by albuminuria, is 
no accident of this exanthem, but of its essence and 
constant. This requires no treatment: but it is 
otherwise when it results subsequently in acute 
desquamative nephritis and dropsy. Several medi- 
cines are in repute for this malady. I am glad to 100 
SCARLATINA. 
see that Dr. Yeldham has softened his recommen- 
dation of Terebinthina (‘ Annals/ vols. i, p. 390, 
iv, p. 171) : I have been wofully disappointed in 
it. Arsenicum, Cantharis, Iielleborus, and Apis have 
been most frequently used. The second would seem 
most truly homoeopathic to the lesion present: but 
I have most reason to be satisfied with Arsenicum. 
Dr. Ozanne, in an epidemic occurring at Guernsey, 
relied on Helleborus with the best results ; and the 
same medicine is also praised by an allceopathic 
physician (‘Brit. Journ./ vol. iv, p. 6). Apis is 
reported to act well in American epidemics : I have 
myself given it occasionally without manifest effect. 
Apocynum and Colchicum, also, are medicines that 
have been suggested,—on grounds more or less 
theoretical. I shall return to this subject when I 
come to speak of renal disease. 
I may dismiss, briefly the other sequelae of scar- 
latina. The engorgement of the glands about the 
neck, with swelling of the cellular tissue, may nearly 
always be dispersed without proceeding to suppura- 
tion by the Biniodide of Mercury. The sore and 
bleeding nose, and the otorrhcea and deafness, which 
often remain behind are singularly under the control 
of Muriatic acid. But when they occur as parts 
of a general bursting forth of the scrofulous dia- 
thesis resultant upon the disease, Sulphur must be 
administered. 
I think I have now pretty well prepared you for 
the treatment of scarlet fever: nor do I doubt but 
that you will be abundantly satisfied with your com- 
parative measure of success. For fuller informa- 
tion I may refer you to our systematic treatises in DENGUE. 
101 
general: to the account of epidemics by Dr. Ozanne 
in vol. iii of the ‘ Brit. Journ. of Horn./ by Dr. 
Wilde and Dr. Bayes, in vol. iv of the f Annals/ and 
by Mr. Nankivell in vol. vii of the ‘ Monthly Ho- 
moeopathic Review :’ and to cases by Dr. Yeldham 
in his ‘ Homoeopathy in Acute Diseases’ and by 
Dr. Laurie in the 2nd vol. of the 1 British Journal/ 
Before leaving the exanthemata, I must say a 
few words about certain rare and curious varieties 
which are sometimes encountered. 
The first is that apparent hybrid of measles and 
scarlatina to which Dr. Copland has applied the 
term Cf rubeola/’ but which (to avoid confusion) I 
shall designate by its German name as 
Rotheln. 
The only accessible description of this disease 
known to me is that contained in Dr. Aitken’s 
‘ Science and Practice of Medicine/ From his 
account of the symptoms, I should feel disposed to 
give Gelseminum instead of Aconite in the prelimi- 
nary febi’ile stage. When the throat symptoms 
begin to call for aid, Apis seems the medicine best 
indicated. In the inflammatory mischief so apt to 
supervene within the chest, Phosphorus would pro- 
bably act as well as in the similar complication of 
measles. 
Another modification of scarlatina is the 
Dengue, 
or scarlatina rheumatica. It is no uncommon 
thing, as you doubtless know, to see rheumatoid 102 
MILIARIA. 
swelling of the joints, with much pain and tender- 
ness, in ordinary scarlatina. Here I have always 
found Rhus to act most satisfactorily,—the affected 
joints being wrapped in cotton-wool. But this 
“ dengue” is described as “ a peculiar febrile dis- 
ease, conjoined with sudden severe pains in the 
small joints, which swell; succeeded by general 
heat of skin, intense pain in the head and eyeballs, 
and the appearance of a cutaneous eruption on the 
third or fourth day” (Aitken). It is epidemic in 
the East and West Indies, and in America. From 
what I read of the symptoms, Rhus, after Aconite, 
appears very fairly to cover them. I should be dis- 
posed to use the “ venenata” species : on account of 
what is noted—“ Decided implication of the mucous 
membrane of the mouth and throat prevailed in the 
last epidemic in Calcutta.’’ If the symptom “ painful 
swellings of the lymphatic glands of the neck, 
axilla, and groins; also of the testicles” be promi- 
nent, Clematis might be used with advantage. 
The last exanthem I have to mention is 
Miliaria. 
This seems to be the modern representative of the 
mediaeval “ sweating sickness.” Dr. Aitken has. 
described it from his personal observation among 
the Turks at Scutari during the Crimean Avar. He 
characterises it as “ a disease in which, there is an 
eruption of innumerable minute pimples, Avitli Avliite 
summits, occurring in successive crops upon the 
skin of the trunk and extremities, preceded and 
accompanied Avith fever, anxietas, oppression of re- MILIA1UA. 
103 
spiration, copious sweats of a rank, sour, fetid odour, 
peculiar to the disease.” Aconite is said to have 
proved of great value in the “sweating sickness:” 
and the symptoms show a very tolerable Homoeo- 
pathicity on its part to the disease. LETTER XI. 
blood diseases (continued). 
I consider the establishment of the “ Enthetie 
Order of Zymotic Diseases’’ a very happy nosological 
thought. Hydrophobia, Glanders, Malignant Pus- 
tule, and Syphilis throw unexpected light upon each 
other when put side by side. In this letter I pro- 
pose to consider them together, and will begin with 
Hydrophobia. 
I need hardly say that excision of the bitten part 
is the duty as much of the Homoeopathic as of the 
Alloeopathic practitioner : and that nothing we can 
offer in the way of either prophylaxis or cure super- 
sedes this paramount necessity. But having done 
this, we can advance to farther treatment with 
larger resources and fairer prospect of success than 
our brethren of the old school. This advantage we 
have in the use of the two great “ mydriatics” 
Belladonna and Stramonium. I need not argue out 
the liomceopatliieity of these drugs to the symptoms 
of hydrophobia: it is sufficiently obvious. But 
what facts have we to offer as to their efficacy ? 
First, as to prophylaxis. Read Mr. Youatfs 
experiments with his mixture of Belladonna and HYDROPHOBIA. 
105 
Scutellaria lateriflora* as given by Watson. Then 
turn to the account cited in Hempel and Teste from 
Murray’s ‘ Apparatus/ and the remarks of Bayle 
there given on the cases. I think you will feel 
inclined, if any one whose life you value has been 
bitten by a suspected dog, to keep such an one 
under the influence of Belladonna until the utmost 
limit of incubation has been reached. 
Again, read the cases of reported cure of hydro- 
phobia by Belladonna in Hempel, and in the * Brit. 
Journ. of Horn.,’ vols. vii, 146, viii, 81, and xi, 140— 
twelve in all. Grant that some of these were the 
effects of fright: it is hardly likely that all should 
have been. And if Belladonna has cured a single 
case, it has done more than all the resources of 
traditional medicine have been able to accomplish, 
and is worthy of repeated trial. 
As to the diagnosis between the two medicines,— 
I should be inclined to choose Stramonium in pre- 
ference where the general nervous irritability was 
extreme, and Belladonna where the throat symptoms 
showed that the stress of the mischief had fallen 
on the medulla oblongata and its issuing nerves. 
Hydrophobia, moreover, would be a suitable dis- 
ease in which to administer our medicines by hypo- 
dermic injection, as lately recommended and prac- 
tised by Hr. Kafka of Prague.f 
* It is of course open to suggestion that the Scutellaria played 
here the more important part. Prom the information regarding 
it given by Dr. Hale in his “ New Remedies,” it unquestionably 
appears to be a neurotic medicine of some energy, 
f ‘ Brit. Journ. of Horn.,’ vol. xxv, p. 353. 106 
MALIGNANT PUSTULE. 
Glanders. 
Of the treatment of this disease I can only speak 
theoretically. In acute glanders, where the suppu- 
rating nostrils and the pustular skin are the chief 
evidence of the constitutional infection, Kali bichro- 
micum ought to prove as serviceable in the human as 
Mr. Moore has found it in the brute subject. Where 
the lymphatic glands receive the main weight of the 
poison—forming the <c farcy-buds” of the veterina- 
rians—Mercurius would seem most suitable. In 
either form, should malignant symptoms—black 
bullse, tendency to gangrene, &c.—be manifest, 
Lachesis or Arsenicum might advantageously be 
alternated with the more locally-acting medicine. 
Malignant Pustule, 
when (as usually) communicated by inoculation, 
doubtless demands the early excision or cauteriza- 
tion of the affected part. But, if seen too late for 
this means, the symptoms are so like those of the 
traumatic gangrene and the malignant carbuncle for 
which Lachesis has proved the specific remedy that 
I should proceed with much hope to its administra- 
tion. Indeed, Dr. Carroll Dunham has already 
used it with the utmost success in an American 
epidemic of this disease (‘Amer. Horn. Rev./ 
vol. iv, 110). 
From these blood-poisonings induced by the 
implantation of a specific animal poison, we pass 
naturally to— SYPHILIS. 
107 
Syphilis. 
I follow the most recent pathologists in limiting 
this term to the indurated sore and its consequences. 
It must be a great satisfaction to you, as it is to 
myself, to find that the doctrines about syphilis we 
long ago imbibed from our excellent teacher, Mr. 
Henry Lee, are now universally received. Soft 
chancre with its suppurating bubo is now relegated, 
with gonorrhoea, to the sphere of local affections, 
amongst which we shall consider it. The disease 
whose treatment we have now to discuss is syphilis 
truly so called. 
Comments upon the treatment of syphilis occupy 
a large space in the field of Homoeopathic literature. 
It is needless to do more at present than refer you 
to our journals generally,—especially the ‘ British 3 
and ‘ North American and to commend to you 
especially Dr. Yeldham’s excellent practical mono- 
graph on ‘ Homoeopathy in Venereal Diseases.5 
The first fact about the treatment of syphilis 
which appears on the face of these observations is 
this,—that small doses of Mercurius (gr. i—iij of 1st 
or 2nd dec. trituration) heal the primary sore aud 
resolve its induration more rapidly than infinitesimal 
doses of the same drug, and without the injurious 
effects of salivating quantities. But then the ques- 
tion arises,—is this rapid extinguishment of the 
local manifestation of the disease desirable ? Dr. 
Schneider of Magdeburg answers in the negative 
(see his papers in the ‘Brit. Journ. of Horn./ vol. 
xxii). He treats his cases with globules saturated 108 
SYPHILIS. 
with the 4th—6th dec. dilution of Mercurius solu- 
bilis. From six to eight weeks are required for 
the disappearance of the chancre ; but no sequela 
appear. This he states on the evidence of 325 cases 
which came under his treatment, in four of whom 
only did secondary symptoms occur; and of these 
only one had been under his care from the first. 
It is highly improbable that these four should have 
been the sole cases of indurated chancre among the 
325. Dr. Yeldham, on the other hand, admits that 
“the appearance, or non-appearance, of secondary 
symptoms is a matter beyond the control, in most 
cases, of the very best treatment that can be 
adopted.” 
It is only fair that I should lay these obser- 
vations of Dr. Schneider’s before you, especially as 
they coincide with Hahnemann’s. The latter gave 
even smaller doses of Mercurius; and he states in 
the 1st vol. of the c Chronic Diseases’ that, in a 
practice of fifty years, he had “ never seen syphilis 
breaking out in the system, when the chancre was 
cured by internal remedies, without having been 
mismanaged by external treatment.” But I con- 
fess that that these results seem to me credible only 
as exceptional. All analogy is certainly against the 
theory they are put forward to support. It was 
supposed by Hahnemann that the breaking out of 
the chancre was an evidence that the syphilitic 
poison had already infected the system. But if so, 
why do the neighbouring lymphatic glands always 
enlarge and harden before secondary symptoms 
appear? Is it not obviously through them that 
the poison, locally implanted, invades the consti- SYPHILIS. 
109 
tution ? Is not the formation of chancre analogous 
to the “recrudescence’’ of the hydrophobic cicatrix? 
With syphilis, accordingly, as with that other, the 
previous incubation does not necessarily imply con- 
stitutional infection, but only a lingering and 
probably a development of the poison at the seat of 
its implantation. 
I hold it, therefore, to be the best practice to 
resolve the primary induration of syphilis as speedily 
as possible, so that no injury is thereby caused 
to the general health. In vaccination, Mr. Marson 
tells us, the more numerous and perfect the 
vesicles, the more complete is the constitutional pro- 
tection. So, by analogy, the longer the focus of 
syphilitic contamination is allowed to continue, the 
more thorough will be the infection of the system. 
There is nothing to my mind irrational in excision 
or cauterization here, any more than in the parallel 
instances of hydrophobia and malignant pustule. But 
as in hydrophobia this remedy, certain at the first 
injury, is dubious when the recrudescence has begun, 
so to destroy a chancre is of but questionable 
benefit. If it can be, as Dr. Yeldham’s cases prove, 
expeditiously dispersed by uninjurious doses of 
Mercury, this seems to me by far the best practice 
to be followed. 
A much larger field is opened to us by the second- 
ary symptoms of syphilis. Those of the mouth and 
throat are admirably controlled by our medicines. 
If Mercurius has not previously been given, it is 
required, and will act well. After, or instead of it, 
Nitric acid is a capital medicine for the “ mucous 
tubercles ” of the mouth, and the cracks about the 110 
SYPHILIS. 
commissures of the lips. Kali bichromicum is very- 
good for indolent ulceration of the throat; but when 
this takes on a destructive action (as in the per- 
forating ulcer of the soft palate), if Mercury is 
inadmissible, Kali hyclriodicum is required. The 
syphilitic exanthemata yield best to the Iodide or 
Biniodide of Mercury, if that mineral has not pre- 
viously been too freely used.* In obstinate cases, 
Dr. Yeldham recommends the alternation, week by 
week, of the Biniodide of Mercury and the Iodide 
of Potassium. 
“ Of tertiary syphilis/’ writes Dr. Aitken, “ gum- 
mata are the characteristic lesions.” Under this title, 
it seems, we are to include alike the familiar “ node” 
of the surface, and those deposits and changes in 
internal organs which recent investigation has 
shown to exist in most syphilitic subjects. Por the 
node it is hardly possible to find a better medicine 
than Kali hydriodicum,—although Kali bichromi- 
cum, Silicea, Aurum, Mezereum, Phytolacca, and 
Guaiacum work in the same direction. Hence, when 
the symptoms of a syphilitic patient point to inter- 
ference with the functions of an internal organ—as 
headache, paralysis, epilepsy, amaurosis—it is ra- 
tional to try the effects of the same medicine,—a 
practice often reported as crowned with success. 
Whether, however, this is Homoeopathy is a ques- 
tion. You will find it very ably discussed by Dr. 
* There is a good case by my friend Dr. Meyhoffer in the * Brit. 
Journ. of Horn., vol. xxiv, p. 363, illustrating the value of Nitric 
acid in the symptoms of mouth, throat, and larynx, and of Biniodide 
of Mercury in the exanthem, with headache and falling off of the 
hair, of syphilis. 111 
SYPHILIS. 
Madden in vol. xxv of the f British Journal.’ The 
affinities of Aurum would probably render it more 
suitable when the bones or the testicles were 
affected: and I know no better medicine for the 
syphilitic cachexia. 
I need say nothing as to the extreme importance 
in these cases of raising and maintaining at a high 
standard the general health. But the following 
case, which I cite from the f North American 
Journal of Homoeopathy ’ for 1864, will show how 
much may be done therein by Homoeopathic medi- 
cation. 
“ A Portuguese, about thirty years of age, had 
been in the hospital at Laliaina for eighteen months; 
during this time he passed through all stages of the 
syphilitic virus. When he arrived in Honololu, the 
first day of July, he exhibited the most loathsome and 
disgusting appearance. The right side of his face was 
covered with a most foetid ulcer of the tertiary form of 
syphilis : it developed itself over the right eye, down 
the outer angle and under the eye to the nose, 
extending to the mouth over the whole cheeks, 
leaving the malar bone entirely bare and dry. There 
was carious affection of the frontal bone, extending 
over the right eye around to the temporal bone; the 
malar and nasal bones were more or less destroyed 
by the disease. The right eye was entirely closed. 
These ulcers were discharging a very foetid and 
offensive watery fluid, and had a dark-red appear- 
ance. In addition to all this he had ascites, and 
was greatly bloated; from this he had suffered for 
the last six months. The ulcers were very painful; 
darting and gnawing pain,burning through the whole 112 
SYPHILIS. 
of the ulcerated surface, as he expressed it, as if 
there were red-hot needles sticking in the ulcers. 
“ For these symptoms I selected Ars. alb. third, 
three doses a day for three days, which greatly 
relieved the burning and mitigated the pain; but 
he was not relieved from the pain wholly until he 
took Belladonna, third, three or four doses. After 
these two remedies ceased to improve, I gave Acid. 
Nit. morning and evening; improvement followed; 
after the first week I gave but one dose per day, 
for two Aveeks. Under the action of these remedies, 
the ulcers put on a more healthy appearance, until 
the end of three weeks, when I could not discover 
any improvement. I thengave Aurum muriat., second, 
one dose per day. This seemed to stop all progress 
of caries, and the whole case looked favourable. I 
continued this remedy three weeks, with occasionally 
a dose of Sulphur, sixth. The healing of the ulcers 
was steady and permanent. His general health 
improved, appetite good. The digestive organs 
completely restored. The urinary secretion became 
normal, he gained strength and flesh. A few doses 
of Hepar sulph., and Ars. alb., sixth, at intervals of 
three or four days. These last remedies removed 
all symptoms of dropsy and venereal disease about 
him. A more grateful person I never saw.” 
This case reminds me to mention that, in the 
treatment of this disease, the Homoeopathic prac- 
titioner enjoys the great advantage of the possession 
of medicines like Arsenicum, Belladonna, &c., in 
addition to the more special anti-syphilitics, which 
enable him to meet many a complication, and 
expedite many a cure. SYCOSIS. 
113 
Hereditary syphilis will come under our notice 
among the diseases of children; and many local 
effects of the poison will be discussed in their proper 
place. At present, I shall only speak of one other 
supposed manifestation of syphilis, which, however, 
I must follow Hahnemann in classing separately 
under the name 
Sycosis. 
This is the constitutional venereal malady whose 
chancre is the condyloma. I must refer you to 
my remarks on Thuja for explanations and authorities 
on the subject. That medicine, as you will see, is 
the sycotic Mercury. But Hahnemann has given 
us a useful adjunct to it in Nitric acid. If you 
ask me to allot their respective spheres of action, I 
would suggest that Thuja will act best in pure 
sycosis; while Nitric acid will prove more serviceable 
when vegetations, especially at or near the muco- 
cutaneous junctions, occur in syphilitic patients. 
Perhaps the case recorded by Mr. Henriques in 
the ‘ Brit. Journ.,’ vol. xix, p. 64, in which Nitric 
acid acted so well, was of this order. LETTER XII. 
DISEASES OE THE NERVOUS SYSTEM. 
The “Blood Diseases” we have hitherto been 
considering are of a general nature, involving more 
or less the whole organism. Leaving these, we 
come now to the disorders of particular systems 
and organs: and among these give pre-eminence in 
place to the diseases of the brain, the spinal cord, 
and the nervous system in general. 
To classify satisfactorily the various forms of 
cerebral disease is no easy matter. I think, how- 
ever, that I shall not have omitted anything of 
importance if I treat, first, of the substantive diseases, 
Meningitis, Phrenitis, Softening, and Apoplexy; 
then of those phenomena—proximately cerebral, but 
of very varied origin—Mental Disorder (including 
Delirium tremens), Headache, Vertigo, and Sleepless- 
ness : lastly, of injuries to the head. In this list 
I have omitted the many brain affections peculiar 
to children, culminating in acute hydrocephalus: as 
these will be considered in the section devoted to 
the subject of children’s diseases. 
Meningitis. 
Theoretically, it would be correct to discuss under 
this heading inflammation affecting the dura mater, MENINGITIS. 
115 
the arachnoid, and the pia mater respectively. But 
practically such a division is untenable. It is 
doubtful whether the arachnoid is ever primarily 
affected. Its upper layer is often involved in 
inflammation of the dura mater: its lower layer 
sympathises with all that affects the pia mater. 
So that the practical division of the subject is into 
meningitis involving the dura mater and cranial 
arachnoid, and meningitis involving the pia mater 
and cerebral arachnoid. 
1. The first form of meningitis commonly comes 
before us as the result of external injury. It is 
that so graphically described by Watson. “ A man 
receives a blow on the head; the blow stuns him 
perhaps at the time, but he presently recovers him- 
self, and remains for a certain period, apparently 
in perfect health. But after some days he begins to 
complain; he has pain of the head, is restless, cannot 
sleep, has a frequent and hard pulse, a hot and dry 
skin, his countenance becomes flushed,his eyes are red 
and ferrety ; rigors, nausea, and vomiting supervene; 
and, towards the end, delirium, convulsions, or 
coma.” On opening the skull, the dura mater is 
found inflamed, and lymph or pus effused upon the 
superior surface of the arachnoid. 
It is obviously to hospital experience that we 
must look for the proper treatment of this malady. 
In the absence of record of such experience, I can 
only suggest the use of Arnica from the commence- 
ment as a prophylactic, and the administration of a 
low* dilution (say the 1st dec.) of Aconite in fre- 
quently repeated doses as soon as inflammatory or 
febrile symptoms appear. 116 
MENINGITIS. 
The only other form of acute meningitis involving 
the dura mater with which I am acquainted is that 
in which there is extension of disease from the 
internal ear. Of this, again, we have no instance 
in Homoeopathic literature,* so that I cannot tell 
you whether our remedies have any power of avert- 
ing its usual termination in death. The free and 
persistent use of Aconite is the only treatment I 
can suggest. 
The dura mater may be chronically affected 
(? inflamed) by the poison of syphilis and perhaps 
by that of rheumatism. I say “ perhaps ” to the 
latter : because when metastasis of acute rheumatism 
to the brain occurs, it is the cerebral arachnoid 
with the pia mater which is found inflamed. For 
the former, which usually comes before us as 
“ syphilitic headache,” Mercurius Corrosivus and 
Iodide of Potassium are in our hands as in yours 
the most efficient remedies. 
2. Inflammation of the pia mater involving the 
* The following case, however, should be read, and taken at its 
worth. “ A youth, a3t. 18, had suffered from a discharge from the 
ear, which became suppressed by cold. He had violent piercing and 
insupportable pains darting from one ear to the other through the 
head; high fever, intolerance of light with very moveable pupils, 
sleeplessness or starting up from slumber, violent cough with pain 
in the forehead, constipation. He took Bryonia 2, one sixth of a 
drop every two hours. At the end of twenty-four hours the dis- 
charge from the ear had returned, he had profuse perspiration, es- 
pecially upon the head, the pain and fever were but slight, the skin 
only moderately warm, thirst not urgent, but he was restless, tossed 
about, thought he was going to die, slumbered a good deal, and had 
an involuntary discharge of mucus from the bowels. Hyoscyamus, 
2nd dil., followed by the 1st, removed all danger in three days, and 
the patient was well in six.” (Peters ‘On Diseases of the Brain.’) PHRENITIS. 
117 
arachnoid appears to be the form of meningitis set 
up by the scarlatinal and rheumatic poisons, and 
from insolation. It is this form also which results 
from tubercular deposition, which we shall study 
as acute hydrocephalus among the diseases of 
children. In the simple variety, Bryonia is pro- 
bably the most homoeopathic remedy: though the 
involvement of the subjacent grey matter of the 
cerebral hemispheres may require the aid of Bella- 
donna. 
Phrenitis (brain fever) 
is, of course, inflammation beginning in the brain 
substance itself, and spreading or not to the mem- 
branes afterwards. In the latter case it constitutes 
the “ encephalitis ” of Watson. In its acute and 
general form it is the kind of mischief we meet 
with in the course of reaction from concussion, and 
ns the result of mental excitement, intemperance, 
and such-like causes. Its various modes of com- 
mencement, according to the part of the brain first 
affected; and its two well-marked stages of excite- 
ment and collapse, are familiar to every student of 
the Cicero of medicine. 
For the typical form of the disease, as described 
in those eloquent pages, the treatment is very 
obvious. In the stage of excitement Aconite is 
always indispensable. Give repeated doses until 
arterial tension relaxes and febrile heat departs in 
perspiration, and you will have won half the battle. 
All the good effects ascribed by Abercrombie 
and his followers to bloodletting in these cases 118 
PHRENITIS. 
will have been obtained, without spoliation of the 
vital fluid. Then follow up with Belladonna; and 
it will not he long before all perverted cerebral 
excitement subsides to the calm of health. Again, 
let us suppose you are called to the patient as the 
stage of excitement is merging into that of depres- 
sion and stupor, or when this latter condition is 
already developed. You will remember Trinks’ 
canon as to the place of Bryonia in serous inflam- 
mations (‘ Pharmacodynamics/ p. 168) : and employ 
it accordingly where you have reason to suppose 
that the meninges are involved.* In other cases, 
most benefit is to be looked for from Arnica or 
Helleborus. Of the place and value of all these 
medicines you will find abundant illustration in 
Dr. Peters’ treatise. As to the general manage- 
ment I will only say that in the first stage quiet 
and darkness are indispensable, while the usual 
cold appliances to the scalp are at least unneces- 
sary ; and that in the second stage you may 
cautiously try stimulants if you like, but I hope 
you will never think it desirable to crown your 
patient’s head with a cap of blistering plaster. 
Your experience, however, if it agrees with my 
own, will tell you that this typical form of the 
disease is rarely met with in practice :—that is, in 
adults. The cases of cerebral inflammation which 
ordinarily come before us present the symptoms 
described in books (as by Rowland in Peters’ 
‘ Treatise on Apoplexy,’ p. 143) as belonging to 
* Wahle states that in cases where Bryonia is indicated, the face 
is very red, or almost mahogany-coloured. (Peters ‘ On Diseases of 
the Brain,’ p. 105.) SOFTENING. 
119 
“inflammatory softening of the brain.” Of this I 
shall now speak. 
Softening 
of the brain seems at length pretty well understood, 
since the microscope has been applied to its post- 
mortem results. It is either an inflammatory pro- 
cess, or a fatty degeneration from obstruction of 
arteries. In the inflammatory form the medicines 
most likely to be of service are Belladonna, Nux 
Vomica, and Mercurius. Belladonna would probably 
suffice in recent cases, where the inflammatory 
symptoms were well marked. The power of Strych- 
nine to produce softening of the spinal cord and 
cerebellum is undoubted (see Peters’ ‘ Treatise on 
Apoplexy/ p. 127) : and I see no reason why, in the 
form of Nux Vomica, it should not exert a similar 
influence upon the cerebrum itself. But the medi- 
cine I should use with most confidence in this disease 
is Mercury. Let me cite two paragraphs from my 
letter to you on this drug. “ The workers in Mer- 
cury get cerebral symptoms as idiopathic as is the 
mercurial tremor. Sleeplessness, loss of memory, 
delirium, and apathy come on: the sufferers may 
die comatose and hemiplegic: and the cerebral 
hemispheres, one or both, are found after death in a 
softened condition, with effusion into the ventricles.” 
And then “When Watson says ‘I have known 
several obscure but threatening symptoms of brain 
disease clear entirely away, when the gums were 
made sore by Mercury, and kept slightly tender for 
some little time’ one feels tempted to suppose that 120 
SOFTENING. 
the power of the drug to cause cerebral disease has 
had something to do with the cure.” 
The softening dependent on deficient nutrition is, 
as I have reminded you, a fatty degeneration, and 
results from arterial obstruction. You maj’- of 
course retard its advance by enriching the blood—as 
by chalybeates and generous diet—and so enhancing 
the quality of such supplies as reach the affected 
part. Or you may act directly on the degenerating 
brain itself by such medicines as Phosphoric acid, 
Anacardium, and Zinc. But it is possible that 
Homoeopathy may help us “tollere causam” here. 
If the arterial obstruction be from an impacted clot 
or from external pressure, there is obviously nothing 
to be done. But if it result from atheroma of the 
coats of the vessel, then a fair trial should be given 
to Phosphorus. Of the relation of this medicine to 
fatty degeneration I have already spoken. Dr. 
Hughes Bennett, indeed, denies that atheroma is a 
true fatty degeneration, and describes it as a chronic 
arteritis, with adipose transformation of the exuda- 
tion between the coats. But Dr. Black says, “ In 
the case of a gentleman, aged sixty, with weakened 
brain and bronchitis, depending on adipose degene- 
ration, I have seen, after five years of long and 
steady use of Arsenic, Digitalis, and Phosphorus, a 
very material gain in health and strength. A large 
arcus senilis diminished; a pulse, felt with extreme 
difficulty, now readily counted; and a weak-beating 
heart now manifesting in its clearer sounds a great 
gain in vigour.”* 
* * Annals of Brit. Horn. Soc./ vol. iii, p. 424. APOPLEXY. 
121 
The last disease of which I shall speak in this 
letter is 
Apoplexy. 
Of the treatment of this very common disorder we 
have abundance of Homoeopathic experience on 
record. I need not refer you to many books, how- 
ever ; for you will find a very complete collection of 
all that has been published on this subject in Dr. 
Peters’ ‘ Treatise on Apoplexy.’ 
There are three stages in the course of the malady 
in which we may have to consider the most appro- 
priate treatment to adopt. 
1. Our patient may be suffering under the well- 
known premonitory signs of the affection. Pre- 
senting constitutional evidence of tendency to cere- 
bral congestion or to arterial degeneration or both, 
he complains of headache, vertigo, transient deafness 
or blindness, double vision, faltering speech, partial 
paralyses or ansesthesise, failure of memory, drow- 
siness, dread, and so on. Here, besides the obvious 
hygienic and general measures, we have medicines 
of inestimable service. Nux Vomica or Belladonna 
(most frequently the former) will control the deter- 
mination of blood to the brain; and Phosphorus will 
in all probability retard the advance of brittleness 
and obstruction of the arteries. 
2. We may be summoned to a patient in an 
apoplectic fit. If extravasation of blood or serum 
has already taken place, we cannot remedy that. 
But if either an excited state of the circulation, or 
active cerebral congestion be present, they must be 122 
APOPLEXY. 
remedied, or farther mischief will ensue. In the 
former case, withhold your lancet, and give Aconite 
at short intervals. You will be astonished at the 
rapidity with which the beneficial results formerly 
obtained by bloodletting will manifest themselves 
under the action of this potent drug. There are 
indeed few cases of apoplexy—none certainly in 
vigorous or plethoric subjects—in which one or more 
doses of Aconite may not be given with advantage. 
If, however, the cerebral congestion be the most 
prominent feature in the case, another medicine will 
have to be selected. Your choice lies between Nux 
Vomica, Belladonna, and Opium. The first I believe 
to be by far the most homoeopathic to the morbid 
condition, and to be generally its best remedy. But 
it is impossible to read the cases narrated by Peters 
without granting that Belladonna and Opium have 
frequently been of signal value in dissipating the 
apoplectic congestion. When, therefore, the symp- 
toms present remind you strongly of those of 
poisoning by the one or the other of these drugs, you 
will do well to choose it as the simillimum. Other- 
wise, I would advise you to rely on Nux. You may 
aid it if you like by cold to the head, warmth to the 
feet, enemata, and such like : but purgatives I think 
you will find as unnecessary as they are dis- 
tressing. 
In old people, where neither arterial excitement 
nor cerebral congestion are present, but the symp- 
toms depend simply on the giving way of a long 
diseased blood-vessel, the case is not very hopeful 
under any treatment. Arnica and the salts of 
Baryta are most in repute in such cases,—the APOPLEXY. 
123 
former at the time of attack, the latter in aid of 
convalescence. 
3. The after consequences of apoplexy are cere- 
britis or hemiplegia. Belladonna should be the 
remedy for the former : the treatment of the latter 
I shall discuss under the head of Paralysis. LETTER XIII. 
DISEASES OF THE NERVOUS SYSTEM [continued). 
In my present letter I shall endeavour to give 
you some hints as to the Homoeopathic treatment of 
Mental Disorders. The field is so vast, and so 
comparatively unworked, that I can do little more 
than give hints. No Homoeopath has as yet had an 
opportunity of trying our remedies on any large 
scale in a lunatic asylum. The statistics of one 
private establishment where the medicinal treat- 
ment was strictly Homoeopathic are given in the 
‘ Brit. Journ. of Homoeopathy/ vol. xii, p. 483, and 
are fairly encouraging. There are numerous cases 
of the successful treatment of mental disorders scat- 
tered throughout our literature. Those collected 
by Riickert have been arranged by Dr. Peters in 
one of his useful volumes On Nervous Derange- 
ments and Mental Disorders/ Radde, New York). 
Some of these I shall mention as I go on : at pre- 
sent I would refer to the seven cases by Dr. Sztara- 
vezki of Hungary, recorded in vol. i of the above 
named Journal, p. 361, and to those given by Dr. 
Mayerhofer in a paper on “ Nervous and Mental 
Disorders” in the fourth volume, p. 385. If to 
these you will add the review of Jalir’s book on the 
subject in the twelfth vol., p. 459, you will have DISEASES OF THE NERVOUS SYSTEM. 
125 
before you all that is necessary to fill in the sketch 
I shall now attempt to give. 
In choosing a specific medicine for a case of 
mental disorder it is more than ever necessary to 
take into account the “ totality of the symptoms.” 
I mean that the intellectual or moral disturbance is 
often intimately connected with a morbid state of 
the blood or of some organ of the body; and the 
remedy for the former must accordingly cover also 
the latter. I need hardly remind you of hypochon- 
driasis and delirium tremens, of the melancholia 
of hepatic disease and of oxaluria, of puerperal 
mania and melancholia—as examples of what I 
mean. And it is here that we gain so much by 
knowing the mental and moral characteristics of 
our medicines. There is no reason to suppose, for 
instance, that Pulsatilla has any direct relation to 
psychical disorders. But when we meet with its 
distinctive morale aggravated into mental disease, 
especially in uterine cases, we may prescribe it 
with the fairest hope of a cure. I shall refer to 
some instances of this when I come to speak of 
female disorders. 
Your first step, then, will be to consider the 
morbid state of the whole organism with a view to 
the choice of a specific remedy. In this way medi- 
cines like Nux Vomica and Sulphur may often be 
the best to administer. The former is invaluable 
in “ hypochondriasis” — i. e., melancholia accom- 
panying, but out of proportion to, dyspepsia—when 
the gastro-intestinal symptoms are (as they generally 
are) those of this drug. Sulphur is the remedy to 126 
MANIA 
be given when the cutaneous symptoms indicate an 
impure state of the blood. 
If, however, there be nothing remarkable about 
the general condition, and no evidence of primary 
disorder of any organ or function, you will have to 
consider the medicines which act more directly upon 
the nervous centres. I will speak of these under 
the heads of the three leading types of mental dis- 
ease,—mania, melancholia, and dementia. 
Mania. 
Excluding the puerperal form of this disorder (of 
which I shall speak in its proper place) your choice 
for its remedy will nearly always lie among the 
three “ mydriatics,” Belladonna, Hyoscyamus, and 
Stramonium. You will remember the differential 
characteristics of these medicines, as I sketched 
them in my letters on Pharmacodynamics,—the 
more furious rage of Stramonium, the marked hy- 
persemia of Belladonna, and the altogether less active 
and sthenic type of the delirium of Hyoscyamus. 
The first of the three has been most frequently used 
with success; but so thoroughly homoeopathic are 
they all to the essential features of mania that you 
will do well to supplement the one by the other 
rather than change to any more distantly-related 
medicine. Veratrum album is the only other re- 
medy I would mention. Its reputation among the 
ancients has been confirmed in our practice. An- 
guish of mind appears to be the symptom calling 
most strongly for it. DEMENTIA. 
127 
Melancholia, 
when not a symptom of dyspepsia, hepatic disease, 
oxaluria, or disordered ovario-uterine function, finds 
its remedy among certain metallic drugs, notably 
Aurum and Platina. After these come Arsenic, 
Iodine, and Mercury; and lastly, one medicine 
from the vegetable kingdom, Ignatia. Aurum is 
the classical remedy for suicidal melancholy. Pla- 
tina is a medicine especially suitable to women. It 
has cured both religious melancholy and that con- 
nected with deranged uterine health in these sub- 
jects. The apprehension of death is said by Dr. 
Y. Meyer to be the special indication for this medi- 
cine. The peculiar psychical states induced by Arse- 
nic, Iodine, and Mercury, you will find described 
under the headings of these medicines in my first 
volume : and the restless, anguished depression of 
Arsenic, the discouragement and dispiritedness of 
Iodine, and the fretful irritability of Mercury may 
guide you to an occasional cure. Arsenic has already 
been used successfully in cases presenting its cha- 
racteristic symptoms. Lastly, Ignatia should gene- 
rally be preferred when the melancholy is recent, 
and is distinctly traceable to a psychical impression, 
as grief, fright, disappointment, &c. 
Dementia, 
when occurring in the young, is nearly always (I 
apprehend) the result of masturbation. If cure is 
possible, Phosphoric acid or Anacardium would be 128 
GENERAL PARALYSIS OF THE INSANE. 
the medicines most likely to effect it. In persons 
advanced in life, the same remedies have some power 
in checking the inroads of senile mental decay. 
Zinc is another remedy of the same order : and 
Helleborus deserves consideration (see Hahnemann's 
remarks on its pathogenesis, Pharmacodynamics, 
p. 298). 
"While the three types of mental disorder already 
discussed embrace every form of Insanity proper, it 
will be necessary to say a few words upon the treat- 
ment of idiocy and of the general paralysis of the 
insane. 
Idiocy 
is so often the cerebral manifestation of general 
mal-nutrition that it is not vain to hope for some 
aid in its treatment from our specifics, especially 
Calcarea and Phosphorus. Dr. Guggenbiihl tried 
them for a time in his well-known asylum for 
cretins, and is reported to have been very pleased 
with the results obtained. 
General Paralysis of the Insane 
appears to be in all cases connected with an inflam- 
matory condition of the cerebral meninges. The 
only other fact guiding our treatment is that the 
mental condition characteristic of it is one of great 
exaltation. This should lead us to try whether any 
benefit is to be obtained in the incipient stage of 
the disease from Cannabis Indica. Dr. Kidd speaks 
of having done something here with Zincum Su/phu- 129 
DELIRIUM TREMENS. 
ricvm Annals/ vol. iii, p. 427) : and Mercurius 
Corrosivus has occasionally been of use. 
Hypochondriasis and Delirium Tremens must 
finally be discussed before we leave the subject of 
mental disorder. 
Hypochondriasis 
has been already alluded to in its most common 
form, i. e. of melancholia accompanying, but out of 
proportion to, dyspepsia: and the value of Nux 
vomica in such a condition mentioned. But in its 
wider range it is well defined by Drs. Gull and 
Anstie* as “ mental depression, occurring without 
adequate cause ; and taking the shape, either from 
the first or soon, of a conviction in the patient's 
mind that he is the victim of serious bodily disease." 
Over and above the moral treatment required for 
these patients, I think you will find Arsenicum and 
Ignatia of service in their management. The latter 
medicine will control their occasional semi-delirious 
exacerbations of mental distress. The former is in- 
dicated by the “ burning pains " so characteristic 
of hypochondriasis, which also corresponds closely 
with the mental condition induced by this poison. 
I)r. Black (Hahnemann f Materia Medica/ Part I, 
p. 25) speaks highly of its value here, in association 
with Mercurius. 
Delirium Tremens 
is confessedly an instance in which more patients 
have died of the doctor than of the disease. Treated 
* ‘System of Medicine/ vol. ii, Art. “Hypochondriasis.” 130 
DELIRIUM TREMENS. 
of old as an inflammation, the antiphlogistic measures 
and regimen adopted were (so "Watson tells us) 
“positively injurious.” But now the same imputa- 
tion is cast upon the opiate treatment which in his 
eyes seemed their rational substitute. “ Great mis- 
chief” is ascribed in the latest treatise on Medicine 
to such belief and practice: and we are told that 
“the idea that patients in delirium tremens require 
to be narcotized into a state of repose may now be 
said to be abandoned by those best qualified to speak 
upon the subject.” The treatment of the present 
day seems to be one of almost pure expectancy,— 
“the successful treatment of delirium tremens, in 
nine cases out of ten, depending on the regular and 
continuous supply of suitable nutriment, whereby 
the functions of the nervous system are supported 
during the struggle towards recovery.” 
I have no statistics to bring forward bearing on 
the question whether Homoeopathy can add any- 
thing to the success of Expectancy here. But I 
think it highly probable : and shall endeavour to 
give you the indications for certain medicines to be 
used in its treatment. 
You will generally require two,—one to control 
the cerebral disorder, the other to meet the gastric 
and general nervous symptoms of the alcoholized 
patient. The former you will find in Hyoscyamus, 
Belladonna, or Stramonium,—far most commonly 
the first. It is rare that the delirium is inflamma- 
tory enough for Belladonna, or sufficiently maniacal 
for Stramonium. The medicines of the latter class 
which will do you good service are Tartar Emetic 
and Arsenicum. The former answers best when DELIRIUM TREMENS. 
131 
there is much mucous gastric derangement, as when 
beer has been the intoxicating agent: the profuse 
cool sweats also indicate it.* Arsenic comes in 
when the condition of stomach is one of true gastri- 
tis, and when the nervous disorder is considerable, 
as shown by the prostration and the muscular tre- 
mors,—the latter of which it remarkably controls. 
By giving one of the latter medicines by day, 
and one of the former by night you will, I think, 
get very satisfactory effects in delirium tremens. 
For some illustrative cases I refer you to a paper 
on the disease by Mr. Moore of Liverpool, in the 
8th volume of the ‘British Journal of Homoeo- 
pathy.* I agree with him in thinking that Hyos- 
cyamus requires to be given here not higher than 
the 1st dec. dilution. 
Delirium tremens is now described as “ acute 
alcoholism,” and is viewed in connexion with a 
series of changes in the nervous functions occur- 
ring in drunkards to which the term “ chronic 
alcoholism” is given. Muscular tremors and morn- 
ing vomiting are the most common of these : grave 
degenerations of the nerve-centres, as indicated by 
paralysis and mental alienation, stand at the other 
extremity of the scale. I need hardly say that if 
such patients are to be treated successfully, their 
vicious habit must be broken off. But besides this, 
you may obtain great benefit by the administration 
of Nux vomica in these cases, when the mischief has 
* The tendency to the supervention of pneumonia in cases of 
delirium tremens is another proof of the homceopathicity of Tartar 
Emetic. 132 
DELIRIUM TREMENS. 
not gone too far. In more advanced forms of the 
disease I suppose we could hardly do better than 
what Dr. Anstie recommends, viz. endeavour to 
improve the nutrition of the nervous centres by 
Phosphorus and fatty foods. LETTER XIV. 
diseases of the nervous system (continued). 
Having now concluded the substantive diseases 
of the brain, I must, before passing to the spinal 
cord, speak of certain phenomena, proximatelv cere- 
bral, but of very various origin, which frequently 
come before us for treatment. These are Headache, 
Vertigo, and Sleeplessness. 
Headache. 
It is one of the glories of Homoeopathy, that it has 
brought within the range of curative treatment a 
multitude of minor ills hitherto thought unworthy 
of the practitioner's attention. Who ever contri- 
butes to the ‘ Lancet' and its fellows a case of 
chronic or recurrent headache successfully treated ? 
It is one of the most prevalent of complaints, espe- 
cially in women : but it has come to be regarded as 
a necessary evil, and neither physicians nor patients 
think of it as curable. It is just the reverse with 
Homoeopathy. Our literature abounds with cases 
of the cure of headache (Dr. Peters has collected 
169 in his treatise on the subject): and the rela- 
tion of many of our medicines to this form of pain 
is accurately fixed. For full details I refer you to 
the ,c Treatise on Headaches” by Dr. Peters, which 134 
HEADACHE. 
I have mentioned : and to the admirable papers 
“ On Headaches ” by Dr. Black in vol. v of the 
‘ British Journal of Homoeopathy.’ I will myself 
endeavour to sketch for you the treatment of the 
leading forms of the malady. 
Of toxajmic (syphilitic, gouty, rheumatic) and 
sympathetic headaches I need not speak particu- 
larly. Their treatment must he that appropriate 
to the blood-poison or the disordered organ on 
which they depend. The three great types of 
headache which come under our notice are the 
nervous, the congestive, and the “sick” headache. 
1. By the “nervous headache” I understand a 
liypersesthesia of the brain itself or of some of its 
issuing nerves, depending upon a morbidly excitable 
condition of the cerebral substance. We have two 
excellent remedies for this trouble,—Belladonna 
and Nux vomica. The former is, as a rule, most 
applicable to women and children; the latter to 
men. They will not only relieve at the time : 
but in many cases their continued use will greatly 
lessen the morbid susceptibility upon which the 
suffering depends. 
There are two varieties of this headache which 
require special mention. The first is the “clavus 
hystericus.” Nux vomica has not seldom proved 
curative here: but as a rule Ignatia is preferable- 
The temperament and constitution of the patient 
Avould decide our choice. The second is hemicrania 
(migraine). It is very curious how rarely this affec- 
tion is met with in the Anglo-Saxon race. Our 
French and German confreres have plenty to say 
about it: but no cases are reported in the journals HEADACHE. 
135 
of England and America. I have myself only seen 
one instance of true migraine : and this was in a 
lady who had spent much of her life in Paris. Has 
our less habitual coffee-drinking anything to do 
with it? Hahnemann and Teste agree in thinking 
so. I refer you to two papers on Migraine by Drs. 
Trinks and Clotar Muller respectively (f Brit. Journ. 
of Horn./ vol. xxi, pp. 1 and 276) for a full con- 
sideration of its remedies. Here also Belladonna 
and Nux vomica bear off the palm,—the former 
being said to give most relief during the paroxysm, 
the latter most frequently effecting a radical cure. 
The other medicines favourably mentioned by Dr. 
Muller are Ipecacuanha, Arnica, Calcarea, Sepia, 
Ferrum, and Yerbascum. He confesses, however, 
that he has only twice succeeded in effecting a 
radical cure of the malady—once with Yerbascum 
and once with Calcarea acetica. Dr. Trinks’ ex- 
perience leads him to commend Arsenicum, Bella- 
donna, Calcarea, Ignatia, Mercurius corrosivus, and 
Sepia. 
2. Congestive headaches should be treated at the 
time by Aconite, Belladonna, Bryonia, Nux vomica, 
or Glonoine if the congestion be active; by Gelse- 
minum or Opium if it be passive. Aconite is most 
suitable when arterial tension is present, with irregu- 
larity or excitement of the circulation throughout 
the body. Belladonna acts well when, without such 
symptoms, there is great hypersemia of the head and 
neck, with flushing of the face and burning of the 
eyes. Bryonia* and Nux vomica suit the conges- 
* The following case is not given in Dr. Peters’ Treatise. It is 136 
HEADACHK. 
tive headache connected with dyspepsia and consti- 
pation. With the former the pain is in the fore- 
head, and accompanied with giddiness; both being 
much increased by stooping, which causes a sensa- 
tion as if the brain would fall out. The Nux 
headache is rather occipital: and is especially- 
aggravated by mental exertion. Glonoine is of great 
value where the headache is accompanied with much 
throbbing. For the headaches of passive conges- 
related by Dr. Chapman in the ‘ Brit. Journ. of Horn.,’ vol. vii, 
p. 505. 
“A lady arrived at Liverpool from South America in a great 
state of suffering. Prom the time she went on board the ship until 
she landed she had been constantly sea-sick; was never free from 
nausea, and vomited frequently. During the last fortnight of her 
voyage there had been hsematemesis several times. The bowels had 
not been relieved for upwards of a fortnight, though she had taken 
pills frequently, which only increased her nausea and the distress of 
her stomach. 
“ Her face was very red; she was very giddy; she could not stand, 
and could scarcely sit. She had considerable headache; a sensation 
of great fulness in the bowels. The slightest movement increased 
her sufferings, which were partially relieved on lying down, and 
keeping quite still. The colon was distended, and to the touch 
seemed loaded with feces. Notwithstanding her repugnance to it, 
half-an-ounce of Castor-oil with a few drops of Laudanum was given 
to her. She retained it; and discharged an enormous quantity of 
feces. 
“ The next day, though the distension of the bowels was relieved, 
and the long-accumulated feces had been removed, all her symptoms 
of sea-sickness continued : the flushed face, the headache, the giddi- 
ness, and the nausea; the distress increased on any movement. A 
drop of Bryony of the 3rd dilution was given her; the next day she 
was quite well, and travelled to London/’ 
Qy. ? If the Bryonia had been given on the first day, would not 
the bowels have acted without the castor-oil, and the other symptoms 
have disappeared simultaneously ? 137 
HEADACHE. 
tion the only diagnostic distinction I can point out 
between those of Opium and those of Gelseminum is 
that sleepiness is more marked in the former, and 
giddiness in the latter. 
The management of these headaches when chronic 
is to a large extent hygienic and regiminal. In the 
choice of medicines the state of the whole health 
has to be taken into consideration; and may some- 
times lead us to medicines like Sulphur, Sepia, and 
Calcarea instead of the more common Belladonna 
and Nux. I will only add that in many cases of 
continuous general headache of congestive type, 
with tendency to deafness and noises in the ears, I 
have seen most satisfactory results from the first 
three triturations of Quinine. 
3. The “ sick-headache” may be, I believe, either 
primarily cerebral, or gastro-hepatic. Migraine, 
already discussed, is an example of the former 
variety : but the pain is often more deeply seated. 
There is retching rather than free vomiting: and 
the ejecta are little more than water and mucus. 
Bryonia and Cocculus are medicines which will often 
relieve this headache at the time : with the latter 
the symptoms resemble those of sea-sickness, as in 
the case I have cited when speaking of this medicine 
(‘Pharmacodynamics/ p. 229). But more reliance 
is to be placed upon treatment steadily pursued with 
a view to prevent the recurrence of these attacks. 
To the two medicines already mentioned I may add 
Stannum, Sepia, and (again) Nux vomica as fre- 
quently useful for this purpose. In the gastro- 
hepatic variety, where the vomiting is free and 
early, and much bile is ejected, we have a most 138 
HEADACHE. 
valuable remedy in the Iris versicolor. It will 
generally cut short the paroxysms; and its continued 
use, with proper attention to diet and hygiene, will 
rarely fail to obviate their recurrence. 
I will just mention a few other medicines suitable 
to occasional varieties of headache, referring you to 
my account of the drugs themselves for the special 
indications for their use. 
Actoea racemosa (in women, pain in eye- 
balls). 
Atropia (where Belladonna is indicated, but 
fails). 
Cactus (headaches of congestion and heart- 
disease). 
Carbo vegetabilis (passive venous congestion in 
old people). 
China (headaches from loss of blood, pressure on 
vertex). 
Coffea (nervous headache with sleeplessness). 
Cyclamen (like Actsea, in chlorotic subjects). 
Ferrum (as China, pseudo-congestive symptoms 
present). 
Helleborus (“ stupid headache”). 
Lachesis (“sick headache,” in menopausic subjects 
on vertex). 
Mur ex purpurea (uterine headache). 
Naja (intense frontal headache, with depressed 
spirits). 
Silicea (headache of organic disease). 
Spigelia (neuralgic and rheumatic headache, eye- 
balls involved). 
Stramonium (hypersesthetic headache in nervous 
subjects). VERTIGO. 
139 
Veratrum album (“sick headache,** with coldness 
and prostration). 
Zincum (chronic headache with depressed cerebral 
energy). 
Vertigo. 
The list of symptoms of nearly every medicine con- 
tained in Jahr’s ‘ Codex* begins with “ vertigo.** In 
the presence of this distressing embarras de richesses 
you will be glad to have the results of experience 
iu the treatment of the symptom in question. 
Symptom it is, and nothing more, in organic 
disease within the cranium, in apoplexy, and in 
gastro-hepatic disturbance. Persistent in the former 
case, temporary in the two latter, in either it affords 
no point for special treatment. But vertigo not 
uncommonly comes before us unconnected w’ith 
either of these causes, and sufficiently prominent to 
require special attention and medication. I suppose 
it to be always dependent upon disorder of the cere- 
bral circulation. When this is of a congestive 
character, and accompanied with headache, the 
medicines already recommended for the latter con- 
sequence will remove the latter also. But cases 
often occur, especially in old people, in which 
chronic cerebral congestion causes much giddiness 
but little or no aching. For this affection I have 
derived singular benefit from Iodine, in about the 
3rd dec. dilution. Sulphur, also, must not be for- 
gotten. Still more frequently, however, vertigo 
owns a cardiac origin, and testifies to deficient 
supply of the brain from an enfeebled heart. This 140 
INSOMNIA. 
is the “ essential vertigo” of Dr. Eamskill (c System 
of Medicine/ vol. ii, art. “ Vertigo”). In such 
cases we shall have some palpitation and breathless- 
ness, a feeble pulse, and a tendency to syncope. 
Here Digitalis is our grand remedy. The disap- 
pearance of the vertigo is generally the earliest 
sign of the toning influence exerted by this drug 
on the muscular tissue of the heart. The giddiness 
of epileptics, when not amounting to the “ petit 
mal,” finds a useful medicine in Hydrocyanic 
acid. 
Insomnia 
is still more rarely met with as a substantive affec- 
tion than vertigo. It will nearly always yield to 
the treatment, medicinal and general, suited to the 
systemic condition. In the rare cases where it 
assumes so much prominence as to require special 
treatment, it has two excellent remedies in Coffea 
and Hyoseyamus. The former is better when the 
sleeplessness is part of a general nervous excitability 
and restlessness,—the latter when the disturbance 
is chiefly cerebral, as when such light sleep as is 
obtained is much broken by dreams. 
The habitual use of Coffee as a beverage, if not 
taken in excess, is no counter-indication to its exhi- 
bition as a remedy. In cases, however, where the 
sleeplessness is traceable to its immoderate use— 
especially when it is drunk by students to keep 
them awake—it must be discontinued, and Nux 
vomica or Chamomilla given as an antidote. When 
sleeplessness arises from the undue use of Tea, Coffea INJURIES OF THE HEAD. 
141 
is generally all that is required ; but China is said 
to be the specific antidote to the morbid effects of 
the Chinese leaf. 
On the subject of 
Injuries of the Head 
I have but a very few hints to give. Iu cases of 
concussion, there is no harm in administering 
Arnica, though its power of benefiting has yet to be 
proved. Belladonna would be the medicine best 
suited to keep the re-action from running on to 
inflammation. The treatment of compression is of 
course that of apoplexy. Of traumatic encepha- 
litis I have already spoken under the head of 
meningitis. LETTER XY. 
diseases oe the nervous system (continued). 
From the diseases of the head I pass to those of 
the Spine. Reserving tetanus and the various 
forms of paraplegia for after consideration, I shall 
speak of meningitis, myelitis, congestion, irritation, 
haemorrhage, softening, induration, and atrophy of 
the cord, and lastly of injuries affecting it. In so 
doing, I shall assume as my basis for pathology and 
diagnosis our latest contribution to the subject, 
Dr. Radcliffe’s article on “ Diseases of the Spinal 
Cord/’ in the 2nd vol. of Dr. Russell Reynolds’ 
‘ System of Medicine.’ 
In discussing the treatment of these maladies, I 
regret that I can do little more than give hints and 
suggest probabilities. There is an almost utter 
absence of well-diagnosed spinal disease in Homoeo- 
pathic literature. I can only hope that by noting 
this deficiency I may stir up some of our practitioners, 
whose large experience must have included cases of 
this kind, to tell us what they can do for them, and 
with what remedies. 
Spinal Meningitis. 
In the acute form of this disease, analogy would 
lead us to expect the best results obtainable from MYELITIS. 
143 
Aconite and Bryonia. The remarkable homceopa- 
thicity of Oxalic Acid,* also, should be borne in 
mind. In the chronic forms, the mischief may 
generally be traced to the rheumatic or syphilitic 
diathesis; in which case I can hardly improve upon 
your Iodide of Potassium, whose virtue is well illus- 
trated in a case of this kind given in Dr. Chambers* 
‘ Lectures, chiefly Clinical.* Dr. Acworth thinks 
there is a “ gouty spine*’ analogous to that of 
rheumatism and syphilis:—Sulphur and Colchicum 
may be suggested in its treatment. 
Myelitis 
not unfrequently complicates spinal meningitis, but 
I cannot think that its presence there would alter 
the treatment. But what can we do for it when we 
meet with it as an independent malady ? In the 
absence of any Homoeopathic experience, the only 
outlook of promise I can discern is in what Dr. 
Brown-Sequard tells us of the value of Belladonna 
and Secale in this malady. He accounts for the 
virtues of each on the ground of their contracting 
influence upon the arteries through the medium of 
the vascular nerves. Without questioning their 
possession of this power, I think it has yet to be 
proved that by means of it a fully-developed inflam- 
mation can be arrested. And when we come to 
think of the other actions of the two medicines used, 
it becomes highly probable that they are after all 
homoeopathic to the morbid condition. Analogy 
would lead us to credit Belladonna with an influence 
* See * Brit. Jonrn. of Horn.,’ Jan., 1869. 144 
SPINAL CONGESTION. 
on the spinal marrow analogous to that which it 
exerts upon the brain; and hence its use in Myelitis 
would answer to its acknowledged virtue and modus 
operandi in phrenitis. Secale causes marked paraly- 
sis, anaesthesia, and other spinal phenomena. I am, 
indeed, unable certainly to identify the pathological 
condition induced by it with myelitis: but the phe- 
nomenal similarity is sufficient, in conjunction with 
its reported usefulness, to justify its fair trial in our 
hands. Perhaps Belladonna may be found most 
suitable in acute, Secale in chronic myelitis. 
Spinal Congestion 
is excellently characterised by Dr. Radcliffe. A 
truly homoeopathic remedy to it is obviously Nux 
vomica or its alkaloid. Dr. Radcliffe himself, in 
the illustrative case he relates, speaks of “Nux 
vomica now and then in small doses ” as part of 
the (successful) treatment. But I can speak most 
favourably, from what I have myself seen, of the 
action of Gelseminum. I would only add that, 
should spinal congestion be met with as a recent 
affection resulting from suppression of a menstrual 
or hemorrhoidal discharge, the timely administra- 
tion of Aconite might restore the disturbed balance 
of the circulation without the aid of any other 
remedy. 
Spinal Irritation, 
moreover, owes to Dr. Radcliffe a description which 
separates it distinctively from hysteria on the one PARALYSIS. 
145 
hand, and from myalgia on tlie other. I have seen 
several cases of this disorder, and find it very in- 
tractable. Ignatia promises fairly in its treatment. 
In a case reported by Dr. Chepmell in his recent 
work it did much good in conjunction with Platina,— 
the latter being given on account of the uterine 
symptoms present. But the medicine from which 
I have most hope in the treatment of spinal irri- 
tation is the Actea racemosa. I am testing it at 
present in several cases, both in the higher and 
lower dilutions; and will some day report my re- 
sults. Cocculus, also, has been found useful, and 
Agaricus deserves consideration. 
The remainder of the diseases of the spine may 
be dismissed, as far as medicinal treatment is con- 
cerned, in a few words. Spinal hemorrhage must 
be treated on the same principles as cerebral 
hsemorrhage. If softening of the cord be diagnosed, 
apart from inflammation, Phosphorus would be its 
most likely remedy. In the rare spinal affections, 
induration and atrophy, Plumbum would be homoeo- 
pathic. And if Arnica failed to remove the effects 
of concussion of the spinal marrow, we have 
another remedy for them in the Hypericum per- 
foliatum. 
I have now to speak of the treatment of the 
various forms of 
Paralysis. 
I have discussed the subject at length, in its patho- 
logical and diagnostic, as well as therapeutical, 146 
PARALYSIS. 
bearings, in two papers in the ‘Brit. Journ. of 
Horn./ for Oct. 1868 and Jan. 1869.* Referring 
you to these for more minute particulars, I will 
now set down what I have to recount or to suggest 
as to the treatment of the various forms of paralysis. 
Adopting a somewhat different arrangement from 
that of my paper, I shall speak here of Hemiplegia, 
Paraplegia, General Paralysis, Constitutional Para- 
lysis, Locomotor Ataxy, Wasting Palsy, and Para- 
lysis Agitans. 
1. Hemiplegia most frequently comes before us 
as the sequel of apoplexy. Now as return of power 
is here generally only a question of time, it is not 
easy to say whether recovery under this or that 
medicine is a case of propter or only post. The 
medicines in most repute for the purpose are Nux 
vomica, Cocculus, Baryta, and Arnica : and you can 
at any rate do your patient no harm by keeping him 
under one or other of these until he recovers. I 
can at present give you no indications for the choice 
of one in preference to the other, except that Nux 
would seem specially indicated when rigidity of the 
paralysed limbs hinted at irritation having been set 
up around the clot. 
The other forms of hemiplegia, as from softening, 
hysteria, syphilis, &c., have been or will be con- 
sidered in their proper place. 
2. Paraplegia also depends upon various causes 
elsewhere considered. Its “ reflex ” form—i. e. 
when it is secondary to some local disease—requires 
of course treatment directed to the part affected, 
as in the case of uterine paraplegia cured by Caulo- 
* Also published separately (Turner). PARALYSIS. 
147 
phyllum mentioned by Dr. Hale, in his “ New 
Remedies.” f£ Tabes dorsalis ” is a name con- 
veniently restricted to that form of paraplegia 
which follows sexual excess or abuse. Phosphorus 
is its main remedy, though Kali bromidum is 
thoroughly homoeopathic to the condition present, 
and Argentum nitrieum is not to be forgotten. 
3. General Paralysis, as occurring in connexion 
with a peculiar form of insanity, has been already 
mentioned. But it is met with independently 
(£C general spinal paralysis ” of Duchenne), and is 
possibly dependent upon softening of the anterior 
columns of the cord. Here again Phosphorus 
ought to be our chief medicine : though pathogenesy 
would poimt to Conium and clinical experience to 
Cocculus as not less strongly indicated. 
4. Local Paralyses will usually come under dis- 
cussion when speaking of the organs whose function 
is affected. But two must be considered here, the 
“ facial palsy ” of Bell and the “ glosso-laryngeal 
paralysis ” of Trousseau and Duchenne. For facial 
palsy, from exposure of the side of the face to cold 
or damp, the remedy in most repute is Causticum. 
Aconite, however, should not be omitted if the 
trouble be recent. When arising, as it sometimes 
does, from fright or other emotion, I should treat 
it as I should a trismus similarly induced, viz., by 
Ignatia. In glosso-laryngeal paralysis our only 
hint for treatment is derived from the fact now 
ascertained, that the local degeneration of the 
nervous centres on which it depends commences 
with hypersemia. Hence Belladonna might help. 
5. Constitutional Paralysis is connected either 148 
PARALYSIS. 
with neurotic or with toxsemic disorders. Hysterical 
paralysis is an example of the former; diphtheritic 
paralysis of the latter. The only constitutional 
paralysis which will fall to be discussed here is the 
rheumatic. In the paper I have referred to I have 
adduced reasons for believing this to be a distinct 
form of paralysis. When it can be diagnosed, I 
should expect to find its remedies in Aconite and 
Rhus in recent cases, aiding the Rhus with Sulphur 
when the affection was chronic. 
6. Locomotor Ataxy is only provisionally classed 
amongst the paralyses. It will probably one day 
occupy in nosology a distinct position of its own. 
In the mean time we have to consider it for treat- 
ment as a neurosis characterised by progressive 
ataxy of voluntary movement, accompanied by 
certain neuralgic, paralytic, and anaesthetic symp- 
toms, and manifesting itself post-mortem (if at all) 
by hypermmic atrophy of the posterior columns and 
roots of the cord. In my paper on Paralysis I 
have pointed out the remarkable homoeopathicity 
of Belladonna to this group of symptoms. I have 
already remarked, when writing to you upon this 
drug, that the disorder of standing and walking 
observed in many cases of poisoning by it does not 
appear to be a true paraplegia: it resembles rather 
that want of control of the lower limbs which is 
induced by alcohol. Then farther, it has also in 
its pathogenesis nearly all of those apparently in- 
congruous symptoms which characterise the idio- 
pathic disease. No medicine equals it in specific 
affinity for the eye, where it has caused the injected 
conjunctiva; the dilated, sometimes varying pupils; 149 
PARALYSIS. 
the diplopia; and the ptosis—so often observed in 
ataxy. Then Lusanua notes that the full effect 
of Atropine is to cause incontinence of urine, and 
even involuntary faecal discharges. Anaesthesia, 
always induced by the local application of the drug, 
has in one case of poisoning been general over all 
parts of the trunk and extremities. Dr. Brown- 
Sequard states that no substance is so powerful 
a depressant of reflex excitability as Belladonna. I 
know, indeed, of no observations of neuralgic pains 
having been caused by Belladonna, but its well- 
known power of curing them, in the small doses 
we use, indicates its homoeopathic relationship 
thereto. Now consider the pathological basis of 
the symptoms of locomotor ataxy,—that it is a 
hypercemia going on to atrophy; and I think 
you will be induced to try Belladonna, in the 
earlier stages at least, with the fairest hopes of 
success. 
The only other medicine I have to mention 
in connexion with locomotor ataxy is Arsenicum. 
The neuralgic pains so distinctive of the disease 
are characteristically those of this medicine; and 
when they were predominant, I should feel dis- 
posed to give to my Belladonna the benefit of its 
aid. 
7. Wasting Palsy, the progressive muscular 
atrophy of Cruveilhier and Duchenne, is also no 
true paralysis, though it must be considered here. 
In the present uncertainty whether the lesion is 
primarily central or peripheral it would be wise to 
administer Belladonna in this disorder also. But 
it should be alternated with medicines capable of 150 
PARALYSIS. 
causing the characteristic changes in the muscles 
themselves. The only known ones are Phosphorus 
and Plumbum. The former would be indicated 
where the muscles undergo fatty degeneration, 
without change in bulk: the latter where they 
simply waste away. 
8. Paralysis Agitans is a third example of a 
palsy which is such only in name. The precise 
analogy borne to it by the mercurial tremor suggests 
Mercurius as its most suitable remedy, if it have a 
remedy. I know no record of its Homoeopathic 
treatment. LETTER XVI. 
diseases of the nervous system (continued). 
Under the head of £f Neuroses” I shall review 
in their therapeutical relations Epilepsy, Tetanus, 
Chorea, Catalepsy, Hysteria, Neuralgia, and certain 
local spasms. 
And first, of 
Epilepsy. 
Under this term I speak solely of the idiopathic 
disease. All symptomatic and toxaemic convulsions, 
however epileptiform in appearance, must here be 
excluded, if we wish to avoid confusion. In this I 
follow all writers—Trousseau, Van der Kolk, Brown- 
Sequard, Russell Reynolds, Sieveking, and Rad- 
cliffe—who have lately written upon the disease. 
To supplement these works on the therapeutical 
side, Homoeopathy has many recorded cases of relief 
and cure, most of which are contained in a paper of 
Dr. Baertl’s, which you will find translated in vol. xxii 
of the ‘ Brit. Journ. of Horn/ You should also 
read the two lectures on Epilepsy in Dr. Rutherfurd 
Russell’s f Clinical Lectures.’ 
The result of old-school experience in the treat- 
ment of epilepsy appears to be that, while occasional 
benefit is to be obtained from ct metallic tonics” 152 
EPILEPSY. 
and “ sedatives,” especially Zinc and Belladonna, 
the only medicine which has displayed really cura- 
tive properties is the Bromide of Potassium. I 
should be sorry to acquiesce in this conclusion. If 
you will study the elaborate account of the action, 
physiological and therapeutical, of this medicine 
given by Dr. Bazire in his translation of Trousseau’s 
‘ Clinical Lectures/ I think you will agree with me 
that its action is simply antipathic. By deadening 
the sensibility of the nervous centres it diminishes 
the frequency or even prevents the occurrence of 
the epileptic paroxysms. But its use must be con- 
tinued indefinitely. It “ keeps down” the disease, 
but does not cure it. Its omission is nearly always 
followed by a recurrence of the symptoms. Al- 
though, therefore, I am loath to shut out a remedy 
so potent to give temporary relief, I must ask you 
to look farther with me for medicines truly cura- 
tive. 
The poisons capable of causing true epileptic 
attacks are—in acute poisoning, Hydrocyanic acid 
and the three Umbelliferoe, GEnauthe crocata, Cicuta 
virosa, and iEthusa cynapium : in chronic poisoning, 
Lead and perhaps Arsenic. The medicines which 
have in a fair number of instances proved curative 
of genuine epilepsy are, in the first rank, Belladonna, 
Calcarea, Cuprum, and Ignatia; in the second, 
Arsenicum, Artemisia, Cicuta, Opium, and Zizia 
aurea. 
On the basis of these facts let me endeavour to 
sketch to you the Homoeopathic treatment of epi- 
lepsy. 
First, as to the fit itself,— can we do anything to EPILEPSY. 
153 
ward it off, when the occurrence of premonitory 
symptoms gives us time and opportunity ? If we 
can, I think it must be by Glonoine. You will re- 
member the reasons I assigned, when treating of 
that drug,* for supposing it to act immediately 
upon the medulla oblongata, and thence on the 
vagus and the vaso-motor nerves of the brain. It 
thus occupies the same ground and traverses the 
same path as the epileptic nisus, and I look with 
some hope to its manifesting a power of con- 
trolling the morbid action. I have hitherto, how- 
ever, had no opportunity of testing its effects in 
practice. 
The treatment we adopt in the interval of the 
paroxysms, writh the view of preventing their recur- 
rence, will be somewhat modified according as the 
disease is recent or of long standing. Eor epilepsy 
of recent origin we have two very valuable remedies, 
which are of little or no power in confirmed cases. 
These are Tgnatia and Hydrocyanic acid. 
Ignatia is so valuable on account of the frequent 
origin of epilepsy in emotional disturbance. There 
is little to be added to Hahnemann's dicta on the 
subject. “ Epileptic fits which only break out 
after chagrin or grief about a moral wrong (and 
never appear from any other cause) may be pre- 
vented by Ignatia, but it is very improbable that 
epileptic fits of a different kind may be, or ever 
have been cured by that drug." And again “ A 
first attack of epilepsy, brought on by some contrary 
event * * may be, in most cases, permanently 
cured by one small dose of the tincture of Ignatia 
* ‘ Pharmacodynamics,’ p. 289. 154 
EPILEPSY. 
(I know this from experience). But it is different 
as regards chronic epileptic fits; these can no more 
than other chronic diseases be permanently relieved 
by Ignatia.” Several cases in Dr. Baertl’s paper 
illustrate the curative action of this medicine. 
The relation of Hydrocyanic acid to epilepsy 
was argued out by Dr. Madden and myself in a 
paper on this substance published in the 20th volume 
of the c British Journal of Homoeopathy.” The 
reality of the resemblance between poisoning by 
Prussic acid and the epileptic paroxysm (though 
affirmed, besides ourselves, by Christison, Pereira, 
and Taylor) has been questioned by Dr. Bussell. 
I have carefully weighed his objections to our views, 
but see no reason whatever to modify them. Be- 
yond an expression of opinion, his only arguments 
against our interpretation of the “ model case” of 
poisoning we cite are the following. 1st. “ Let us ob- 
serve that the convulsions did not occur at all till after 
the bloating of the face and the insensibility of the 
pupils demonstrated that narcosis or poisoning of 
the brain with venous blood, had already taken 
place.” To estimate the force of this objection we 
will set beside it two of the propositions in which 
Dr. Bussell Beynolds embodies the modern doctrine 
of epilepsy. “ The arrest of breathing” (which is 
a phenomenon of the first stage of the epileptic 
paroxysm, and which occurs also in poisoning by 
the acid) “leads to the special convulsions of as- 
phyxia, and the amount of these is in direct pro- 
portion to the perfection and continuance of the 
asphyxia. The subsequent phenomena are those of 
poisoned blood, i. e. of blood poisoned by the re- EPILEPSY. 
155 
tention of carbonic acid, and altered by the absence 
of a due amount of oxygen.” Dr. Russell’s other 
objection is “ We miss entirely the early dilatation 
of the pupil before the establishment of uncon- 
sciousness, which is one of the pathognomonic 
symptoms of the malady.” It is sufficient to reply 
that there is no statement that the pupil was not 
dilated from the first. It only appears from the 
narrative that as soon as it was examined it was 
found in this condition. 
I have no doubt, then, of the homoeopathicity 
of Hydrocyanic acid to epilepsy. Its curative 
power is another question. Dr. Russell has indeed 
hit upon a fatal defect in this medicine when he 
points out the evanescent character of its action. 
Nevertheless I think that in epilepsy of recent 
origin, whose exciting cause is not such as to call 
for Ignatia, this medicine, from the 2nd to the 
4th dec. dilution, will give you every satisfaction. 
In epilepsy of some standing, the leading reme- 
dies in the hands of Homoeopaths are Belladonna, 
Calcarea, and Cuprum. 
Belladonna still holds in our affections that highest 
place which it once occupied in the old school until 
dethroned by Bromide of Potassium. When you 
have refreshed your memory as to Trousseau’s 
observations, read the cases collected by Baertl and 
those recorded by Dr. Russell. No doubt will 
remain but that Belladonna has radically cured 
many a genuine case of epilepsy. I have argued 
in my letter to you on this drug, and more fully in 
my “ Cases of poisoning by Belladonna, with Com- 
mentaries” in the 20th vol. of the c Brit. Journ. of 156 
EPILEPSY. 
Horn./ that it modifies epilepsy (as it does laryn- 
gismus stridulus, hooping-cough, and hydrophobia) 
in virtue of its tissue-irritant action on the medulla 
oblongata. This centre is pretty uniformly found to 
he hyperaemic in the autopsy of epileptics. In Dr. 
Russell's very satisfactory cases the drug was given 
in the 2nd dilution. 
That Calcarea has proved hardly less useful than 
Belladonna appears from the cases in Dr. Baertl's 
paper. It is of course especially indicated when 
the constitutional condition is one for which this 
great modifier of nutrition is suitable. But it seems 
often to have acted well when no symptoms of this 
kind were present. 
In the use of Cuprum we again occupy the same 
ground with our allceopathic brethren. Many cures 
by it are detailed by Baertl; and Dr. Bayes has 
lately borne testimony to its especial value. It 
has usually been given in the potencies above the 
third. 
If you are to benefit epilepsy by Homoeopathic 
means, it will probaby be with one or other of these 
medicines. A word before concluding, however, 
upon certain minor medicines which may in excep- 
tional cases become serviceable. 
Arsenicum has unquestionably, though rarely, 
both caused and cured epilepsy : and may be given 
with advantage when the paroxysms occur period- 
ically, and when the constitutional condition is such 
as to indicate this remedy. 
Artemisia has occasionally benefited and even 
cured the “ petit mal ” in children. 
Cicuta is credited with some cures. Predomi- TETANUS. 
157 
nance of the tonic contraction over the clonic con- 
vulsions would indicate this remedy. 
Opium is said, and with fair probability, to 
have cured cases where the fits recurred only in 
sleep. 
Zizia aurea (see Hale’s ‘ New Remedies/ 2nd 
Ed.) acts as a poison much like iEthusa and Cicuta, 
It has cured (3rd dec. dil.) in Dr. Marcy’s hands 
two genuine cases of epilepsy of some standing. 
Of (Enanthe crocata, JEthusa Cyn opium, and 
Plumbum, though more or less Homoeopathic to 
epilepsy, we have no recorded experience. 
Shall I add Strychnia to this list? Dr. Walter 
Tyrrell, of Great Malvern, has lately been publish- 
ing in the ‘Medical Times and Gazette’ a series of 
cases of epilepsy, in which the curative effects of 
this drug were not a little remarkable. He thinks 
that “ its value lies in the effect it has in deadening 
that condition of exalted sensibility and activity of 
the medulla oblongata, which most recent authors 
consider to be the predisposing cause of the disease.” 
If it does this, it must be by Homoeopathic action, 
for its physiological effect is obviously increased 
excitability of the cord and its intra-cranial pro- 
longations. Mr. Tyrrell’s success, as reported by 
himself, is something marvellous; and the subject 
may repay investigation. 
The second of the neuroses on our list is 
Tetanus. 
This malady is (happily) too rare to come fre- 158 
TETANUS. 
quently under our treatment, and is indeed seldom 
encountered save in hospital practice. Our results 
in this sphere have not hitherto been of a brilliant 
character, if we may judge from the following state- 
ment, which I take from the £ British Journal of 
Homoeopathy/ vol. xii, p. 444. “ On examining 
the reports of the Homoeopathic hospitals of Vienna, 
Linz, Kremsier, and Nechanitz, from 1832 to 1848, 
we find that ten cases of tetanus were received, 
and that of these six died, and only four recovered; 
one at least of the latter not being a case of trau- 
matic tetanus.” 
Nevertheless, we should not undertake with 
hopelessness the treatment of a case of this disease. 
We have three potent medicines which are tho- 
roughly homoeopathic to it, and which have already 
displayed considerable control over its progress. 
These are Strychnia, Aconite, and Hydrocyanic 
acid. 
The homoeopathicity of Strychnia to tetanus needs 
no demonstration. It is one of those facts which 
go to prove the fundamental character of the law of 
similars, since we see Nature herself making pro- 
vision for its application. Curiously enough, how- 
ever, the only use of Strychnia in tetanus hitherto 
has been in alloeopathic hands. In the ‘New York 
Journal of Medicine and Surgery ’ for Nov. 1846 
will be found seven cases of traumatic tetanus cured 
by this medicine ; so writes Hempel. It is scarcely 
singular that the practice should not have been 
followed up in the old school : but I hope to hear 
some day of its successful reappearance in our own. 
That Aconite can cause tetanus is less generally TETANUS. 
159 
known, but the references to cases of poisoning 
which I will give in a note will set the fact beyond 
a doubt.* If now you will look through the recent 
volumes of Braithwaite’s c Retrospect/ you will find 
seven cases of traumatic tetanus in which Aconite 
was the main remedy ; and six of these recovered. 
The remedy would be most applicable when exposure 
to cold and wet formed some part at least of the 
exciting cause of the disease. In the purely idio- 
pathic tetanus it is rarely a question of life or death ; 
but I should expect from Aconite a decided abate- 
ment of the duration of the symptoms. 
The homceopathicity of Hydrocyanic acid to 
tetanus was pointed out by Dr. Madden and myself 
in our article on the poison in the 20th vol. of the 
f British Journal.’ In the 24th vol. Dr. George 
Moore records a case of the traumatic form of the 
disease successfully treated by drop doses of Scheele’s 
preparation of this acid. It will not do to lay too 
much stress on this one case, for the patient might 
have recovered spontaneously. Still, during the 
first forty-eight hours of the treatment, which was 
commenced with Aconite and Belladonna, the spasms 
were more numerous and violent, and the patient 
much more prostrate. Improvement commenced 
the night after beginning the acid. 
Whether, in addition to these specific medicines, 
any “ auxiliaries ’’ should be used in the treatment 
of this terrible disease, is a fair question. The 
application of ice along the spine, and the division 
* ‘ Brit. Med. Journ./ Dec. 1, 1860 j * Lancet/ Oct. 6, 1860 (two 
cases). ‘ Hahn. Mat. Med./ Sympt. 664; “ Fleming on Aconite” 
(two cases). 160 
TETANUS. 
of the nerve-trunk leading to any wound that may 
be present, seem eminently rational procedures. 
Homoeopathy has nothing to say against them. 
I have only to add that the sources of the expe- 
rience mentioned above render it necessary that, if 
we would emulate its success, we should eschew 
infinitesimal doses of whichever of these medicines 
we select. LETTED XVII. 
diseases of the nervous system (continued) 
Chorea 
is the first disorder which comes before us in the 
present letter. I restrict the term here to the 
typical S. Vitus’s dance, leaving the numerous 
“ choreiform ” neuroses for later consideration. 
There is not much Homoeopathic experience on 
record as to the treatment of chorea. What little 
we had up to 1834 is collected by Jahr in his treatise 
on f Nervous and Mental Diseases/ of which there 
is an English translation by Dr. Galloway. Com- 
bining with the materials furnished by him a few 
later facts, pathogenetic and clinical, and taking into 
account the most recent observations of the symp- 
toms and pathology of the disease, I venture to 
present the following as a fair account of the 
Homoeopathic treatment of chorea. 
For therapeutical purposes, at any rate, I think 
we may speak of three varieties of chorea. The 
first is that induced by a definite exciting cause, 
whether mental or material, as a fright or the 
presence of worms. In the second, the chorea seems 
to be an expression on the part of the nervous 
system of a general diathesis or constitutional con- 
dition—as chlorosis, rheumatism, or tubercle. The 162 
CHOREA. 
third form, in our ignorance, we must class as 
idiopathic. 
1. There seems no doubt that chorea, like epi- 
lepsy, arise from a sudden and profound 
emotional impression, such as fright. Prof. Trousseau 
records two well-marked instances of the kind. In 
these cases we should expect the same benefit from 
Ignatia as in recent epilepsy thus caused; and the 
pathogenesis fully favours the expectation. Like 
epilepsy, again, chorea may be a symptom of the 
presence of worms in the intestinal canal. When 
I come to speak of the treatment of helminthiasis, 
I shall refer to a very pretty case in which severe 
chorea subsided on the expulsion of ascarides con- 
sequent upon the administration of Cina. This will 
generally be the appropriate medicine where worms 
are suspected to lie at the bottom of the symptoms. 
Another which may fairly be named here is Spigelia, 
whose relation to rheumatism strengthens the in- 
dication for its use in chorea. 
2. Iron is deservedly a favourite remedy in the 
old school for chorea : and the frequent co-existence 
of chlorosis and anaemia with this disorder explains 
its efficacy. In such cases, Homoeopathy has 
nothing better to suggest; and you had better give 
Ferrum redactum as if you had a simple case of 
anaemia before you. On the other hand, Trous- 
seau’s statement that chorea is not uncommonly an 
expression of the tubercular diathesis leads me to 
call attention to the place of Iodine in its treatment. 
Something very like the twitchings of chorea appears 
among the phenomena of iodism: and from my 
observation of the action of this precious medicine 163 
CHOREA. 
on the nervous system in general I should look for 
good results from it in cases of this kind. 
But by far the most important diathetic relation- 
ship of chorea is that which it bears to rheumatism. 
Wherever you can trace this relationship, I advise 
you to depend upon Actcea racemosa in its treat- 
ment. The cases recorded in the second edition of 
Dr. Hale’s fNew Remedies ’ ivill encourage you in 
this course : and will also, I think, lead you to give 
it in not less than drop doses of the mother- 
tincture. 
3. In the treatment of idiopathic chorea we are 
in much the same plight as our alloeopathic brethren; 
we have so many remedies that we question whether 
any of them really cure, or whether the disease does 
not get well of itself. The Arsenic and Zinc so 
much relied on in the old school we also use, adding 
Cuprum. Wre have also the group of vegetable 
neurotics, Belladonna, Hyoscyamus, and Stramonium; 
and Agaricus. The last named has perhaps been 
credited with most cures in our school: and its recent 
proving by Prof. Zlatarowich shows its perfect 
homoeopathicity to the disorder. I myself once 
rapidly cured a case of long standing in an old man 
with drop doses of the mother-tincture of this drug. 
It had the peculiar feature that the twitchings of 
the arms ceased when he used them in his work of 
shoemaking. Mr. Clifton adds as another indica- 
tion for Agaricus the ceasing of the convulsions 
during sleep (‘Monthly Horn. Review,’July, 1868). 
W'hile with this medicine and Cuprum we may 
combat the ordinary cases of the disorder, Bella- 
donna, Hyoscyamus, and Stramonium will be 164 
CATALEPSY. 
more suitable in nervous and delicate children ; 
Zincum where the nervous centres and general 
nutrition are much depressed : and Arsenicum in 
those graver forms of the disorder where even life is 
threatened. 
I may add that there is nothing to prevent our 
availing ourselves of the advantages ascribed by Drs. 
Anstie and Radcliffe to the free use of fatty foods, 
including cod-liver oil, in this disease. Nor should 
we neglect the unquestionable benefit obtainable 
from properly regulated gymnastic exercises and 
cold bathing. The influence of music, moreover, 
when the rhythm is well-marked, is not to be 
despised. 
Catalepsy 
is so rare a disease, that there is little likelihood of 
the question of its best homceopathic treatment 
being brought before you. Nevertheless it is well 
to remind you of the perfect picture of its pheno- 
mena occasionally presented by susceptible persons 
under the influence of Cannabis Indica. 
Dr. T. K. Chambers, in the capital essay on this 
disorder which he has contributed to Dr. Russell 
Reynolds’ ‘ System of Medicine/ associates it more 
or less closely with Ecstasy and Somnambulism. 
The treatment of the former, when it is a disease 
at all,* is moral rather than medical. When, 
* “ It is usual to speak of all such experiences as morbid, and so 
to dispose of them. But I think that this does not quite dispose of 
them. Morbid they certainly are, if morbid means dependent upon 
abnormal and imperfect conditions of health. But it appears to CATALEPSY. 
165 
however, it manifests itself in bodily movements, it 
is worth inquiry whether the alleged connexion of 
the convulsive epidemics of the middle ages with 
the bite of the Tarantula has any foundation in 
fact. Dr. Nunez of Madrid has lately published a 
proving of this spider,—an estimate of which you 
will find in the f Brit. Journ. of Horn./ vol. xxii, 
p. 274. To somnambulism Dr. Chambers has given 
quite a new interest, by connecting it not alone with 
sleep-talking, but with nocturnal seminal emissions 
and incontinence of urine. These phenomena will 
come under consideration in their proper place. As 
to sleep-walking itself, Dr. Chambers’ opinion that 
it is a sign of “ a slumber morbidly profound ” 
may guide us to Opium as its best remedy. I need 
hardly say that the digestive functions, if dis- 
ordered, should be attended to; and that light meals 
and sleeping with the head high are indispensable 
adjuncts to the treatment. 
me far from certain that the most perfect condition of the organiza- 
tion is always the most favourable for the exercise of the highest 
powers of the soul. Exalted conditions of intellect and imagination 
are very frequent incidents of disease. When the body is trembling 
on the borders of illness, then the mind is oftentimes most active 
and most sensitive. And unless things hard to disbelieve he alto- 
gether false, that moment when disease has almost reached its con- 
summation in death is, now and then, the moment when powers of 
preternatural intensity flash out from the soul. Therefore I think 
that in the mouths of those who are wise, ‘ a morbid condition of 
mind’ should rather be used to mean a condition of mind indicating 
a morbid condition of body, than to pronounce any judgment upon 
the condition of the mind itself. By what name this condition 
should he described must he determined upon other and higher con- 
siderations.” (Tainsh. Study of the Works of Alfred Tennyson.) 166 
HYSTERIA. 
Hysteria 
is the next in order of our neuroses. Here, besides 
the all-important mental and moral treatment, we 
can do a good deal by medicine,—thus advancing 
a step beyond the old school, which, according to 
its latest expositor, knows “ not one single drug 
which exerts any specific action on the disease.5’* 
We have sucfi a drug in our Ignatia. Its continued 
use, in varying dilutions, will almost certainly modify 
favourably that morbid impressionability—emo- 
tional, sensational, and reflex—in which so much of 
hysteria consists. With Moschus, moreover, we 
can sometimes arrest and always shorten the 
hysteric paroxysm. It should be given in the 
lowest dilutions of the tincture, as its odour has 
much to do with its rapid action. For hysterical 
aphonia, paralysis, and contractions we have gene- 
rally to call in the aid of electricity, unless we are 
content to trust to time for their disappearance. 
Hysterical pains—as in the joints—will subside 
under Ignatia, or Chamomilla, aided if necessary by 
local anodynes. Hysterical vomiting is a very 
obstinate affection; but will sometimes yield to the 
ordinary remedies for vomiting, especially Kreasote. 
An offset of Hysteria is Hypersesthesia, or, more 
simply, Nervousness, to which very common affec- 
tion Dr. Madden has lately devoted a capital article 
in the £ Monthly Homoeopathic Review.’ His 
remarks on the reality of the disease, and on the 
general principles of its psychical and physical 
* Dr. Russell Reynolds, in ‘ System of Medicine,’ vol. ii, p. 327* NEURALGIA. 
167 
treatment are wTorth your attentive consideration. 
He justly says “The means used and the medicines 
employed will vary in every case, and will embrace 
every known method of building up the general 
strength, of soothing the irritability of weakness, of 
toning the various organs which have become 
diseased, and of establishing healthy and health- 
giving habits of mind and body.” Among the 
medicines most suitable for “ nervousness” itself I 
may enumerate Agaricus, Chamomilla, Coffea, Hy- 
oscyamus, Ignatia, Stramonium, and Tliea,—to 
which the advocates of the “New Remedies” would 
have us add Cypripedium and Scutellaria, for which 
I refer you to Dr. Hale’s book. 
Neuralgia. 
Of the Homoeopathic treatment of this painful 
neurosis I am able to give you a most favourable 
account. You need resort to none of the painful 
local measures at present in vogue in the old 
school. Yet you need seldom fail to effect a rapid 
cure of the ordinary varieties of the disease, and 
even the intractable “ tic-douloureux” will some- 
times yield to your remedies. If you need further 
encouragement than my assertion affords, let me 
ask you to read the cases of Neuralgia recorded by 
Dr. Quin in the fourth, by Dr. Morgan in the 
thirteenth, and by myself in the twenty-second 
volume of the ‘British Journal of Homoeopathy/ 
At the conclusion of the paper last named, I 
have mentioned the medicines found most useful in 
the treatment of neuralgia, and have endeavoured 168 
NEURALGIA. 
to allot to each its distinctive sphere and kind of 
action. I shall follow this course at present with 
two medicines only; and shall speak of the re- 
mainder under the headings of the local varieties of 
the disease in which they have proved useful. The 
two I mean are Arsenicum and Belladonna,—re- 
medies called for twenty times in Neuralgia where 
others are required once. 
Arsenicum is one of the few drugs capable of 
causing true neuralgia. The nerve-pains it induces 
co-exist with anaesthesia in the sensory sphere, with 
paralysis and painful cramps in the motor : as well as 
with profound adynamia of the general system. It 
becomes thus a truly homoeopathic remedy for the 
pure and simple form of neuralgia,—idiopathic, or 
traceable only to general debility, and unaccom- 
panied by local hyperaemia. The pains most 
characteristic of it are agonising in degree, darting 
and burning in character; sometimes described as 
if red-hot needles were running through the affected 
nerves. They are accompanied with great rest- 
lessness and anguish; are generally increased (even 
though at first relieved) by the application of cold ; 
and are worse at rest, and diminished during ex- 
ercise. Periodic intermittence is an additional 
indication for this medicine : though, if it led to the 
discovery of a malarious origin, Quinine might 
sometimes be preferable. 
Belladonna exerts a magical power over neuralgia 
of the fifth pair accompanied with marked local hy- 
persemia. I was for some time puzzled to account for 
this virtue of the drug: as there is no evidence to 
prove that it is capable of causing true neuralgia. I NEURALGIA. 
169 
could only set it clown to its general power over 
active determination of blood to the head, face, and 
throat. But the late researches of Dr. Anstie* 
have thrown light on the problem. Referring to 
the numerous instances in which, besides congestive 
and inflammatory phenomena (as iritis and ery- 
sipelas), modifications of secretion and nutrition, of 
sensation and motion, take place in parts affected 
with neuralgia, he points to a lesion of the nervous 
centres as the most reasonable explanation of the 
phenomena. Grant that this lesion is—primarily 
at least—inflammation, and we have the explana- 
tion of the value of Belladonna in the treatment of 
such cases. 
Let us now pass in review the local varieties of 
neuralgia with a view of seeing what has been or 
may be done for their treatment. 
1. Neuralgise of the trigeminal nerve are the 
most frequent we are called upon to treat. Many 
of these affect its supra-orbital branch alone. Of 
“ hemicrania” and “ clavus hystericus,” ranked by 
Dr. Anstie as supra-orbital neuralgise, I have 
spoken when treating of Headache. The sympa- 
thetic neuralgia of gastric disorder generally attacks 
this nerve (some persons cannot swallow an ice 
without being attacked by it) : it then finds its 
remedy in Kali bichromicum. “ Brow-ague,” again, 
is a supra-orbital neuralgia: and when truly ma- 
larious finds its best remedy in Quinine, which 
* See his “ Lettsomian Lectures ” in the ‘ Lancet’ for 1866, and 
his article on “Neuralgia” in the ‘System of Medicine,’ vol. ii. 170 
NEURALGIA. 
need not be given in large doses to cure.* In 
cases falling under none of these headings, you will 
do well to bethink yourself, unless Arsenicum or 
Belladonna be indicated, of Chelidonium,f which 
indeed its prover, Dr. Buchmann, extols as sove- 
reign for most superficial neuralgise. 
Neuralgia of the superior and inferior maxillary 
branches of the fifth (often including the ophthalmic 
also) is met with under two forms : the one recent 
and readily curable; the other chronic, and very 
intractable. 
a. Acute prosopalgia (as from exposure to cold), 
and acute paroxysms of recurring prosopalgia (with 
hypersemia), are readily controlled by Aconite. The 
first case in Dr. Morgan’s series well illustrates 
this. In sub-acute cases, even of some standing, 
where in each attack of pain the face flushes up 
(especially, sometimes only, on the side affected), 
the cheeks being hot and the eyes red and watering, 
Belladonna will give you the utmost satisfaction. 
My own cases concur with Dr. Morgan’s in bearing 
out this statement. 
b. Of the true tic-douloureux, the “ epileptiform 
neuralgia ” of Trousseau, there seems a general 
assent to his statement that it is never radically 
cured. We can happily speak otherwise. Several 
of the cases recorded by Dr. Quin were unmistake- 
ably of this nature,—in the first the neuralgia had 
actually superseded epilepsy : and all these were 
cases of some standing. Arsenicum, in high dilu- 
* See a case of my own in ‘Brit. Journ. of vol. xxvi, 
p. 131. 
f See Ibid., vol. xx, p. 47. NEURALGIA. 
171 
tions, was the chief remedy in all, though it was 
powerfully re-inforced in most of them by Bella- 
donna. The cases are too long to cite: but their 
attentive perusal will well repay you. None of the 
cases in Dr. Morgan’s paper or my own were of 
this severity; but I have now a case under treat- 
ment in which very great amelioration has already 
been effected by the steady use of Arsenicum, in 
the medium and higher potencies. 
2. Intercostal neuralgia must be distinguished 
from myalgia on the one hand, and from the infra- 
mammary pain symptomatic of ovario-utorine dis- 
turbance on the other. For the former Arnica, for 
the latter Actaea racemosa will generally be found 
the best remedy. In the true neuralgia of this 
region Ranunculus bulbosus often acts very satis- 
factorily :* but if much debility be present (as in 
Case I of my series) Arsenicum will be sovereign 
here as elsewhere. 
I wish I could speak as favourably of the treat- 
ment of that form of this neuralgia which in aged 
persons is so frequently the legacy of shingles. 
This is one of the most rebellious neuroses I 
know of. 
3. The last local variety of neuralgia of which I 
shall speak is sciatica. There are two principal 
forms under which this malady is encountered,—- 
the pure and the rheumatic. For pure sciatica 1 
always rely upon Arsenicum. Case xxviii in 
my collection is a capital instance of its virtue. 
Here sciatica of eleven months’ standing, yielded, 
* My friend Mr. Kyngdon tells me he has found this medicine 
effective in brachial neuralgia also. 172 
LOCAL SPASMS. 
after the failure of Colocynth, to one day’s admi- 
nistration of Arsenicum 30. I may mention that 
this man died about two years later of cardiac 
disease, but had had no return of his neuralgia. 
Rheumatic sciatica, when recent and inflammatory, 
yields readily to Aconite, which I have always given 
in such cases in the 1st dec. dilution. In chronic 
cases, Rhus will rarely fail to relieve (see my 30th 
case). 
The various visceral neuralgise will come under 
our notice in their proper place. 
Local Spasms. 
Under this heading I purpose speaking of several 
forms of involuntary muscular contraction, tonic and 
clonic, which, although local, will not come under 
consideration among the disorders of particular 
organs. 
The most common of these are the well-known 
“cramps” of the calves. Seen at their highest 
intensity in cholera, they are symptomatic of other 
forms of intestinal irritation, or may result merely 
from fatigue. In the latter case Arnica is the 
medicine. In the former, the Cuprum w'hich is so 
valuable for the cramps of cholera may occasionally 
be indicated, hut I have generally found Nux 
vomica as curative as it is homoeopathic. 
A more general and continued form of cramp of 
the extremities has been described by Prof. Trous- 
seau under the name of “ tetany.” The kind of 
contractions here present, and the numbness, ting- 
ling, and formication with which they begin, forcibly 173 
LOCAL SPASMS. 
remind us of the pathogenetic effects of two medi- 
cines, Aconite and Secale, The facts which lead 
Trousseau to consider the affection of a rheumatic 
nature, the occasional presence of febrile symptoms, 
and the benefit observed from bloodletting, all 
point to Aconite as the most important remedy. 
That “tetany” occurs so frequently among nursing 
or pregnant women confirms the indications for 
Secale, and would lead us to choose it for such 
patients when no decided Aconite symptoms were 
present. 
In the facial muscles we meet with clonic spasm 
in the complaint known as “ tic non-douloureux,” 
or “ histrionic spasm of the face.” This is a kind 
of local chorea. I can only suggest Hyoscyamus 
for its treatment, which may be curative in young 
people. In adults it is a very intractable malady. 
“ Trismus” is the tonic spasm of the masticatory 
muscles. Excluding its appearance as a part of 
tetanus, it arises either from rheumatic causes, when 
Aconite will help; or as a symptom of hysteria, 
when the indications for Ignatia will be plain. 
“ Torticollis,” in its genuine spasmodic form, is as 
yet unknown to our therapeutics. I suspect that it 
is nearly always of central origin, and should be 
disposed to try the continued use of such medicines 
as Nux vomica, Belladonna, and Mercurius. 
“ Writer’s cramp” is the last of these local 
spasms that I shall specify. It is included by Dr. 
Bussell Beynolds with the disorders pathologically 
similar to it in the following definition, “ A chronic 
disease, characterised by the occurrence of spasm 
when the attempt i3 made to execute a special and 174 
LOCAL SPASMS. 
complicated movement, the result of previous edu- 
cation ; such spasm not following muscular actions 
of the affected part when the special movement is 
not required.” Of this disorder also we have no 
experience. Dr. Reynolds knows of no help for it 
save perfect rest: and I can only suggest the 
administration of Arnica as a possible auxiliary, if 
the symptoms are traceable to over-exertion. This, 
however, is by no means always the case. LETTER XVIII. 
DISEASES OF THE EYE. 
We begin to-day the consideration of the diseases 
of the eye. The outline I shall give you of the 
Homoeopathic treatment of these maladies may be 
filled up from two sources. The first is an ad- 
mirable series of papers on the various forms of 
“ Ophthalmia ” by my friend Dr. Dudgeon, which 
you will find in vols. vi and vii of the ‘ British 
Journal of Homoeopathy.’ The second is a ff Treatise 
on Diseases of the Eyes ” by Dr. Peters, founded on 
Biickert’s collection of cases. This includes the 
non-inflammatory affections of the eye—cataract, &c. 
—and also the morbid states of the ocular append- 
ages. The sections on eye diseases in Laurie and 
in Marcy and Hunt are very unsatisfactory,—the 
latter especially quite failing to convey a due esti- 
mate of the value of Homoeopathic treatment in 
these cases. 
I shall commence with the appendages of the 
eye. And first, of the lids. 
Inflammation of the Eyelids, 
when acute, requires different remedies according to 
its precise seat. Thus, when it affects the skin and 
cellular tissue outside the lid (blepharitis), it is of 176 
INFLAMMATION OF THE EYELIDS. 
an erysipelatous character, and demands the reme- 
dies for that disorder—Belladonna, Rhus, or Apis— 
according to the indications I shall give when 
treating of erysipelas itself. When it is seated at 
the edges of the lids (ophthalmia tarsi), its best 
remedy is Hepar Sulphuris. When it invades the 
lining mucous membrane (conjunctivitis palpebra- 
rum), it yields to the remedies for catarrhal oph- 
thalmia, Euphrasia or Sulphur. A peculiar form of 
inflammation of the lids is “ stye.” The exact seat 
of this troublesome little phenomenon is dubious : 
but there is no doubt that its progress may gene- 
rally be arrested by a few doses of Pulsatilla. 
Should there be a disposition to recurrence, Sulphur 
will check it almost as effectually as it does with 
boils. 
Inflammation of the lids most frequently comes 
before us in its chronic form,—causing, if at the 
edges, lippitudo, if inside, granular lids and vascular 
cornea. The former is still best treated with Hepar, 
aided, if necessary, by Mercurius. The latter often 
repays the persistent use of one of the three great 
remedies for chronic mucous inflammations, Arsenic, 
Mercurius Corrosivus, and Kali Bichromicum. I am 
not sure, however, that we have not in Argentum 
Nitricum a better remedy here than any of them. I 
do not mean locally applied : but given internally. 
The specific irritant influence of this medicine on 
the conjunctiva is so strikingly displayed in Dr. 
Muller’s beautiful proving, that it seems very likely 
that even when applied locally it acts as a dynamic 
and Homoeopathic agent; and a wide field of use- TARSAL TUMOURS. 
177 
fulness seems open to it when given in our usual 
way. 
Not, however, that I would exclude local appli- 
cations in these chronic cases, so long as they are 
used mildly and unfrequently. It is true Homoeo- 
pathy, though of the crudest sort, to treat chronic 
inflammation with local irritants, as the Nitrate of 
Silver and Sulphates of Zinc and Copper commonly 
applied in these cases. I only ask you to try 
internal remedies thoroughly first before you resort 
to this more unsafe and questionable proceeding. 
Spasmodic and Paralytic Affec- 
tions of the Eyelids, 
causing the phenomena known as ectropium, entro- 
pium, lagophthalmos, blepharospasm, and ptosis, 
must be carefully traced to their causes if we desire 
to treat them successfully. I can only say here 
that in apparently idiopathic paralysis of either the 
orbicularis or levator palpebr® superioris muscle, the 
medicines worthy of trial are Phosphorus,* Gelse- 
minurn, and Conium. 
Tarsal Tumours 
have disappeared under the action of high dilutions 
of Calcarea Carbonica. (See ‘ Annals/ vol. i, p. 
272.) 
Before leaving the eyelids I would mention that 
that troublesome quivering sometimes felt in them, 
* See Dr. Gallavardin’s observations in ‘Brit. Journ. of Horn., 
vol. XX. 178 
CONJUNCTIVITIS SIMPLEX. 
and vulgarly described as “ live blood,” is greatly 
under the control of Pulsatilla. I would now say 
a word or two about the diseases of the lachrymal 
apparatus. 
Inflammation of the lachrymal sac 
was once rapidly cured, in Dr. Dudgeon’s hands, 
by Silicea 6 (‘ Brit. Journ. of Horn./ vol. xiii, p. 
135) : and I have myself had a very similar case. 
Fistula Lachrymalis 
is also reported to have been cured by the same 
medicine: in other cases by Calcarea, Fluoric acid, 
and Causticum. 
With these few hints upon the treatment of the 
diseases of the ocular appendages I pass to the con- 
sideration of the affections of the conjunctiva,—the 
ophthalmias proper. 
Conjunctivitis simplex, 
catarrhal ophthalmia, the common “ cold in the 
eye” yields readily to Homoeopathic treatment 
without the need of any local application. A few 
doses of Euphrasia will generally effect the cure: 
hut if the patient be of unhealthy constitution, a 
dose of Sulphur should initiate and may conclude 
the treatment.* 
* The following are Dr. Dudgeon’s more detailed instructions. 
“ When the affection is recent, and the symptoms are, dry itching or 
smarting sensation in the eyes and lids; feeling as if something had 
got into the eye; frequent winking, and occasional discharge of CONJUNCTIVITIS SIMPLEX. 
179 
It is in the chronic form that we are most fre- 
quently called upon to treat this affection. The 
remedies I have recommended for chronic blephar- 
ophthalmia come into play here also. Arsenicum, 
however, is facile princeps among them : and I 
would hardly advise you to try any other until you 
have given this great medicine a full opportunity of 
doing good. Here, too, you must remember that 
in unhealthy constitutions (even though we have 
not actually strumous ophthalmia before us) an 
occasional dose of Sulphur is indispensable in the 
treatment. 
Leaving now the simple conjunctivitis, we come 
tears, the conjunctiva being partially or uniformly injected; little or 
no mucus secreted ; the conjunctiva of the lids being comparatively 
redder than that of the hall; a dose or two of Sulphur, in almost any 
dilution, usually suffices to effect a rapid cure. When, in the com- 
mencement of the disease, there is great dry burning feeling, with 
frontal headache, and symptoms of congestion of the head, Bella- 
donna, preceded or not by Aconite, will often be found of use. If the 
flow of tears is considerable, and even of an acrid character, with 
corresponding watery discharge from the nose, sneezing, and other 
indications of coryza, Euphrasia is the remedy indicated. Where, 
along with copious flow of tears, there is much smarting and burning 
pain, the tears being particularly acrid and corrosive, or if there is 
chemosis or cedematous condition of the lids, Arsenicum will be 
found useful. If at the outset of the disease there is considerable 
mucous discharge, Chamomilla should be borne in mind. Where the 
mucous secretion is excessive, the injection considerable, and the 
caruncula particularly inflamed and enlarged, Argentum Nitricum 
will, I imagine, prove specific. When the meibomian glands seem 
much affected, and the edges of the lids red and swollen, the secre- 
tion forming during sleep yellow crusts on the cilice, Mercurius solu- 
bilis or Jlepar Sulphuris will be given with advantage. When the 
evening exacerbations, which are usually present, are very well- 
marked, Pulsatilla will be found useful.” 180 
GONORRIHEAL OPHTHALMIA. 
to its purulent form, of which we have three varie- 
ties, the ophthalmia neonatorum, gonorrhoeal oph- 
thalmia, and Egyptian or purulent ophthalmia. 
Ophthalmia neonatorum 
is a disease commonly dreaded as much for the 
severe local measures it is thought necessary to use as 
for the seriousness of its own symptoms and conse- 
quences. I am happy to tell you that beyond the 
observance of simple cleanliness, you need do nothing 
whatever to the eyes of babies thus affected. Give 
them a dose of Argentum nitricum 3 every few hours, 
and you will find the inflammation rapidly subside, 
without leaving any traces of its presence. Dr. 
Dudgeon, who taught us this practice, considers the 
local use of the same medicine justifiable if neces- 
sary. I have myself been as well able to do without 
this as without the Euphrasia, with which in my 
first trials I used to alternate the less familiar 
remedy. 
Gonorrhoeal ophthalmia 
is so strictly local a disease (for I have no faith in 
the occurrence of metastasis), that if ever local 
treatment is to be relied upon in these maladies, it 
is here. Nevertheless, so close is the analogy 
between the ophthalmia neonatorum in its most 
common mode of causation—viz. from the contact 
of vitiated vaginal secretions—and the present dis- 
order, that I should begin with the internal admin- 
istration of Argentum nitricum alone, though in a PURULENT OPHTHALMIA. 
181 
lower potency. So rapidly does the mischief spread, 
however, that unless twenty-four hours saw it de- 
clining instead of advancing, I would advise you no 
longer to delay the local application of this drug. 
You may use it in the solid stick, in a strong solu- 
tion, or in Guthrie’s ointment (gr. x to 3j of lard). 
In so acting, you may comfort yourself with the 
admission of Watson. “Mr. Guthrie,” he says, 
“ considers this to be a local disease of a peculiar 
character; and, acting upon the aphorism of John 
Hunter (an aphorism, however, which requires some 
qualification), that two diseases or actions cannot 
go on in a part at the same time, he proposes to 
set up in the inflamed conjunctiva a new action 
which shall supersede the original disease, and 
create another that is more manageable. In this 
point of view Mr. Guthrie s ratio medendi agrees 
with that of Hahnemann, about which there has 
been so absurd a noise made of late years.”* 
You will see that I have had no personal expe- 
rience with gonorrhoeal ophthalmia. There are two 
cases of it in Peters’ ‘ Treatise’:—the one is said to 
have been cured by China, the other by Nitric 
Acid. 
Purulent ophthalmia 
is another disease of which I can speak only from 
the experience of others. Dr. Peters states that he 
and his colleague “ treated over forty cases of puru- 
* Dr. Dudgeon, indeed, considers that, even when locally applied, 
Argentum Nitricum acts specifically; and that no mere irritant 
without affinity for the inflamed tissue would have the same effect. 182 
DIPHTHERITIC CONJUNCTIVITIS. 
lent ophthalmia in children, at the Home for the 
Friendless, without the loss of a single eye, although 
three or four cases proved exceedingly intractable.” 
Local applications were employed: but I suppose 
the unusual success must be ascribed to the internal 
medication, which consisted in most cases of Hepar 
Sulphuris, 1st to 3rd trit., night and morning, and 
Rhus, 1st to 3rd dil., every two to eight hours, 
according to the severity of the symptoms. I know 
of no other records of the Homoeopathic treatment 
of this malady. 
I need hardly say that in all forms of purulent 
conjunctivitis the removing of all collections of matter 
and the prevention of its reaccumulation by frequent 
ablution is attended to by Ilomoeopathic as well as 
by Alloeopathic practitioners. 
Diphtheritic conjunctivitis 
is so rarely seen save in Germany that you are 
hardly likely to have to treat it. This is fortunate, 
as I know of no extant Homoeopathic experience to 
help you. For myself, I should be disposed to rely 
(with M. Giraldes) on the general and topical 
employment of Kali Chloricum. LETTER XIX. 
diseases of the eye (continued). 
Before passing from the affections of the con- 
junctiva to those of the deeper tissues of the eye, I 
shall consider the four great diathetic ophthalmias 
known as the scrofulous, rheumatic, gouty, and 
syphilitic respectively. Involving, as some of these 
do, more tissues than one, they occupy a middle 
place between the maladies we have already con- 
sidered and those which have yet to come before 
us. 
Strumous ophthalmia 
is one of the most annoying diseases we are called 
upon to treat—the frequent relapses causing re- 
peated disappointments. Nevertheless, the treat- 
ment I shall sketch out for you is sure ultimately 
to succeed : though whether it contrasts favourably 
or not with that of the prevalent school I am unable 
to say. It is at any rate pleasanter. 
You must first take into account the constitution 
of your patient, and give him accordingly, besides 
attending to his general health, a course of Sulphur 
or Calcarea. This I regard as indispensable in all 
cases. Sulphur is most suitable when the oph- 
thalmia is the only sign of scrofulous taint; or when 184 
STRUMOUS OTHTHALMrA. 
the latter shows itself chiefly in unhealthiness of the 
skin. Calcarea is better when the diathesis is 
strongly marked, especially by enlargements of the 
lymphatic glands. A course of one or both of these 
medicines, with the occasional aid of the shorter- 
acting remedies for inflammation and photophobia, 
will sometimes be sufficient to effect a cure.* 
In most cases, however, the aid of the remedies 
for chronic inflammation will be required. I speak 
especially of Mercurius Corrosivus, Kali Bichromi- 
cum, and Argentum Nitricum. The first is by far 
the most important. If you will read the cases de- 
tailed by Dr. Bocker, in the ‘ Brit. Journ. of Horn./ 
vol. iii, and those by Dr. Kidd in vol. xxii of the 
same journal, you will be satisfied of its extreme 
value in this disease, at any rate in the lowest 
potencies. Its only rival is Hepar Sulphuris. Nume- 
rous cases illustrating the action of this medicine 
will be found in Peters’ ‘Treatise’:—it is one in 
which I myself have great confidence, when nume- 
rous and repeated ulcers form. 
There are two somewhat exceptional medicines 
now to be mentioned, which often play an important 
part in the treatment of strumous ophthalmia. 
There are certain forms occasionally assumed by 
this disease which have led some pathologists to 
set it down as an eruptive disorder, and others to 
class it among the neuroses. When the former 
seem right,—when the ophthalmia appears but a 
part of a general eczema of the face, then Rhus, 
after a dose of Sulphur, will prove the best medicine. 
* A case of this lciud, by Dr. Guinness, may be read in the ‘ Brit. 
Journ. of Horn./ vol. v, p. 21. RHEUMATIC OPHTHALMIA. 
185 
When on the other hand the inflammation seems 
too fugacious to be real, and the nervous element in 
the case is predominant, Arsenicum will do what no 
other medicine can. You will find ample illustra- 
tions of these statements in the cases furnished by 
Drs. Dudgeon and Peters. 
In whatever way you are treating strumous oph- 
thalmia, you will find it useful to use intercurrent 
remedies to check inflammatory exacerbations and 
to relieve photophobia. Por the former purpose 
Belladonna or Euphrasia is useful; for the latter 
Conium in almost any dilution seems very effi- 
cacious. 
Rheumatic ophthalmia 
at once brings us into a new region. We have got 
to the deeper tissues of the eye; and we require 
a somewhat different set of medicines to combat the 
symptoms. 
By “ rheumatic ophthalmia” I understand a pain- 
ful inflammation of the eye, arising either idiopa- 
thically in a rheumatic subject, or from exposure of 
the eye itself to the causes of rheumatism. Such 
an inflammation may affect the sclerotica primarily, 
with but slight involvement of the iris, and none of 
the conjunctiva (rheumatic sclerotitis); or it may 
be from the first nearly confined to the iris (rheu- 
matic iritis); or it may include both the con- 
junctiva and the membranes—sclerotica and cornea 
—covered by it. 
In rheumatic sclerotitis we have two grand reme- 
dies in Aconite and Spigelia. Aconite acts here so 186 
11IIE U M AT IC O PIIT H A L MIA. 
well, not only because the constitution sympathises 
with the local mischief, but because the sclerotica is 
one of the few tissues which it has the pathogenetic 
power of inflaming. I advise you to depend upon 
it at first alone; but if, when its action seems ex- 
hausted, farther help is required, I think you will 
get it from Spigelia. Lest, however, this medicine 
should leave you in the lurch, I will refer you to 
two cases lately reported by Dr. Dudgeon (‘ Brit. 
Journ. of Horn./ vol. xxii, p. 355), in which, after 
the failure of several remedies, Euphrasia displayed 
curative powers of a very striking nature. 
If rheumatic ophthalmia consists mainly in iritis, 
it will be little responsive to Aconite, and will re- 
quire the medicines which act specifically on that 
tissue. Of these I will speak more particularly 
under the head of syphilitic ophthalmia. At pre- 
sent I will only cite a case from Peters which shows 
that the chief of these medicines—Mercurius—is 
as useful here as there. 
“ A healthy, blooming girl, set. 19, had suffered 
with her eyes for twelve days. Both eyes had been 
attacked simultaneously, but the right one had im- 
proved rapidly, so that the pupil was only a little 
too widely dilated and the iris too little sensitive to 
light. The sight was gone, however, in the left eye. 
“ The sclerotica was inflamed, as was evident 
from the peculiar redness around the cornea and 
beneath the conjunctiva. The centre of the cornea 
was transparent and free from ulceration, but its 
circumference was dim and greyish like ground 
glass; the pupil ivas contracted, irregular, and im- 
movable ; the colour of the iris was greenish, the RHEUMATIC OPHTHALMIA. 
187 
pupillary edge was swollen, and there was a delicate 
gray exudation of lymph within the circumference 
of the pupil; there was also a small deposit of yellow 
pus at the bottom of the anterior chamber. Daylight 
could be distinguished from darkness with the 
diseased eye, but everything seemed changed into a 
gray mist; there was no intolerance of light, some 
lachrymation, no great pain by day, but violent, 
rending, tearing pains set in in the eye and its 
neighbourhood, in the temples, forehead, aud cheeks, 
every evening and night. 
“ One grain of Mercurius Solubilis 3 was given 
daily for two weeks. In a few days the pains had 
ceased, and there was only a slight redness about 
the cornea; but the eye was dim : still the pupil 
was clear, and no longer irregular; the iris blue 
and sensitive; the lymph and pus had disappeared, 
and sight was restored. A perfect cure soon 
followed.” 
The catarrho-rheumatic ophthalmia is deservedly 
dreaded on account of its great tendency to involve 
the cornea and produce severe ulceration and sup- 
puration in that precious membrane. Sulphur (in 
the lower triturations) and Kali bichromicum pro- 
mise most for the arrest of the inflammation in its 
earlier stages : but if corneal mischief has already 
occurred, I recommend you to rely upon Hepar 
Sulphuris. You may read in Peters’ ‘ Treatise ’ 
several cases in which onyx, hypopion, and pro- 
lapsus iridis were present, and in which this medi- 
cine (chiefly in the lowest potencies) acted most 
satisfactorily. If it needed any help, it might find 
it in Euphrasia. You will observe how, with the 188 
SYPHILITIC OPHTHALMIA. 
involvement of the conjunctiva, we are falling back 
upon our old medicines. 
Arthritic Ophthalmia 
is rarely seen in this country as compared with 
Germany : but we Homoeopaths make so much use 
of German literature that it is, theoretically at least, 
quite a familiar disease to us. From the cases re- 
corded I gather the following as to its treatment. 
It generally sets in with very severe pains in the 
eyeball: and at this stage may be arrested by anti- 
neuralgic medicines like Arsenicum, Colocynth, and 
Spigelia. Dr. Anstie, indeed, believes that both 
this affection and rheumatic iritis are primarily 
neuralgia?. When fully established, it requires 
either Cocculus or Sulphur, or both, for its cure, if 
this indeed be possible. 
The “arthritic ophthalmia” in which these 
medicines have proved curative is primarily seated 
in the iris, but soon involves the other tissues of 
the eye, even to the lens. There is an arthritic 
iritis, pure and simple, described by Lawrence: 
whose remedies would probably be those of the 
idiopathic and rheumatic forms of the malady. 
Syphilitic ophthalmia 
means iritis, and nothing else : for the interstitial 
keratitis of the subjects of congenital syphilis will 
come under consideration hereafter. 
The treatment of syphilitic iritis has undergone 
a great change since Watson wrote. Of the blood- SYPHILITIC OPHTHALMIA. 
189 
letting (with “ active purgatives ” and “ the whole 
antiphlogistic regimen”), Mercury, and Belladonna 
regarded as indispensable in his day, the last only 
remains unquestioned in ours. The first is aban- 
doned ; and the use of Mercury is as vigorously 
opposed by some as it is still recommended by 
others. There seems no doubt but that iritis may 
get well without any mercurialization, On the 
other hand it is difficult to believe that so good an 
observer as Watson is mistaken when he writes 
thus “ You may have bled your patient sufficiently, 
and purged him well, and yet, on looking into his 
eye, you perceive the mischief to be still going on, 
and the deposition of lymph increasing. But the 
instant that his gums and breath acknowledge the 
specific agency of Mercury upon his system, a wel- 
come change becomes apparent: the red zone sur- 
rounding the cornea begins to fade ; the drops of 
lymph to lessen; the iris to resume its proper tint; 
and the puckered and irregular pupil once more to 
approach to the perfect circle; till, at length, the 
eye is restored to its original integrity, and beauty, 
and usefulness.” Mr. Haynes Walton, moreover, 
tells us that this curative effect of Mercury is almost 
always to be obtained short of salivation, which he 
justly regards as one of its poisonous effects. Put 
this together with the probability (to say the least) 
that Mercury can cause iritis, and with its curative 
power, already exemplified, in the rheumatic form 
of the malady, and 1 think we have reason for 
believing that we have a good Homoeopathic remedy 
for syphilitic ophthalmia in Mercurius. 
There is another medicine from which I have 190 
SYPHILITIC OPHTHALMIA. 
seen very good results in syphilitic ophthalmia; 
and that is Clematis. Indeed, on recalling my own 
experience of the disease, I feel so satisfied with the 
action of this remedy that I should be disposed to 
trust to it alone for the future, holding Mercurius 
in reserve should it prove insufficient. But what- 
ever medicine you are giving internally, let me 
advise you never to neglect the local use of Atropia 
to dilate the pupil. It is simply a mechanical pro- 
ceeding. You want to hold the iris away from the 
capsule of the lens lest it should adhere there; and 
to prevent the contraction of the pupil, which may 
become permanent. To effect this by a mydriatic 
is surely open to no objection. We have Yon 
Graefe’s authority that the formation of adhesions 
is a far more potent cause of the recurrence of iritis 
than the presence of a constitutional taint: and 
that “ the dangers of iritis in general have materi- 
ally diminished since the introduction of a bold use 
of mydriatic remedies in the acute form.” The 
little gelatine scales of Mr. Ernest Hart, saturated 
with a solution of Atropine, so that each contains 
the 100,000th of a grain, are infinitesimal enough 
to please us, and are thoroughly effective. One of 
these may be introduced into the eye daily or 
oftener according to the acuteness of the attack. 
I recommend Atropine simply for its mydriatic 
effect. But since in all probability it produces 
this by stimulation of the sympathetic nerves of the 
part, it must also contract the blood-vessels, and in 
this "way help to subdue the inflammation. From 
what I have seen, moreover, of the action of Bella- 
donna given internally in traumatic iritis, I am dis- SYPHILITIC OPHTHALMIA. 
191 
posed to think that the medicine has a true specific 
control over inflammation of this tissue. 
I would say in conclusion that I see no objection 
to another local application in these cases, which 
Watson states to be a piece of practice we owe to 
the Germans. It is “ adapted to those cases in 
which severe pain is felt round and over the orbit 
of the eye at night. Ten grains of the strong mer- 
curial ointment, intimately mixed with two grains 
of finely powdered Opium, and well rubbed into the 
temple a little while before the nocturnal pain is 
accustomed to recur, will in many cases completely 
prevent it.” LETTER XX. 
diseases or the eye (continued). 
Having now considered the ophthalmise in 
general, I shall lead you through the several com- 
ponent elements of the visual organ, noting as we go 
any morbid conditions affecting them which have 
not as yet come within our ken. 
Of the conjunctiva the only affection remaining 
for consideration is 
Pterygium. 
This, as I have mentioned in ray ‘ Pharmacodyna- 
mics/ I have more than once cured both in man and 
the lower animals, by Ratanhia, in the 2nd dilution. 
Dr. Carroll Dunham has contributed a case to the 
‘American Homoeopathic Review* (vol. v, p. 71) in 
which a pterygium disappeared under Zincum 200. 
It is the “ pterygium crassum ” of which I speak. 
The affections of the cornea which require our 
notice are its inflammations and its opacities. 
Corneitis (Keratitis) 
may be simple, scrofulous, or syphilitic. The 
medicines which pathogenesv and experience prove 
to act specifically on the membrane are Apis, IRITIS. 
193 
Euphrasia, Hepar Sulphuris, and Mercurius Corro- 
sivus. It is pretty obvious that the two former are 
best adapted to simple inflammation of the cornea : 
the two latter to the strumous and syphilitic forms 
of the disease, especially when ulceration is present. 
Corneal Opacities 
may arise from interstitial deposit of lymph (nebula, 
albugo), or from the cicatrization of an ulcer (leu- 
coma). The prognosis of the former is of course 
the more satisfactory of the two. If the continu- 
ance of the medicine under which the cure of the 
original disease took place be insufficient to remove 
this consequence of it,* the remedy may generally be 
found in Calcarea, Cannabis, or Causticum. Cases 
illustrating the action of these medicines may be 
found in Peters’ f Treatise.5 
And now as to the iris. We have not done with 
Iritis, 
though we have discussed its rheumatic, arthritic, 
aud syphilitic forms. There is yet a traumatic in- 
flammation of this tissue; an idiopathic variety, 
arising from excessive use of the eye; and a scrofu- 
lous iritis. The only one of these three of whose 
treatment I have any knowledge is the first. In 
two well-marked cases which lately occurred in my 
* Druitt says that Gooch used to cure opacities of the cornea, even 
of long standing, by full doses of corrosive sublimate. There are also 
some good cases of the same kind by our own Ozanne, in the ‘Annals,’ 
vol. iii. 194 
CHOKOIDIT1S. 
practice the curative action of Belladonna 1, two 
drops every two hours, was exceedingly satisfactory. 
Mydriasis 
is said occasionally to occur idiopathically,—most 
commonly in connexion with ptosis, and from the 
same cause, viz. paresis of the third nerve. I 
should be disposed to try Belladonna in a high 
dilution if the mydriasis stood alone: if ptosis 
were present, its remedies—Phosphorus, Conium, 
and Gelseminum—would be more suitable. 
The choroid is known pathologically only by its 
inflammation, 
Choroiditis. 
There is a case seemingly of this disease reported 
in the ‘Brit. Journ. of Horn.’ vol. xviii, p. 253 in 
which Ipecacuanha 12 proved curative. A more 
satisfactory example is the following from vol. xxii 
of the same Journal, p. 568. 
u Mr. H. G—, of tuberculous constitution, was 
attacked with severe inflammation jjft-the eyes, in 
consequence of continuously strainiSljr them by 
drawing at night. Burning, boring 
pains spread from the eyeball over the- supra-orbital 
region to the head, and produced in their almost 
periodic returns nausea and retching. Great in- 
tolerance of light and a contracted pupil were com- 
bined with diminished powers of vi&bn, and looking 
as if through a veil. Professor Kyber, by the use 
of the ophthalmoscope, diagnosed not only distinct 195 
CATARACT. 
appearances of hyperemia of the choroid, but like- 
wise congestion of the ciliary veins. Dr. Altschul 
so entirely cured this condition by the administra- 
tion of Arsenic of the 6th dilution, that the sight 
was restored so as to suffice for the most minute 
drawing.” 
In connexion with the crystalline lens and its 
capsule we have to consider that important disease, 
Cataract. 
You may be surprised at my including this disease 
in a treatise on Medicine, as it is ordinarily sup- 
posed to be amenable to surgical measures only. 
But it is difficult to see why it should be beyond 
the reach of medicines. Grant that in aged persons 
a hard lenticular cataract is merely, like ossified 
arteries, an evidence of senile decay. But this is 
one variety only of the disease. Capsular cataract 
is nearly always the result of inflammation, and 
corresponds pathologically with opacity of the cornea. 
Both capsular and lenticular cataracts have been 
known to form within a few days, or even in a 
single night. They have followed retrocedent gout, 
suppression of the menses, of cutaneous eruptions, 
and of habitual perspiration of the feet. Morbid 
conditions so characterised ought to be amenable 
to specific remedies: and Homoeopathic literature 
already witnesses that such remedies are in existence. 
A paper by Dr. Malan in the 5th vol. of the 
‘ Brit. Journ. of Horn./ and the section in Peters* 
‘Treatise,’ contain all the cases of Homoeopathic cure 196 
CATARACT. 
or relief of cataract with which I am acquainted. 
Some of these are of dubious value : but even when 
they are eliminated, the power of Sulphur, Silicea, 
Cannabis, Pulsatilla, and Calcarea must remain un- 
questioned. Silicea has been most frequently suc- 
cessful : it should be especially thought of when 
suppressed perspiration of the feet seems to have 
been the exciting cause. Sulphur ranks next: its 
value is obviously best marked when the trouble 
dates from repercussion of a cutaneous eruption. 
Cannabis, and perhaps Euphrasia, would be suitable 
when the cataract was capsular,—the result of in- 
flammatory action. Should we catch such a cataract 
in the act of formation, i. e. in the inflammatory 
stage, it seems probable from one of Peters* cases 
that Belladonna might be relied upon to disperse it. 
Pulsatilla was a reputed remedy for cataract in the 
hands of Storck. It acted very satisfactorily in one 
of Peters’ cases where a chronic catarrhal ophthalmia 
calling for it was present: and would be specially 
indicated where suppression of the menses was the 
exciting cause. Calcarea* would naturally be 
thought of in strumous subjects, as in the follow- 
ing case: 
“ A farmer, set. 51, of small stature, and with 
light brown hair, had suffered for the last few weeks 
with impaired sight; the patient had formerly been 
troubled with scrofula. 
<f The patient sees with the right eye only those 
* Mackenzie states that cataract is a common disease in all coun- 
tries where wine is so cheap as to be the habitual beverage of the 
lower orders. Has this anything to do with the lime and flint so 
commonly found in natural wines ? CATARACT. 
197 
objects which are above him, and with the left only 
those which are at his side, but in all other direc- 
tions everything appears as dark as night to him. 
Partial opacities of the crystalline lenses were clearly 
observable; the one in the right occupied the 
larger, and that in the left the smaller half of the 
pupil. 
“ Cannabis 2, three drops daily in water for three 
weeks, was without benefit. Calcarea 3, six doses, 
at first one dose a day for two days, afterwards 
one dose every week ; before the last dose had been 
taken, the patient had entirely recovered his sight.” 
(Peters, p. 224.) 
There is a form of cataract known as “ traumatic,” 
and it is said to have been occasionally cured by 
Comum. A case of this kind has recently been put 
on record by my friend Dr. Bayes (£ Monthly Horn. 
Review/ August, 1867). It must be remembered, 
however, that the pathology of this affection shows 
that spontaneous recovery is at least a probable 
issue. The aqueous humour, rushing in through 
the ruptured capsule, at first renders the lens 
opaque: but, unless the rent closes, will ultimately 
dissolve it and so clear the vision. 
I add a note furnished me by my friend Dr. 
Madden, who has had unusual experience in the 
treatment of this disease. 
“ In the early stage, where vision is but clouded, 
and streaks only of opacity are seen by the ophthal- 
moscope, a check to further deposit may very often 
be expected. If there is nothing more than smoki- 
ness of the lens, it may clear away entirely. The 
medicines I have found of most service are Mer- 198 
GLAUCOMA 
curius, Calcarea, and Phosphorus,—all in the higher 
dilutions.” 
Since increase of fluidity and quantity of the 
vitreous humour constitutes the most permanent 
element in 
Glaucoma, 
I will rank the disease under this heading. The 
pathology of glaucoma seems to be involved in much 
uncertainty. The “acute glaucoma” for M'hich 
Yon Graefe advises iridectomy so strongly appears 
identical with the “ arthritic ophthalmia” already 
described. By chronic glaucoma I understand a 
condition in which the intra-ocular pressure is 
much increased by reason of the dissolution of 
the hyaloid membrane, and the consequent fluidifi- 
cation and abnormal quantity of the vitreous humour 
(Mackenzie). Where the morbid process begins is 
uncertain ; if, as Yon Graefe thinks, it is in the 
choroid, the remedies found valuable in choroiditis 
(.Arsenic and Ipecacuanha) should be thought of. 
The only case on record with which I am acquainted 
is the following from Peters. 
“ Mrs. E— became affected with arthritic oph- 
thalmia and leucomatous opacity of the cornea, and 
after the gradual clearing off of the opacity, the 
lens was noticed to be of the colour of a beginning 
cataracta glaucomatosa. After Phosphorus 30 the 
lens returned gradually to its former healthy state.” 
As affections of the retina I will rank the various 
derangements of vision. But first a few words upon AMAUROSIS. 
199 
Retinitis. 
I know of no experience in the treatment of the 
acute form of this disease. If a case came under 
my own notice, I should give Aconite and Bella- 
donna. In sub-acute and chronic retinitis, I should 
follow the plan of your own authorities, and ad- 
minister small but continued doses of Mercurius. 
Amaurosis 
is a generic term under which are ranged all defi- 
ciencies of actual visual power, including amblyopia 
(by which I mean indistinct vision) and liemiopia. 
Its treatment is of course very various, according to 
its cause, If this be seated behind the retina—in 
the optic nerve or brain itself—of course the treat- 
ment must be directed thither, according to the 
principles already established. If the amaurosis 
be sympathetic, you will attack the peripheral irri- 
tation as you best may. This leaves for our con- 
sideration two leading and frequent varieties of the 
disease—the inflammatory and the atonic. 
a. If the symptoms are those of retinal irritation 
—if light is dreaded and the pupil tends to con- 
tract, the persistent use of Mercurius, as in chronic 
retinitis, promises the best results. Even very infi- 
nitesimal doses may effect our purpose, as in tbe 
following case, which—though very imperfectly re- 
ported—seems to belong to this variety.* 
“ A lady about thirty years of age, of mild tern- 
* It is of course abridged, being from Dr. Peters’ ‘ Treatisebut 
I have no means of consulting the original. 200 
AMAUROSIS. 
perament and delicate constitution, noticed for a 
year a gradual loss of sight in the right eye ; some- 
times she became almost blind without using the 
eye more than ordinarily; there was a considerable 
discharge of tears; and she could not bear the glare 
of light. 
“ After the use of Mercurius 12 for fourteen 
weeks, the whole trouble disappeared, except the 
morbid discharge of tears, which ceased after having 
taken Euphrasia.” 
b. The atonic form of amaurosis is most fre- 
quently seen as a part of general debility from loss 
of blood or other exhausting discharge. It will 
sometimes yield to the China which, with suitable 
diet and hygiene, recruits the general strength. 
But more frequently it will persist, and require 
treatment as a substantive malady. Quinine, Bella- 
donna, and Gelseminum are the medicines chiefly 
to be considered. The well-known blindness w7hich 
often accompanies the deafness of cinchonism appears 
to be non-inflammatory in its nature. In one case, 
the patient so blinded could look steadily at the 
sun without seeing it, and without any painful sen- 
sation being produced (Peters, p. 242). Gelse- 
minum desei-ves attention in amaurosis. The 
“ thirst for light” is a symptom specially indicating 
it. Ruta is a medicine of much value in weakness 
of sight arising from over-straining the eyes ; but 
whether the affection it cures is true amaurosis or 
only asthenopia (of which I shall speak immediately) 
I cannot say. Lithium has lately, upon the strength 
of its proving, been used with success in liemiopia 
(see 'Brit. Journ. of Horn./ vol. xxvi, p. 409), DIPLOPIA. 
201 
and Dr. Madden has found it of benefit in amau- 
rosis. 
I must add that but few of Dr. Peters* cases are 
instances of true amaurosis; they accordingly add 
little to our knowledge of its treatment. 
Asthenopia. 
By this term I understand, with Peters, “ that 
state of vision in which the eyes are unable to 
sustain continued exercise upon near objects, al- 
though one can see them distinctly at first, and can 
employ his sight for any length of time upon dis- 
tant objects: there is also no external appearance 
of disease of the eyes.” 
I am inclined to think that it is in this affection 
of sight that Buta is so useful. When it is ac- 
companied with aching on using the eyes, in sub- 
jects of general debility, I consider the muscles ot 
the eye-ball at fault, and give Arnica with much 
benefit. 
Hemeralopia 
has several times been cured by Belladonna, and 
once by Hyoscyamus. Pulsatilla and Solanum 
Nigrum are also recommended. With nyctalopia 
we have no experience. 
I will not speak of hemiopia, as it is never a 
substantive affection of the eye, but always sympa- 
thetic. It is otherwise, however, with 
Diplopia, 
which is sometimes a disorder of accommodation of 202 
PHOTOPSIA AND CHROMATOPSIA. 
the muscles of the eyeball. Conium or Gelseminum 
would then be its remedy. 
Myopia and Presbyopia 
generally depend upon unalterable mechanical de- 
fects. But since they sometimes occur suddenly, 
and are then necessarily of a functional nature, it 
is well to remember that for far-sightedness, at any 
rate, we have homoeopathically acting medicines 
in the mydriatics,—Belladonna, Hyoscyamus, and 
Stramonium. 
Photophobia. 
Under this term I include all forms of over-sensi- 
tiveness of the eye to sight. I know of no ex- 
perience in their treatment; but the value of 
Conium, Ignatia, and Arsenicum in the intolerance 
of light accompanying strumous ophthalmia would 
suggest their trial here. 
Photopsia and Chromatopsia 
are generally symptoms of retinitis. Should the 
latter ever occur independently, the list of medicines 
capable of causing colorations of vision given in 
Peters may be consulted. Belladonna and Hyos- 
cyamus are the most important. 
We have only remaining for our consideration 
the muscles of the eye-ball. I am of opinion that 
they are more frequently the cause of distress in 
the eyes than is commonly supposed. Sometimes 203 
STRABISMUS. 
they ache from debility, when Arnica will give great 
relief. Sometimes rheumatism attacks them, when 
Spigelia and Actcea Bacemosa are the most pro- 
mising remedies. But their best-known disorder 
takes the form of 
Strabismus 
You will find some successful cases of the Homoeo- 
pathic treatment of this disease in vol. xviii of 
the f Brit. Journ. of Horn./ p. 240. Belladonna 
and Stramonium were the most important remedies ; 
and would obviously be indicated when spasm of 
one of the muscles was the cause of the distortion. 
If, on the other hand, paralysis of a muscle be the 
fault present, Phosphorus would seem to promise 
best for its cure. LETTER XXI. 
Diseases of the Ear. 
Aukal disease has not received much attention 
from Homoeopathic practitioners, if the paucity of 
our literature concerning it is any test. I can only 
refer you to two treatises on the whole subject 
— and these but fragmentary — a paper “ On 
some Morbid Affections of the Ear” by Mr. Chas. 
Cutmore, in the 3rd vol. of the 'Annalsand 
another entitled “ Remarks on some Diseases of 
the Ear” in the 21st vol. of the ‘Brit. Journ. of 
Homoeopathy,’ unnamed, but evidently from the 
pen of Dr. Dudgeon. Some references to German 
literature on the subject are given in the latter essay. 
There are also a few occasional papers on Aural 
Disease by Dr. E. M. Hale in the recent volumes 
of the ‘North Amer. Journ. of Homoeopathy/ 
In passing through the various diseases wrhich 
affect the ear, I shall follow pretty closely Mr. 
Toynbee’s classification. 
The external ear may be attacked with erysipelas 
or with eczema. 
Erysipelas aurium 
is generally met with in the acute form, when it 
yields to Belladonna or Rhus as elsewhere. I have OTITIS EXTERNA. 
205 
never seen a chronic case, but should expect benefit 
in such from Arsenicum. 
Eczema aurium, 
when recent, will subside pretty rapidly under Rhus 
or Croton. It more frequently comes under treat- 
ment as a chronic affection, when, as you know, 
it is liable to extend into the meatus, and cause 
deafness by blocking up the passage with exfoliated 
epidermis. Mr. Cutmore has contributed two good 
cases of this affection to vol. xx of the f British 
JournalJ (p. 439). The curative effect of Arsenicum 
and Clematis in the first case was very marked. 
Muriatic acid is often a very useful remedy both in 
the acute and in the chronic form. 
I have now to speak of the numerous diseases 
which attack the external meatus. I do not include 
among these mechanical obstruction, whether from 
foreign bodies, or from accumulated cerumen ; since 
with us as with all the remedy here is the syringe. 
I cannot say that we have any medicine which 
checks the over-activity of the ceruminous glands, 
on which the accumulation referred to may possibly 
depend. Mr. Cutmore thinks we have in Spongia 
an excellent remedy for the opposite condition, viz.: 
where there is a total deficiency of wax. 
Otitis externa, 
when acute, has in my experience assumed two 
different forms, requiring different remedies. The 
former is the “ inflammation of the connective 206 
OTITIS EXTERNA. 
tissue"’ of Kramer (see Dudgeon’s paper, p. 213), 
confined to the outer half of the meatus, whose 
orifice becomes an almost imperceptible slit. Here 
Belladonna is indicated ; and, with the aid of moist 
heat continuously applied, will effect resolution as 
speedily as possible. In the other form the mischief 
is in the dermis itself, and chiefly in the deeper 
part of the meatus, where there is no connective 
tissue. The extreme sensibility of the dermis in 
this place makes the inflammation a horribly painful 
one; and when (as often happens) it spreads to the 
membrana tympani, distressing head-symptoms 
occur. Of this latter complication more anon. It 
is to this form of inflammation of the meatus, I 
think, that Dr. Bayes’ experience belongs, with 
which my own entirely coincides. “ In otitis, of 
which I have seen many very severe cases, Aconite, 
1st decimal, has proved rapidly curative, in 2- to 5- 
drop doses every hour or two hours until the pain 
is relieved. I have never seen the higher dilutions 
of Aconite, nor Pulsatilla or Chamomilla of any 
marked service in the maddening pain of acute otitis, 
while Aconite 1st dec. has acted admirably ” 
(‘Monthly Horn. Review,’ vol. x, p. 663). 
Chronic cases of this disease consist sometimes 
in the repeated recurrence of the acute attacks. 
Dr. Dudgeon mentions one such case, in which the 
tendency was checked by the persistent use of 
Nitric Acid 3. Not uncommonly the recurring 
trouble comes in the shape of boils. I think you 
will find the usual treatment of boils sufficient here, 
viz., repeated doses of Belladonna 1 at the time, 
and Sulphur to check the recurrence. Chronic OTOllRHCEA. 
207 
inflammation of the meatus, when continuous, may 
be with or without discharge. The latter is too 
much of a local affection for internal medicines to 
do much : and although you may administer Ar- 
senicum or Mercurius Corrosivus with possible ad- 
vantage I think you will do best—as in the 
corresponding affection of the eye—by the local 
application of Nitrate of Silver, say gr. j to the 
ounce. So Mr. Cutmore also advises. The more 
common form, accompanied with discharge, con- 
stitutes in most cases what we call 
I think it is practical still to treat of this symptom 
as a disease, though it doubtless depends upon more 
than one pathological condition. The important 
point is that when chronic, it is nearly always con- 
nected with impaired general health on the part of 
the patient, and requires constitutional treatment 
accordingly. The two leading forms of otorrhcea 
are 1st, that dependent on primary chronic inflam- 
mation of the dermis of the external meatus and 
membrana tympani. 2nd, that symptomatic of 
catarrh of the tympanic mucous membrane. In 
the former of these the dermis becomes a kind of 
mucous membrane, suffers a “ catarrhal ” inflam- 
mation, and pours out a milky discharge. Besides 
daily syringing, you will get very good results in 
these cases from medicines like Mercurius, Hepar 
sulphuris, and Nitric acid. When occurring after 
scarlatina, I have seen very satisfactory results from 
Muriatic acid. I should mention, too, that on 
the strength of its proving, Tellurium has been 
Otorrhoea. 208 
POLYPUS AURIUM. 
much used of late in America for this complaint, 
and with reported good effects. 
The second form of otorrlioea may occur with or 
without perforation of the mcmbrana tvmpani, which 
the speculum will disclose if present. Its distinction 
from the first form is this, that it is a true mucous 
membrane, and not a skin, which is here the seat 
of disease. The medicines for it are those of which 
we shall speak wrhen on the diseases of the Eusta- 
chian tube and tympanic cavity,—Pulsatilla, Iodine, 
and the Iodides of Mercury and Potassium, and 
Mercurius Corrosivus. 
Polypus aurium 
is a frequent accompaniment of otorrhcea. The 
different forms assumed by the growths will affect 
the appropriate surgical treatment for their removal, 
if such should be deemed necessary. But I know 
at present of no relation between them and the 
medicines required for the otorrhcea, with the re- 
moval of which they will generally spontaneously 
disappear. A case in point, in which Mercurius 
wras the remedy, is given in Dr. Dudgeon’s paper. 
The polypus appears to have been of the “ raspberry 
cellular *’ kind of Toynbee. There must be some 
reason why polypi appear under these different 
forms; and some day we may discover the link 
between them and the kinds of otorrhcea from which 
they arise, and ultimately (it may be) affix to each 
its appropriate medicine. 209 
THROAT-DEAFNESS. 
Exostoses 
of the external meatus are described by Mr. 
Toynbee as of no infrequent occurrence. He con- 
nects them with the rheumatic and gouty diatheses, 
and reports much benefit from the local application 
of Iodine, and the internal use of Iodide of Potassium. 
I know nothing about their homoeopathic treatment. 
Of the affections of the membrana tympani it is 
needless to say mncli. The outer dermic layer 
belongs to the external meatus, in whose diseases 
and their treatment it shares. Its inner mucous 
membrane is part of the tympanic cavity. Relax- 
ation of the membrane appears always connected 
with a morbid state of the middle ear, and is curable 
by the remedies which influence the mucous mem- 
brane. The only part peculiar to this membrane is 
its fibrous layer; and when the symptoms point to 
this as the seat of inflammation, I would suggest 
Bryonia and perhaps Aconite as its most likely 
remedies. The evening exacerbations of this medi- 
cine remind one forcibly of rheumatic ophthalmia. 
The Eustachian tube contributes its quota to 
aural disease by frequently suffering closure of its 
faucial orifice. This is the familiar 
Throat-deafness. 
I assume your acquaintance with all that is now 
known respecting the physiology of the Eustachian 
tube, and with the various mechanical expedients 
adopted to obviate its closure. When you have 210 
THROAT- DEAFNESS. 
ascertained its want of patency,, and the dependence 
of this upon an nnhealthy state of the faucial raucous 
membrane, you will naturally turn to the remedies 
we have for modifying the latter condition. Mr. 
Toynbee has some good remarks upon the merely 
palliative action of mechanical measures and topical 
applications here. “ There arises a third suggestion,” 
he writes, “to ascertain the signification of this 
thickened mucous membrane, to make out what 
nature may be endeavouring to effect by thickening 
it. And if the patient be a child, perchance it may 
be that nature, through this thickened membrane, 
is endeavouring to rid itself of the scrofula taint; 
or, if the patient be a middle-aged man, it may be 
that nature through this thickened membrane is 
endeavouring to rid herself of the gout poison. And 
if we address ourselves to the assistance of nature, 
we shall, so to speak, ward off the necessity of her 
thickening the membrane; this will then return to 
its natural state, the Eustachian tube will be opened 
by its muscles, and the deafness disappear, in this 
case permanently.” 
This is the basis of our treatment of these cases. 
The medicines with which we aim at effecting the 
ends proposed are Pulsatilla, Iodine, the Iodides of 
Mercury and Potassium, and Mercurius Corrosivus. 
Pulsatilla is invaluable in recent cases, the relics of 
a catarrh. In chronic cases I have generally ob- 
tained such good results from Iodine (3rd dec. dil.) 
that I have felt it unnecessary to resort to any 
other remedy; but the favorable experiences of 
others has induced me to mention the three addi- 
tional medicines. Mr. Toynbee draws a distinction INFLAMMATION OF TYMPANIC MUCOUS MEMBRANE. 
211 
between the “ thickened” and the “ relaxed” mucous 
membrane of the throat in these cases; and future 
observation may determine the relation between 
such varieties and the medicines I have mentioned. 
Obstruction of the Eustachian tube at the tym- 
panic orifice really belongs to the affections of the 
tympanum itself, to which I now turn. 
Congestion, or sub-acute inflammation of the 
tympanic mucous membrane, appears to be in most 
cases the substratum of— 
Otalgia. 
There is doubtless a truly neuralgic ear-ache— 
either primary, when Arsenicum will be the remedy, 
or sympathetic of carious teeth, when Chamomilla 
will at least give temporary relief. But this is rare 
as compared with the sub-inflammatory form. It 
is here that Pulsatilla plays another of its great 
parts in affections of the ears. I would suggest 
that with children it should not be left off too soon, 
as the mucous membrane is apt to get permanently 
thickened by repeated attacks. 
Inflammation of the Tympanic 
Mucous Membrane, 
when acute, will probably yield best to repeated 
doses of Aconite (1st dec.), as recommended for 
otitis externa. Pulsatilla may be required to clear 
away the last remains of the morbid condition. If 
cerebral symptoms should appear, Belladonna should 
be given alternately with the Aconite, if this should 
still be required. This treatment is hypothetical, 
as I know of no instance of the disease on record. 212 
ANCHYLOSIS OF THE TYMPANIC OSSICLES. 
Chronic inflammation of this membrane requires 
much the same remedies as those recommended for 
throat-deafness. Here, too, the symptoms of com- 
mencing brain-mischief, from sympathy or actual 
extension, must be jealously watched for and guarded 
against. 
Hypertrophy and Rigidity of the 
Tympanic Mucous Membrane 
are considered by Mr. Toynbee to arise in the 
majority of instances independently of inflammation. 
The former would occur in scrofulous children, and 
would be benefited by the medicinal and hygienic 
treatment proper to that diathesis. The latter 
belongs to adults, whether rheumatic or not, in 
advancing life: and Mr. Toynbee considers it “ the 
cause of deafness in advancing years.” The cases he 
cites appear to show that great benefit is obtainable 
in these cases from the so-called “alterative treat- 
ment,” i. e.} the administration of mild mer- 
curials. 
Anchylosis of the Tympanic 
Ossicles, 
especial]}' of tlie base of the stapes to the fenestra 
ovalis, is probably always dependent upon gout or 
rheumatoid arthritis in the system. The treatment 
suitable to the general diathesis may be expected to 
do some good here, when the symptoms are recent. 
In confirmed cases I should have little expectation 
of benefit. 
The mastoid cells are, as you know, lined by an CARIES OF THE MASTOID PROCESS. 
213 
extension of the tympanic mucous membrane. They 
are therefore liable to disease from the same causes, 
and in their measure amenable to the same treat- 
ment, as the cavity of the tympanum itself. But the 
practical importance of disease in this seat is its 
frequent extension to the osseous tissue. I shall 
therefore name as a distinctive malady 
Caries of the Mastoid Process. 
Here, as elsewhere, prevention is better than cure; 
and if we can check the affection of the mucous 
membrane—as by the remedies already suggested— 
or even secure the free egress of the discharge, we 
may prevent its extension to the bone. If we have 
reason to believe, however, that caries has already 
commenced, the remedies suitable to that malady 
when occurring elsewhere, notably Mercurius and 
Aurum, must be brought into play. At the same 
time a careful watch must be kept after ulterior 
mischief. Purulent infection may take place, through 
involvement of the lateral sinus, when Lachesis may 
help. Above all, cerebral symptoms may show them- 
selves, and must be combated as far as possible by 
Belladonna. Whether the “free incision down to 
the bone” recommended by most aurists in these 
cases is a necessary auxiliary to our remedies, expe- 
rience only can decide. 
Of the affections of the internal ear there is not 
much known. Inflammation there is described by 
Kramer, but is, I suppose, met with only as second- 
ary to tympanic mischief. If Toynbee is right, 
its occurrence even thus is of the rarest. I shall 214 
NERVOUS DEAFNESS. 
speak only of “ nervous deafness” and of “ tinnitus 
aurium.” 
Nervous Deafness 
is said by Mr. Toynbee to arise from 1st. Con- 
cussion. 2nd. The application of cold. 3rd. Various 
poisons, as of typhus, scarlet, or rheumatic fevers, 
of measles and mumps, of gout, of an accumulation 
of bile in the blood, and of quinine in large doses. 
4th. Excess of mental excitement. 5th. Physical 
debility. I will endeavour to give you a few hints 
as to its treatment when occurring in these dif- 
ferent ways. 
1. Nervous deafness from concussion, when no 
physical lesion is apparent, ought to find its best 
remedy in Quinine. The deafness confessedly caused 
by large doses of this medicine appears to me to be 
brought about by an action on the auditory nerve 
very much resembling that of concussion. Dr. 
Brown-Sequard naively remarks, that it is curious 
that some forms of deafness should be curable by 
Quinine, which so often causes it. 
2. The deafness which follows cold is, I suppose, 
congestive or sub-inflammatory, with a rheumatic 
character about it. Aconite when recent, Mercurius 
Corrosivus and Iodide of Potassium when chronic, 
would be the remedies. 
3. For deafness without apparent disease following 
typhus and scarlatina I would suggest Belladonna. 
If after measles or mumps I should prefer Pul- 
satilla. When connected with rheumatism or TINNITUS AURIUM. 
215 
gout the proper treatment would be that of the 
diathesis.* 
4. Deafness from mental excitement, besides the 
obvious general treatment, might be helped by 
Phosphoric Acid. 
5. If physical debility be the cause, the remedies 
suitable to the general condition will also answer 
best for the deafness. 
Tinnitus aurium 
often depends upon some appreciable exciting cause, 
as pressure upon the membrana tympani. But, 
when all such are removed it may persist: and then, 
if not always, we may call it a hyperesthesia or 
neuralgia of the auditory nerves or centres. It is a 
very obstinate affection; but I commend Belladonna 
to your attention when you think the mischief intra- 
cranial ; Quinine' when it is associated with deafness; 
Nux vomica or Ignatia when there is increased sensi- 
tiveness for sound. 
* Mr. Toynbee appears to have passed over the blood poison 
which most frequently causes deafness. This is syphilis. At Guy’s 
Hospital Mr. Hinton tells us that syphilitic deafness furnishes more 
than one twentieth of the aural patients. He can tell us nothing 
about the pathology of the disease, and has found no benefit from 
the usual Bichloride of Mercury and Iodide of Potassium. LETTER XXII. 
DISEASES OE THE DIGESTIVE ORGANS. 
This is a very inclusive title: but it enables us 
to carry our thoughts along the whole alimentary 
canal, from the mouth to the anus, taking in also 
the glands associated with it in function. We 
begin with the affections of the mouth and its 
contents. 
And first, of the mouth itself. The various 
forms of stomatitis are essentially diseases of 
children, and fall to be considered under that 
heading. I have only to speak here of ulcers of 
the buccal mucous membrane and of cancer of the 
lips. 
Ulcers of the Mouth, 
when recent, are readily curable by a few doses of 
Mercurius, followed if necessary by Nitric Acid. 
When chronic and recurring I have found them 
very intractable. 
Cancer of the Lips, 
being of the epithelial variety, need not receive a 
gloomy prognosis. It has more than once yielded 
to Arsenic. In a case under my own care which 
had this happy issue, I gave the medicine in the GLOSSITIS. 
217 
3rd dec. trituration, and also applied an ointment 
composed of five grains of the same to a drachm of 
lard. 
The tongue is the seat of acute inflammation, of 
ulceration, of syphilis, and of cancer. 
Glossitis. 
This rapid and formidable disease is completely 
under the control of Homoeopathic remedies, with- 
out the need of the incisions or leeches considered 
indispensable in the old school. A case of Dr. 
Guinness’s, in the 5th vol. of the f British Journal 
of Homoeopathy/ illustrates my statement. The 
remedies were Belladonna 3, alternated every hour 
with Mercurias 5. The description of the patient, 
twenty-four hours after the initial rigor, is as fol- 
lows :—“ The whole tongue was enormously swol- 
len ; it nearly filled the cavity of the mouth, so 
that it was quite impossible to see the throat; hut 
the tonsils externally felt enlarged, and were pain- 
ful to the touch; his face very red and swollen, 
headache, pulse 100, full. . . . The surface 
of the tongue was coated white, hut the point, and 
edges, and inferior surface were deep red, glossy, 
tense, and shining. His skin was burning hot, and 
he had passed a very restless night.” Swallowing 
and speaking were almost impossible through the 
pain thereby occasioned. Improvement began 
almost immediately; and in forty-eight hours 
hardly a trace of the illness remained. 
There is an acute oedema of the tongue which is 
rather urticarious than inflammatory. It is due to 218 
SYPHILTS OP THE TONGUE. 
the ingestion of some offending article of diet; and, 
if the time has past for an emetic, might be treated 
with advantage by Apis. 
Ulcers of the Tongue 
require and yield to the same treatment as that of 
ulcers of the mouth, with which they are pathologi-' 
cally identical.* A very obstinate form of ulcera- 
tion here is one which appears at the tip of the 
tongue, and frequently recurs after healing. If the 
application of caustic is ever necessary it is to these 
troublesome and painful little sores. 
Syphilis of the Tongue 
often appears in the form of ulceration, when there 
will rarely be need to depart from the Mercurius or 
Nitric Acid, or both, already recommended for 
simple ulcers. The bichromate (or chromate) or 
even hydriodate of potash should be borne in mind 
in severe or obstinate eases. Another form of 
syphilis of the tongue is a sort of chronic inflam- 
mation, with deep fissures and hypertrophied papillae. 
The description given by Mr. Langston Parker of 
the condition of tongue produced in some persons 
by the long-continued use of Iodide of Potassium is 
so like this, that you will feel yourself thoroughly 
homoeopathic in prescribing it. This is also the 
local manifestation of syphilis in which Dr. Laurie 
found Fluoric Acid so beneficial,—a bit of expe- 
* “ Ulcers of the tongue resulting from the action of Mercury 
are usually associated with similar ulcerations of the gums.” 
(Aitken.) CANCER OF THE TONGUE. 
219 
rience which I have myself followed in one case 
with marked advantage. 
Cancer of the Tongue. 
Conium is in some repute for this grave malady: 
on what grounds I know not. The only case of 
the disease with which I am acquainted in which it 
seems to have been cured is the following from 
Petroz’ collected writings. 
“ In 1829 a woman living in the Hue S. Nicolas, 
whose family was known to me, came to ask my 
advice about a disease of the tongue, for wdiich she 
had been under the care of Dr. I/Herminier. The 
organ was profoundly altered by an ulcer, which 
appeared to me cancerous, and which occupied 
its right side; the edges, especially posteriorly, 
were indurated, raised, and knotty; speech was 
difficult, indistinct, and accompanied with much 
pain. The patient could only take liquid nourish- 
ment. Distrusting my own diagnosis, I sent her 
to Prof. Marjolin. She brought me back the fol- 
lowing judgment:—Cancerous ulcer; no chance 
of cure but from operation; and this impossible, 
for the base of the tongue is involved.'’ 
“ In the presence of so grave a disease I turned 
my thoughts to diminish her sufferings. I pre- 
scribed the —th of a grain of hydro cyan ate of po- 
tassa, to be repeated every fourth day. After 
fifteen days I again saw the patient. She suffered 
less, the tongue appeared to me not so thick, the 
edges less hard, the speech easier. The medicine 
was continued in the same way. Fifteen days later 220 
ODONTALGIA. 
the patient, whose countenance had lost its gray 
hue and drawn features, said to me with joy, f I 
begin to be able to eat a crumb of bread/ The 
hydrocyanate was continued for a month longer, 
when the cure was complete. It is now eighteen 
years ago, and there has been no relapse.”* 
I have next to speak of troubles arising from the 
teeth. Reserving morbid dentition till I come to 
the diseases of children, I shall speak here of 
toothache from its various causes, and of gumboil. 
Odontalgia. 
There are three leading forms under which tooth- 
ache appears, and under these heads I think wre 
may class most of the medicines of real use in its 
treatment. 
First, there is the ache which accompanies caries 
of the teeth. If there is any exposure of the pulp, 
ff stopping ” of some kind is of course essential. 
But with or without this procedure, you will earn 
* I cannot say whether the induration in the following case was 
syphilitic, cancerous, or neither; hut it is worth rescuing from its 
obscurity. (‘ Medical Investigator/ Jan., 1867.) 
“ Jane Cheshire, a dispensary patient, set. 13, was admitted on 
the 18th of April, 1866, complaining of a hard lump the size of a 
large marble, which had existed for two or three months on the 
superior surface of her tongue, about half an inch from the tip, to 
the right of the middle line. 
“ Knowing that Muriatic Acid had a peculiar action on the 
tongue, I ordered her gtt. % of the 12th cen. dilution three times a day. 
25th. Tongue very much better, nearly well; can now eat her 
dinner without the slightest inconvenience. 
“ May 2nd. One may now very well pronounce her cured, and the 
merest trace only remains of induration.” PARULIS. 
221 
the thanks of your patient if you give him Kre.asote 
in the 12th dilution to take frequently until lie is 
relieved, and then continue it twice a day or so as 
a prophylactic. 
Next, there is the burning, throbbing misery of 
inflammation of the dental pulp. Here you will 
find Belladonna specific, in almost any dilution. 
Last, we have a neuralgic toothache. To give 
immediate relief, try Chamomilla where the patient’s 
nerves seem unable to endure the pain, Coffea 
where there is much temporary relief from the appli- 
cation of cold, Aconite (not too low) where neither 
of these special indications are present. But rely 
upon a course of Arsenicum for permanent cure. 
Parulis, 
or gum-boil. By this familiar name I understand 
an inflammation of the alveolar and neighbouring 
periosteum, tending speedily to abscess. I think I 
can promise you that you may cut short this in- 
tensely painful inflammation, if taken in time, by 
repeated doses of the 1st dilution of Aconite and 
Belladonna. I suspect that the Aconite is here (as 
in the very similar otitis) the true remedy, but I 
have not tried it singly. Then you ■will have cases 
to treat in which gum-boils frequently recur. If, 
as is usually the case, a diseased fang is the cause 
of the mischief, and extraction is undesirable, you 
may try what a course of Mercurius will do. But 
I should have still better hopes from Phosphorus, 
whose theoretical indication in this trouble received 
striking confirmation in the only case in which I 222 
PAllOTITIS. 
have tried it. If the recurrent periostitis arose 
from general rather than local causes, Mercurius 
would be preferable. 
The salivary glands are so closely connected with 
the mouth that their morbid conditions must fall to 
be considered here. I shall have to speak of sali- 
vation, and of mumps. 
Ptyalism, 
when part of the mercurial sore-throat, now 
(happily) rarely met with, will yield to such anti- 
dotes to mercury as Iodine and Nitric Acid. In 
idiopathic salivation these medicines, and Mereurius 
itself, will obviously be indicated : and have been 
known to cure. The salivation incident to preg- 
nancy is, however, proof against every remedy that 
I have tried for it. 
Parotitis 
would get well as rapidly without as with any me- 
dicine. Nevertheless, I think you contribute to 
the patient’s well-doing by giving him some daily 
doses of Mercurius, with Aconite if he he feverish. 
In the metastasis to the testicles or mammae Pulsa- 
tilla is the remedy : in that to the brain—rare 
enough, but I have seen two instances of it— 
Belladonna will relieve. 
This is a short letter: but I must defer till my 
next the important subject of the diseases of the 
throat. LETTER XXIII. 
diseases of the digestive organs (continued). 
The next division of the alimentary canal is the 
throat. This is indeed a pathological, rather than 
an anatomical or physiological entity, comprising as 
it does parts so diverse from one another and so 
blended with their neighbours as the soft palate with 
the uvula, the tonsils, and the pharynx. The throat, 
thus understood, is liable to be involved in erysipelas 
and variola, and presents special phenomena under 
the influence of scarlatina and syphilis; it is often 
also invaded by aphthse. The treatment of these 
affections has been or will be discussed under their 
appropriate heads. I shall here consider catarrhal 
angina: quinsy and enlargements of the tonsils: 
chronic pharyngitis ; and diphtheria. 
Angina. 
The mucous membrane of the throat is frequently 
inflamed from the usual causes of catarrh. This is 
quite a distinct affection from true quinsy (tonsil- 
litis) with which it is often confounded. It shows 
itself under several forms. The membrane may be 
highly inflamed, without much swelling. Here 
Belladonna displays those wonderful powers which 
have given it such repute in throat affections, and 224 
ANGINA. 
which I see have lately been re-discovered in the 
old school of medicine. You have probably already 
tested its value; but you may confirm your faith 
by consulting the authorities collected by Dr. 
Imbert-Gourbeyre in the ‘ Brit. Journ. of Horn./ 
vol. xiv, p. 602. You will there see, moreover, that 
it occasionally needs the aid of Aconite, when there 
is much excitement of the general circulation. 
The presence of ulcers is no contra-indication to 
this treatment by Belladonna, with or without 
Aconite, if they are on an inflamed base and very 
painful. It is only when the inflammation is of a 
low grade, with tendency to general ulceration, that 
Mercurius is preferable. Dr. Imbert-Gourbeyre, in 
the article I have cited, bears testimony to the value 
of this medicine also in sore-throat. I must confess 
that for one case in which I see indications for its 
use, I see twenty in which Belladonna is the true 
simile. And I do not remember a single case 
'which seemed to call for the routine alternation of 
the two. 
There is yet another form of acute sore-throat. 
When you examine the fauces, you find general 
oedema of the sub-mucous cellular tissue covering 
the tonsils, uvula, soft palate, and even the posterior 
portion of the hard palate. It looks almost as if a 
bee had flown in and stung the patient there. I 
am repeating what I have already said under the 
head of Apis when I tell you that you will find 
this medicine invaluable here. 
The only other remedies I have to mention in 
connection with angina are the serpent-poisons, 
Lachesis and Naja. The former is very good for TONSILLITIS. 
225 
what may be called a nervous sore-throat, where 
the pain (generally of an aching character) is out 
of all proportion to the inflammation present. Naja 
acts exceedingly well in pharyngo-larvngeal catarrh, 
of which a good instance is given by Dr. Russell 
in vol. xii of the * Brit. Journ. of Horn.,’ p. 213. 
Tonsillitis. 
I think that this term ought to be strictly con- 
fined to those cases where it is the parenchyma of 
the tonsils rather than the mucous membrane which 
is affected :—the “ quinsy’’ (i.e. cynanche tonsillaris) 
of popular diction. I must re-iterate that in 
Baryta Carbonica, 6tli or 12th, given early, we have 
an almost infallible means of dispersing the en- 
gorgement here before suppuration can supervene. 
Such has been and is my own experience : but I 
am bound to mention the very opposite results 
obtained by Mr. Clifton of Northampton, who 
states that he has given the medicine in fourteen or 
fifteen cases of tonsillitis, hoping to prevent suppu- 
ration, but without a single success (‘ Monthly Horn. 
Review/ July, 1868). As it is thus not impossible 
that Baryta may fail in your hands as in his, I 
would direct your attention to Hepar sulphuris, 
which, from a case related in the 6th vol. of the 
c British Journal/ p. 233, appears to control suppu- 
ration in the tonsils at an even more advanced stage 
of the disease. 
As regards chronic inflammation of the tonsils, I 
am again unfortunate enough to be at issue with 
Mr. Clifton, for while he states that “in chronic 226 
CHRONIC ANGINA. 
enlargements of the tonsils, Baryta earbonica is a 
valuable remedy,” I have never seen it make any 
impression upon the hypertrophied glands. I much 
prefer the Phosphate of Lime and Iodide of Mercury, 
upon which you will find an excellent paper by Dr. 
Cooper of Southampton in the ‘Monthly Horn. 
Review ’ for Sept. 1867. He assigns the following 
as the diagnostic marks between them. u The latter 
(Merc, iod.) is to be relied upon where we are 
apprehensive of further inflammatory action setting 
in, where superficial ulceration is present, the tongue 
furred, and where there is a tendency to glandular 
enlargements in other parts, or any appearances 
leading us to suspect hereditary syphilis. The 
former will be found indicated in old chronic cases, 
especially if there is a tendency to fleshy, polypoid 
growths upon the mucous membranes, if the breath- 
ing is much affected (here it would seem specific), 
or if symptoms of a decidedly strumous character 
are present.” The Calcarea phosphorica Dr. Cooper 
recommends in the 3rd dec. trituration. 
Chronic Angina. 
I prefer using this term to that of pharyngitis, 
as the pharynx is not the only part affected. I 
cannot yet classify the various forms assumed by 
this disease: and must content myself with men- 
tioning the indications for three leading medicines. 
Mercurius Iodatus. — The observations of Dr. 
G. W. Cook, of New York, which you will find in 
Hull’s fJahr,’ point to this medicine as pecu- 
liarly adapted to chronic follicular pharyngitis, DIPHTHERIA. 
227 
the well-known “ clergyman’s sore,-throat/’ Dr. 
Black concurs in Dr. Cook’s recommendation 
of the drug in question, and, like him, gives it 
in the 1st trituration. But he points out how 
frequently this disease is dependent upon con- 
stitutional taint (the “herpetic” diathesis of the 
Drench) or upon unhealthy modes of living : and 
the necessity for such medicines as Sulphur and 
Nux Aromica, with hygienic measures, in its treat- 
ment. 
Kali bichromicum is often a useful supplementary 
medicine in the same condition, especially when 
much tenacious mucus collects about the fauces. It 
is also very valuable for chronic simple ulceration 
of the pharynx or tonsils. 
Lachesis is pre-eminently the medicine for the 
“ irritable throat.” Instances of this affection 
cured by it may be read in the ‘ Brit. Journ. of 
Horn.,’ vol. ii, p. 369, and vol. xxii, p. 488. 
Choking, hawking, and coughing are present; and 
sensations as of a ball or of a dry spot in the throat 
are not uncommon. Ignatia, Chamomilla, and 
Ambra are similarly acting medicines. The Ignatia 
sore-throat, according to Hahnemann, is charac- 
terised by a sensation of a lump during deglutition, 
and of stinging afterwards. 
Diphtheria. 
I have classed this disease among the affections 
of the throat; for it is there that it chiefly shows 
itself. But it is unquestionably a specific toxaemia, 228 
DIPHTHERIA. 
distinct either from scarlatina or croup ; and having 
other local manifestations besides the angina. 
The treatment of diphtheria illustrates well the 
conditions necessary for the successful application 
of the Homoeopathic law. When cholera first 
appeared in Europe, Hahnemann was able from the 
knowledge of pathogenesy then acquired to indicate 
Camphor, Veratrum, and Cuprum as its specific 
remedies. Later, Arsenicum was added : and now 
every homoeopath throughout the world treats cholera 
with these medicines, and with a comparative suc- 
cess which is abundantly satisfactory. It is very 
different with diphtheria. If you will read the 
numerous papers upon it (a list of which I have 
subjoined)* which have appeared in our Journals 
since Dr. Black opened the ball in 1858, you will 
find an endless variety of medicines in use, and no 
great success to boast of with them all. It must 
be confessed that it is not a disease which one feels 
any great satisfaction in being called upon to treat. 
Nevertheless, amidst the floating mass of experience 
which has now accumulated there seem certain 
patches of firm ground on which we can take our 
stand in laying down, provisionally, the best Homoe- 
opathic treatment of the malady. 
In the first place, I would recommend a freer 
resort to the aid of Belladonna. I always commence 
the treatment with this medicine, in the 1st dilu- 
tion : and have seen mild symptoms almost imme- 
diately, and pretty severe ones rapidly, disappear 
under its use. If decided improvement has not 
* See the bibliographical postcript to this letter. DIPHTHERIA. 
229 
resulted within forty-eight hours of commencing its 
use, there is no advantage in persevering with it. 
If, moreover, as sometimes happens, the symptoms 
disappear at first under the influence of the remedy, 
hut soon return, it should not be continued. 
I must now speak of the mercurial preparations. 
It tvas but natural, on the first glance being taken 
at the phenomena of diphtheria, to treat it with 
this mineral in some form. With the ordinary 
preparations, however, Mercurius solubilis and cor- 
rosivus, and the red oxide—no advantage was 
gained. But a different story began to be told as 
the Iodides of Mercury came into play. Dr. Black 
with the prot-iodide, Dr. Madden with the biniodide 
obtained very encouraging results, and our American 
colleagues followed suit. With one or other of 
these, in the lowest triturations, perhaps the majo- 
rity of Homoeopathic practitioners treat diphtheria. 
I wish I could commend them to you from my own 
experience. I have repeatedly given them, and 
carefully watched their action : and I have been 
unable to perceive the least influence exerted by 
them over the disease.* I have already, when 
speaking of Mercurius, adduced reasons for doubting 
its true homceopathicity to the diphtheritic process: 
and I cannot see what difference is likely to be 
made in this respect by its combination with Iodine. 
However, I cannot ignore the results obtained by 
my colleagues: and I must set the Iodides of 
Mercury in the forefront of the battle with diph- 
theria. To obtain their full effect, the triturations 
* Dr. Neidhard, the author of our latest treatise on c Diphtheria/ 
confesses to a similar experience. 230 
DIPHTHERIA. 
should have been recently prepared, and the dose 
should be placed dry in the mouth. 
I come next to Phytolacca, in which some of my 
colleagues appear to hope that the true specific for 
diphtheria has been found. I must remind you of 
Avhat I have already written when upon this medi- 
cine. I find in none of the cases reported as cured 
by it the symptoms I have learned to dread in diph- 
theria : while in nearly all there was high fever, 
with aching pain in the head, bach, and limbs,— 
symptoms which are never present, according to my 
experience, in bad cases. From three instances 
in which these symptoms occurred, and in which 
Phytolacca, given after the failure in two of Aconite 
and in one of Belladonna, acted with magical 
rapidity, I am disposed to believe that in this febrile 
form of the disease it is truly specific, but that it 
has no power when malignant symptoms appear. 
The mother-tincture seems required. 
What, then, can we do when diphtheria comes 
before us in its full and terrible severity ? To give 
the medicines hitherto mentioned seems to me mere 
waste of time; nor have such remedies as Arsenicum 
and Lachesis—so valuable in malignant scarlatina— 
been found available here. The following are the 
directions in which I think we have before us the 
most hopeful outlook. 
In the majority of bad cases the symptoms, both 
local and general, are those of blood-poisoning. The 
only one of our ordinary remedies which has, in my 
hands, exhibited any marked power over this condi- 
tion is Muriatic Acid. But I think that a new 
mine of wealth has lately been opened to us in the BIFIITHEIUA. 
231 
study of the antiseptic medicines. Of these, the 
Permanganate of Potash has been proved and given 
successfully by Dr. H. S. Allen; while the Chloride 
of Lime has been largely used by Dr. Neidhard, and 
with results surpassing any that have yet come 
before us. They were given in material, but small 
doses,—about — of a grain of the former and ~ of 
the latter,—frequently repeated.* 
In another class of bad cases the symptoms are 
those of croup,—the false membrane has invaded 
the larynx and trachea. Bromine and Kali bichro- 
micum are said to have cured this form of diph- 
theria. I can only say that I have used them 
freely, as also Iodine, without the least benefit. I 
think that Dr. Neidhard’s suggestion is very good, 
that it is necessary to attack the poison in the blood 
even while, by the medicines specifically affecting 
the air-passages, you are combating its dangerous 
local manifestation. He usually administers the 
Bichromate of potash (1st trit.) in alternation with 
his Chloride of lime. He has recorded two instances 
in which this treatment proved successful. In cases 
where the blood-poisoning and the laryngeal ob- 
struction are of equal severity, I should prefer the 
Permanganate of potash with Bromine. 
I need hardly say that with our medicines, as 
with those in use in the old school, the general 
management of the patient is of immense import- 
ance. Among other things I have learnt from my 
friend Dr. Hilbers the value of removing the patient 
from the house where the disease was incurred. For 
* I regret to learn that our Liverpool colleagues have found the 
Permanganate a complete failure in their hands. 232 
DIPHTHERIA. 
adults and older children, ice is very useful; but to 
young children the extreme cold is repulsive. As 
to local applications, I have gone through three 
stages of opinion. At first I used them in every 
instance; but when I found all the very bad cases 
dying in spite of them, and observed how much 
they added to the patient’s distress, I abandoned 
them entirely. Now I adopt a middle course. In 
the Belladonna cases they are unnecessary. In 
those calling for Phytolacca, a gargle of the same 
drug is useful when there is much exudation ; but 
only, I think, to clear it away the sooner. In croupal 
diphtheria gargling or pencilling the fauces is of 
course futile: but the Bromine or Kali bichromicum 
we are administering may advantageously be applied 
to the laryngo-tracheal membrane by inhalation or 
(better) spray. The only unquestionable value of 
local applications seems to me to appear when the 
false membrane is very foetid, especially if it is also 
abundant in quantity. Here it is likely that the 
system becomes secondarily re-infected by the throat 
deposit; and it is undoubted that great temporary 
relief follows its removal. You may effect this, if 
you like, by a solvent of the membrane, as glyce- 
rine ; or by one which corrugates and detaches it, as 
pernitrate or perchloride of iron. Muriatic acid 
also is an agent of the latter class ; and has addi- 
tional claims in virtue of its specific relationship 
with the disease. All these have been used with 
advantage as local applications, in conjunction with 
our internal remedies. But seeing that there are no 
more powerful solvents and de-odorizers of the diph- 
theritic deposit than the permanganate of potash DIPHTHERIA. 
233 
and the chloride of lime, I would recommend that 
in all cases in which these drugs are being adminis- 
tered they should also be used (save in young chil- 
dren) as gargles to the throat. I suspect that local 
applications here are like laryngeal medicines in the 
croupal form; they are useful in conjunction with 
the haematic remedy, but of none but temporary 
avail alone. 
The post-diphtheritic paralysis generally tends 
towards spontaneous recovery in pure air and with 
generous diet. The restoration of power may be 
aided, however, by Gelseminum, Conium, or Curare. 
In a long standing and progressive case of general 
spinal paralysis and anaesthesia thus brought about, 
Cocculus proved in Dr. Trinks* hands the curative 
medicine. 
P. S.—The following is a list, as correct as I can 
make it, of the principal papers and monographs on 
Diphtheria which have appeared in Homoeopathic 
literature to the present time. 
1858. —‘Brit. Journ. of Horn./ vol. xvi, p. 633. 
Paper on, by Dr. Black, with supplementary remarks 
by Dr. Madden. 
1859. —Ibid., vol. xvii, p. 210. Paper on, by Dr. 
Kidd, p. 222. Paper on, by Dr. Madden, p. 606. 
Paper on, by Dr. Black.—‘Annals of Brit. Horn. 
Society/ vol. i, p. 213. Paper on, by Dr. Morgan. 
—‘North American Homoeopathic Journal/ vol. viii, 
p. 133. Paper on, by Dr. Snelling. 
1860. —* Brit. Journ. of Horn./ vol. xviii, p. 159. 
Cases by Dr. Smith, of Oldham, p. 650. Case by 
Dr. Suss Hahnemann, p. 655. French Discussion on. 234 
DIPHTHERIA. 
1861. —Ibid., p. 410. Paper on, by Mr. Gelston, 
p. 443. Editorial article on, summarising Horn, ex- 
perience up to that time, p. 451. Conclusion of 
French Discussion on. — ‘North Amer. Horn. 
Journal/ vol. ix, p. 393. Paper on, by Dr. Peterson. 
—Monograph on, by Dr. Snelling :‘ The Homoeopa- 
thic Treatment of Diphtheria/ New York. 
1862. —‘Annals of Brit. Horn. Soc./ vol, ii, p. 
373. Paper on, by Dr. McGilchrist, with Discus- 
sion.—‘North Amer. Horn. Journ./ vol. x, p. 362. 
Paper on, by Dr. Freligli, p. 422. Paper on, by 
Dr. Duke. 
1863. —‘Brit. Journ. ofHom./vol.xxi,p.l09. Case, 
by Dr. MacLimont.—‘North Amer. Horn. Journ./ 
vol. xi, p. 94. Paper on, by Dr. J. Davies, p. 168. 
Paper on, by Dr. W. Williamson, p. 231. Paper 
on, by Dr. Colton.—Monograph on, by Dr.Ilelmuth: 
‘ On Diphtheria/ S. Louis. Ibid., by Dr. Ludlam : 
‘ A Course of Clinical Lectures on Diphtheria/ 
Chicago (reviewed in ‘Brit. Journ. of Horn./ vol. 
xxii, p. 456). 
1864.—‘Brit, Journ. of Horn./ vol. xxii, p. 358. 
Case, by Dr. Dudgeon, p. 509. “ Experience in 
Diphtheria,” by Dr. Diller, p. 513. “Guaiacum offi- 
cinale as a remedy in Diphtheria,” by Dr. Couch.— 
‘ Monthly Horn. Review/ vol. viii, p. 308. Abstract 
of Mr. Moore’s Paper on, with Discussion.—‘ North 
Amer. Horn. Journal/vol. xii, p. 94. “Albuminuria 
in Diphtheria,” by Dr. Ludlam, p. 113. “ Diph- 
theritis Pharyngea,” by Dr. Meyhoffer.—Dr. Burt’s 
cases treated by Phytolacca in Hale’s ‘ New 
Remedies,’ 1st Ed. 
1865.—‘ Brit. Journ. of Horn./ vol. xxiii, p. 67. DIPHTHERIA. 
235 
“ Diphtheria, with Consecutive Paralysis/’ by Dr. 
Chancerel.—-* Monthly Horn. Review/ p. 279. Dr. 
Sherwin on "Phvlotacca Octandra in Diphtheria/’ 
p. 665. “ A few Practical Remarks on the Use of 
Carbolic Acid and of Phytolacca in Diphtheria/’ by 
Dr. Bayes. 
1866. —'Monthly Horn. Review/ p. 117. Dr. 
Matheson on " Phytolacca in Diphtheria/’ p. 169. 
Dr. Hughes on Phytolacca in, p. 240. Mr. E. T. 
Blake on do., p. 262. Dr. Bubb on do., p. 243. 
Dr. Rhodes Reed on do., p. 369. "An Unsuccessful 
Case of Diphtheria,” by Mr. E. T. Blake.—'North 
Araer. Horn. Journ./ vol. xiv, p. 553. 'Treatment 
of Diphtheria/ by Dr. E. P. K. Smith.—‘ Brit. 
Journ. of Horn./ vol. xxvi, p. 621. " On Pharyngo- 
laryngitis Membranacea,” by Dr. Meyhoffer. 
1867. —' Brit. Journ. of Horn./vol. xxv, p. 350. 
" On Permanganate of Potash in Diphtheria,” by 
Dr. H. C. Allen.—Dr. Hale’s 'New Remedies/2nd 
Ed., contains all experience up to that time with 
Phytolacca.—Monograph. ‘ Diphtheria/ by Dr. 
C. Neidhard. New York. LETTER XXIV. 
DISEASES OF THE DIGESTIVE ORGANS (Continued). 
I now come to tlie stomach. This much-abused 
though long-suffering organ so frequently brings its 
possessors to you for help, that you will expect me 
to give you the fullest possible information as to the 
Homoeopathic treatment of its ailments. I will 
endeavour to do so, to the best of my power. After 
much pondering as to the best plan of arranging 
my materials, I have decided upon the following 
arrangement. First, I will speak of the treatment 
of the organic affections of the stomach, inflam- 
mation, ulcer, and cancer. Then I will tell you 
what we can do for its nervous derangements. 
Last, I will discuss the remedies for the various 
forms and elements of dyspepsia. 
Before I proceed, let me refer you to what we 
have of literature upon the subject. Besides the 
numerous clinical cases scattered through the jour- 
nal, many of which I shall mention in their places, 
there are essays at a systematic treatment of gastric 
disorders by Dr. Hofrichter, in vol. xi, and by Dr. 
Y. Meyer, in vol. xviii of the c Brit. Journ. of 
Homoeopathy/ There is a semi-popular treatise by 
Dr. Wm. Morgan, which is not without use to begin- 
ners, on the‘Homoeopathic Treatment of Indigestion, 
etc.’ Best of all are Dr. Marston’s ‘Notes of Cases 
of Indigestion ’ in the ‘ Monthly Homoeopathic 
Review* from Sept. 1867 to Feb. 1868. GASTRITIS. 
237 
Gastritis. 
There is no doubt that acute gastritis, in the 
strictest sense of the term (“ croupous form ” of the 
Germans), is, except as a consequence of irritant 
poisoning, hardly ever seen. I must agree with 
Dr. Wilson Fox,* however, that “ acute gastric 
catarrh ” is a very common affection. It is usually 
an acute dyspepsia: but sometimes arises from 
climatic and even epidemic influences. An account 
of a number of cases apparently springing from the 
last-named cause is given by Dr. Yeldham in the 
‘ Brit. Journ. of Horn/ vol. xvi. 
There is one medicine, and one only, on which I 
advise you to rely whenever you are sure of the 
presence of gastric inflammation. This is Arsenicum. 
Do not give it in too low a potency,—the 6th or 
12th will serve you best. Its homceopathicity to 
the morbid condition I need not demonstrate. If 
you want an instance of its action, I refer you to a 
case by Dr. Laurie in the tenth vol. of the c British 
Journal/ With the aid of a suitable diet, and 
perhaps a cold compress to the epigastrium, you 
will need no other treatment. 
I know that “ indications ” are given in our books 
for many other medicines in this affection,—asNux 
vomica, Bryonia, Pulsatilla, and Ipecacuanha. Patho- 
genesy also would suggest the possible place of Mer- 
curius corrosivus, Kali bichromicum, and Tartar 
emetic in its treatment. It is but right that I should 
mention these : but I repeat that you will seldom, if 
ever, want any remedy but Arsenicum. 
* Russell Reynolds’ ‘ System of Medicine,’ vol. ii. 238 
ULCEll OF THE STOMACH. 
The same is true of chronic gastritis, which under- 
lies many obstinate forms of dyspepsia. Only here 
I think you will find the lower potencies of the drug 
(as the 3rd dec. trituration) preferable. I refer 
you to two excellent cases in the first (p. 71) and 
fourth (p. 255) vols. of the ‘ British Journal/ I have 
never seen any medicine succeed in these cases when 
Arsenic had failed. For I need not tell you that 
they are often incurable, as being but symptomatic 
of organic disease elsewhere. This is especially 
true, 1 think, of ‘ chronic gastric catarrh/ par ex- 
cellence, where much mucus is formed and vomited. 
Pulsatilla, Antimonium crudum, or Ammonium 
muriaticum may relieve, but will seldom cure this 
complaint. 
The alternatives of Arsenic in chronic gastritis— 
if needed—are those already named for the acute 
form, with Phosphorus and Iodine.* The latter 
is reported to have cured a case in a child accom- 
panied—which is rare—by bulimia (f Annals/ 
vol. i, p. 293). 
If “ gout in the stomach ” should ever assume a 
truly inflammatory form, Colchicum would probably 
be as curative as it is homoeopathic. 
Ulcer of the Stomach. 
I am only acquainted with three unquestionable 
* Perhaps Hydrastis should be added. Dr. Mackechnie reports a 
case in the ‘Annals’ (vol. iv, p. 541) of chronic vomiting, which 
recovered rapidly under Hydrastis 3. The state of the tongue and 
of the complexion make me think this to have been an instance 
of gastritis rather than of ulcer ; hut the diagnosis must remain 
uncertain. ULCEll OF THE STOMACH. 
239 
cases of this disease in our literature: one in the 
4th vol. of the ( Brit. Journ. of Horn/ by Dr. 
Holland, one in the 24th vol. by Dr. Watzke, and 
one in the f Annals ’ for June 1868. In the first 
the progress of ulceration was apparently checked 
by Arsenicum 30, and the patient regained her 
health: but some months afterwards perforation 
took place after an indigestible meal, and she died. 
In Dr. Watzke’s case all symptoms disappeared 
under Arsenicum and Nux vomica: but a relapse 
occurred six or seven years subsequently. In both 
death from marasmus seemed impending when the 
treatment was begun. Dr. Mackechnie’s case was 
treated with Kali bichromicum 3 ; but illustrates 
the advantage of rest of the stomach rather than 
the virtue of the medicine, as the patient grew 
worse under the latter without the former. The 
case is too recent, moreover, to be considered com- 
plete. The same must be said of a case of my own, 
which rapidly recovered at the time under rest and 
Kali bichromicum: but I know not her subsequent 
history. 
Such experience proves that we are at least not 
worse off than the old school in the treatment of 
gastric ulcer. On the contrary, analogy makes it 
probable that, upon the common and indispensable 
basis of rest, our medicines exert a real healing 
and restraining influence upon the morbid process 
which without them can hardly be attained. The 
Argentum Nitricum, indeed, used by some is 
thoroughly homoeopathic to the disease,—as much 
so as the Arsenicum and Kali bichromicum which 
you will see are our favourite remedies. Patho- 240 
ULCER OF TIIE STOJIACII. 
genesy bears out Mr. Pope’s suggestion that Arseni- 
cum would be most suitable when the ulcer is at 
the pyloric, Kali bicliromicum when at the cardiac 
end of the stomach. 
But we ought to be able to do more than this. 
Gastric ulcers seldom occur singly. If one is healed, 
others may appear: and the morbid process may 
even be set up in the cicatrix. Have we any means 
of arresting this tendency ? In the absence of ex- 
perience, and the obscurity of the pathology of the 
subject, I can neither affirm nor suggest any answer 
to this question. One thing is certain,—that the 
ulceration is not inflammatory: so that the reme- 
dies for gastritis will not help us.* 
What can we do in the accidents of gastric ulcer, 
—haemorrhage and perforation ? The former is 
rarely prolonged enough to call for any other treat- 
ment but that of the ulcer. But if such should 
be required, the remedies I shall speak of when I 
come to haematemesis—notably Ipecacuanha and 
Hamamelis—will probably avail. As to perforation, 
I do not know what to say about omitting the 
usual treatment by Opium. “No other agent” 
says Dr. Wilson Fox “appears to have any cura- 
tive influence. The only favourable recorded termi- 
nations to this event are those in which the opiate 
treatment was pursued.” In Dr. Holland’s case, 
the patient rallied from the immediate collapse 
under Arsenicum 30; but the medicine was not 
continued, the same symptoms returned a few 
* In this connexion the results of Mr. Edward T. Blake’s most 
valuable and exhaustive experiments with Nitrate of Uranium should 
be considered (‘ Brit. Journ. of Horn.’ vol. xxvi). CANCER OF THE STOMACH. 
241 
hours afterwards, and she died nineteen hours after 
she was first attacked. No peritonitis was found 
at the post-mortem. I should expect to be able to 
control the latter casualty with our Aconite and 
Mercurius Corrosivus : and if Arsenicum can rally 
from the shock, the Opium may be unnecessary.* 
Cancer of the Stomach. 
Can we modify the hopeless prognosis which 
comes from Old Medicine when she recognises this 
disease ? I have only probabilities to offer you in 
the affirmative : but such as they are, they would 
inspire me with more hope for gastric than for any 
other form of internal cancer. 
There are two cases in the ‘ British Journal of 
Homoeopathy ’ in which supposed cancer of the 
stomach has been cured. One of these, by Dr. Y. 
Meyer (vol. xiii, p. 321), may well have been ulcer, 
with much plastic thickening about it. You will 
weigh, however, the reasons assigned by this excel- 
lent physician for believing it to have been true 
scirrhus. The patient, who was desperately ill, got 
quite well, mainly under Arsenicum 3 and Calcarea 
12. Of Dr. Bolle’s case, in the 12th volume (p. 173), 
I can only say, if it is not cancer, what is it ? It 
bears no resemblance to any other disease of the 
* Since writing the above I have come upon another case in which 
perforation of a gastric ulcer seems to have taken place. It is re- 
corded by Dr. Kafka, of Prague, in the 15th vol. of the ‘ British 
Journal.’ Belladonna removed the symptoms; and the ulcer finally 
healed under Sulphate of Atropia, gr. TJ3, night and morning. 242 
GASTRODYNIA. 
stomach with which I am acquainted. There was 
coffee-grounds vomiting, and the patient was sixty 
years old. The curative agent was Phosphorus. 
To these Dr. Mackechnie (‘ Annals/ vol. iv, p. 542) 
adds the mention of a case “ where there was every 
reason to suppose cancer of the pylorus—a case that 
had been pronounced hopeless by the first allopathic 
physicians; but where the patient is now quite 
well. This result is to be attributed principally to 
Hydrastis.” 
Arsenic, Phosphorus, and Hydrastis—these are 
the medicines from which experience would lead us 
to hope a possible benefit in gastric cancer. To 
these I would add Kreasote. I cannot affirm that 
I have ever cured this disease, but I have seen 
several such suspicious cases clear up under Arsenic 
and Kreasote that I cannot think we are altogether 
powerless against it. 
The neuroses of the stomach may be classed under 
the general heading of 
Gastrodynia, 
otherwise “ gastralgia/’ or “ cardialgia.” It is in 
this affection that Nux vomica has won its eminent 
place in the treatment of disorders of the stomach. 
You will of course look out for the well-known 
indications for the drug—the occurrence of the 
symptoms in intellectual workers, and in those 
addicted to w'ine and coffee, the co-existence of 
constipation, and so on. The only one of these to 
which I attach much importance is that the sufferer 
shall be tolerably robust and wiry,—not a delicate GASTRODYNIA. 
243 
youth or female. I venture to say that in nine- 
tenths of such patients Nux vomica, in almost any 
dilution, will cure their gastrodynia. The remainder 
may require a minute comparison of their symptoms 
with the Materia Medica, especially with those of 
Lycopodium, Cocculus, Bismuth, and Opium. The 
Hydrocyanic Acid which is so great a favourite in 
the old school for this affection I also have found 
very useful where there is a distressing sense of 
“sinking” complained of, and where the pain is 
temporarily relieved by food.* I think the symptoms 
in these cases referable to the solar plexus : and 
have found other disturbances of this great ganglio- 
nic centre amenable to the same medicine. 
There is another form of cardialgia, which pre- 
sents itself in delicate women, and in individuals of 
the same type in the opposite sex. This assumes 
the character of hypersesthesia or neuralgia,—that 
already described partaking more of spasm. The 
neuralgic variety—which is by far the most common 
—is often sympathetic, especially of ovario-uterine 
disturbance, and may then yield to the remedies for 
the primary disorder. Its own remedies are all 
taken from the class of metals. Bismuth, Zinc, 
Argentum, Cuprum, even Manganese have been 
used with good results; but my favourite medicine 
is Arsenicum. With the dilutions 6 to 30 of this 
drug I have performed some of the most satisfactory 
cures I can recall in the subjects of this malady. 
The hvpersesthetic variety, in which the stomach 
immediately resents by pain and vomiting the intro- 
* Dr. Y. Meyer says of the Nux cardialgia that it is “ only caused 
by partaking of solid food.” 244 
GASTROUYNIA. 
cluction of food, is usually associated with hysteria, 
or spinal irritation, or both. Dr. Kafka gives two 
cases of the kind in which a cure took place under 
the Sulphate of Atropia, in doses of the 180th 
of a grain. (f Brit. Journ. of Horn./ vol. xv, 
p. 242.) 
I reserve for another letter the large subject of 
dyspepsia. LETTER XXV. 
diseases of the digestive organs (continued). 
The difficulty of classifying the disorders of the 
stomach culminates when I come to that multiform 
malady which we call “ dyspepsia.” I am not sure 
but what Dr. Marston’s plan is the best—to run 
through the list of medicines of service in the disease, 
indicating the special place and value of each. You 
would hardly be content with this, however; and I 
must still keep disease in the fore-front, and hang 
on my medicines to its several forms. I will speak, 
then, first of acute indigestion; then of chronic 
indigestion in general; next of the special elements 
of this latter—pain, acidity, heart-burn, water-brash, 
and flatulence—each of which sometimes comes 
before us for treatment as a substantive malady: 
and last of vomiting, with hsematemesis as an 
appendix. 
Acute indigestion. 
By this I mean, of course, the immediate results of 
the ingestion of improper food. If it is not too late 
for an emetic, I hope that your Homoeopathic con- 
victions will not be felt as a bar to your resorting to 
this common-sense remedy. I do not, however, 
recommend a purgative when the offending food 246 
CHRONIC DYSPEPSIA. 
has passed the pylorus. It will act as its own 
cathartic. 
Besides a judicious temporary starvation, you will 
find either Nux vomica or Pulsatilla of inestimable 
service in these cases. The former comes into play 
when the indigestible substance is such on account 
either of its bulk, or of its hardness and insolubility, 
—as cheese, white of egg, and such like.* The 
symptoms are those of violent pain and expulsive 
action ; it is the nervo-muscular apparatus which is 
here at fault. I recommend frequent doses of the 
1st dilution. The indigestion calling for Pulsatilla, 
on the other hand, generally arises from taking fat 
or other rich food. The prominence of mucous 
derangement—white tongue, nausea with little 
vomiting, passive diarrhoea, and absence of much 
pain—is the indication for this drug. Teste adds 
Arsenicum as the specific remedy for the disturb- 
ance of the stomach caused by sour fruits and crude 
vegetables : of this I have no knowledge. 
Chronic Dyspepsia 
generally comes before us as a more or less complex 
condition ; and requires the full resources of diet and 
hygiene to be brought into play for its aid. But 
over and above these we have medicines of the 
utmost value in its treatment. If you have fallen 
in with Dr. Chambers’ suggestion of the impotence of 
our remedies in this disease, let me recommend you 
to read Dr. Marston’s papers, which were written in 
* “ Foreign bodies usually appear to cause pain through exciting 
spasm of the muscular coats.5’ (Dr. Wilson Fox, loc. cit.) CHRONIC DYSPEPSIA. 
247 
reply. I cannot refer you to a better account of the 
place and action of our chief anti-dyspeptic remedies. 
I will give them here in brief. 
Nux vomica is the medicine to be given when the 
nervous and muscular energy of the stomach is 
defective and perverted. The food either causes 
pain and—less commonly—vomiting, or it lies like 
a load at the stomach, oppressing the brain, and 
soon developing much flatulence. Water-brash 
occasionally occurs. The tongue is coated at the 
posterior part only. There is constipation, often 
with ineffectual urging to stool; and tendency to 
piles. This is the dyspepsia of men of business and 
intellectual workers, when they do their business 
with hurry and worry, and give their brains insuffi- 
cient rest. Nux is also the best remedy for the 
non-inflammatory dyspepsia of those who take alcohol 
largely. 
Pulsatilla expends its influence upon the mucous 
membrane. The mucus is increased; hence slow 
digestion, fermentation of the food, acidity, heart- 
burn, foul eructations, and nausea. Rich and fat 
foods are instinctively avoided. The bowels tend to 
looseness. It is the dyspepsia of persons of soft 
fibre and feeble circulation. 
Bryonia is less frequently indicated than either 
of the two great remedies now described. Its indi- 
gestion is more directly the consequence of an 
unsuitable diet than of constitutional derangement. 
I have already, when writing to you upon this drug, 
cited Trills* graphic description of the cases to which 
it is suitable. With this Dr. Marston’s experience 
fully coincides. The sense of pressure after food, 248 
CHRONIC DYSPEPSIA. 
even as if a heavy stone lay in the stomach, bitter 
taste and vomiting; and the tenderness of the epi- 
gastrium to touch and on movement, especially when 
making a false step,with water brash and constipation, 
—are characteristic symptoms for Bryonia. I think 
Dr. Marston has made a very happy suggestion when 
he points to the muscular coat of the stomach as the 
part mainly at fault in these cases. The liver is 
probably also involved. 
Lycopodium, though not mentioned by Dr. Mars- 
ton, I regard as far superior to any other of the 
medicines he has used, save only these three. It 
is in the thoroughly atonic dyspepsia of weakly 
subjects, where the digestion is delayed through 
deficient glandular secretion and muscular energy; 
where there is so little nervous force to spare for 
digestion that during its process an irresistible 
drowsiness comes on, and the sleeper wakes ex- 
hausted ; and where from like causes flatulence 
collects in abundance, and the bowels are utterly 
torpid,—that Lycopodium displays its powers. I 
must again refer you to Dr. Hutchinson’s case in 
vol. xxv of the ‘ British Journal/ p. 503, as a typical 
one for this medicine. A copious deposit of lithates 
in the urine is another indication for its choice. 
Carbo vegetabilis is often a capital medicine for 
the chronic dyspepsia of old people. Much flatu- 
lence, acidity, and heart-burn are usually present, 
and often frontal headache and giddiness, but rarely 
constipation. 
Sulphur and Calcarea are said by Dr. Marston 
to be often required in obstinate cases and in dys- 
cratic subjects# The former helps forward the PAIN AFTER FOOD. 
249 
action of Nux; the latter that of Pulsatilla. Sul- 
phur is especially suitable to the bilious and sanguine 
temperament, and where there is a tendency to 
constipation and haemorrhoids, and to retarded and 
scanty catamenia. Calcarea suits children, females, 
and persons of phlegmatic temperament or scrofu- 
lous diathesis; and is indicated by the presence of 
acidity, and the tendency to looseness of bowels and 
to menorrhagia. 
These are all the medicines I need speak of for 
chronic dyspepsia. I believe that a thorough know- 
ledge of their distinctive action will enable you to 
dispense with all others: and I hope you will do as 
well as Dr. Marston, who cures even his Dispensary 
patients in the proportion of 77 per cent. 
And now as to the treatment of the different 
elements of indigestion which I have enumerated. 
Pain after Food 
may signify either organic disease of the stomach,— 
inflammation, ulcer, or cancer; or one of its neu- 
roses,—the spasmodic, neuralgic, or hypersesthetic 
forms of gastrodvnia. The treatment of these I 
have already discussed. But there is another not 
unfrequent variety, in which the pain comes on 
directly the food is swallowed and continues during 
the whole process of digestion, but unattended with 
vomiting, which I cannot refer to any of these 
morbid states. In some of these cases the patient’s 
history and general condition have disclosed a 
rheumatic tendency, which may easily be conceived 
of as affecting the muscular coat of the stomach. 250 
ACIDITY. 
Here I have found Bryonia of much service. In 
others the same muscular coat seems affected with 
debility, so that its contractions are attended with 
pain and soreness. Here, besides the obvious tonic 
measures, Arnica may be given with decided ad- 
vantage. 
Acidity. 
Dr. Chambers lias very forcibly pointed out liow 
this trouble may arise from deficient vitality of the 
stomach, allowing the saccharine and fatty elements 
of the food to undergo acid fermentation. But I 
think he is led away by his theory when he rejects 
the possibility of hyper-secretion of gastric juice, 
as if it were an excess of vitality, which is impos- 
sible. One of his own school, Dr. Inman, has taken 
much pains to prove that excessive secretion always 
implies a depressed condition of the secernent organ 
or of the general system. And I cannot but think, 
with Dr. Wilson Fox, that acidity—as with an 
empty stomach—often depends on livper-secretion. 
It is a symptom not easy to remove. Something 
may be done by careful dieting; something by 
giving lemon-juice as Dr. Kidd advises in his capital 
paper on this agent, two hours after meals. On 
the whole, I find Calcarea the most useful medicine. 
Phosphorus, Kali Carbonicum, and Sulphuric Acid 
also are recommended. I need hardly tell you that 
the favourite alkaline palliatives of the old school 
are quite inadmissible, except as a very rare tem- 
porary expedient. WATER-BRASH. 
251 
Heartburn 
is another troublesome symptom of indigestion;— 
troublesome to bear, and troublesome to cure. When 
obviously connected with acidity, the treatment of 
that affection may be all that is required. Where 
no symptoms of excess of acid are present, Dr. 
Chambers suggests that heart-burn arises from 
hypertesthesia of the gastric nerves. It would then 
be felt soon after a meal, and not, as in the other 
form, three or four hours later. The medicines 
from which I have derived most benefit in this 
affection are Pulsatilla and Capsicum,—the latter at 
the time of suffering, the former taken regularly. 
Dr. Drury recommends Ammonium Carbonicum. 
Water-brash 
is much more under control, but is proportionately 
rarely met with. I have seldom failed to remove 
it pretty rapidly with Lycopodium; and, where this 
has not hit the mark, Nux vomica has succeeded. 
Bryonia, too, has water-brash so well marked in its 
pathogenesis (including the contractive pain at the 
lower end of the oesophagus so often seen in con- 
nection with it), that it must not be forgotten. I 
think that the “ water-brash” of sour or foul- 
tasting fluid mentioned by Dr. Marston as curable 
by Pulsatilla is an eructation from the stomach 
rather than true water-brash. 252 
VOMITING. 
Flatulence, 
like acidity, may result from disengagement of gas 
from decomposing food, and so yield to the treat- 
ment called for by the primary disorder. It may 
also arise from a, bad habit of swallowing much 
air with the food. But I cannot help thinking, 
with Dr. Inman, that the intestine has a property, 
when in a weakened state, of forming gaseous accu- 
mulations. Whence, otherwise, the tympanitis of 
peritoneal inflammation, where there is nothing but 
the paralysed state of the muscular fibre to account 
for it ? 
We have two excellent medicines for this trouble, 
Carbo Vegetabilis and Lycopodium. Both are suited 
to the general and intestinal adynamia usually 
present where excessive flatulence is complained of. 
The former I think preferable where the stomach 
and small intestines are the seat of distension, which 
often keeps the patient awake at night (as observed 
by Drs. Chambers and Bayes): the bowels are natu- 
ral, or tend to diarrhoea. The flatulence calling for 
Lycopodium seems to be situated in the colon, and 
is nearly always accompanied by constipation. 
The last of the diseases of the stomach of which 
I shall speak is 
Vomiting. 
I need not tell you that this is a very common 
symptom of organic disease of the stomach, of its 
neuroses, and of its dyspepsia. Nor need I remind HjEMATEMESIS. 
253 
you how frequently it is sympathetic of mischief 
elsewhere,—of disease of brain, ears, heart, lungs, or 
kidneys, of abdominal tumours, even of the presence 
of the gravid uterus. In all these cases the main 
treatment must be addressed to the primary diseases, 
of which I have spoken or shall speak in this place. 
But even in disease elsewhere, especially when 
chronic, you will often want a medicine for the 
vomiting itself: and this I think you will find in 
Kreasote. We owe the settlement of the distinc- 
tive place of this medicine to Dr. Hilbers; and it is 
no inconsiderable debt. 
The other grand remedy for vomiting is Ipecacu- 
anha. You will remember the indications for its 
use we arrived at when upon Pharmaco-dynamics,— 
the presence of a moderate mucous irritation causing, 
by reflex excitation, disproportionate muscular ex- 
pulsive action in the part. This we constantly have 
in gastric cases: and wherever in these vomiting 
is a prominent symptom, you must think of Ipe- 
cacuanha. 
The vomiting of sea-sickness is not greatly under 
control of medicine given at the time, though I, in 
common with others, have derived considerable 
benefit from Petroleum. Cocculus, however, has 
been found so beneficial in checking the tendency 
to the same kind of sickness which affects some 
people from riding in a carriage, that it might fairly 
be tried as a prophylactic here. 
Hsematemesis, 
whether signifying ulcer or cancer, or portal con- 254 
IliEMATEMESIS. 
gestion, must be stopped at once. Ipecacuanha is 
very good here also; so is Hamamelis. I generally 
give the two in rapid alternation. When you have 
checked the haemorrhage for the time, then you can 
see about removing the cause. If the haemorrhage 
be the result of mechanical injury, you will of course 
give Arnica. 
The power our medicines have over haemorrhage 
is curious, but it is undoubted. Although quite 
prepared to use the haemostatics of the old school in 
case of need, just as I should put a ligature around 
a superficial artery which had been wounded, yet I 
have never had occasion to resort to them. This is 
a point on which a beginner naturally needs en- 
couragement, and I am glad to be able to give it 
you. LETTER XXYT. 
diseases op the digestive organs (continued). 
When passing from tlie throat to the stomachal 
ought to have noticed some oesophageal disorders 
which our medicine may sometimes relieve. There 
is a case of oesophagitis in Dr. Hale’s f New Reme- 
dies/ sub voce Gelseminum, and apparently induced 
by that drug. Phosphorus was here the curative 
remedy, after Arsenicum had failed. In spasmodic 
stricture of the oesophagus I should recommend 
Ignatia and Naja. 
I must now treat of the diseases of the intestines. 
And first, of 
Enteritis. 
By this name I mean an inflammation beginning in 
the intestinal mucous membrane: and either limited 
thereto, or involving also the other coats of the 
bowel. This gives us one division of the subject, 
viz. mueo-enteritis and enteritis. Then again the 
affection takes a special form according to the por- 
tion of the tract affected, and so we have to distin- 
guish for treatment duodenitis, typhlitis, colitis, and 
proctitis. I will endeavour to give you some thera- 
peutic hints as to each of these. 256 
ENTERITIS. 
1. Muco-enteritis lias for its two most common 
forms “ inflammatory diarrhoea” and the “ gastric 
remittent fever” of young children. Both these 
will be considered in their proper place. I have 
here to speak only of muco-enteritis as it occurs 
in adults, usually in a chronic form,* generally 
associated with gastritis, and evidenced by the patho- 
gnomonic “beefy” tongue. It is not a hopeful 
disease. Arsenicum will do more for it than any- 
thing : then come Mercurius Corrosivus and Oxalic 
Acid. I think, also, that you will do well to call 
hydropathy to your aid, in the form of a continual 
abdominal compress. 
2. True enteritis, distinguished from muco-enter- 
itis by its severe peritonitis-like pain and its con- 
stipation, would be admirably met by Mercurius 
Corrosivus or Colocynth if in the large intestine. The 
latter would be preferable to the former if there 
were much colic, and if the rectum were involved. 
Aconite might advantageously precede or be alter- 
nated with either. In true enteritis of the small 
intestine, however, I cannot indicate a remedy with 
precision. Podophyllum is the only poison which 
inflames the mucous membrane of this portion of 
the tract: and I have no evidence of its action 
reaching down to the peritoneum. I should trust to 
Aconite, given not higher than the 1st dec. dilution, 
* A case of acute muco-gastritis and enteritis is recorded by Dr. 
MacLimont, in the ‘Brit. Journ. of Horn.,’ vol. xxi, p. 106. Arse- 
nicum 2 rapidly removed the gastric symptoms; but left the enteric 
(at least those of the colon and rectum) untouched. Mercurius 
eorrosivus also failed to influence these; but they soon yielded to 
Colocynth 1. ENTERITIS. 
257 
rather than to any other medicine. Of enteritis 
occurring in connexion with hernia, internal stran- 
gulation, obstruction, and intus-susception, I shall 
speak farther on. 
3. Duodenitis usually comes before us as the 
basis of a form of dyspepsia, acute or chronic. In 
the former the catarrhal process is apt to extend 
along the biliary ducts, and to cause jaundice. Here 
Podophyllum will be found specific. Nor will it fail 
to help in chronic duodenitis, though I think you 
will even prefer Arsenicum. Kali bichromicum, 
which acts so specifically upon this part of the in- 
testine, is most valuable in the “ duodenal dyspep- 
sia” of authors, where its bitter taste of food, thickly- 
coated, whitey-brown tongue, and pale stools are 
present.* 
4. Typhlitis is the term, more correct than self- 
luminous, by which we must designate inflammation 
of the caecum. There is an acute case of this 
disease, by Dr. Black, cured by Lachesis 6, in the 
5th vol. of the ‘Brit. Journ. of Horn.a chronic 
case by the same physician, in the 9th vol., cured 
* It is not my province in these pages to speak of diet; hut I 
must mention here the obvious indication in duodenal disorder of 
giving the part rest by making the food mainly animal, so that the 
stomach may deal with it. In a case of this kind occurring in a 
cobbler (qy. ? from the pressure of his last), his (allceopathic) at- 
tendant had kept him for eleven weeks almost entirely upon farina- 
ceous diet. No improvement whatever ensued, and he came to see 
what Homceopathy could do for him. He got Arsenicum, 3rd dec., 
and was ordered an animal diet. The pain subsided in a few days; 
and the only return he had of it (I kept him under observation for 
three or four weeks) was after partaking of rabbit-pie, and eating 
the crust rather freely with the meat. 258 
INTESTINAL ULCERATION. 
bv Arsenicum 3 ; and a case of acute paratyphlitis, 
by Dr. Trinks, in the 22nd vol., which recovered 
under Belladonna in tolerably large doses. I think 
you can hardly do better than follow Dr. Black’s 
guidance should you encounter this disease in your 
practice. 
5. Colitis has been already mentioned under the 
head of enteritis of the large intestine, and will 
come again under notice in the form of dysentery. 
6. Proctitis, also, will find its place in the latter 
category. 
Intestinal Ulceration 
also requires its medicinal treatment to be modified 
according to the portion of intestine affected. In the 
duodenum it is met with occasionally as a consequence 
of burns of the surface : and here Kali bichromicum 
will be truly homoeopathic both to the seat and the 
character of the malady. The same medicine pro- 
mises the best results in simple chronic ulceration 
of any part of the intestinal tract, as in some excel- 
lent cases communicated by Dr. Iiilbers to Dr. 
Drysdale’s article on the Bichromate in the ‘ Hahne- 
mann Materia Medica.5 In the ileum it constitutes 
the well-known lesion of typhoid fever : in both ileum 
and colon obtains to a large extent in both phthisis 
pulmonalis and tabes mesenterica : and in the colon 
accompanies the dysenteric process. Of all these in 
their place : here the only other form of intestinal 
ulceration for notice is that which attacks the 
rectum. I have met with it more than once, and 
have obtained the most gratifying results in its treat- 
ment from the higher dilutions of Phosphorus. ENTERODYNIA. 
259 
Cancer of the Intestine 
is hardly likely to be reachable by medicinal spe- 
cifics. We at least shall not aggravate our patient’s 
sufferings by purgatives : and if Opium in full doses 
promotes, as Dr. Habershon’s cases seem to shew, 
his well-being, we must not refuse him the benefit 
of it. 
Intestinal Haemorrhage, 
when not resulting from ulcer or cancer, or occur- 
ring as a portion of purpura, is (I suppose) nature’s 
rough way of relieving portal congestion. You 
will of course attend to the cause, which may be 
hepatic, splenic, pulmonary, or cardiac. The haemor- 
rhage itself, if in undue amount, may be stayed by 
Ipecacuanha or Hamamelis, as I have recommended 
for hsematemesis. 
Enterodynia, 
vulgo, colic, or “ spasm/’ is to the intestine what 
gastrodynia is to the stomach. It is rarely, how- 
ever, neuralgic, at least to my thinking : but is seated 
in the muscular coat of the bowel, this being over- 
distended or fretted into spasm by flatulence. In acute 
attacks, the pain may be rapidly relieved by frequently 
repeated doses of Colocynth. This medicine is so gene- 
rally effectual that I would recommend you to try it 
first (in not too low a dilution) in preference to any 
other.* But should it fail to give speedy relief 
* A series of cases of colic treated by Colocynth is given in the 
appendix to Dr. Watzke’s proving. Here is one of them: 260 
ENTERODYNIA. 
there are other good remedies to be thought of,—as 
Chamomilla and Cocculus in nervous subjects, Bella- 
donna where the transverse colon is so distended as 
to project like a pad, Plumbum where there is much 
constipation, Colchicum in gouty patients. One of 
the American indigenous plants, moreover, the 
Dioscorea villosa, bids fair to take a prominent place 
in the treatment of colic. Dr. Helmuth thinks it 
preferable to Colocynth where the pain is constant 
rather than paroxysmal. 
A course of Nux vomica is often very useful in 
subduing the morbid irritability of bowel which leads 
to repeated attacks of colic. 
In lead-colic, Opium seems not so much anodyne 
as specific, for it soon gives relief even in the 
potencies used in our school. Cases illustrative of 
this statement may be found in the ‘Brit. Journ. 
of Horn.,’ vol. iii, p. 213, and in the ‘Annals of the 
Brit. Horn. Society/ vol. iv, p. 287. There is of 
course no reason why warm baths and enemata 
should not expedite your patient’s relief. Alumina 
and Platina also are recommended in lead-colic. 
“ Its effect was more rapid in the case of a young man, of weakly 
constitution, who, as he supposed, from catching cold, suffered 
such excruciating pains in the belly, that he thought he should go 
wild. He cried out constantly for help; he felt as if his intestines 
were being cut to pieces. Occasional intermissions were succeeded 
by more violent paroxysms. This had lasted the whole night. 
Bitter drops, the Spiritus Hoffmanni, and essence of caraway had 
no effect. Henning then gave half a drop of tincture of Colocynth, 
and in half an hour all pain was gone.” LETTER XXVII. 
diseases or the digestive organs (continued). 
In my present letter I shall speak of the morbid 
fluxes of the intestines under the heads of Diarrhoea, 
Dysentery, and Cholera. And first, of 
Diarrhoea. 
I have nothing to say here of this malady as it 
occurs in children, nor of its appearance as a com- 
plication of general disorders, as fevers, or as a 
symptom of intestinal disease, as ulceration. I 
shall confine my remarks to those cases in which 
diarrhoea, acute or chronic, comes before us for 
treatment as a substantive ailment. 
In suggesting medicines for its various forms, I 
must guard you against supposing that I mean that 
these are the only, or even the best remedies you 
can use. No pathogenetic effect of drugs is more 
common than purging; and it is probable that 
every substance in nature which, by specific affinity, 
and not merely by local irritation, causes diarrhoea, 
has some corresponding variety of the idiopathic 
disorder for which it is a remedy better than any 
other. Indeed, you cannot do better than refresh 
your memory from time to time as to the character- 
istics of the action of vour former friends, the 262 
DIARRHOEA. 
cathartics, if you would be thoroughly fitted to deal 
with diarrhoea. But in a work like this such 
minute detail is impossible. I can only tell you 
what medicines myself and others have found most 
useful in the leading forms which the malady 
presents. 
1. Unquestionably the most frequent cause of 
acute diarrhoea is elevation of the temperature. All 
through the summer we are being called upon to 
treat it. In my own experience the history of the 
malady and of its treatment has been in most years 
as follows. In June and July there has been a 
simple increase in the fluidity, frequency, and 
quantity of the stools, with griping pains more or 
less severe in the abdomen. The medicine I have 
found specific for such a diarrhoea has been China, 
in the 1st dilution. Giving a drop or two at once, 
and repeating the dose after each relaxed motion, it 
is rare that more than two or three administrations 
are requisite. The pain yields almost immediately. 
Sometimes the stools are more watery, and expelled 
with more violence, but with less griping: and the 
whole attack is ushered in by a sudden attack of 
vomiting. Here Veratrum acts even better than 
China. As we get into August and September, 
vomiting and purging go together throughout the 
attack, and the ejecta are largely admixed with bile. 
This is the diarrhoea which in its severer forms is 
known as “ English cholera.” I believe its specific 
remedy to be the Iris versicolor, which I give in 
drop doses of the 1st dilution every hour or so. 
I have been obliged to put my own experience 
in summer diarrhoea prominently forward, as it is DIARRHCEA. 
263 
too common a disorder for cases of it to appear in 
print. So far as I know of the practice of my 
colleagues, however, China and Veratrum are with 
them as with me its leading remedies. And Dr. 
Lade, of King’s Lynn, has published (f Monthly 
Horn. Review,’ Jan. 1866) results similar to those 
I have myself obtained with Iris in English cholera. 
2. Acute diarrhoea from improper food is of 
course hut a further manifestation of acute dyspep- 
sia, and requires the same treatment, of which 
temporary starvation is an essential element. 
3. Diarrhoea from noxious effluvia is probably 
salutary, and at any rate requires no other treat- 
ment than the Baptism you will give to prevent or 
remove any other results in the system at large. 
4. Inflammatory diarrhoea is a kind of intestinal 
coryza, and is a step in the advance from simple 
diarrhoea to muco-enteritis and dysentery. Aconite, 
and perhaps Dulcamara, are its remedies;—the 
latter especially when it occurs in damp weather. 
5. Chronic diarrhoea is generally a symptom of 
some deeper mischief, intestinal or general. But 
eases do occur which are diarrhoea and no more. 
Of this nature is the “ white flux ” of the Indian, 
and the “camp diarrhoea” of the European and 
American soldier,—the result of continued bad 
diet, exposure, and foetid exhalations. I cannot 
say whether improved hygienic conditions are as 
indispensable as they are desirable for these patients. 
I can only tell you that you will find Arsenicum 
a most valuable medicine for them. A friend of 
mine in the Peninsular and Oriental Company’s 
service had several opportunities of treating soldiers 264 
DYSENTERY. 
invalided for chronic diarrhoea with this medicine: 
and he tells me that one of his colleagues said to 
him “Well: I know nothing of Homoeopathy, 
but I certainly believe in Arsenic for chronic 
diarrhoea.” 
Another form of chronic diarrhoea is the so-called 
“lientery,” in which the food passes away by stool 
little if at all digested. Ferrurn has some claim to 
be considered specific here. Teste recommends 
Arsenicum, China, and Oleander. I have only 
seen two cases of the disease. Both were in 
children: and both got well under China. 
The last variety of this trouble I shall mention 
is the chronic diarrhoea which is often associated 
with nervous debility. Phosphorus and Phosphoric 
Acid, the latter especially, will be found valuable 
medicines for it. 
Dysentery. 
It seems very doubtful whether true dysentery is 
ever seen in its acute stage in this country, save 
under exceptional circumstances, as in the Millbank 
prison epidemic of 1847. By true dysentery, I 
mean a specific febrile disease, caused by malarious 
emanations, and having the same relation to the 
solitary glands of the large intestine as typhoid 
fever has to the agminated glands of the small. The 
nearest approaches to the disease we have in Eng- 
land are 1st. Dysenteric diarrhoea, where a flux 
primarily faecal becomes sanguineo-mucous, attended 
with tormina and tenesmus. 2nd. Muco-enteritis 
of the colon and rectum. In both these conditions DYSENTEltY. 
265 
Mercurius corrosivus, with or without Aconite, is 
ordinarily the specific remedy. It is sometimes 
useful to alternate it with Colocynth or Arnica if 
the tormina be very severe, or with Ipecacuanha or 
Aloes* if there be great tenesmus. If the mischief 
is from the first confined to the rectum, Podophyllin 
may be a better medicine than any: it certainly is 
so with children. If you see the case only when 
it is far advanced, and the prostration is extreme, 
Arsenicum must first be prescribed. 
Now although we have as yet no Indian homoeo- 
pathic experience on record, I see no reason why 
the same remedies should not be found effectual in 
the true dysentery which there occurs. The post- 
mortem appearances after poisoning by Corrosive 
sublimate are precisely those of the idiopathic 
disease, and are similarly confined to the large 
intestine. In the “ sthenic” form described by 
Dr. Maclean, Aconite would undoubtedly be required; 
and where the symptoms intermit and return pe- 
riodically, it seems that Quinine must be given as in 
simple ague. In the malignant (typhoid) form I 
should depend upon Arsenicum. 
In America, whose dysentery is probably mid-wav 
between ours and that of the tropics, they report 
very satisfactory results from treatment, especially 
with Mercurius corrosivus and Arnica. 
Chronic dysentery not unfrequently comes before 
us for treatment, especially in returned Anglo- 
Indians. A capital case is reported in vol. i of the 
‘Annals/ p. 266. Mercurius corrosivus, followed 
* Aloes has been found to relieve a troublesome tenesmus left 
behind after such an attack. 266 
CHOLERA. 
up by iSTux vomica and ultimately Phosphoric Acid, 
were the curative medicines, all in medium dilutions. 
Cod-liver oil also was given,—the emaciation being 
great: and milk only allowed for food. My own 
experience has been similar as regards Mercurius 
corrosivus and Nux vomica. I would add Nitric 
Acid to the list of remedies. “ The dysenteric 
process offers the greatest analogy to the corrosion 
of the mucous membrane produced by a caustic 
acid” (Rokitansky). 
Cholera. 
The history of the Homoeopathic treatment of 
Asiatic Cholera is one of the brightest pages in our 
records. From Russia and Germany in 1831-2, 
from Liverpool and Edinburgh in 1849, from 
Barbadoes and the Golden Square Hospital in 
London in 1854, and again from Liverpool in 1866, 
we have abundant evidence of the comparative value 
of our method in the treatment of this terrible 
scourge. Let me indicate before I go any farther 
where you can find the narratives which bear out 
this statement. 
For the epidemic of 1831-2 our main source of 
information is Dr. Quin’s Traitement Homceo- 
pathique clu Cholera. I fear this is now out of 
print; but several of its statistical results are given 
by Dr. Black in his paper on the “ Homoeopathic 
Treatment of Asiatic Cholera” in the 1st vol. of 
the ‘ Brit. Journ. of Homoeopathy.’ The epidemic 
of 1818-9 was carefully observed by Dr. Russell in 
Edinburgh, and by Dr. Drysdale in Liverpool, both CHOLERA. 
267 
of whom had large opportunities of treating the 
disease. Dr. Russell has given his narrative in the 
7th and Dr. Drysdale in the 8th volume of the 
‘ British Journal —the former having subsequently- 
expanded his remarks into a f Treatise on Epidemic 
Cholera.’ Headland, 1849. The results obtained 
in London and (by Dr. Goding and others) in 
Barbadoes in 1854 are narrated by Dr. Russell in 
his Lecture c On Cholera. An Historical Sketch, 
with a Practical Application,’ published in vol. iv of 
the c Annals,’ p. 252, and in vol. xiii of the f British 
Journal.’ The experience gained in Liverpool in 
the last epidemic has been put on record by Mr. 
P. Proctor in vol. xxv of the Journal: and esti- 
mates of our present knowledge on the subject by 
Dr. Ker and by myself will be found in vol. xxiv, 
pp. Ill and 477. The American experience up to 
1853 is gathered up by Dr. Joslin in his f Homoeo- 
pathic Treatment of Cholera,’ &c. (Walker, 1863.) 
You will be especially interested, as you read 
these papers, to observe the substantial identity of 
the treatment pursued in every epidemic and in 
every country. Hahnemann, before he had seen a 
single case of the disease, indicated Camphor as its 
specific antidote, suggesting also Veratrurn and 
Cuprum as likely to be beneficial. To these later 
experience, more especially in Great Britain, had 
added Arsenicum : and beyond these four medicines 
it is rarely necessary or desirable to go. Let me 
endeavour to lay down their distinctive spheres of 
action. 
Camphor is, in the words of Dr. Russell, “ an 
almost infallible remedy for cholera, if given at the 268 
CHOLEKA. 
very outset of the attack.” “ There is the most 
perfect unanimity among all Homoeopathic prac- 
titioners,” as he truly says, “ as to the efficacy of 
Camphor in curing the first stage of cholera.” The 
experience of the two later epidemics has abundantly 
evidenced and confirmed this unanimity. Indeed 
Dr. Rubini of Naples has urged us to rely more 
exclusively upon Camphor in our treatment,—to 
give it in full doses and frequent repetition in all 
forms and stages of the disease. He supports his 
recommendation by alleging success of the most 
unique character, some 592 cases having been 
treated by this method without a single death. One 
is of course disposed to think at the first blush that 
very few of these cases could have been real cholera. 
But if you will read the details of his experience, as 
given by Dr. Bayes in the f Monthly Horn. Review’ 
for June 1866, you will hardly assent to such a 
conclusion. In opposition to his results stand those 
of Mr. Proctor, obtained in Liverpool in 1866. He 
used Dr. Rubini’s stronger solution : but says that 
though it was “ invaluable in the initial shock to 
the system when the chill, the prostration, and 
giddiness set in, and also for the abdominal spasms 
at the same early period of the attack; yet when 
vomiting and purging supervene it is of little or no 
iise.” There I must leave the question. 
Veratrum album stands next to Camphor in the 
certainty of its action in cholera, when restricted to 
its proper sphere. This is, by general consent, the 
cases marked by profuse vomiting and purging, with- 
out that sudden deadly collapse which, as we shall 
see, indicates Arsenicum. It will sometimes suffice CHOLERA. 
269 
alone to control the cramps : hut Cuprum is often 
given with advantage in alternation with it for this 
purpose. 
Cuprum is confessedly the best remedy for the 
choleraic cramps, and Mr. Proctor says also for the 
vomiting. He adds, “ In the stage of collapse I 
gradually found myself trusting mainly to Cuprum, 
and the impression is very strong on my mind that 
in collapse it is the most reliable of our remedies. 
It appears to go deeper into the organism, and to 
fasten upon the disease with a quieter but a firmer 
and more tenacious grip/’ This, however, is not 
the general experience;—the most trusted remedy 
in collapse being—• 
Arsenicum. Dr. Drvsdale and Dr. Russell con- 
cur in regarding this remedy as the greatest we have 
when the period for the administration of Camphor 
is past, and when the danger is less from the dis- 
charges than from the general depression of vitality. 
You will remember what I said upon this point 
when speaking of Arsenic :—that in its relation to 
the essential disease, with its collapse, cramps, and 
suppression of urine, and not to the vomiting and 
purging, stood its homoeopathicity to cholera. But 
upon collapse I must add a few words from what I 
have written elsewhere. 
“ Arsenicum is the medicine generally prescribed 
in those terrible cases where collapse comes on very 
rapidly, with little or no premonitory illness, and 
unattended by copious evacuations. But again we 
must say that a mortality of 26 per cent., good as it 
is comparatively, means that we must seek for better 
remedies still. We would suggest that Aconite 270 
CIIOLEKA. 
is the right medicine here. The spheres of Aconite 
and Arsenic, though so widely different, intersect and 
overlap each other in one spot; and the picture here 
presented closely corresponds with that of simple 
choleraic collapse. Let a few cases of acute poison- 
ing by Aconite be read with this thought in the 
mind, and the resemblance will seem striking. We 
have the intense chill, even the cold tongue; the 
blueness; the difficult respiration ; the almost impei’- 
ceptible pulse; the cramps and tendency to tetanus. 
After death the arterial system is found empty and 
the venous full. And if, as far as homoeopathicity 
goes, our choice between Aconite and Arsenic is 
balanced, the greater rapidity of the action of the 
former medicine must turn the scale. 
“ This is not the first time that Aconite has been 
recommended for cholera. A French physician has 
lately communicated twelve cases cured by this 
remedy alone in drop doses of the mother-tincture. 
But we desire to call attention to its claims on our 
notice as one of the most hopeful directions in whieii 
to look for the perfecting of our treatment of this 
deadly malady.” (f Brit. Journ. of Horn./vol. xxiv, 
p. 491.) 
Of these medicines, Camphor is always administered 
in the primary solution : but Arsenic, Veratrum, and 
Cuprum have been given in the highest (30th) as well 
as the lowest potencies, and with success in either 
case. Arsenic has been given by Dr. Drysdale in 
cholera in the form of Arseniuretted Hydrogen. The 
directions for the preparation of this gas may be 
found in vol. vii of the ‘ British Journal/ p. 559. 
I must add that Mr. Proctor found Phosphoi'us CHOLERA. 
271 
of great use in arresting the drain of brownish fluid 
from the bowels after the other symptoms were re- 
moved. The same medicine, and Phosphoric Acid, 
have gained much repute in choleraic diarrhoea: 
though I should have more reliance upon Camphor 
and Yeratrum. LETTER XXVIII. 
DISEASES OF THE DIGESTIVE ORGANS {continued). 
Euom Diarrhoea and its congeners I pass to 
the opposite condition of the bowels, and in the 
present letter shall discuss Constipation and some 
of its offshoots. 
The way in which we behave towards consti- 
pation, and in regard to the action of the bowels 
generally, affords one of the most obvious points of 
difference between the new school and the old. 
Purgation by various means constitutes at least 
one half of the ordinary practice of physic : and 
“ aperient medicines” form the staple alike of the 
apothecary’s stock of trade and of the family medi- 
cine chest. Conceive, then, the revolution which 
ensues when Homoeopathy is adopted, whether by 
physician or patient. With fear and trembling at first 
the treatment of cases is conducted without the custo- 
mary “ unloading of the bowels.” But as time goes 
on we come to see that our patients do all the better 
without having an artificial diarrhoea added to their 
other troubles. We find that daily defsecation is by 
no means an essential of health; that the bowels are 
a part of the whole organism; that this inaction, if 
obviously morbid and injurious, is a disease requir- 
ing specific treatment, and not an obstruction to 
be overcome by temporary expedients. Instead of CONSTIPATION. 
273 
‘'clearing out tlie alimentary canal” with drugs which 
act like brooms and shovels,we become convinced that 
Nature is her own scavenger. Remove the morbid 
condition which hampers the intestinal action, and 
the bowels will act of themselves. See how it is in 
acute febrile disorders. The constipation which ob- 
tains here is of the same nature as the anorexia on 
the one hand, and the scanty secretion of urine 
on the other. You would not dream of whipping up 
the appetite by bitters, or stimulating the kidneys 
by diuretics. You know that both the gastric and 
the renal inaction depend upon the fever, and will 
depart with it. You have only to apply the same 
principle to the bowels. If you will just leave them 
alone, and apply yourself to the fever, they will give 
you no trouble. Three, ten, fourteen days may 
pass before they act, but no inconvenience will re- 
sult : and at last they will be opened as naturally 
as though they had been so the day before. As it 
is with fevers, so it is with other diseases, both acute 
and chronic. The constipation is but one element 
in the whole morbid condition. It should be taken 
into account, often into special account. It may 
guide us to medicines like Sulphur, Nux vomica, and 
Lycopodium in preference to Calcarea, Pulsatilla, 
and Carbo. But it would be unscientific to go out 
of our way to treat it independently,—-still more so 
to do so with purgatives. In chronic disease accom- 
panied with constipation the bowels will often begin 
to act regularly under a medicine having no special 
relation to the intestines, but which is influencing the 
whole organism for good. 
I am not denying that constipation, both acute 274 
INTESTINAL OBSTRUCTION. 
and chronic, may come before us as a substantive 
and primary intestinal disorder. Indeed, it is my 
object in this letter to tell you how to treat it when 
so occurring. Without further preface, then, we 
will proceed to our subject. 
Constipation in its acute form may he said to be 
present when the bowels become temporarily inac- 
tive in consequence of a sudden change from active 
to sedentary habits, as at the beginning of a sea- 
voyage,or of the confinement necessitated by a fracture 
or other accident; also sometimes from change of air, 
and (in women) from marriage. But this is no 
disease, generally rights itself, and hardly calls for spe- 
cific medication. You may give your Nux or Opium if 
you like : or, if inconvenience is caused, you may let 
the patient use an enema, or take a seidlitz powder 
or a dose of castor oil. The temporary trouble 
is removed by temporary means ; and then all will go 
on as before. But the true disease in which acute 
constipation occurs as a substantive malady is 
Intestinal Obstruction, 
tlie ileus or passio iliaca of the old writers. I need 
not remind you hoiv large an addition to our power of 
diagnosing this malady has been made by the re- 
searches of the late Dr. Brintou. Nor can we do better 
than follow his guidance in the management of these 
cases as regards the limitation of the ingesta and the 
maintenance of rest. We need not, but we are glad to 
agree with, his injunctions to refrain from purgative 
medicines. And the use of enemata, of insufflation, of 
electro-magnetism, and of surgical procedures is INTESTINAL OBSTRUCTION. 
275 
common ground between us; the only difference 
being that the medicinal remedies we possess make us 
to a large extent independent of these aids. 
For practical purposes, the important diagnosis 
is between cases of simple obstruction and cases of 
strangulation, the latter of course including intus- 
susception. That simple obstruction, without 
special tendency to inflammation, may exist, is I 
think abundantly evident if we look over any col- 
lection of cases of this kind. It has its parallel in 
incarcerated hernia. If faecal accumulation can be 
detected, the explanation is evident; and not less so 
the indications for treatment. Opium is the medi- 
cine called for, as sluggishness of the peristaltic action 
must have preceded the accumulation : and enemata, 
manipulation, and electro-magnetism are available 
auxiliaries. Where no such mechanical obstacle 
exists, I take it that partial spasm or paralysis is at 
the bottom of these cases. I commend to you here 
the steady use of Plumbum. It has hardly been 
given with the confidence it merits: but it has 
played an important part in the treatment of several 
cases of intestinal obstruction (see f Brit. Journ. 
of Horn./ vol. xvi, p. 76, and c Monthly Horn. Rev.,’ 
vol. ii, p. 66). As to its perfect homoeopathicity I 
need say nothing. 
When the symptoms of obstruction are attended 
with those of local inflammation, we have to fear 
intussusception in the child, internal strangulation 
(more commonly) in the adult. In the former case, the 
Hippocratic inflation of the intestines with air seems 
the most reasonable mechanical remedy’for the mecha- 
nical disturbance : while Nux vomica and Aconite mav 276 
HERNIA. 
help to correct irregular and excessive peristalsis, and 
to obviate inflammation. Was Dr. Morgan’s case, in 
which these remedies proved curative, an instance of 
this form of obstruction in the adult (see ‘ Monthly 
Horn. Review/ Feb. 1865) ? If internal strangulation, 
as by bands, adhesions, &c., external to the intestine, 
be satisfactorily diagnosed, I can suggest no better 
medicines, but I could not hope much from their 
action. If I were myself the sufferer, I do not 
think I should hesitate to have my abdomen opened 
with a view to having the strangulation relieved. 
The chances of recovery from the operation would 
be materially enhanced by our possession of such 
remedies as Aconite, Arnica, Belladonna, and Mer- 
curius corrosivus to obviate its evil consequences. 
It is obvious that if our medicines can give this 
help in intestinal obstruction, they should not be 
less serviceable in 
Hernia. 
I do not mean that they can cure a rupture of 
any standing: although such an accident in young 
children, having evident connexion with some con- 
stitutional fault, might not unfairly be expected to 
yield under treatment. But when the hernia be- 
comes incarcerated or strangulated, you may do much 
by medicines to effect spontaneous reduction, or to 
turn a previous failure of the taxis into success. In 
incarceration, Opium; in strangulation, Aconite, 
Belladonna, and Nux vomica have been used with 
frequent success. 
And now of CHRONIC CONSTIPATION. 
277 
Chronic Constipation. 
I need not dwell upon tlie hygienic and regiminal 
measures best adapted to obviate intestinal inaction. 
They will depend to a great extent upon its probable 
causation. But I can tell you of some capital 
medicines for it, out of which you will generally be 
able to select one which will materially improve your 
patient’s condition. 
As a rule, I would advise you to begin the treat- 
ment of chronic constipation with Sulphur. The 
bowels will generally improve immediately under its 
action : but curiously enough, if it be continued, 
they will almost as certainly relapse into their origi- 
nal condition. I never continue it longer than a 
week, and then either discontinue all medicine, or 
change to one of the remedies I shall now mention. 
Nux vomica, Bryonia, Opium, Plumbum, Lyco- 
podium, Graphites, and Hydrastis are the leading 
medicines which help against constipation. Nux 
vomica and Bryonia are good for the milder cases, 
when the head is affected by the state of the bowels. 
A distinction between the two is that with the former 
there is ineffectual urging to stool, with the latter 
complete torpor. Opium is suitable in torpid cases, 
with drowsiness : I have rarely used it. Plumbum 
is invaluable in the most obstinate cases: the presence 
of colicky pain and the coming away of the stools 
in hard balls are special indications for its use. In 
patients with much rigidity of fibre, Aconite helps 
Plumbum considerably: you may give one in the 
morning, and the other at night. Lycopodium is 278 
CHRONIC CONSTIPATION. 
good where much flatulence and other signs of im- 
paired intestinal vitality co-exist with the constipation. 
Graphites, in the higher dilutions, seems to have been 
very successful in Dr. Epps’ hands, especially where 
cutaneous and joint diseases were present: I have 
no experience with it. When there is no special 
indication present for these or other remedies, I can 
confidently recommend the Hydrastis Canadensis, in 
the 2nd and 3rd dec. dilutions. 
I think you will rarely require to go beyond this 
list. But that I may omit no medicine which has 
been useful in constipation I will add iEsculus, Col- 
linsonia, Natrum Muriaticum, Sepia, and Yeratrum. LETTER XXIX. 
DISEASES OF THE DIGESTIVE ORGANS ([continued). 
In the present letter I have first to speak of some 
troubles affecting the lower bowel,—hsemorrhoids, 
fissure, prolapsus, and fistula: then of intestinal 
worms: and last of the morbid conditions of the 
peritoneum. 
Haemorrhoids. 
It cannot be too widely or too clearly known, that 
Homoeopathy possesses medicines for piles which in 
the great majority of cases render unnecessary the 
knife, the ligature, or the application of nitric acid. 
If it had done nothing else for the art of healing, 
it might base on this alone its claims to the grati- 
tude of mankind. 
I distinguish three conditions under which piles 
may occur. 
1. They may be the expression, in the primary 
radicles and lowest gravitating point of the abdomi- 
nal venous system, of impeded circulation higher 
up. The obstruction may be portal, abdominal, or 
pelvic. In a paper in the f Brit. Journ. of Horn.,' 
vol. xxv, p. 426,1 have adduced reasons for believing 
that portal obstruction is not a frequent cause of 
hemorrhoids. Where it is present, however, Podo- 280 
HEMORRHOIDS. 
phyllum or Hepar Sulphuris will be indicated, the 
latter especially where clay-coloured stools are pre- 
sent. More frequently, according to my experience, 
the delay of the venous current is on the hither 
side of the portal vein. This is the “ abdominal 
plethora” of the old writers. The piles accom- 
panying it are of the “ blind ” character: they 
bleed little, but are very annoying by their fulness. 
It is here that Sulphur and Nux vomica display their 
great anti-hsemorrhoidal virtues. They seem to act 
better conjointly (i.e. in alternation) than when either 
is given separately. Pelvic congestion is of course 
more common in 'women than in men. Por hsemor- 
rhoids thus arising the classical and truly homoeo- 
pathic remedy is Aloes. But it has recently found 
a rival in one of the indigenous American medicines, 
the Collinsonia Canadensis. Both from the proving 
of this drug and from its therapeutic reputation it 
appears that congestive inertia of the lower bowel is 
the condition to which it is specifically related. In 
constipation and haemorrhoids resulting from this 
cause—as in pregnancy—I myself prefer Collinsonia 
even to Aloes, 
2. The most common of all causes of piles is, I 
think, constipation. It is rare that lisemorrhoidal 
sufferings are absent when this condition is of long 
continuance. These too are of the “ blind ” variety, 
and cause more pain than bleeding. The means 
whereby we remove the primary constipation are 
often sufficient to cure also the resulting haemor- 
rhoids. But in many cases the trouble is too in- 
veterate to disappear with its exciting cause. Here, 
if Sulphur has not already been used in the treat- 281 
HAEMORRHOIDS. 
raent of the constipation, it may be given with 
benefit: as it has a decided influence upon the 
rectum. But I have rarely seen Sulphur cure these 
cases. They find, I believe, their best remedy in 
the JEscuius hippocastanum. Dr. Hale has narrated 
several cases illustrating the action of this medicine 
in the article on it in the 2nd Ed. of his ‘ New 
Remedies.’ I cannot resist citing here a case of 
my own from vol. xxiii of the ‘British Journal.’ 
“I give the narrative in the patient’s own words. 
“ fI first began to suffer when thirteen years old’ 
(she is now forty-eight). ‘I fancy from being one 
of a great number of girls, with small accommoda- 
tion, hence waiting and costiveness, the bowels only 
relieved once a week or so. I should say that con- 
stipation is hereditary on both sides. For a few 
years I was constantly taking medicine to relieve 
the bowels. The pain was nothing particular, and 
there was but a small protrusion. Matters grew 
worse from the age of twenty-five to that of thirty- 
four, when I was attacked with the first dreadful, 
very dreadful pain. I could not sit, stand, or lie, 
the only possible position was kneeling. This lasted 
for many weeks in the winter; in the summer it 
was, as always, better. For about two years the 
pain was bad off and on. I then used leeches, 
which eased the severe pain; but still it was bad. 
The next very severe attack was in 1862 ; it lasted 
for weeks, and returned again in 1863. The pain 
was like a knife sawing backwards and forwards, 
almost a martyrdom for agony. I took Belladonna, 
Pulsatilla, Aconite, and Mercurius, with no benefit; 
was recommended some stuff to apply, which relieved 282 
HEMORRHOIDS. 
a little. Again in 1864 things became very bad, 
much pain, the bowels always wanting to be relieved/ 
“In the November of that year I was consulted 
by this lady. I prescribed iEsculus, in the 2nd 
centesimal dilution, three drops to be taken in a 
wineglassful of water morning and evening. Her 
report continues: 
“ ‘ I then took the iEsculus. At the end of one 
wreek I was a degree better, after another better still, 
and so on for a month. At the end of this time I 
was wonderfully better. The medicine seemed to 
relieve the bowels, and cause the protrusion to be 
soft. I left it off for a time, and when the pain 
returned again at all badly, took the medicine and 
became relieved. I have taken nearly a bottle (two 
drachms) since November, on and off. I only take 
it when I am bad, and cannot sleep for pain. The 
protrusion always remains. I feel so grateful to you 
for the advice and relief given me/ 
“ I wrote to recommend her to take the medicine 
regularly. She next reported f I have now taken 
the iEsculus as before for another month, and may 
fairly call myself well. I have no pain, and the 
protrusion is nothing but a flabby piece of skin/ ” 
This was in 1865, and the following, dated Nov. 
1868, completes the history. 
“ I had no return of them till February last, when 
I had a severe attack. I took iEsculus for a fort- 
night, and it did no good. You came for a few 
hours, and finding that the bowels were loose instead 
of confined, told me take Hamamelis. I did so, 
and was very soon well again. Since then I have 283 
HAEMORRHOIDS. 
not suffered at all, and only a few pieces of skin 
hanging which cause no pain.” 
I recommend the iEsculus, also, in those cases 
where a few days* constipation will bring on hsemor- 
rhoidal symptoms often of long duration. Two of 
such I have given at p. 485 of the same volume 
of the Journal. One of them is worth citing here. 
“ Mrs. E—, set. 60, was years ago a martyr to 
haemorrhoids. Each attack would last from six to 
ten months, during which time she could rarely leave 
the recumbent posture. Since adopting homoeopathy, 
the bowels had acted with much greater regularity, 
and the haemorrhoidal attacks had been absent. On 
May 22nd, 1865,1 was called to see her. I found her 
in bed, suffering intensely from several large piles, 
which seemed quite to block up the rectum. The 
bowels had been confined for several days in the 
preceding week; and on the 20th the old haemor- 
rhoidal symptoms had supervened, and were increas- 
ing in intensity. There was little or no bleeding. 
She anticipated many weeks of suffering. I gave 
her a drop of iEsculus 3 every four hours. Next 
morning there was improvement rather than the 
reverse. On the 24th she was decidedly better.. 
She said cAre you giving me an aperient? the 
bowels are acting so comfortably.* On the 25th she 
was well and about the house; and I took my 
leave.’* 
3. Lastly, haemorrhoids may be idiopathic. With- 
out portal, abdominal, or pelvic congestion, and with- 
out constipation, piles may be present. I believe this 
form of haemorrhoids to be a true varicosis : and it 
is sometimes associated with the same morbid con- 284 
FISSUKE OF THE ANUS. 
dition of the veins elsewhere. These are the 
“ bleeding piles ” of the popular phraseology : and 
the amount of blood lost at each evacuation is often 
very considerable. We have one grand remedy for 
them, and that is Hamamelis. I have now in my 
mind at least half-a-dozen cases in which this medi- 
cine has proved curative. It would be useless to 
detail them, as they tell but one story. Hemorrhage, 
more or less profuse, occurring with every evacuation 
for months or years, with other symptoms of piles : 
and rapid improvement and complete cure under the 
use of Hamamelis, generally in the 2nd centesimal 
dilution. I do not remember a case in which it 
failed. 
I have only to add that when the piles become 
much inflamed Aconite is indispensable : and when 
they project externally may be applied locally with 
benefit. 
Fissure of the Anus. 
This is another local trouble which Homoeopathy 
has found means of reaching through the constitu- 
tion. It has several times been cured without 
operation by our medicines. There is a case by 
Hahnemann himself in vol. vii of the ‘British J ournal’ 
(p. 496), and several by Dr. Perry of Paris and one 
of the Editors in vol. viii, p. 560. In all these 
Nitric Acid was the curative remedy, in high dilu- 
tions. Ignatia also was of service. I must add 
the following case of my own, which seems to have 
been one of fissure. 
“Miss W—,ret. 40, consulted me Sept. 26th, 1865. PROLAPSUS ANI. 
285 
She had been suffering for two months with haemor- 
rhage and pain after stool. The bowels were moved 
every other morning; the bleeding was considerable 
and the pain intense; gradually subsiding afterwards, 
but not leaving her until evening. She felt much 
weakened, and was beginning to suffer from neural- 
gic pain in the face. 
“ Regarding the haemorrhage as the more impor- 
tant symptom, I prescribed Hamamelis 2, a drop 
three times a day. 
“ Sept. 30th. The bowels had been twice moved 
without any bleeding, but the pain was as intense as 
ever. JEscidus 2, a drop three times a day. 
“ Oct. 3rd. The last evacuation was painless, as 
well as bloodless. Continue. 
“ 7th. No pain or bleeding since. The neuralgia 
troublesome. Arsenicum 6, twice a day. 
“ 14th. The neuralgia much better, and no pain 
after stool, but some return of bleeding. Hama- 
melis 2, twice daily. 
“ 21st. No bleeding since the 16th; much better 
and stronger. Omit.” 
I saw this lady again last year (1867), and found 
that she had had no return of her troubles. 
Dr. Bayes has cured two cases of anal fissure by 
the local application of powdered Hydrastis, gr. x 
to 3ss—3j of lard. (See ‘Annals/ vol. iii, p. 499.) 
Prolapsus Ani 
is cured witli little difficulty in children: but it 
is a difficult matter to overcome in adults. There 286 
WORMS. 
is a case in the 5th vol. of the ‘British Journal/ in 
which Arnica in mother-tincture seems to have 
been curative. 
Fistula in ano 
you would hardly expect to be reached by internal 
remedies : and I am not confident that it would be 
so cured without local applications also. But with 
the Calendula and Hydrastis of our own Materia 
Medica thus applied, we have several cases to report. 
There is one by Dr. Eadon in the f Monthly Horn. 
Review’ for June 1865,in which Calcarea phosphorica, 
with injections of Calendula lotion and the steam- 
douche proved curative : another by Mr. Clifton in 
the same Journal for July I860, Causticum, with 
Calendula, being the remedies: and a third from 
America in the ‘British Journal’ for Oct. 1868,where 
Nux and Sulphur were given with injections of 
Hydrastin. 
Worms. 
In recommending specific remedies for the various 
kinds of helminthiasis, I must not be supposed to 
doubt the parasitic nature of worms, or to adhere to 
the exploded theory that they are products of the 
morbid intestine. I make no question but that it is 
very good practice to expel the tape-worm with oil 
of male fern and the round worm with material 
doses of Santonine, and to exterminate thread-worms 
by injections of quassia, salt, iron, sulphuric ether, 
&c. I should have no hesitation in using such PERITONITIS. 
287 
measures did I find it necessary. But, explain it 
how we may, there is no doubt but that homoeopathic 
remedies, given in the usual way, have a singular 
power of abolishing the morbid symptoms produced 
by worms, and often of effecting their expulsion. 
Thus, in cases of tape-worm, drop-doses, frequently 
repeated, of the Filix Mas, of Mercurius corrosivus, 
or of Cuprum aceticum will often free the patient 
entirely from all worm symptoms, even though joints 
continue to pass away by stool. The same may be 
said of Cina and Santonine where lumbrici are pre- 
sent : and here a cure may often be effected by the 
expulsion of the worms. Ascarides offer more re- 
sistance to treatment. Cina and Santonine are good 
here also ;* but my favourite remedy is Teucrium, 
in the 1st dec. dilution. Under its use quantities 
of worms are usually expelled : and all morbid 
symptoms disappear. In obstinate cases, I have 
found the course of medicine recommended by Teste 
very efficacious; viz. Lycopodium 30 for two days, 
Yeratrum 12 for four days, and Ipecacuanha 6 for a 
week. I have tried his Stannum and Yiola odorata 
for lumbrici without perceiving any benefit. 
I must not leave the intestines without noticing 
the morbid conditions of the peritoneum. And 
first, of 
Peritonitis. 
I do not speak here of the acute puerperal, or of 
the chronic tubercular form of this malady. The 
* See Dr. Hamilton’s case in the ‘ Brit. Journ. of Horn.,’ vol. xiii, 
p. 254. 288 
ASCITES. 
former belongs to the disorders incident to preg- 
nancy &c.: the latter to the diseases of childhood. 
Simple acute peritonitis, as excited by cold or me- 
chanical injury, or by extension from the intestines, 
is very satisfactorily controlled by Bryonia or Mcr- 
curius corrosivus, especially the latter. Aconite is 
generally required in alternation. Whether these 
medicines would prove sufficient when peritonitis 
Avas lighted up by extravasation of the gastro- 
intestinal contents is a question. I have not met 
with such a case, nor do I know of any on record. 
In the most severe case I have seen the mischief 
was set up by mesenteric tubercle; it was the ana- 
logue of the intercurrent pleurisy of phthisis. The 
patient rapidly recovered under Aconite and Mer- 
curius corrosivus. 
Ascites. 
There is an article on this disease in the f Brit. 
Journ. of Horn./ vol. xix, p. 636. You will see that 
it has pretty frequently been cured by Homoeopathic 
treatment. Of the medicines used Arsenicum, Apis, 
Apocynum, and China seem to have been most effi- 
cient. When depending on cirrhosis of the liver, 
the treatment for the primary disease is of chief 
importance. Nor indeed is ascites ever of individual 
importance, qua peritoneum : save in chronic (tuber- 
cular) peritonitis, of which I shall speak among the 
Diseases of Children. It will thus come under our 
notice in several other places in these letters. LETTER XXX. 
diseases of the digestive organs (continued). 
I have now remaining only the glands subsidiary 
to the digestive process. Of these the salivary 
glands have already come under our notice : and in 
the present letter, after saying a few words upon the 
pancreas, I shall devote myself to the diseases of the 
liver. 
Of the diseases of the pancreas the only one I 
can specify is simple inflammation of its substance, 
Pancreatitis. 
Rademacher lias described this disease as occur- 
ring in both an acute and a chronic form : and 
states that its “ organ-remedy ” is Iodine. There 
is no doubt but that this medicine is homceopathically 
indicated here, as also are Mercurius and Iris. 
It would seem, moreover, that we must look to 
the pancreas in cases of diarrhoea adiposa: where 
probably Iodine would also be of service. Dr. 
Horace Dobell’s views, moreover, as to the part 
played by the pancreas in the development of phthisis 
are worthy of consideration: and confirm the indi- 
cations, already strong, for Iodine in the latter com- 
plaint. For cancer of the pancreas I have no 
suggestion to offer. 290 
HEPATIC CONGESTION. 
The diseases of the liver constitute a wide field 
for study, and present many difficulties in the way 
of classification. I think I shall best present the 
therapeutics of the subject to you if I consider 
hepatic maladies under the headings of congestions, 
inflammations, and degenerations, ending with jaun- 
dice and gall-stones. 
Hepatic Congestion. 
The treatment of this affection will necessarily 
vary according to the forms under which it presents 
itself. These are at least three in number. 
1. There is the excited state of the liver which 
shows itself in increased secretion of bile, familiar 
to those who practise in warm climates, and not un- 
known to us after a hot summer. I have already 
spoken of this among the forms of diarrhoea, and 
indicated Iris as its specific remedy. When the 
“ bilious” symptoms are more pronounced, and 
patient and physician concur in talking of an “ over- 
flow of bile ” (polycholia of Freriehs), Podophyllin 
is better still; but I think that a dose of Aconite 
may be premised with advantage. 
2. A more common variety of hepatic congestion 
is the passive or venous form. The engorgement 
may be seated either in the hepatic vein, as from 
valvular disease of the heart: or in the portal vein, 
from the habits which induce abdominal plethora. 
In the former case, the liver can hardly be aided by 
specific remedies, and the cause must receive our 
chief attention. In the latter, Sulphur is a remedy 
of great value, supposing that the patient will modify HEPATITIS. 
291 
in the right direction his way of life. Hepar sul- 
phitris is highly commended by Dr. Bayes, especially 
when hsemorrhoids result: and Mr. Pope gives the 
place next Sulphur to Lycopodium. 
3. In neither of those forms of congestion is there 
any tendency to inflammation. But there is a con- 
gestion of the liver which is obviously sub-inflam- 
matory. Here Bryonia and Mercurius solubilis are 
our best remedies; and I think that this is one of 
those instances of “ binary Homoeopathy ” in which 
the two in alternation act better than either singly. 
Inflammation of the liver is described by Prerichs 
as circumscribed, tending to suppuration ; or diffuse, 
goingon either to softening and atrophy,orto cirrhotic 
induration. I shall limit the term hepatitis to the 
first of these; considering the two latter under the 
headings of acute atrophy and cirrhosis. 
Hepatitis, 
then, in its simple form, is rare in this country. In 
the only case I have seen, Bryonia and Mercurius 
solubilis, each in the 3rd dec. potency, rapidly re- 
moved the symptoms. I see no reason -vvhy the 
same medicines should not prove serviceable in the 
malady as met with in tropical climates. The for- 
mer would correspond best where the surface, the 
latter where the parenchyma was most affected. 
For hepatic abscess they would be useful only when 
it threatens to supervene directly upon such inflam- 
mation. When, as I believe is most frequent, it is 
metastatic,'—the result of morbid material conveyed 
along the portal vein, as from the intestinal ulcera- 292 
CIRRHOSIS OF THE LIVER. 
tions of dysentery—I should expect more benefit 
from Hepar sulphuris. But I fear that such cases 
escape from the domain of Medicine into that of 
Surgery. 
Acute Atrophy of the Liver, 
as forming the pathological basis of the “ malignant 
jaundice ” of the old writers, has given rise to some 
of the most interesting investigations of recent 
Medicine. Is it not remarkable, moreover, that no 
sooner has it been distinctly recognised than its 
pathogenetic analogue appears in the shape of Phos- 
phorus ? The symptoms of acute poisoning by this 
drug are those of malignant jaundice, and we have 
Ererichs* own authority for the statement that the 
pathological state induced is identical with that of 
the acute atrophy he has so well studied. I have gone 
much into this subject in my letter on Phosphorus : 
at present I have only to mention the medicine as 
a promising, and indeed the only promising remedy 
for this disease. 
Cirrhosis of the Liver. 
I know of no recorded instance in Homoeopathic 
literature in which this affection has been diagnosed, 
and cured. In its earlier stages, while interstitial 
hepatitis only is present, I should expect benefit from 
the steady use of such medicines as Mercury and 
Iodine, or some of their salts or compounds. Nitric 
Acid, too, has a decided action upon the liver: and 
I have seen great benefit from its use in a case pre- 293 
AMYLOID DEGENERATION OF THE LIVER. 
sumably of this nature. Its probable influence 
upon amyloid degeneration, moreover, would make 
it more applicable than Iodine or Mercury in ad- 
vanced cirrhosis, in which this condition is often 
present, more especially in syphilitic subjects. Ait- 
ken’s statement that “in nearly one-half of the 
cases fatty degenerations occur/’ should also lead 
us to Phosphorus in cases of long-standing. Of 
the ascites accompanying cirrhosis I have already 
spoken. 
The degenerations of the liver which are of prac- 
tical import are the fatty; the amyloid, waxy or 
lardaceous; the pigmentary ; and the cancerous. 
Fatty degeneration of the Liver, 
if its possessor will abstain from following volun- 
tarily the habits practised against their will by 
Strasburg geese, ought to be checked by a medicine 
so thoroughly homoeopathic as Phosphorus. 
Amyloid degeneration of the 
Liver. 
The only case I know of in which a cure of this 
malady has occurred is one reported by Dr. G. Budd, 
in the Brit. Journ. of Horn. vol. xxi. 672. The 
remedy was Nitric Acid, in full doses. It has lately 
been urged that the waxy degeneration is the con- 
sequence of the drain of alkali from the system 
through the suppurations which nearly always ac- 
company it. This is against the idea of any chemical 
virtue of the mineral acid; and suggests that its 294 
JAUNDICE. 
specific action on the liver was that called into 
operation in the instance recorded. 
Pigmentary degeneration of the 
Liver 
appears to be the pathological condition present in 
the enlarged liver left behind by malarious fevers. 
The Biniodide of Mercury bids fair to prove its 
specific remedy. 
Cancer of the Liver. 
Of this dire malady I have nothing to say as re- 
gards treatment; though I should keep my patient 
on Hydrastis, that no stone might be left unturned. 
Jaundice. 
I have gone rather fully into the pathology of this 
disease, and the medicines which claim homoeopathic 
relationship with it, in an article in vol. xxii. of the 
Brit. Journ. of Homoeopathy. The results may be 
summed up in the following recommendations. 
1. When jaundice occurs as one of many symp- 
toms pointing to disorder or disease of the liver, its 
presence can hardly modify the treatment already 
suggested. But very often it appears, especially in 
children, as the one and only symptom that any- 
thing is wrong with this organ. The German 
pathologists say that we have here a catarrh of the 
bile-ducts, causing obstruction and re-absorption of 
the secretion. Mercurius, China} Digitalis, and. GALL-STONES. 
295 
Hepar sulphuris are the medicines in repute here; 
I have never had occasion to give any but the first- 
named. When the obstruction arises from the im- 
paction of a gall-stone, it is obvious that dynamic 
remedies have little room for action. 
2. Where jaundice occurs as a complication of 
certain toxsemic disorders, as yellow fever, we have 
as our remedies Arsenic, Phosphorus, and the snake- 
poisons. I should rely upon Phosphorus in cases 
where hypochondriac pain and tenderness indicated 
the existence of diffuse inflammation of the liver; 
upon the snake-poisons—especially Crotalus—where 
the jaundice sets in with great rapidity, as in yellow 
fever; and upon Arsenic where the blood appears 
deeply disorganized, as in petechial types. 
3. In jaundice from nervous excitement Chamo- 
milla has considerable reputation. Remembering, 
however, that every now and then a jaundice thus 
arising (especially in pregnant females) is the be- 
ginning of an acute atrophy of the liver, we must 
be on the watch with our Phosphorus; on which, 
in all cases of “ malignant jaundice,” our only 
dependence can be placed. 
Gall-stones 
belong to the gall-bladder rather than to the liver : 
yet they must be considered here. To relieve the 
pain of their passage along the biliary ducts you 
might fairly use the ordinary palliatives ; but let 
me ask you first to try the effect of Calcarea 30. 
It is almost incredible what this medicine will do. 
Dr. Bayes concurs with me in confirming from 296 
GALL-STONES. 
experience Dr. Drury’s original recommendation of 
it. Sulphur will perhaps aid appropriate diet and 
hygiene in obviating the tendency to their for- 
mation. 
You must have observed, while we have been 
upon the liver, that certain of our most highly- 
esteemed medicines have found no place in its 
therapeutics. Arsenic, Belladonna, Nux vomica, 
Pulsatilla have not been once named ; while the 
first rank has been taken by Phosphorus, Mercury, 
Iodine, and Nitric Acid,—Bryonia, Podophyllum, 
and Ilepar sulphuris following close in their train. 
This is an illustration of the first principle of specific 
therapeutics: the remedy must act, by elective 
affinity, upon the organ affected. The kind of 
affection, though very important, gives place to 
this. LETTER XXXI. 
DISEASES OP THE RESPIRATORY ORGANS. 
From the alimentary canal and its associated 
glands we now pass to another great tract of mucous 
membrane, and proceed to consider the morbid 
states of the respiratory organs. The nose, as being 
the commencement of the true air-passages, will 
have its diseases treated of in this category : and 
we shall then go on to those of the larynx and 
trachea, the bronchial tubes, the lungs, and the 
pleura. I shall not, however, as in the alimentary 
canal, consider each region separately: as so many 
respiratory affections—e. g. influenza, hay-fever, 
broncho- and pleuro-pneumonia—involve more than 
one of these. 
Nasitis. 
The nose, like the eyelids and the ears, may he 
inflamed without as well as within : and the in- 
flammation in the former case partakes of the 
character of erysipelas. When acute, Belladonna 
with or without Aconite will be necessary. But 
I have generally seen nasitis as a sub-acute and 
tardy inflammation, which has found its effectual 
remedy in Sulphur. 
Internal nasal inflammation is nasal catarrh, or— 298 
CORYZA. 
Coryza. 
This is one of the minor but daily ills of humanity, 
for Avhose treatment the blunderbuss of ordinary 
medicine is worse than useless, but which the 
Homoeopathic arms of precision often enable us to 
strike and conquer. It is everything to attack a 
“cold” while yet it is incipient. Here we have 
two potent weapons against it, Camphor and Aconite. 
The former I think (herein differing from Dr. 
Hayward *) is more generally useful. A few doses 
of it rapidly dissipate that chilly feeling which with 
most persons is the precursor of a cold in the head. 
Aconite is required in its stead when the chilliness 
is evidently the first stage of catarrhal fever, and the 
temperature is already rising. Such a cold is a 
true catarrhal fever: and Aconite is its remedy 
throughout. Sometimes, however, especially in old 
people, the symptoms resemble those of gastric 
fever, and here Baptisia is preferable. 
When once established and localized, the cure of 
a cold is not an easy matter: but a good deal may 
be done to relieve its symptoms and to shorten its 
duration. In the “running cold ” or fluent coryza 
Mercurius, in medium potencies, is the established 
remedy: but I have myself a special favour for 
Euphrasia, with which I have arrested many a 
catarrh of this kind. Arsenicum, Kali bichromicum 
and hydriodicum are also thoroughly homoeopathic, 
and are sometimes preferentially indicated :— 
the first when there is prostration like that of 
* On Taking Cold. INFLUENZA. 
299 
influenza, the second when a foul tongue indicates 
the involvement of the digestive mucous membrane, 
the third when the nose is red and swollen ex- 
ternally. For the “ stuffy cold ” I think Nux 
vomica the specific. 
I must add that Dulcamara is a capital prophy- 
lactic against catarrh brought on by damp. 
There are two special forms of nasal catarrh,— 
the one epidemic and (perhaps) specific, the other 
seasonal and idiosyncratic. These are Influenza and 
Hay-fever. 
Influenza 
is generally classed by nosologists after bronchitis, 
because the great epidemics of this malady have 
been characterized by bronchial as well as nasal 
catarrh. I do not, however, think bronchial com- 
plication of its essence; I take it that we have 
influenza present when a severe fluent coryza is 
accompanied by headache, pain in the limbs, and 
great prostration. If it be so, then I can state 
that Arsenicum—in about the 6th dilution—is the 
specific remedy : though I not unfrequently give a 
few alternate doses of Eupatorium perfoliatum 
when the hone pains are distressing. If I am 
wrong, and this morbid condition is to the true 
epidemic influenza what English is to Asiatic 
cholera, then I have nothing to say from experience. 
But on reading the description of the malady as 
given by Watson and Parkes I can see no medicine 
so truly homoeopathic to it as this same Arsenicum. 
Of the bronchitis accompanying influenza I will 
speak when I come to that complaint itself. 300 
OZ.ENA. 
Hay-fever 
is a very troublesome complaint. Arsenicum, 
Euphrasia, and Kali hydriodicum are its most 
homoeopathic remedies when it chiefly affects the 
nose and eyes : Ipecacuanha when it invades the 
chest (“ hay-asthma”). But you will try these 
medicines with, I fear, little success. I have 
sometimes seen Hydrocyanic Acid give rapid relief 
to hay-asthma: but again it has totally failed. I 
know of no notice of its successful treatment in our 
literature: but from private sources I may mention 
that Kali bichromicum 30, Silicea 12, and Taxus 
baccata <p have been given with advantage. 
Chronic or frequently-recurring catarrh deve- 
lopes, in unhealthy subjects, into 
Ozsena. 
This is another intractable disease. Iodide of 
Mercury, Bichromate of Potash, and. Aururn have 
done most for it : but I must confess that I have 
never seen a case cured. The following, by one of 
our ablest recruits, Dr. Chalmers of Dumfriesshire, 
is a good illustration of the efficacy of Aurum. 
“ A married lady, suffering from great general 
debility, loss of appetite, but chiefly complaining of 
heat and burning pain in the nostrils, with great 
pain over the frontal sinuses; obscure vision and 
pain in the eyes, which are much inflamed; there 
is a profuse discharge of sero-purulent matter, 
gluing the lids together; she has a copious dis- 
charge of yellowish-green pus from the nostrils, of OZiENA. 
301 
a very foetid odour, and she soils five or six hand- 
kerchiefs daily. All the lining membrane of the 
nose is red, much swollen, and has many small 
ulcerated points on it, especially along the septum 
on both sides; she cannot breathe through the 
nostrils. 
“This state of matters has been going on for 
several months, during which she has had various 
local and general applications without relief, and 
she is now almost sick of existence from the dis- 
charge and smell, &c. I gave her Fowler’s Arsenic 
in two drops, twice daily, which was continued 
through January, with no relief as far as the nose 
was concerned, but the eyes are much improved as 
well as the general health. 
“ Feb. 1st, 1867. Aurum met. 2, gr. 1 morning 
and evening. 
“ Feb. 14th. Is now considerably better in 
health, and the discharge from the eyes and nose 
is much diminished, especially so that from the 
former; from the latter there is still abundant 
foetid discharge; she eats better, and the pain in 
the frontal sinuses is removed. 
“ Continue Aurum, nightly. 
“ 28th. Eyes are quite well, being free of 
redness or discharge ; vision is quite well; discharge 
from the nose much diminished in quantity and is 
now pure pus, with little or no foetor. She has a 
good appetite, and looks fresh and well, and has no 
complaint if the nose were but right. 
“ Continue Aurum every second night. 
“ March 14th. Still improving, and the discharge 
from nose almost gone; the redness, swelling, and 302 
rOLYPUS NARIUM. 
ulceration quite so, and she now breathes com- 
fortably through the nostrils. 
“ Aurum every third night. 
“ She is now quite well, and has had no dis- 
charge from nostrils for a week past.” (Monthly 
Horn. Review, Sept. 1868.) 
Epistaxis 
is rarely sufficiently severe or obstinate to require 
medical treatment. When it is so, it is either the 
result of a blow, when Arnica is all that is required; 
or it is a local expressjon of a general haemorrhagic 
tendency, in which case you will give Hamamelis; 
or it is (so to speak) an haemoptysis higher up in the 
air-passages, which will find its remedy in Mille- 
folium,. In this, as in other haemorrhages, if the 
circulation be excited, Aconite is indispensable : and 
if cerebral congestion be at the bottom of it, you 
will give Belladonna or Nux vomica with advantage. 
Polypus narium 
deserves mention here, because it has not uufre- 
quently been cured by the internal administration of 
Homoeopathic remedies, especially Calcarea and Teu- 
crium.* Thuja, also, should not be forgotten where 
there is any likelihood of the “ sycotic ” taint being 
present in the constitution. 
From the nose we pass to the larynx. 
* See * Brit. Journ. of Horn./ vol, xi, p. 484; ‘ Monthly Horn. 
Review,’ vol. viii, p. 559. LARYNGITIS. 
303 
Laryngitis 
is not with us the dreaded disease it is under the old 
system. We do not say, as Aitken does, if inhala- 
tion, leeches, and fomentations fail, “tracheotomy 
ought not to be delayed.” I will refer you to some 
cases in the Monthly Homoeopathic Review for 1866 
by Dr. Meyhoffer of Nice. You will see that we 
have some capital medicines in specific relation with 
the larynx and its inflammatory states. Aconite 
seems indispensable at the commencement, and is 
sometimes sufficient for the cure. Spongia, Kali 
bichromicum, Bromine, and Hepar sulphuris stand 
next in order of requirement. The first two have most 
experience in their favour. Hepar is most suitable 
when the cough has become loose, but hoarseness 
remains. Should oedema glottidis supervene, re- 
peated doses of Apis would give the best chance of 
averting tracheotomy. 
A more superficial form of laryngitis may be 
called “laryngeal catarrh.” Under this title there 
is a good article by Dr. Kleinert in the 20th vol. of 
the British Journal. He seems to have had much 
experience among professional singers, who indeed 
in all places are found to resort in preference to 
Homoeopathic advice. You will profit much by a 
perusal of his remarks and cases. Causiicum, Bro- 
mine, and Selenium, with Aconite, in recent cases: 
and Carbo Vegetabilis (which is also a favourite at 
the Leopoldstadt Hospital) in those more chronic, 
appear to be his especial remedies. 
Chronic laryngitis requires and repays assiduous 
treatment by the medicines already mentioned as 304 
APHONIA. 
acting upon the larynx, viz. Spongia, Kali bichro- 
micum, Bromine and Hepar sulphuris; and Dr. 
Wurmb’s experience in the Leopoldstadt Hospital * 
would lead us to add to these Carbo vegetabilis. If 
the laryngoscope revealed the existence of ulcera- 
tion, Kali bichromicum would deserve the preference : 
I hardly know the relative indications for the others. 
In syphilitic subjects' Iodine itself would supersede 
Spongia ; and Mercury (especially the Iodide) and 
Nitric Acid might be required, as in a case recorded 
by Dr. Meyhoffer in vol. xxiv of the British Journal 
(p. 360). 
It is said, indeed, that chronic laryngitis is 
nearly always syphilitic or tuberculous,—in the 
latter case an extension from primary pulmonary 
mischief.t I have seen laryngeal symptoms super- 
vening in the course of phthisis clear away very 
rapidly under the influence of Spongia (1st dil.). 
You will weigh, also, the advantages of local 
medication in these cases, by applying your specific 
remedies in the form of spray. There is nothing in 
Homoeopathy to contradict this mode of practice, 
whose range of usefulness, however, has yet to be 
determined. 
Aphonia. 
The laryngoscope has revealed numerous patho- 
logical conditions at the basis of this symptom. Of 
inflammation, acute and chronic, I have already 
* See ‘Brit. Journ. of Horn.,’ vol. xxii, p. 347. 
f See Dr. Austin Flint’s ‘ Treatise on the Respiratory Organs,’ 
2nd ed., pp. 578-9. APHONIA. 
305 
spoken; I must add that for recent catarrhal aphonia 
I know no remedy so good as Causticum. Dr. 
Meyhoffer extols the same medicine in affections of 
the voice induced by over-exertion, as in singers. 
Where polypi or other vegetations are discovered, 
Thuja and perhaps Nitric Acid may be given with 
advantage. When no material cause, or nothing but 
paralysis of one or both vocal chords can be dis- 
covered,—i. e., in “ hysterical aphonia ”—I should 
hardly expect any drug to supersede localized gal- 
vanism. LETTER XXXII. 
DISEASES OF THE RESPIRATORY ORGANS (Continued). 
The only disease of the larynx remaining for our 
consideration is Laryngismus stridulus. With this, 
as a spasmodic affection, wre should naturally connect 
Hooping-cough and Asthma. But the first two of 
this series are so characteristically children’s diseases 
that I shall reserve them till I come to that division 
of my subject. Nor can I consider Asthma till I 
have devoted some attention to Bronchitis. With 
this important disease, therefore, I commence my 
present letter. 
Bronchitis. 
A paper on this disease, which I read before the 
British Homoeopathic Society, will be found (with 
the discussion following it) in vol. v of the ‘Annals/ 
p. 193. Of that paper my present remarks will 
contain the substance, though in a somewhat different 
arrangement. 
I shall speak here of simple acute bronchitis, of 
capillary bronchitis, of toxsemic bronchitis, and of 
chronic bronchitis. 
1. For simple acute bronchitis in the fairly 
healthy adult, it is rare that any medicine but 
Aconite is required, if the case be taken in time. BRONCHITIS. 
307 
It must be remembered, however, that this medicine 
attacks inflammation through the blood-vessels, and 
not—like a specific irritant of the part—by influ- 
encing the inflamed tissue itself. It is only because 
in a catarrh like this the tissue is so lightly affected 
that I believe Aconite capable of breaking up the 
disease. But should the inflammation have thorough- 
ly established itself, we cannot expect Aconite alone 
to cure it. Even here it is a most useful auxiliary; 
and a few introductory or alternating doses will 
greatly help the specific irritant of the tissue to 
effect a cure. 
Of the medicines falling under the latter category 
I shall speak of Bryonia, Kali bichromicum, and 
Ipecacuanha. 
In our domestic treatises, Bryonia generally heads 
the list of bronchitic medicines. I think, however, 
that too extensive claims are made for it. It un- 
questionably produces inflammatory irritation of the 
trachea and largest bronchi, but there is no evidence 
that its influence goes farther than these. I have 
argued this point in my paper, and you will see 
from the discussion that my colleagues share in my 
dissatisfaction with its action in most cases of bron- 
chitis. Good for the common “ cold on the chest3> 
—i.e. where the catarrh invades only the trachea 
and largest bronchi—it is of little use beyond. 
In animals poisoned by Kali bichromicum it is 
noted that the bronchise were inflamed as far as 
their ramifications could be traced. My own ex- 
perience with it is that, in most cases of simple 
bronchitis, if, after Aconite has expended its action, 
any other medicine is required to modify the condi- 308 
BRONCHITIS. 
tion of the inflamed tissue, Kali biehromicum will 
do it. It is also very effectual in the bronchitis of 
influenza. We have here a general condition which 
demands, not Aconite and cold water, but Arsenicum 
and champagne. When the influenzal catarrh runs 
down into the bronchial tubes, Arsenic will not fol- 
low it; and here Kali biehromicum comes in most 
usefully. There is one symptom often present in 
these cases, which is especially characteristic of the 
remedy now under notice. This is a thickly coated 
tongue, which, with loathing of food, indicates that 
the catarrh has involved the alimentary passages. 
Every now and then a case will occur whose 
symptoms remind you of the phenomena which, in 
susceptible persons, follow the inhalation of Ipecacu- 
anha. One such instance I have recorded in my 
paper. In these attacks—midway between bronchitis 
and asthma, half neurosis and half phlogosis—the 
power of Ipecacuanha is very great. 
2. Capillary bronchitis, as constituting one of the 
pulmonary affections of childhood, will come under 
our notice later on. At present I shall consider it 
as it occurs in old persons,—the “ peripneumonia 
notha” and “suffocative catarrh” of the older 
writers. The grand remedy for this dangerous dis- 
order is Tartar Emetic. Perfectly homoeopathic 
to both the local and the general condition, I have 
almost invariably relied upon it single-handed, and 
have seen desperate cases recover under its use. 
Arsenicum is often recommended: but I cannot see 
its homoeopathicity, and have never used it. The 
danger in these subjects is from paralysis of the 
lungs. I have suggested (Pharmacodynamics, p. 273} BRONCHITIS. 
309 
the homceopathicity of Solania, the “ active princi- 
ple” of Dulcamara, to this condition: and from 
what I have seen of its action in chronic semi- 
paralytic coughs should try it with much hopefulness. 
3. Toxsemic bronchitis is liable to be set up by 
the specific poisons of measles, of typhus and 
typhoid fever, and of gout, and by the excess of 
urea in the blood which obtains in chronic Bright's 
disease. Of the first I have already spoken, and 
shall speak again. The bronchitis of fever gene- 
rally calls for Tartar Emetic. In that which 
occurs in sufferers from chronic Bright’s disease, I 
would suggest Mercurius corrosivus, which is ho- 
moeopathic to the primary malady, and in a case of 
poisoning by which, recorded by Dr. A. Taylor, the 
bronchial mucous membrane was found inflamed 
throughout its course. The connection of bron- 
chitis with gout has lately been insisted upon by 
Dr. Headlam Greenhow. If the disease proved 
obstinate in a patient owning this diathesis, I should 
be disposed to give him the benefit of the as yet 
mysterious powers of Colchicum. 
4. Chronic bronchitis presents itself under such 
various forms, that it is well-nigh impossible to lay 
down any general laws for its management. Each 
case requires to be studied as an individual, and to 
be treated on its own merits. But I will make an 
attempt to classify its leading varieties, and to sug- 
gest their most suitable treatment. I will base my 
classification on the pathological character of the 
expectoration,—viz., whether it is mucous, puru- 
lent, or fibrinous. 
a. In chronic bronchitis with mucous expectora- 310 
BRONCHITIS. 
tion, the choice generally lies between two great 
medicines,—the determining symptoms being the 
consistence of the mucus. If it come up in lumps, 
be easy to detach and expel, or difficult only be- 
cause of the muscular debility present, Tartar 
Emetic is usually the remedy. But where the 
sputa are difficult and tenacious, and come up in 
long strings of opaque white mucus, the preference 
should be given to Kali bichromicum. This indica- 
tion for the latter medicine, which has been verified 
over and over again, w'e owe to Dr. Drysdale. 
b. Chronic bronchitis with puriform expectora- 
tion is a very serious matter. In cases of mode- 
rate severity I have seen Mercurius in the medium 
dilutions of great service. Perhaps Silicea, w'hich 
Teste commends highly in chronic bronchitis, may 
find its place here. China will at all events be 
useful in sustaining the constitution. 
c. If you meet with the rare form of chronic 
bronchitis, in which semi-membranous expectora- 
tion (bronchial polypi) occurs, Dr. Curie’s experi- 
ments would point to Bryonia as its most homoeo- 
pathic remedy, though Kali bichromicum is hardly 
less so. 
In all forms of bronchitis, but especially in the 
influenzal and the senile varieties, the cough is 
sometimes violent quite out of proportion to the 
local affection. We have here to call in the help 
of the neurotic drugs, the chief of which are Senega, 
Hyoscyamus, and Conium. Hyoscyamus is gene- 
rally a capital medicine for such a cough occurring 
in influenza,—the characteristic indication being 
aggravation on lying down. In old persons, where EMPHYSEMA. 
311 
the cough is harassing, I have much confidence in 
Senega. These neurotics may be given at the same 
time with the more strictly curative remedies, 
either in alternate doses, or (which I think better) 
the one by day and the other by night. 
Sometimes even, both in acute and in chronic 
bronchitis, we have to depend upon the neurotic in 
preference to the tissue-irritant medicines. I have 
already spoken of Ipecacuanha in acute bronchitis; 
and not uncommonly in chronic ie winter-cough ” 
you will find no medicine so efficacious as Nitric 
Acid. 
Sequelse or concomitants of bronchitis are Bronchi- 
ectasis, Emphysema, and Asthma. 
Bronchiectasis (dilatation of the bronchi) 
I take to be pathologically the same lesion as 
emphysema, only seated in the air-tubes instead of 
the air-cells. I have only seen one case of it; it 
ended fatally by abscess of the lung. Beyond the 
general roborant treatment obviously suitable to all 
degenerations, I have nothing to suggest as regards 
its management. 
Emphysema. 
When this lesion is partial and mechanical, as 
from the coughing of pertussis and bronchitis, 
medicine can have little to say to it. There seems 
no doubt, however, that emphysema, in its local 
and most important form, is a primary degeneration 
of the pulmonary vesicles, constitutional and here- 
ditary, often appearing to be a manifestation of 312 
ASTHMA. 
gout. If we only knew further what was the 
nature of the degeneration,—whether fatty, fibroid, 
and so on,—we might find specific remedies for it, 
and so at least prevent the farther yielding of the 
cell walls. The hypothesis of fatty degeneration is 
supported by Rainey, Williams, and Chambers : but 
Dr. Waters’ more systematic investigations do not 
sustain it. It is a pity : for in that case Phospho- 
rus would have bid fair to help us greatly. But if 
we are driven back upon simple functional debility 
of the elastic fibres which conserve the diameter of 
the air-cells, then morbid anatomy will not help us 
to the remedy. Symptomatology is equally at fault; 
and experience is silent, at least so far as our lite- 
rature is concerned. I have myself treated one 
well-marked case of idiopathic emphysema for 
months with Phosphorus, Nitric Acid, and Nux 
vomica with little result. Perhaps the frequent 
alliance of the malady with gout may give us a 
useful hint, as it does with regard to Asthma : and 
Sulphur may prove as valuable here as there. 
Whatever medicines we use, the general man- 
agement of the patient must be of the character 
indicated by Drs. Waters and Chambers, including 
(if you like) the administration of iron as a food. 
Bronchitis, when occurring in emphysematous sub- 
jects, is of a low type, and attended with profuse 
secretion : Tartar emetic will be its medicine from 
the outset, and free stimulation seems indispen- 
sable. 
Asthma. 
I of course limit this term to true idiopathic ASTHMA. 
313 
paroxysmal dyspnoea, and do not include under its 
heading the varieties of difficult breathing which 
are sometimes miscalled “ Asthmatic.” Yet I can- 
not distinguish it as “ spasmodic asthma,” for I 
think it has yet to be proved that spasm is of the 
essence of the affection. I know few more inter- 
esting pieces of pathological reasoning than Dr. 
Russell's argument* that the dyspnoea of asthma is 
a morbid exaggeration of the normal besoin de 
rescuer, and that no real asphyxia is present or 
imminent. 
Dr. Russell follows up his discussion of the na- 
ture of asthma by a study of the remedies most 
suitable to meet it. If to his remarks you will 
add the paper of Dr. Blundell in vol. ii. of the 
“ Annals,” p. 1, with the discussion following, you 
will have got the substance of the experience of our 
school hitherto in its treatment. 
First, what can we do in the paroxysm? Have 
we any medicines which give speedy relief? or 
must we resort to the Stramonium-smoking or in- 
halation of the fumes of nitre-paper in vogue in 
the old school? The latter, at least, is harmless 
enough if it is needed. But very often our reme- 
dies act with great rapidity. In pure nervous 
asthma, uncomplicated with bronchial irritation, 
Cuprum and Lobelia are most effectual. Drs. Rus- 
sell and Drury each give a case illustrating the 
virtue of Cuprum; and I myself, in common with 
many other practitioners, have seen very satis- 
factory results from Lobelia, not given as an emetic 
or depressant, but from the 2nd to the 6th dilu- 
* See his ‘ Clinical Lectures/ Lect. ix, x; “On Asthma.” 314 
ASTHMA. 
tion. When the asthma is bronchitic, I agree 
with Drs. Russell and Blundell in considering Aco- 
nite the best palliative. Its use by inhalation may 
be conjoined, as recommended by these physicians. 
It is to this variety that I consider Ipecacuanha 
homoeopathic, and not, as Dr. Russell seems to 
think, to pure nervous cases. It is especially indi- 
cated where there is much cough. 
When by these or other means you have got 
your patient through his paroxysm, you will have 
to consider the best means for obviating the ten- 
dency to its recurrence. The medicines I shall 
mention under this head are Nux vomica, Arseni- 
cum and Sulphur. 
Nux vomica is about the best curative medicine 
we have for simple “ spasmodic ” asthma, where 
there is no bronchial lesion, but a standing reflex 
excitability of the pneumogastric to impressions 
from without or through the stomach. One of the 
early cases which made Hahnemann famous was of 
this kind: and the Nux was given in material 
doses. Dr. Kidd, also, states that he considers it 
our best anti-asthmatic. While giving you con- 
fidence in the medicine, his testimony may also 
suggest the doses in which you should use it.* 
* I can confirm the following remark of Dr. Russell about this 
drug. “ After the paroxysm subsides, it leaves a condition of the 
digestive organs for which Nux Vomica is the great remedy. The 
tongue is coated with a thick, yellow fur; there is often slight 
nausea, flatulence, and constipation. Besides, the breathing is 
seldom quite right; generally there remains a sort of physical 
memory of the struggle. The patient feels that no liberties must be 
taken, either of diet or exercise. Out of this secondary state of 
bondage nothing will liberate so effectually as Nux Vomica.” ASTHMA. 
315 
Arsenicum is the best medicine where bronchitic 
asthma tends to become, or has become, chronic. 
Of this Dr. Russell furnishes several illustrations: 
and you cannot do better than read them in his 
capital lectures. The same medicine may still 
farther benefit asthmatic sufferers by relieving the 
symptoms of the heart disease to which they are 
nearly always, sooner or later, subject. 
In a great number of cases of asthma you will 
discover on inquiry gouty inheritance or proclivity, 
or, what is almost the same thing, some form of 
cutaneous disease alternating with the dyspnoea. 
In these cases you will get most satisfactory results 
from Sulphur. You may send your patients to a 
sulphureous spring, as Dr. Russell recommends; 
but I think they will do nearly as well at home 
under the usual potencies of the drug, of which 
here I prefer the lowest. LETTER XXXIII. 
DISEASES OP THE RESPIRATORY ORGANS (iContinued). 
I propose, in the present letter, to discuss the 
treatment of the hypersemic affections of the pul- 
monary parenchyma, i. e. the air-vesicles them- 
selves. I begin with pneumonia. 
Pneumonia 
has been one of the great battle-fields of statistics. 
After it had been shown what per-centage of cases 
bloodletting, and tartar emetic, and calomel could 
kill, Expectancy stepped in to demonstrate that a 
larger proportion recovered when left alone, and 
Homoeopathy declared that its treatment gave a 
lower death-rate still, and a shorter average dura- 
tion of disease.* But alas ! we have been outdone 
by Prof. Hughes Bennett, whose results would lead 
us to believe that under a system of judicious ma- 
nagement, with small doses of tartar emetic at the 
beginning, and nutrients and stimulants later, no 
uncomplicated case of pneumonia need be lost. 
I have myself very little faith in statistics, when 
applied to so difficult and delicate a subject as the- 
rapeutics. But I can sketch to you a treatment of 
pneumonia which partakes neither of the lowering 
* See Dr. Henderson’s paper in ‘ Brit. Journ. of Horn.,’ vol. x, 
p. 629. PNEUMONIA. 
317 
and spoliative measures of our forefathers, nor of 
the other extreme of stimulation into which the 
present age has rushed : but which, while rational 
in its method, gives obvious relief to the symptoms, 
shortens the duration of the disease, and will rarely 
permit your patient to slip through your fingers. 
I will speak first of the typical form of the dis- 
ease, as it occurs from chill in tolerably healthy 
adults. 
If you see your patient sufficiently early, while 
the fever—as marked by pulse and temperature—• 
is still high, you are sure to be doing right if you 
give him a few doses of Aconite. The observations 
of Dr. Parkes make it appear that in pneumonia 
the fever is out of all proportion to the local in- 
flammation, and runs an independent course of its 
own,—defervescence (which is very rapid) occurring 
at or even previous to the height of the consolida- 
tion. If we can anticipate this crisis by our 
Aconite, as probably we can, we shall be rendering 
an unquestionable benefit to our patient, whose 
distress depends far more on his general than on 
his local symptoms. If, moreover, Drs. Stokes and 
Waters be right, that there is a stage of pneumonia 
prior to that of engorgement, characterized by dry- 
ness and intense arterial injection of the pulmo- 
nary membrane, and revealing its presence to the 
ear by a harsh, loud, puerile, respiratory murmur 
in the very spot where dulness and crepitation are 
afterwards discovered,—if, I say, these observers 
are right, Aconite may fairly be expected at this 
stage to extinguish the whole morbid state unaided. 
Aconite is not a specific irritant of the lungs; 318 
PNEUMONIA. 
and if within twenty-four hours of its administra- 
tion the symptoms have not materially abated, or if 
general fever has already ceased to be a prominent 
feature, it is useless. Our grand remedy then is 
Phosphorus. We owe the establishment of its re- 
putation to Dr. Fleischmann of Vienna: hut it has 
since gained universal confidence. Its only rival is 
Bryonia, for which Tessier has done in Paris 
what Fleischmann has done with Phosphorus 
in Vienna. It is not easy to decide between the 
two. Bryonia would undoubtedly be more suitable 
to pleuro-pneumonia, and Phosphorus to broncho- 
pneumonia. But I apprehend that both these 
diseases are rare; and tha$ the bronchitis and 
pleurisy associated with pneumonia are generally 
secondary and partial extensions of the primary 
inflammation of the pulmonary tissue itself. 
The only other medicine I have to mention in 
connexion with acute pneumonia is Tartar Emetic. 
I have already argued out the unconscious homceo- 
pathicitv of the common use of this drug in pneu- 
monia. Its reputation, as usual, has been injured 
by the quantities in which it has been given. I 
am glad to find Dr. Waters writing, “ It is rarely, 
if ever, necessary to give it in large doses. From 
one sixteenth to one fourth of a grain I have usu- 
ally found quite enough.” I think it rarely appli- 
cable in the primary form of the disease. Its 
pathogenesy shows it to be most suitable when the 
inflammation has run down from the air-tubes into 
the cells (catarrhal pneumonia), and when exuda- 
tion is free and early. We have both these con- 
ditions present in the pneumonia of epidemic PNEUMONIA. 
319 
influenza, and here Tartar Emetic is specific. Of 
its action in the neighbouring capillary bronchitis 
I have already spoken. 
You will find some valuable remarks on the 
place of these four medicines, Aconite, Phosphorus, 
Bryonia, and Tartar Emetic, in the treatment of 
pneumonia, in an editorial article on the disease in 
vol. ix. of the British Journal. Also by Dr. Clotar 
Muller on Phosphorus and Tartar Emetic in 
Laurie’s ‘ Homoeopathic Practice of Physic/ p. 282. 
The only other medicine I think likely to be added 
to the list is Chelidonium. All I can say of it at 
present is that it is likely to prove useful when the 
right lung is inflamed and the liver involved. 
But I have hitherto been speaking only of pneu- 
monia in its typical form, and in its ordinary 
course. I have not included in the latter the 
occurrence of suppuration. This rare event has 
not had any definite treatment assigned to it. Dr. 
P. P. Wells recommends Lachesis and Cannabis 
sativa (American Horn. Bev., vol. iv, p. 100), Dr. 
Drvsdale Sanguinaria (Monthly Horn. Rev., vol. 
x, p. 115). Of circumscribed pulmonary abscess I 
will speak presently. If gangrene should occur, 
Lachesis and Arsenicum would be indicated. 
Again, if pneumonia supervened in the course of 
continued fever, you of course would not think of 
Aconite: but Phosphorus or Bryonia would still 
apply, or Tartar Emetic if there had been previous 
bronchitis. The latter medicine would also seem 
suitable to the pneumonia which sometimes com- 
plicates delirium tremens. 320 
HEMOPTYSIS. 
I have only to add that when the exudation is 
slow in taking its departure, or the disease 
threatens to become chronic, Sulphur should be 
given. For simple chronic pneumonia itself, 
should you meet with that very rare affection, 
Lycopodium is a valuable remedy. 
Abscess Of the Lung (non-tubercular) 
I believe to be more common than is usually sup- 
posed. I myself have seen five well-marked cases 
of it. Under suitable climatic conditions, there is 
nothing to prevent its being recovered from :— 
Iodine and China being the medicines most helpful 
towards such an issue. 
Congestion of the Lungs 
stands on the other side of pneumonia, and is also, 
though rarely mentioned in text-books, far from 
uncommon. If it originates in a chill, Aconite 
may be necessary: but Phosphorus is the really 
important medicine. Mechanical congestion of the 
lungs is of course common enough in cardiac 
disease: but this you must treat from the side of 
the heart. 
Haemoptysis. 
A word is sufficient to say that in pulmonary 
haemorrhage from mechanical violence, Arnica is 
sufficient: and that when it constitutes a vicarious 
menstruation, Bryonia is said to be efficacious in (EDEMA PULMONUM. 
321 
restoring the menstrual haemorrhage to its proper 
place. The haemoptysis of cardiac or aortic disease 
is generally the result of mechanical embarrassment 
of the circulation : and would be helped by Aconite, 
or by Digitalis if the heart be dilated and feeble. 
And now we have left the most important and 
frequent variety of this haemorrhage; that occurring 
in connexion with pulmonary tubercle. 
In sanguine temperaments, and when the pulse 
is full and bounding, Aconite is indispensable here, 
and may be all that is required. I confess I have 
never had occasion to use it. The two medicines 
on which I have learnt to rely are Millefolium and 
Hamamelis, in the 1st dilution of each. The 
former is most suitable when the haemorrhage is 
predominantly arterial, the latter where it is venous 
and passive. Other medicines of importance are 
Ipecacuanha and Ferrum Aceticum, for the latter 
of which I refer you to the ‘ Annals/ vol. v, 
p. 409. 
Pulmonary Apoplexy 
is, therapeutically, the same thing as haemoptysis, 
and can be helped by no other treatment. 
So much for the hyperaemiae of the lungs : but 
before passing to phthisis let me say a word upon 
(Edema Pulmonum. 
Drs. Wurmb and Caspar, in their reports of the 
Leopoldstadt Hospital, mention more than once 322 
(EDEMA PULMONUM. 
having cured this condition with Tartar Emetic. 
I myself have seen oedema of the lungs, occurring 
in the course of general dropsy, subside entirely 
under the use of the same medicine. I gave it, as 
they did, in the 12th dilution. LETTER XXXIY. 
DISEASES OF THE RESPIRATORY ORGANS (iContinued). 
I shall begin my present letter with the thera- 
peutics of 
Phthisis Pulmonalis. 
I desire to yield a hearty and ungrudging tes- 
timony to the advance which Old Medicine lias 
made in the treatment of this disease. There is 
no doubt that the mortality is less, and the duration 
of life greater, in phthisis than it was thirty years 
ago : and it has been a genuine triumph of scientific 
investigation. The unanimous consent of all the 
teachers of the present day as to the principles of 
treatment to be observed in phthisis is worthy of 
admiration : and commends the method to us with 
unwonted force. 
When we examine the method in question, 
however, we find it to be purely regiminal and 
dietetic,—the iron and cod-liver oil which are the 
only “ medicines ” given falling under the latter 
heading. And herein is illustrated that which Dr. 
Madden has insisted upon,—that the recent ad- 
vances made in the old school are on the com- 
mon ground of hygiene, and have no relation to 
the administration of drugs. We can thankfully 324 
PHTHISIS FULMONALIS. 
recognise and adopt them : while in our own 
department of specific medication we still, unhappily, 
stand alone. Some day we hope that prejudice 
will no longer 
“ to the marriage of true minds 
Admit impediments.” 
Let it be fully understood, then, that the basis 
of the treatment of phthisis must be with us as 
with others hygienic. Let us nourish our patient 
well and wisely; let him always breathe fresh air, 
and take plenty of exercise ; choose his climate for 
him if possible; and give him cod-liver oil and— 
save in the rare “ phthisis florid a ”—chalybeate 
food. But Homoeopathy will enable you to do 
more than this. It will enable you to keep down 
pulmonary inflammation without lowering the sys- 
tem. It will give you “ cough medicines” Avhich 
will not spoil the stomach, “ alteratives ” free from 
the poisonousness of mercurials, and remedies for 
diarrhoea which do not constipate. It has even 
means of no slight energy for modifying the tuber- 
cular diathesis itself. Let me tell you all I know 
about the medicines which are useful in phthisis. 
1. The most recent researches “ leave very little 
room for doubt that the bad habit of body in 
scrofulous affections associated with the growth of 
tubercle-matter must be established in the first 
instance through the digestive processes, as first 
described by the late Dr. Tweedy Todd under the 
name of strumous dyspepsia, and which has been 
since so fully described by Sir James Clark, 
Bennett, Hutchinson, and others” (Aitken). The PHTHISIS PULMONALIS. 
325 
characteristic features of this strumous dyspepsia 
are dislike to and difficulty in the assimilation of 
fats, “ biliousness/’ heart-burn, flatulence, and, 
above all, acid eructations after taking food. Such 
dyspeptic symptoms, when ordinarily occurring, 
call for Calcarea carbonica and Pulsatilla. The 
former medicine, specially indicated by the acid 
eructations, would be quite in place here: but I 
think that only temporary and superficial benefit 
could be expected from Pulsatilla. The mischief 
lies, I suspect, not so much in the stomach, as in 
the organs devoted to the assimilation of fatty 
matters,—the pancreas and the mesenteric glands. 
Iodine is the medicine which has the greatest 
control over these: and on Iodine, with an occa- 
sional dose of Calcarea, I would advise you to rely 
whenever you meet with phthisis in this “ pre- 
tubercular stage.” Test your patient's progress by 
his temperature and his weight rather than by the 
sounds of his chest: and direct your attention to his 
stomach rather than to his lungs. 
2. When phthisis has thoroughly localized itself 
in the lungs, although Calcarea and Iodine are still 
very good, and in the absence of indications for 
special medicines may be persevered with, yet 
urgent needs generally call for other remedies. 
Above all, we have to keep down pulmonary irri- 
tation and hypersemia : and for this purpose Phos- 
phorus is invaluable. Not only in intercurrent 
attacks of inflammation, but continuously, this 
medicine may be given with advantage. When the 
pneumonic symptoms are more chronic and passive 
in character, especially in young men, Lycopodium 326 
PHTHISIS PULMONALIS. 
is even preferable to Phosphorus. The cough, 
which is the most troublesome symptom in this 
stage, may be sufficiently moderated by these 
means: but often requires a medicine to itself, 
which you may find in Ipecacuanha, Hyoscyamus, 
Drosera, or Kali carbonicum, according to the symp- 
toms present.* 
3. Again, our patient comes to us when softening 
has set in, and when puriform expectoration brings 
hectic in its train, whose colliquative sweats are 
matched by diarrhoea, and its exhausting influence 
enhanced by vomiting of the ingesta. It is by 
checking this hectic, this diarrhoea, this vomiting 
that medicine can give most help in the present 
stage. If Iodine and Phosphorus have now lost 
their power to modify the symptoms (Calcarea and 
Lycopodium have long been left behind), other 
remedies will come into play. China and Phos- 
phoric Acid will oppose the hectic, if you will not 
be afraid to give them (the former especially) in 
pretty full doses. Arsenicum (3rd dec. trituration) 
has often in my hands arrested the diarrhoea. 
Kreasote (2nd) is specific against the vomiting : and 
Dr. Hilbers credits it with a supporting and resto- 
rative influence over the whole system. 
These are the medicines from which I think you 
will gain most help in your endeavours to arrest 
the progress of phthisis in its several stages. Too 
often, alas ! your best-directed efforts will fail, and 
* I.e. Ipecacuanha and Drosera when the cough is spasmodic, with 
retching : Hyoscyamus when it is much increased at night and on 
lying down; Lachesis and Kali Carbonicum when it seems kept up 
hy irritation of the fauces and pharynx. PHTHISIS PULMONALIS. 
327 
increasing exhaustion and emaciation with uncon- 
trollable diarrhoea and commencing aphthae herald 
the fatal issue. Still perseverance in what might 
be curative will be found palliative: and will best 
promote the euthanasia. I can say nothing as to 
our per-centage of cures until we have a Con- 
sumption Hospital: but I can answer for the 
power of our system to smooth the passage to the 
grave. 
And now a few words upon varieties and compli- 
cations of phthisis. Acute pulmonary tuberculosis 
I have seen arrested by Arsenic and Phosphorus; 
Mr. Pope, in his excellent paper on the therapeutics of 
Consumption in vol. xx of the British Journal, speaks 
of a case in which Arsenic and Calcarea effected a 
cure. The same writer, following Dr. Clotar Muller, 
calls attention to the well-known fact that Iron, 
injudiciously administered, often brings on ha3mo- 
ptysis and phthisis: and suggests the homoeopathicity 
of Ferrum to the form of disease known as ft phthisis 
florida.” If laryngeal symptoms should supervene 
in the course of phthisis, you may give Spongia 
with good hope of success : but primary laryngeal 
phthisis is another matter. Iodine and Drosera 
would promise most in its treatment: but the few 
cases I have seen have invariably gone on from 
bad to worse. Of the intercurrent pleurisy of 
phthisis I shall speak when I come to the former 
disease. 
I cannot but feel that we are on the eve of a 
revolution in our pathological notions of pulmonary 
phthisis. On the one side, we have experimental 
researches into the inoculability of tubercle, which 328 
PULMONARV SYPHILIS. 
are leading to unexpected conclusions as to its 
nature and history. On the other, the cases called 
“ phthisical ” are being analysed and distinguished ; 
and many other pulmonary deposits besides genuine 
miliary tubercle are shown to be capable of causing 
the phenomena which go under its name. Thus 
we hear of “ scrofulous or epithelial phthisis,” of 
“ pneumonic phthisis,” of “fibrous,” “amyloid,” 
“syphilitic,” “haemorrhagic,” and “embolic” 
phthisis (see Dr. Andrew Clark’s table in Aitken, 
vol. ii, p. 760). In time our therapeutics of the 
disease will have to receive a parallel development: 
and we shall probably learn what were the varieties 
of the disease which the older Homoeopaths curSd 
with Kali carbonicum, Sulphur, and Stannum. For 
the present, this must suffice. 
A few words before I end this letter upon syphilis 
and cancer of the lungs. 
Pulmonary Syphilis 
is described as occurring in two forms. It may be 
a chronic bronchial irritation, with the general 
symptoms of phthisis, complementary to the se- 
condary cutaneous syphilides. Or it may consist 
in the deposit of gummatous nodules, which some- 
times soften like tubercle (syphilitic phthisis). In 
the former variety the Iodides of Mercury would 
probably prove specific: in the latter I cannot 
suggest any improvement upon the ordinary use of 
Iodide of Potassium. PULMONARY CANCER. 
329 
Pulmonary Cancer 
must be named here, for the sake of completeness : 
but I have no information to give or suggestions to 
make as to its treatment. It is happily very rare. LETTER XXXV. 
DISEASES OF THE RESPIRATORY ORGANS (Continued). 
In the present letter I shall speak of the affec- 
tions of the pleura, and of those of the thoracic 
walls, concluding with a few remarks on the treat- 
ment of injuries of the chest. 
Pleurisy 
is a disease the Homoeopathic treatment of which is 
as well established as is that of pneumonia. If 
you will read the monographs upon it by Drs. 
Wurmb and Trinks in vol. i and by Dr. Beilby in 
vol. x of the ‘ Brit. Journ. of Homoeopathy/ and 
further look out in the index for the separate cases 
of the disease -which have been published from time 
to time, you will see a remarkable uniformity in the 
medicines given by different practitioners in the 
recognised varieties and stages of the disease. These 
are as follows. 
In simple acute pleurisy, arising from exposure to 
cold in a healthy person, and beginning with a dis- 
tinct rigor, Aconite is the one sufficient medicine. 
The pleura is one of the few parts to which it is a 
specific irritant: hence it covers the whole disease. 
The effusion in these cases is rather plastic than 
serous: and should its re-absorption be delayed, PLEURISY. 
331 
Dr. Wurmb highly commends Sulphur as a medicine 
capable of hastening it. Still farther off from the 
primary disorder, a lingering deposit of lymph has 
disappeared under the action of Hepar Sulphuris 
(see a case in fBrit. Journ. of Horn.,’ vol. xviii, 
p. 162). 
But I must admit that this typical pleurisy is 
rarely seen. Without speaking now of the occur- 
rence of the disease as a secondary lesion, it com- 
monly sets in after a more insidious manner, with 
no distinct rigor, and with early serous effusion. 
Hence the great anti-pleuritic is the remedy for this 
variety of the disease, Bryonia. You will remember 
my citations from Trinks as to the place of this 
medicine in all serous inflammations (Pharmaco- 
dynamics, p. 168). Consider in addition the Reports 
of the Leopoldstadt Hospital, in which Bryonia 
stands from year to year at the head of the remedies 
for pleurisy: and you will see that an almost in- 
variable use of it in this disease is well warranted. 
When the (serous) effusion is very rapid and 
copious, Bryonia must be replaced by or at least 
alternated with Arsenicum. Dr. Wurmb speaks of 
this medicine in pleurisy as follows. “Arsenic is 
especially indicated in serous pleurisy, and our con- 
fidence in it is so great, that we wholly despair of 
the possibility of curing a case of serous pleurisy in 
which Arsenic has produced no beneficial change at 
all, as in the art-defying haemorrhagic diathesis. 
The first good effects of Arsenic are manifested by 
the alleviation of the painfully asthmatic respiration ; 
after this the dropsical swellings abate, the febrile 
attacks become less frequent, and at length the 332 
HYDROTHORAX. 
absorption of the effusion takes place . . . Arsenic is 
also one of those medicines which do good speedily, 
if they are to do good at all.” 
Secondary pleurisy, when calling for special 
attention, is to be treated upon the principles 
already mentioned. If it supervene upon rheumatism, 
you will continue your Aconite and Bryonia. If 
it occur in connexion with pulmonary tubercle, 
Bryonia may suffice; but it is here that Kali 
carbonicum has attained so much repute. The 
pleurisy attendant on Bright's disease would pro- 
bably be helped by Arsenicum in preference to any 
other medicine, 
This brings us to 
Hydrothorax, 
■which may be either serous pleurisy in its chronic 
stage, or a secondary dropsy. In the latter form 
Apis and Apocynum are said to have proved cura- 
tive ; but I should have much greater reliance upon 
Arsenicum. Indeed I think Apis much more suit- 
able when hydrothorax has remained behind after 
pleurisy. Iodine, in some of its forms, appears in 
as high repute as ever for causing the absorption of 
pleural fluid : and I have already mentioned obser- 
vations which go to show that Iodide of Potassium 
can cause pleurisy, and that effusion into the 
pleura may be found as the result of poisoning with 
Iodine (‘ Pharmaco-Dynamics/ p. 321). PLEURODYNIA. 
333 
Empyema 
undoubtedly requires paracentesis for the evacua- 
tion of the fluid. But when you have effected this, 
you may find in Silicea a potent means of prevent- 
ing fresh suppuration. You might inject it into the 
cavity of the pleura, besides giving it internally. 
Do not forget, also, the power of China over the 
hectic which drain of pus excites. 
Pneumo-thorax 
must be mentioned here : but it is obviously out of 
the range of medicinal influences. 
The thoracic walls are the seat of 
Pleurodynia. 
I include under this heading every form of pain 
occurring in the chest walls. Pleurodynia, in this 
extended application, may be either a rheumatism, 
a myalgia, or a neuralgia. 
1. In rheumatic pleurodynia you will give Aconite, 
in repeated doses of a low dilution, if the attack be 
recent, especially if fever be present. But unless 
speedy relief is obtained, you will do well to substi- 
tute remedies having more local affinity with the 
thoracic walls. Bryonia, Actcea racemosa, Ranun- 
culus bulbosus, and Colchicum are all more or less 
homoeopathic and curative. I should choose the 
first where the rheumatic diathesis was marked: 
the second for women: the third where the pain 334 
INJURIES OF THE CHEST. 
was very intense, so that the patient dare not move 
(see Dr. Dudgeon’s case in vol. xxiv of the ‘ Brit. 
Journal/ p. ICO) : the fourth where a gouty as well 
as a rheumatic tendency was present. 
2. Myalgic pleurodynia has also found its remedy 
in Ranunculus, as in some cases by Dr. Strong in the 
‘Monthly Horn. Review* for Dec. 1866. But its 
chief medicine is Arnica. When it resembles 
pleurisy so much as to render diagnosis very diffi- 
cult (“ spurious pleurisy **), a few doses of this drug 
will often clear up the question by extinguishing 
the symptoms. 
3. Neuralgic pleurodynia (intercostal neuralgia, 
infra-mammarypain) appears under twoleadingforms. 
First, in young women otherwise fairly healthy, 
where it is hysterical, or otherwise symptomatic of 
deranged uterine function. Here Actcea Racemosa 
is specific. Secondly, as an idiopathic neuralgia in 
anaemic or debilitated subjects. In these Arsenicum 
or Ranunculus again will relieve the pain; but its 
return must of course be guarded against by mea- 
sures suited to build up the system at large. 
Injuries of the Chest 
—I refer especially to penetrating wounds—derive 
tlieir chief importance from the strong tendency to 
inflammatory excitement which occurs. You must 
carefully be on the watch for this: but should 
it appear, you may trust to Aconite to do at 
least as much as the usual bloodletting to allay it. COUGH. 
335 
APPENDIX TO DISEASES OF THE RESPIRATORY 
ORGANS. 
Cough is such a frequent accompaniment of the 
affections of the air-passages and chest that I have 
thought it well to append here a special list of 
cough medicines, noting briefly under each the 
symptoms which call for its use. 
Acidurn nitricum. Spasmodic cough. 
Ambra. Hysterical cough. 
Ammonium carbonicum. Incessant cough excited 
by a sensation as of down in the larynx. 
Antimonium tartaricum. Cough with profuse and 
easy mucous expectoration. 
Arsenicum. Cough of asthmatic subjects and of 
cardiac disease. 
Belladonna. Dry spasmodic cough, with deter- 
mination of blood to the head; pertussis in second 
stage. 
Bromine. Laryngeal cough, with hoarseness. 
Bryonia. Dry, irritative, shaking cough, worse 
in day-time; tickling, or heat and soreness behind 
sternum; pains in walls of chest and abdominal 
muscles. 
Causticum. Laryngeal cough, dry; urine spirts 
out during paroxysm. 
Coccus cacti. Violent cough causing vomiting 
and expectoration of much thick mucus. 
Conium. Nocturnal cough, dry, hacking, and 
almost continual. 
Corallia rubra. Nervous, spasmodic, and hys- 
teric cough ; second stage of pertussis. 336 
COUGH. 
Crotalus. Cough of phthisis. 
Drosera. Spasmodic cough, worse at night, with 
retching : second stage of pertussis. 
Hepar sulphuris. Laryngeal cough, with expec- 
toration : hoarseness. 
Hyoscyamus. Nervous cough, continual hack- 
ing; worse on lying down. Often best in alterna- 
tion with Ipecacuanha. 
Iodium. Laryngeal cough, dry. 
Ipecacuanha. Spasmodic cough with mucous 
expectoration; retching and vomiting. Pertussis 
in first stage. See Hyoscyamus. 
Kali bichromicum. Laryngeal cough, with hoarse- 
ness : cough with tough stringy expectoration. 
Kali carbonicum. Chronic coughs of obscure 
chest disease, a bow to be drawn at a venture 
occasionally.* 
Lachesis. “ Throat-cough ; ” cough of cardiac 
disease. 
Lycopodium. As Kali carbonicum. 
Mercurius. Chronic bronchial coughs, -with puru- 
lent expectoration. 
Naja. Cough of cardiac disease and of phthisis. 
Nux vomica. Spasmodic cough, hurting head; 
“ stomach cough,” worse after food. 
Phosphorus. Cough of phthisis. 
Pulsatilla. Loose mucous cough in children : 
loose night-cough of pulmonary disease. 
Rumex crispus. Laryngo-tracheal cough, dry, 
irritating, incessant, aggravated by pressure, talk- 
* Also from irritation of relaxed uvula (see ‘ Annals,’ vol. iv, 
p. 543). COUGH. 
337 
ing, and inspiration of cool air : sense of excoriation 
behind sternum. 
Scilla. Tracheal coughs, with much expectora- 
tion. 
Senega. Dry, irritating cough, with pains about 
chest. Comp. Bryonia. 
Sepia. As Kali earbonicum. Expectoration 
greyish-white and saltish. 
Spongia. Laryngeal cough, dry. 
Stannum. As Kali earbonicum. Expectoration 
profuse, of greenish colour and sweetish taste. 
Sulphur. Cough of asthma, especially in gouty 
subjects. 
Verbascum. Hoarse dry night-coughs. LETTER XXXVI. 
DISEASES OF THE CIRCULATORY SYSTEM. 
Instead of passing from the Respiratory organs 
to the next great tract of mucous membrane,—the 
genito-urinary, I shall first review the disorders of 
the Circulatory system, with which the former are 
both anatomically and physiologically so closely con- 
nected. Under this heading I shall consider the 
diseases of the Heart, of the Arteries and Veins, of 
the Lymphatics and Lacteals, and of those ductless 
glands—notably the Spleen and the Thyroid— 
which functionally belong to the blood and its 
circulation. 
I take first the diseases of the heart. In their dis- 
cussion I shall follow closely in the footsteps of the 
late Dr. Russell, who, in his papers on cardiac dis- 
orders in the ‘British Journal of Homoeopathy’ (vol. 
xii), and in his ‘Clinical Lectures/ has done so 
much for this subject. With him I shall begin with 
Palpitation. 
Dr. Russell divides the cases of this disorder into 
those in which the primary evil is, 1st, in the heart 
itself, 2nd, in the blood, 3rd, in the stomach. 
1. The heart beconms liable to palpitation from 
any cause which weakens its nervous energy. Such HYPERTROPHY. 
339 
are great mental exertion, anxiety or emotional 
tension of any kind, masturbation or excess in 
venery, abuse of tea and tobacco, and so on. To 
relieve an acute attack of this kind, there is nothing 
equal to Moschus. The chronic tendency may he 
obviated, if the exciting cause can be removed, and 
suitable regimen carried out, by such medicines as 
Lachesis and Naja, Glonoine, Digitalis, and Phos- 
phoric Acid. The last named is of course specially 
suitable where sexual excess has been the exciting 
cause. 
2. The presence of the gouty poison in the 
blood, and ansemia, are frequent causes of palpita- 
tion. Treatment directed against the diathesis in 
the one case, and Iron in the other, are the 
curative remedies. Nux moschata would probably 
give temporary relief to palpitation of gouty origin. 
3. Dyspeptic palpitation is often nothing but 
gout. When it owns no relation with that diathesis, 
you may with advantage remember what Dr. 
Elliotson says of Hydrocyanic Acid, that it is good 
for “ those disorders of the stomach which, in some 
of their symptoms, resemble affections of the 
heart.” 
Passing now from the functional to the organic 
diseases of the heart, I will take first those of its 
muscular substance, beginning with 
Hypertrophy. 
In the acute attacks of palpitation incident to 
this disease, Aconite takes the place filled by 
Moschus in nervous palpitation. The continued 340 
DILATATION OF THE HEART. 
use of the same medicine is also very serviceable in 
relieving the permanent distress of these sufferers. 
A still higher value in this direction is assigned by 
Dr. Russell to Naja and by Dr. Rubini to Cactus 
Grandiflorus. A good case is given by the former 
illustrative of the value of his favourite medicine 
(‘ Brit. Journ/ vol. xii, p. 543). But whether with 
these or any other medicines you can actually 
reduce an hypertrophied heart is quite another 
question. The only form of the disease in which 
such a result may fairly be expected is, I think, 
that which results from violent exercise, as rowing. 
Here the curative medicine, as you may suppose, is 
Arnica (see Dr. Madden’s paper on f Myalgia ’ in 
the c Brit. Journ. of Horn.5 vol. xxv, p. 80, and Dr. 
Bayes’ observations on Arnica in the f Monthly 
Horn. Review ’ for Dec. 1866). 
The above remarks apply to hypertrophy, whether 
accompanied with dilatation or not. But we have 
now to consider 
Dilatation of the Heart 
itself. I have nothing to say against the usual 
prescription of Iron in this disease, but everything 
in its favour. I would only recommend you in its 
treatment always to add to your dietetics homoeo- 
pathy, in the shape of Digitalis. I am not going 
to re-open here the questions as to the cardiac 
action of this drug, which I have already discussed 
at length when writing to you upon it. I content 
myself with recommending to you its continued use. 
At the first appearance of dropsy in these cases it ANGINA PECTORIS. 
341 
may often be banished by Apis: but sooner or later 
Arsenicum will be required : and with the aids already 
mentioned will long keep it at bay. 
Fatty Degeneration 
of the heart presents itself under two forms. In 
the first, the fat is in the first instance deposited 
upon the heart, and the degeneration of tissue is 
secondary : in the second it is primary. The treat- 
ment varies accordingly. Patients of the former 
kind have to be urged to a diet and mode of life 
calculated to avoid obesity ; and perhaps Calcarea 
would be a useful medicine for them. For the 
medicines suited to the latter variety I refer you to 
an able paper by Dr. Drury in the f Brit. Journ. of 
Horn/ vol. xix. Arsenicum and Phosphoric Acid 
are the medicines he most favours : but I think that 
both must now yield the first place to Phosphorus, 
the power of which to produce fatty degeneration 
in the heart as well as the liver is undoubted. 
The chalybeate food on which most reliance is 
placed in the old school will harmonize as well with 
Phosphorus here as with Digitalis in dilatation. 
Angina Pectoris 
is generally considered to be a symptom of fatty 
heart and atheromatous coronary arteries. Dr. 
Anstie maintains that it is a neuralgia. But how. 
ever this may be (and the two views are not ir_ 
reconcileable) you will find Arsenicum a capita^ 342 
PERICARDITIS. 
medicine for it. I do not mean in the paroxysms 
themselves, where at present no specific medicine* 
has availed to take the place of chloric ether: but 
given continuously to check their recurrence. Naja, 
also, has here again done good service, this time in 
Dr. Bradshaw’s hands (see ‘ Annals,’ vol. i, p. 296). 
When angina is plainly a spasm,—especially when 
there is a sensation as if the heart were grasped by 
a hand of iron,—Cactus is a better medicine than 
either. 
Pericarditis. 
The idiopathic form of this disease is so rarely 
witnessed : and so little is known either to Patho- 
logy or Therapeutics of its pysemic, haemorrhagic, 
or tubercular varieties, that I shall speak of its 
treatment only as occurring in connexion with acute 
rheumatism and in the course of Bright’s disease of 
the kidney. 
If in the progress of a case of acute rheumatism 
a double-friction sound begins to be heard, and the 
other sj'mptoms of pericarditis are setting in, you 
can nearly if not quite always arrest them in twenty- 
four hours by giving your Aconite alone in sufficient 
strength and frequency (a drop of the 1st dec. dilu- 
tion every hour or so), and covering in the heart 
with a hot linseed-meal poultice. Experto crede. 
But you are not always fortunate enough thus to 
catch the disease at its first breaking out, and must 
be prepared for its treatment in its several stages. 
You will begin by reading the cases narrated by 
* Spigelia, however, should be tried. ENDOCARDITIS. 
343 
Dr. Drysdale in the fBrit. Journ. of Horn/ vol. xii, 
p. 557, by Dr. Laurie in vol. v of the same Journal, 
p. 310, by Dr. Kidd in vol. xiii, p. 198, and by Dr. 
Russell in his ‘ Clinical Lectures,’ Lect. II. You 
will find that after Aconite, Bryonia, Colchicum, 
Spigelia, and Arsenicum are in highest favour. 
Bryonia has never been trusted to alone, but always 
in alternation with Aconite or Spigelia. I think 
the distrust only natural, and always suspend its 
administration in rheumatic fever in favour of other 
medicines when cardiac mischief sets in. Colchicum 
has no a priori evidence in its favour; but its 
action in Dr. Kidd’s and one of Dr. Laurie’s cases 
was not a little remarkable. Spigelia has the 
highest reputation, and has in its favour the testi- 
mony of Dr. Fleischmann, who uses no other medi- 
cine. Arsenicum is preferable to it only when 
serous effusion into the pericardial sac is consider- 
able. It is noted here by more than one observer 
that it frequently relieves the anxiety and oppression 
some time before the physical signs announce the 
resorption of the fluid. 
Armed with these medicines, you may with much 
confidence encounter the rheumatic form of peri- 
carditis. In that which occurs in Bright’s disease 
Colchicum and Arsenicum are the only members of 
the group likely to be called into requisition. 
And now of 
Endocarditis, 
which for all practical purposes may be considered 
exclusively in its connexion with rheumatism. You 344 
CHRONIC VALVULAR DISEASE. 
will find a capital case by Huber in vol. xii of the 
* British Journal/ p. 562, where Aconite 1 was the 
only medicine : and another by Dr. Bayes in the 
£ Monthly Horn. Review 3 for June 1867, in which 
Spigelia proved effectual. Dr. Russell’s case, more- 
over, in the second of his c Clinical Lectures ’ was 
one of endo- rather than of pericarditis, though 
there was a little of the latter. Aconite was of 
most service, though several intercurrent medicines 
were required. Aconite and Spigelia are thus, in 
inflammation of the lining as well as the covering 
membrane of the heart, the principal remedies. 
This is only to be expected, when we consider the 
close similarity of the two textures, and the identity 
of the usual exciting cause. I must add Arsenicum, 
which has genuine endocarditis among its poisonous 
effects. 
The sequelae of endocarditis are the various forms 
of 
Chronic Valvular Disease. 
The power of Homoeopathic medicines to give 
relief to the sufferings of patients thus afflicted is 
very considerable. From Dr. Russell’s experience 
it seems that Naja should always be given during 
the convalescence from an acute endocardial attack, 
and has great power of ensuring complete recovery. 
Nor is it less useful as a palliative medicine subse- 
quently, when this happy result has not been 
obtained. Two other very useful medicines here 
are Cactus and Arsenicum. The former is most 
useful where there is hypertrophy with the valvular CHRONIC VALVULAR DISEASE. 
345 
disease, as in Dr. O’Brien’s case which I have cited 
when writing upon this medicine. Arsenicum is 
better when the right heart has become dilated, 
and dropsy is threatening. The acute paroxysmal 
attacks incident to valvular disease are best relieved 
by Camphor. 
This is all I have to say upon the treatment of 
cardiac disease. But you will forgive the brevity, 
when you see that it arises, not from scanty know- 
ledge of its remedies, but from their fewness in 
number, and their accurate adaptation to its varie- 
ties. I only wish I could dismiss with so few 
words the whole nosological series. LETTER XXXVII. 
DISEASES OE THE CIRCULATORY SYSTEM [continued). 
I am now going to approach a class of diseases 
most of which are sufficiently obscure patholo- 
gically, but which are still less known to thera- 
peutics. These are the diseases of the blood- 
vessels : of the lymphatic and lacteal system: and 
of the vascular glands. 
As diseases of the arteries I will consider arteri- 
tis, aneurism, and atheroma. 
Arteritis, 
if you ever diagnose it, would probably be met by 
the treatment suitable to endocarditis, viz. Aconite 
in low dilution and repeated doses. If it occurred 
in a superficial artery, as the carotid or the femoral, 
the local application of the same medicine in the 
form of a strip of rag soaked in a strong solution 
would be advisable. 
Aneurism, 
•when not amenable to surgical procedures, you will 
probably treat by the rest in the horizontal posture 
and the limited diet now usually adopted. In aid 
of such measures Aconite will again come in most PHLEBITIS. 
347 
usefully. It will give the relief from pain for 
which resort is so often had to bloodletting: and 
it will at least quiet the circulation to its norm. 
Lycopodium has some credit in the treatment of 
aneurism : and nothing would be lost by adminis- 
tering it during the intervals when Aconite is not 
required. Should a tendency to the recurrence of 
aneurism manifest itself, you must treat the un- 
healthy state of the arteries, as for 
Atheroma. 
If this change be, as is usually supposed, a fatty 
degeneration, we ought to have a useful medicine 
for it in Phosphorus. But I have already quoted 
Prof. Hughes Bennett's statement, that the fatty 
change here is not in the arterial tissue, but in the 
exudation of an arteritis. This would alter the 
case : and so, though we had better try what Phos- 
phorus will do, we must not be disappointed should 
it fail us. 
The diseases of the veins which we shall have to 
consider are phlebitis and varicosis. 
Phlebitis, 
in its most familiar form of phlegmasia alba dolens, 
will come under notice among the Diseases of 
Women. When occurring under other circum- 
stances, you will find two excellent medicines for 
it in Pulsatilla and Hamamelis. I hardly know 
to which to give the palm. The former would cer- 
tainly be preferable in chronic cases, as in the one 348 
PYJ5MIA. 
narrated in the f Brit. Journ. of Horn/ vol. xxiv, 
p. 496. The only cases of acute phlebitis known to 
me in our literature are by Mr. Ayerst in the 
* Brit. Journ/ vol. xv. Lachesis seems to have 
been the most efficient of the several medicines used. 
Varicosis, 
while capable of considerable relief from the old 
medicines Pulsatilla, Silicea and Fluoric Acid, is 
still more effectually helped by Hamamelis. Where 
the external veins are affected, as in the leg, the 
local application of the diluted tincture is of service, 
while the 1st or 2nd dilution is being given internally. 
Before leaving the arteries and veins I must 
speak of pvsemia, under which heading the facts 
recently being brought to light regarding embolism 
and thrombosis will find their place. 
Pyaemia. 
The following are the conclusions arrived at by 
Dr. Bristowe, in his article on this disease in Rus- 
sell Reynolds’ c System of Medicine.’ 
“ 1. Pyaemia is almost invariably, if not always, 
preceded by some local suppuration, and this of an 
erysipelatous, gangrenous, or otherwise unhealthy 
sort. 
“ 2. The link between the local mischief and the 
constitutional infection is most frequently inflam- 
mation of the veins of the part affected, hut may be 
simply absorption of unhealthy ichor. 
“ 3. The local lesions which characterize pyaemia 
are congestions, extravasations of blood, inflamma- 
tory deposits, abscesses and necrosis. These are PYAEMIA. 
349 
generally, if not always, the result of blocking up 
of small arteries either by 1 emboli’ detached from 
the veins of the part primarily affected, or by 
£ thrombi ’ formed within the artery by the un- 
healthy blood. To the c ichorsemia * itself are due 
certain diffused inflammatory processes (as inflam- 
mation of the joints and of serous surfaces) for 
which arterial obstruction will not account. 
“ 4. The constitutional symptoms of purulent in- 
fection are rigors followed by sweating, a typhoid 
condition, quick and weak pulse, jaundice, early 
prostration, and generally death. The jaundice is 
not dependent on any appreciable affection of the 
liver. When the disease takes a more chronic 
course, the symptoms are those of hectic.’-’ 
I have put down these details that you may estimate 
the warrant I have for saying that Lachesis is the 
most promising remedy we have for this condition. 
The phenomena, local and general, which follow 
the serpent’s bite lead us to expect that when a 
local affection assumes a malignant character, and 
from thence proceed poisoning of the blood and 
prostration of the nervous energies, there Lachesis 
will be homoeopathic and curative. Now this is 
just what we have in pysemia. Experience has 
proved the value of the medicine in such analogous 
conditions as traumatic gangrene, malignant pustule, 
and septicaemia from dissecting wound; and the 
following record by Dr. C. Dunham reads very like 
phlebitic pyaemia itself. “ I have three times,” he 
w rites, “ been called to cases of chronic ulcer of the 
lower extremities (probably of syphilitic origin) in 
which the discharge had ceased, the extremity had 350 
ANGIOLEUCITIS. 
become oedematous, and a hard, slightly red swell- 
ing extending up along the coarse of the principal 
veins—together with a great and sudden prostration 
of strength, low muttering delirium, and general 
typhoid symptoms—gave good reason for supposing 
that general phlebitis had occurred. In these cases 
a careful study of the symptoms induced me to 
give Lachesis. The effect was all that could be 
desired, the patients rallying promptly—all symp- 
toms of phlebitis speedily disappearing ” (‘Amer. 
Horn. Review,’ vol. iv, p. 110). 
In chronic pysemia, with hectic, the administra- 
tion of China would probably aid good food and 
wine in supporting the system through the exhaust- 
ing suppuration. 
It is to be hoped that the surgeons attached to 
our hospitals, and who must have had opportunities 
of treating pysemia, will communicate the results of 
their experience. 
Of the diseases of the lymphatics and lacteals very 
little is known. The scrofulous affections of the 
mesenteric, bronchial, and cervical glands will come 
before us hereafter. I must, for the sake of com- 
pleteness, mention 
Angioleucitis, 
though I cannot tell you how it should be treated. 
The only form in which I know it is where the 
lymphatics of the arm inflame after a poisoned 
wound. Aconite and Belladonna, in low dilutions 
and frequent doses, are good for this. 
The glands subservient to the circulatoi’y system 351 
LEUCOCYTH.'EMIA. 
are, besides the lymphatic and the mesenteric al- 
ready mentioned, the spleen, the supra-renal cap- 
sules, and the thyroid. 
The spleen is sometimes attacked by inflamma- 
tion, 
Splenitis. 
China and Perrum both have a specific action upon 
the spleen: and considering that inflammation of 
this organ is nearly always of malarial origin, the 
former medicine would appear remarkably well 
suited to it. 
Hypertrophy of the Spleen, 
as a sequela of ague, is not uncommon. The medi- 
cines already mentioned are useful in its treatment, 
but Dr. Maclean’s results with the ointment of the 
Biniodide of Mercury* would lead me to try the 
internal administration of this medicine with the 
best hopes of success. 
In connexion with the lymphatic glands and the 
spleen, I must speak of 
Leucocythsemia. 
We have no known medicine which causes any 
phenomenal resemblance to this disease. Nor does 
Pathology help us; for she has hardly made up her 
mind whether the mischief begins in the blood 
itself, or in the blood-glands. Aitken, however, 
mentions two cases in which its “ origin obviously 
dated from inflammatory swellings of the lymphatic 
glands after exposure to cold and wet.” This may 
* See ‘Brit. Journ. of Horn./ vol. xxvi, p. 476. 352 
Addison’s disease. 
give us a hint for the administration of Iodine, 
especially as he adds “ a high degree of emaciation 
ordinarily accompanies it.” But we want a medi- 
cine which shall certainly influence all the blood- 
glands,—the supra-renal capsules and the thyroid 
as well as the lymphatic glands and the spleen. 
The only affection of the supra-renal capsules of 
which we know anything is 
Addison’s Disease 
According to Dr. Wilks, there is one special 
form of disease of the capsules with which the 
bronzed skin and other phenomena described by 
Addison are connected. This is analogous to the 
scrofulous enlargements of the lymphatic glands. 
The asthenia and other symptoms of the malady 
probably depend upon the relation of the organs to 
the ganglionic nerves. It becomes a question, then, 
whether we should treat the disease symptomatically, 
and as a whole, in which case Arsenicum would be 
indicated: or whether we should endeavour to 
attack the “ scrofulous ” disease of the capsules as 
if lymphatic glands were in question, as by Calcarea 
and Iodine. Perhaps the Arsenite of Lime (Cal- 
carea Arsenica) would be useful in this disease. I 
have only seen one unquestionable case of it: and 
there neither Arsenicum nor Kreasote were of any 
avail to check the vomiting or to avert the fatal 
issue. But as the old school reports no better 
success, we are at least not worse off than they. 
As diseases of the thyroid gland I shall speak of BRONCHOCELE. 
353 
the simple hypertrophy which we call bronchocele* 
and of the curious vascular enlargement generally 
styled exophthalmic goitre. 
Bronchocele. 
By this name, I say, I understand simple hyper- 
trophy of the thyroid gland, excluding all cystic 
and other growths within it, which latter are the 
subjects of Surgery. I have already argued the 
liomoeopathicity of the later Iodine, and therefore 
of the older burnt Sponge, in its treatment. It is 
from these twro medicines that we, in common with 
the old school, obtain most benefit in goitre. Nor 
is it always necessary to give them in material 
doses for the purpose. That such doses, carefully 
proportioned to the state of the gland and of the 
patient, may be given without risk is certain, from 
the observations of Dr. Kidd in the Brit. Journ. 
of Horn., vol. xxv, p. 177. But in an earlier 
volume of that Journal (vol. iii, p. 439) you will 
find striking results recorded from Iodine 30: and 
in vol. xxvi, p. 670, no less satisfactory effects from 
medium and high dilutions of Spongia. Curiously 
enough, in one of the cases last referred to the 
burnt sponge was given in 3 grain doses of the 
crude powder, and with equal benefit. 
Perhaps, then, your best plan will be to try in 
the first instance high dilutions of Spongia or 
Iodine, with which at any rate you can do no 
harm : and if these fail, to administer with caution 
small but material doses. Should you have to seek 
farther for remedies, I would call your attention to 354 
EXOPHTHALMIC GOITRE. 
the cases apparently cured by Apis in vol. xxiii of 
the Journal, p. 674; and to the observations on the 
power of the fluorides to produce goitre in vol. 
xxiv, p. 418. 
Exophthalmic Goitre, 
with its associated palpitation of the heart and pro- 
trusion of the eyeballs, is a very interesting disease. 
I have seen three cases of it, but in each have been 
hindered from some cause or other from following 
up the treatment. When ansemia is present, there 
can be no doubt of the advantage of Iron, as in the 
case so well recounted by Dr. Ker of Cheltenham 
in the Brit. Journ., vol. xxvi, p. 594. But very 
often no such condition of the blood obtains; and 
here you cannot do better than follow Dr. Kidd’s 
practice in the case narrated by him (vol. xxv, p. 187), 
and give Belladonna as he did. I am not sure that 
I agree with him as to the similarity between the 
symptoms of disease and drug: but as to the true 
specific relation of Belladonna to the vascular nerves 
at fault there cannot be a doubt. 
Of any diseases which may affect the thymus and 
pineal glands and the pituitary body I know 
nothing. And so I end my discussion of the cir- 
culatory system and its offsets. LETTER XXXIX. 
DISEASES OF THE URINARY ORGANS. 
In the present letter I enter upon the diseases of 
the Urinary Organs. The diseases of the Kidney 
will first engage our attention; and of these we 
shall begin with those morbid conditions of the 
organ with which albuminuria is associated. 
Before proceeding to therapeutics, however, we 
must agree upon certain points as regards pathology 
and nosology. When writing to you upon Pharma- 
codynamics, I used the nomenclature of renal dis- 
eases which we learnt together from Dr. George 
Johnson. I do not find that I have been led into 
any real misstatements thereby. But to those who 
adopt a later pathology than his some of my lan- 
guage about “desquamative” and “ non-desquama- 
tive ” nephritis seems hardly correct. Let us come 
to an understanding, then, upon the terms we shall 
use. 
There is no question raised but that (besides fatty 
and amyloid change) there are two distinct forms of 
Bright’s kidney,—the large, white, and smooth, and 
the small, hard, and granular. The causes and 
symptoms of the two varieties are as well recognised 
as their post-mortem appearances. Now Dr. Johnson* 
calls the former of these morbid conditions a “chronic 
* On Diseases of the Kidney. 1852. 356 
DISEASES OF THE URINARY ORGANS, 
non-desquamative nephritis.” He states that in it 
the epithelial cells are not found detached after 
death, nor do they appear in the urine during life; 
and that in fact the enlargement of the gland con- 
sists of a real hypertrophy of its secreting structure. 
He considers that the disease sometimes appears in 
an acute form, of which he gives three instances. 
Hr. Dickinson,* on the other hand, maintains 
that the large white kidney of Bright's disease is 
simply the chronic form of the “acute desquamative 
nephritis ” which both authors recognise as the result 
of cold and of scarlatina. I must say that on com- 
paring the observations and arguments of the two 
writers, my judgment inclines to the side of Dr. 
Dickinson. Dr. Johnson’s “ non-desquamative 
nephritis ” must thus drop out of my nosology. 
His acute cases I can without difficulty refer to the 
category of renal congestion or ischuria: while the 
chronic cases he so characterises are mostly, I think, 
examples of amyloid disease,—when he wrote little 
understood. 
And now as to the hard, contracted kidney. Dr. 
Johnson styles it “chronic desquamative nephritis,” 
and thinks that the diminution of the size of the 
organ results from the shedding of its epithelial 
cells. Dr. Dickinson, on the other hand, considers 
that the mischief begins in the fibrous matrix, and 
that the whole process is identical with that which 
obtains in cirrhosis of the liver. I care less here, 
save as a matter of pathological interest, to make 
my choice between the two. Both are describing 
the same disease, and both recognise its most im- 
* On Albuminuria. 1868. NEPHRITIS. 
357 
portant relationship, viz. that which it bears to gout. 
So, though I will call it, with Dickinson, “ granular 
degeneration” (a name purely phenomenal), I will 
leave untouched the question whether it is a cirrhosis 
or a desquamative nephritis. You will find that 
the matter of treatment lies outside the sphere of 
dispute. 
I have also, in my former letters, distinguished 
simple acute nephritis (as from cold) from the post- 
scarlatinal inflammation of the kidney. As the 
morbid condition in the two is identical, I will 
include them here under the common heading 
Nephritis. 
This will therefore correspond with the “ tubal 
nephritis ” of Dr. Dickinson, the “ acute desquama- 
tive nephritis” of Dr. G. Johnson. In its recent 
form it is the lc acute renal dropsy,” “acute albu- 
minuria,” and “ post-scarlatinal dropsy ” of authors. 
In its chronic form it constitutes the majority of 
the cases in which the large white kidney of Brights 
disease is diagnosed or discovered. I shall best 
treat it by discussing the principal medicines which 
have been used in its treatment. 
Terebinthina, by general consent, stands at the 
head of our remedies for acute hypersemic states of 
the kidney. That it is, speaking generally, homoeo- 
pathic thereto I need not demonstrate to you. But 
I think it necessary to examine, with more accuracy 
than in my Pharmacodynamics, what is the exact 
condition to which it corresponds. 
There is a typical case of its pathogenetic effects 358 
NErilRITIS. 
related in eh. xi of Dr. Johnson’s treatise. Besides 
the evidence of inflammation of the urinary passages, 
there was considerable haemorrhage, which the pre- 
sence of blood-casts of the renal tubes proved to 
have come from the kidneys themselves. But ob- 
serve that albumen was found only when blood was 
present, and that no desquamation of renal epithe- 
lium could be discovered. These are, as I have 
satisfied myself, the usual effects of Turpentine upon 
the kidney. They signify, I take it, that its main 
influence is expended upon the Malpighian bodies, 
causing their congestion, which may manifest itself 
in hsematuria on the one side, or in diminution even 
to suppression of the aqueous portion of the urine 
on the other. I shall have occasion to speak here- 
after of its supreme value in these conditions. But 
now as to its application to nephritis. It would be 
preferable according as the congestion predominated 
over the desquamation. This obtains, according to 
Dr. Dickinson, in the nephritis from cold as distin- 
guished from that from scarlatina. Our experience 
with the drug fairly corresponds with these patho- 
genetic indications. Dr. Kidd’s paper on Bright’s 
disease (Brit. Journ. of Horn. vol. xiii) first brought 
it prominently forward as a remedy. The first case 
in which he gave it was one of albuminuria of some 
months’ standing, with great anasarca, from cold. The 
urine was scanty and smoky, sp. gr. 1018 ■ under the 
microscope blood-globules only were observed. Com- 
plete recovery took place under four-drop doses of 
the pure spirit three times a day. The other case 
was apparently one of granular degeneration. But 
it had begun with haematuria from mechanical NEPHRITIS. 
359 
violence: there was much anasarca, with hvdro- 
thorax ; and the urine contained fibrinous casts and 
blood-discs. Terebinthina gtt. j ter die, removed 
the anasarca and hydrothorax, and the general health 
righted; but the urine remained albuminous and of 
sp. gr. 1010 only. Nor do the cases of post-scarla- 
tinal nephritis adduced by Drs. Henderson and 
Yeldham (Brit. Journ. vol. xiv, p. 1. Annals, vol. i, 
p. 386) lead to any different conclusion. In all the 
immediate effect of the Turpentine is to make the 
urine freer and clearer;—i. e. it liberates the Malpi- 
ghian capillaries from their congestive torpor, so that 
the aqueous portion of the urine is freely secreted, 
and the loaded tubes flushed of debris and cleared 
for action. I have already said that I myself prefer 
Arsenicum in this form of the disease; but I do not 
question the results said to have been obtained from 
Turpentine. 
Cantharis. It is generally assumed of this drug 
that its action is identical with that of Turpentine. 
But read SchrofFs experiment with it as detailed by 
Hr. Clotar Muller (Brit. Journ. of Horn., vol. xvii, 
p. 550). Besides blood, albumen, and fibrinous 
casts, “ epithelial cells from the renal tubes ” were 
observed in the sediment. Then consider the case 
related by Dr. Dickinson (p. 50) in which the ad- 
ministration of iqxxv doses of tincture of Canthari- 
des caused pain in the loins and increased desqua- 
mation, but no blood : and after death there was 
intense injection of the superficial capillaries, i. e. 
those belonging to the secreting tubes. I think 
there can be no doubt but that Cantharis acts more on 
these latter than on those of the Malpighian bodies : 360 
NEPHRITIS. 
and is accordingly most suitable when desquamation 
predominates over congestion. It lias been but little 
used in renal disease,—its action on the bladder 
seeming to have been most prominent in the eyes of 
our therapeutists. But it deserves attention in 
desquamative nephritis, especially when acute. 
Moreover, while neither Cantharis nor Turpentine 
has caused the oedema characteristic of Bright's 
disease, the former does produce its “ head symp- 
toms,”—delirium, convulsions, coma : and as these 
usually come on some days at least after the ingestion 
of the poison, they are very probably secondary to 
the renal mischief it sets up. 
Arsenicum. This great medicine expends a con- 
siderable share of its influence upon the kidneys. 
In acute poisoning by it the urine is nearly always 
diminished or suppressed : and the presence of 
albumen is so constant a phenomenon that it has 
been assigned as a diagnostic mark between Arseni- 
cal poisoning and Antimonial. Then we have Dr. 
Mitchell's observations (New York Medical Journal, 
June 1865) of the repeated appearance of anasarca, 
with or without albuminuria, as an effect of large 
medicinal doses of Arsenic. Only “ a few very pale 
tube-casts” were here observed by the microscope. 
But Dr. Quaglio’s experiments, related by Dr. Cl. 
Muller in his paper already cited, enlarge our know- 
ledge on this score. He sloAvly poisoned six cats 
with the Arsenite of Potash, during periods of from 
one to ten months, and produced in all more or less 
completely developed Bright's disease. During life 
the urine was scanty, and contained albumen, fat- 
globules, renal epithelium, fibrin-casts, and blood- NEPHRITIS. 
361 
corpuscles; it was neutral in re-action, and the 
proportion of solids was below the standard. The 
animals died comatose : and after death their kidneys 
were found enlarged and hypersemic, and the epithe- 
lial cells charged with fat and granules. 
I should unhesitatingly have set these patho- 
genetic effects down to tubal nephritis but for the 
fact that in four out of these six cats there was 
found hypertrophy of the left ventricle. This Dr. 
Dickinson states he has never found in connexion 
with any other disease of the kidney but granular 
degeneration. While, therefore, I place Arsenicum 
among the remedies for Bright’s enlarged kidney, I 
think it must be borne in mind in relation to gra- 
nular and also to fatty degeneration. 
It is perhaps the favourite remedy in our school 
—it is certainly mine—in post-scarlatinal ne- 
phritis. In the Brit. Journ. vol. xii, p. 485, and in 
the Annals, vol. iii, p. 477, you will find cases of 
albuminuria with dropsy otherwise occasioned in 
which it was of the utmost service : and a very re- 
markable cure by it (in drop doses of the Liquor 
Potassse Arsenitis) is given by Dr. Henderson in 
vol. xiv, p. 20, of the Journal. Ascites and hydro- 
thorax here complicated the anasarca. 
The relation of Arsenic to inflammation of the 
serous membranes gives us another element in its 
homceopathicity to Bright’s disease : and indicates 
its employment, if not previously, at least when 
they occur. 
I must now speak very briefly of some other 
medicines which appear specifically related to tubular 
nephritis. 362 
NEPHRITIS. 
Digitalis appears to be the favourite remedy for 
this disease in the old school. It is administered 
as a “ diuretic.” But it is generally admitted that 
this action on its part is very different from that of 
the other substances which bear the name: and is 
rarely if ever to be obtained in the healthy subject. 
Indeed, in poisoning by large doses, suppression of 
urine is often noticed. 
Chelidonium has caused very striking symptoms 
of desquamative nephritis. Besides the general 
phenomena of renal irritation, an examination of 
the urine in one case shewed the presence of cylin- 
drical casts with epithelial cells. The mischief in 
this case was so considerable that cedematous swell- 
ings of the extremities occurred. The relation of 
Chelidonium to pneumonia here becomes import- 
ant, because of the frequent occurrence of this in- 
flammation as a complication of tubal nephritis in 
children. Dr. Buchmarm gives one case of cure 
of chronic renal disease by this medicine: but it 
was treated at a distance, and too imperfectly 
described for identification. 
Ferrum, especially in the form of the tincture of 
the muriate, is universally recommended in ne- 
phritis, when the acute symptoms have subsided. 
Dr. Johnson’s own caution indicates the homoeo- 
pathicity of its action here. “ If,” he writes, “ the 
urine becomes more scanty or more deeply-coloured 
and albuminous after the use of the steel, it may 
be necessary to suspend it for a time, or to give it 
in smaller doses.” In a discussion on a paper on 
the action of Iron at the British Homoeopathic So- 
ciety, Dr. Metcalfe mentioned a case in which GRANULAR DEGENERATION. 
363 
symptoms very like those of acute ursemia followed 
a single overdose of Iron, and subsided upon its 
elimination in the urine. 
Of some of the complications of this form of 
Bright’s disease I have already spoken under Can- 
tharis, Arsenicum, and Chelidonium. I have only 
to add that for the vomiting Kreasote would pro- 
bably prove the best remedy. 
Granular Degeneration 
is a very serious matter. Dr. Kidd, though ascrib- 
ing benefit to the use of Nitric Acid, and—as in 
the case mentioned—to Turpentine, acknowledges 
its ultimate fatality in nearly all cases. I think 
our most hopeful outlook is in the direction of 
Plumbum. So frequent is granular kidney the 
result of plumbism, that in 26 out of 42 workers 
with lead, dying from various causes in St. 
George’s Hospital, this lesion was discovered post- 
mortem (Dickinson). Cachexia and degeneration of 
tissue are characteristic of lead-poisoning, and in 
such conditions it has always been a valued remedy 
in our hands. Nor does the supposed intermedi- 
ary development of gout impair the significance of 
the fact. Dr. George Moore, after a most tho- 
rough examination of the question, arrives at a 
verdict of “ not proven ” as to the causation of 
true gout or rheumatism by lead (Brit. Journ. of 
Horn., vol. xxiv). And it is admitted that in many 
instances the granular kidney is the only gouty 
manifestation present in these subjects. I should 
prescribe, therefore, a lengthened administration of 364 
GRANULAR DEGENERATION. 
Plumbum to all gouty persons—not lead-workers— 
in whom symptoms of renal degeneration began to 
appear. But what if this variety result from lead 
itself, or from valvular disease of the heart, or as a 
sequel to the albuminuria of pregnancy. In these 
cases I would direct attention to Colchicum. 
There is little doubt of this medicine exerting a 
specific action upon the kidney, showing itself 
sometimes by increase, sometimes by diminution of 
the urinary water, but always by a decrease in the 
elimination of the organic solids (Bocher). Such 
is the condition Ave have before us. The certain, 
though unexplained, relation of Colchicum to 
gout confirms the indications for its selection. 
You will remember, moreover, what I have said 
about the possible relation of Arsenicum to this 
form of Bright’s disease. 
Of the complications of granular kidney the car- 
diac hypertrophy need not be mentioned, as it is a 
compensatory change. The bronchitis which so 
frequently occurs would hardly call for Aconite: I 
have already suggested that this is probably the 
form of bronchial inflammation caused by Mercu- 
rius corrosivus. For pericarditis occurring in these 
patients I should depend upon Colchicum, or Arse- 
nicum if the effusion be great. The dim sight of 
which they often complain appears to consist in a 
serous infiltration of the retina, with extravasations 
into its substance, and thickening of its connective 
tissue. It is not a hopeful condition: and for 
this, with the atheroma, the tendency to haemor- 
rhage, the cachexia, and the depression of spirits, I 
could only rely on such a medicine as Plumbum AMYLOID DEGENERATION 
365 
which covers the central mischief. For the dys- 
pepsia, if accompanied with much slimy mucus 
about the fauces, Dr. Kidd recommends Nitric 
Acid. Vomiting probably gets rid of some of the 
urea: but if it is excessive, Kreasote might help. 
When ursemic symptoms set in Opium is the only 
medicine from which much help can be expected: * 
but you will do well to aid it by setting the skin to 
work by a hot-air bath. 
Of the general treatment of these cases I have 
nothing to say in addition to what has already 
been said by Drs. Johnson and Dickinson. The 
facts brought forward by the latter writer as to the 
influence of climate are very important. For my- 
self, were I the subject of this disease, I would 
place abandonment of the British Islands as the 
first item in my treatment. 
Amyloid Degeneration 
of the kidneys—of old styled waxy or lardaceous, 
and by Dr. Dickinson (upon a hypothesis of its 
causation) named “ depurative infiltration ”—ap- 
pears to be in all cases the result of a drain upon 
the system, especially of pus. In seeking for a 
remedy to suggest, I have come upon Phosphoric 
Acid as promising most. This medicine has well- 
known virtues in the hectic of the suppuration 
from phthisical lungs and carious bones : it might 
also remedy the more remote consequence now 
* Dr. Drury declares it to be often of striking efficacy. Dr. G. 
Schmid recommends Cuprum Aceticum, and Dr. Marcy Cannabis 
Indica. 366 
FATTY DEGENERATION. 
before us. Its close relative, Nitric Acid, has 
cured the same degeneration in the liver, and 
Phosphoric Acid has an affinity almost equal for 
the kidney, as we shall see farther on. Dr. 
Dickinson also notes the constant diminution of 
Phosphoric Acid in the urine in this disease. 
The pulmonary complications of this amyloid de- 
generation probably call for the same treatment as 
those of tubal nephritis. The oedema and diarrhoea 
ought not to divert our attention from the main 
current of the treatment. 
Fatty Degeneration 
is a not uncommon accompaniment of the last- 
named, and indeed of every form of albuminuric 
disease. Correspondingly it has been caused and 
may be cured by Arsenicum. But whenever it 
presents itself, as in the cases described by Dr. G. 
Johnson, as an idiopathic and substantive affection, 
I would direct your attention to Phosphorus. You 
already know the relation of this medicine to fatty 
change as such; aud a case of poisoning by it re- 
corded by Dr. Hempel well shows its specific affi- 
nity for the kidneys.* In this connexion it is 
interesting to note that in one of Dr. Johnson’s 
cases the affection (which came on in three weeks’ 
time) appeared to be the immediate result of sexual 
excess. Moreover, fatty degeneration of the kid- 
* The face was swollen: the urine scanty, high-coloured and 
frothy, containing albumen and exudation cells : amaurosis occurred. 
After death the kidneys were found congested and the uriniferous 
tubes blocked up. FATTY DEGENERATION. 
367 
neys has been observed in connexion with acute 
yellow atrophy of the liver; and the homoeopathi- 
city of the symptoms of Phosphorus poisoning to 
those of this malady has been attested by Frerichs 
himself. 
Besides, the references already made, I may men- 
tion in connexion with renal disease and dropsy a 
paper by Mr. Pope in vol. xvi and another by Dr. 
Atkin in vol. xvii of the c British Journal of Ho- 
moeopathy/ and one by Dr. Gibbs Blake in vol. iii 
of the ‘ Annals/ LETTER XL. 
diseases of the uiiinary organs (continued). 
In my last letter I spoke of those conditions of 
the kidney with which albuminuria was associated. 
A few additional remarks upon this symptom in its 
more general relations will bring us to those mala- 
dies, obviously renal, but really in most instances 
lying farther back than those organs through wdiich 
they manifest themselves to our observation. These 
are Chylous Urine, Diabetes, Gravel, and Azoturia. 
Albuminuria. 
That this condition may exist prior to, or even in- 
dependently of, renal disease is unquestionable. You 
cannot read a better defence of this position than 
Dr. Meyhoffer’s papers in the Monthly Horn. Review 
for 1866-7. Claude Bernard’s experiment, by Avhich 
irritation of the nervous centres induced albuminuria 
as well as glycosuria, hints the frequent neurotic 
origin of such cases. Phosphoric Acid and Helonin 
will then claim your attention. One of Dr. Mey- 
hoffer’s cases, and another in Hempel sub voce, will 
illustrate the action of the former: of that of the 
latter you will find evidence iu the article on it in 
Dr. Hale’s book. DIABETES. 
369 
Chylous Urine 
is rarely seen in this country. Dr. Chapman, men- 
tioning the value of Phosphoric Acid in nutritive 
derangements of children accompanied with a milky 
state of the urine,* suggests the use of this remedy 
in the “chylous urine” of the West Indies. If 
now you will read Dr. Lionel Beale’s account of 
the constitutional symptoms of this disease, as ob- 
served by him in several cases,f you cannot fail to 
see Dr. Chapman’s recommendation confirmed, and 
the homoeopathicity of Phosphoric Acid to the whole 
condition established. Uva ursi, also, has some 
evidence in its favour (see Brit. Journ. of Horn., 
vol. iv. p. 420). 
Diabetes. 
The dietetic treatment of diabetes must always 
be of high importance. But it is not, in the nature 
of the case, and by the confession of its advocates, 
curative. Sometimes indeed under its use Nature, 
relieved of much of her burden, asserts her recu- 
perative power, and when the patient returns to his 
usual regimen, he finds it unattended by its pristine 
consequence. But too often the diabetic regimen 
proves but a continuous and most irksome palliative; 
the least abatement of its rigid restrictions is followed 
by an increase of the malady, and the patient at length 
succumbs under pulmonary disease, carbuncle, or 
* ‘ Brit. Journ. of Horn.,’ vol. vii, p. 391. 
f ‘ Brit. Med. Journal’ for 1860, p. 772. 370 
DIABETES. 
simple exhaustion of the powers of life. Until we 
can do more than cut off the supplies,—until we 
can attack the morbid process, we cannot consider 
ourselves in a position to cure diabetes. 
In a paper on this disease in vol. xxiv of the 
Brit. Journ. of Horn., I have endeavoured to esti- 
mate our resources for effecting this end. 
Traditional medicine has given us nothing but 
Opium and Kreasote. The former is confessedly 
only palliative; and though the virtues of the latter 
are dynamic if any at all, they are in this disease 
rare and uncertain. 
Homoeopathy on the one hand reports decided 
benefit in diabetic cases from general and symptom- 
atic treatment, as by Arsenicum, Nux vomica, Cal- 
carea phosphorica, and such like. On the other 
hand it reports certain complete or proximate cures 
with medicines presumably homoeopathic to the essen- 
tial lesion. Referring you to my paper for informa- 
tion as to Natrum sulphuricum and Asclepias vince- 
toxicum, I desire to concentrate your attention here 
on Phosphoric Acid and the Nitrate of Uranium. 
Acidurn Phosphoricum stands at present unques- 
tionably in the highest place among the remedies for 
diabetes. The first notice of it is contained in the 
16th vol. of the British Journal. Three very in- 
teresting cases are there recorded by the late Dr. 
Walker of Manchester, of which the following is a 
summary. Case 1 is briefly told : sugar was present 
in the urine, Avith the usual symptoms; improvement 
ensued, and the disease Avas for some time kept at 
bay by Phosphoric Acid and the saccharated (!) 
carbonate of iron (quantities not stated) but the DIABETES. 
371 
patient eventually sank under pulmonary disease. 
Case 2 was equally well-marked; the patient was 
put upon rigid diet, and took three times a day a 
dessert-spoonful of a solution of 14 grains of 
anhydrous Phosphoric Acid in 6 oz. of water. The 
sugar and the general symptoms soon disappeared; 
and when, six months after, the patient returned to 
his usual diet, he felt no ill effects; he was cured. 
In Case 3 the Phosphoric Acid was given in the 
same manner ; but the diet wras unrestricted. The 
sp. gr. of the urine fell in eight days of this treat- 
ment from 1035° to 1023°. The ultimate issue of 
the case is not recorded.—Next, in vol. xix of the 
same Journal, Dr. Hansford contributes two cases 
in which Phosphoric Acid was the main remedy,— 
in the first in the 6th dilution, in the second in grain 
doses of the anhydrous acid. The usual restrictions 
were put upon the diet. In both the sugar disap- 
peared from the urine, and the patient got well.— 
Two other cases are cited in my paper in which the 
disease wras kept at bay or nearly cured by the 
medicine. 
What is the rationale of this unquestionably 
curative action of Phosphoric Acid ? It cannot be 
other than dynamic, for it is exerted in all dilutions, 
though more markedly in the lowest. Whether it 
is homoeopathic or not, the proving contained in the 
‘ Chronic Diseases3 does not enable us to say. But 
it deserves to be noted that Dr. Pavy found saccharine 
urine to result from the injection of Phosphoric 
Acid into the general venous system, and also from 
its introduction into the intestinal canal (On Diabetes, 
p. 82). He considers the acidity of the drug to 372 
DIABETES. 
have caused the phenomenon; but he did not try 
•whether other acids would produce the same effect. 
In estimating the claims of Phosphoric Acid to be 
a remedy for diabetes, we must not forget its power- 
ful action on the nervous centres, in whose derange- 
ment the disease often essentially consists. 
Uranium Nitricum has even higher claims on our 
attention. In the Brit, and For. Medico-Chirurgi- 
cal Review for 1857, it is stated, as the result of 
some experiments by M. Lecomte, that the gradual 
poisoning of dogs with small doses of Nitrate of 
Uranium invariably caused the urine to become 
saccharine. This fact, curious only in the eyes of 
an alioeopathic reader, was to a homoeopath pregnant 
with suggestiveness. Its import was first pointed 
out by Dr. Bradford, of America, in the ‘ North 
American Journal of Homoeopathy.’ The earliest 
cases, however, were supplied by Dr. E. M. Hale, 
in the No. of the same Journal for Nov. 1861. 
Unfortunately no examination was made of the 
urine ; but the symptoms were those of genuine dia- 
betes. Of the three cases, two were cured, and one 
greatly ameliorated. I have given a resume of these 
cases in my paper, and have followed them with three 
from my own practice. In the first, the sp. gr. of 
the morning urine was reduced under five weeks of 
the Uranium from 1042° to 1025°; and this with- 
out change of diet, which had previously been 
restricted. I have since seen this patient about, 
and he looks thriving: but I have had no profes- 
sional intercourse with him. In the second, an old 
man, dieting and Nitrate of Uranium reduced the 
sp. gr. in a fortnight from 1035° to 1019° : and he DIABETES. 
373 
became and continues free from all diabetic symp- 
toms. The third case, up to the end of the report, 
was a brilliant one. In four months’ treatment he 
gained thirteen pounds in weight, improving corres- 
pondingly in health and strength. The urine had 
fallen from six pints daily to three, and its sp. gr. 
from 1035° to 1022-8°; but it still contained some 
sugar. Much to my disappointment, I heard that 
this gentleman, of whom I had lost sight since Feb. 
1866, had died of acute pulmonary disease. 
I have had no cases of diabetes under my care 
since I wrote the paper above cited. But Dr. 
Drysdale (Brit. Journ. of Horn. vol. xxv, p. 597) 
has spoken of obtaining great benefit from the 
Uranium in this disease: and Dr. Eugene Curie, of 
Paris, has published three cases in the Bull, de la 
Soc. Med. Horn, de France corroborative of its 
value. One was cured : and in the other two the 
quantity of sugar in the urine was reduced to one 
half. Another, from an American source, you may 
read in vol. xxvi of the Brit. Journal, p. 661. 
During the present year, however, Mr. Edward 
Blake, of Wolverhampton—worthy scion of a worthy 
bouse—has been publishing in the same Journal a 
series of experiments with the Nitrate of Uranium 
on both men and animals. In none of these was 
sugar eliminated by the urine, and the only con- 
stant post-mortem appearance in the animals was 
ulceration of the stomach and duodenum. Mr. 
Blake’s comments on the results he has obtained 
are 
“ 1st. That the Nitrate of Uranium will not 
-cause the urine to become saccharine. 374 
POLYURIA. 
“2nd. That the Nitrate of Uranium exerts a 
specific action on the circulation of the stomach 
and duodenum resembling that of Kali bichromi- 
cum and Arsenicum. 
“ 3rd. That that action, which is usually ulcera- 
tive, is displayed to the most marked degree in the 
neighbourhood of the pylorus. 
“ If the power of producing glycosuria be denied 
to this drug, it will be asked ‘ How, then, can the 
success of the Uranium treatment be explained ?’ 
I think it must be attributed to the homoeopathic 
rapport which exists between the pathogenesis of 
Nitrate of Uranium and the digestive symptoms so 
commonly seen in the diabetic.” 
As a remedy for 
Polyuria, 
the so-called “ diabetes insipidus,” you will natu- 
rally seek to medicines of the order “ diuretics.” 
Of these Scilla deserves your best attention. The 
first case in which I gave it was an Indian officer, 
who had for two years been passing an inordinate 
quantity of pale urine. There were no special 
symptoms present, but the drain seemed to keep 
his health and strength below par. Phosphoric 
Acid, which I first gave, did no good. He then 
got Scilla 2, three drops in water twice daily. 
After taking this for three or four weeks, he re- 
ported that the urine had fallen to its normal 
amount, and that he was feeling quite well. 1 
have since given it in a similar case with equally 
good results. GRAVEL. 
375 
Gravel. 
It is necessary to have clear ideas about the 
various morbid states included under this term. I 
will divide them into four groups. 
1. There may be actual excess of lithic or phos- 
phoric acid formed in the system, and eliminated 
by the urine. This is indeed rare, especially as 
regards phosphoric acid. Excess of lithic acid is of 
course characteristic of the gouty diathesis: and I 
have already told you what we can do to modify 
this. The only additional question raised by this 
manifestation of the diathesis is that of giving alka- 
lies. I cannot think that we should refuse the 
temporary aid of these remedies when we have 
reason to apprehend concretion. Excess of phos- 
phoric acid implies waste of nervous tissue (more, 
rarely disease of bone, as mollifies ossium). Its 
best medicine would probably be Phosphoric Acid 
itself in the dynamized form. 
2. There may be deposit, without excess, of 
lithic acid or lithates on the one hand, or phos- 
phates on the other. They arise, as you know, the 
one from a too acid, the other from a too alkaline 
urine. Again there can be no objection that I can 
see to redressing temporarily the balance of an 
over-acid urine by chemical measures. But you 
will be too wise to expect its radical cure from 
anything but proper diet and mode of living. In 
this category you will consider the regulated use of 
Lemon-juice, of whose value Dr. Kidd has fur- 
nished so many striking illustrations (Brit. Journ. 376 
GRAVEL. 
of Horn., vol. xxi, p. 43). Deposit of lithates is 
generally connected with some temporary derange- 
ment of health, and here requires no special treat- 
ment. Its occurrence in a permanent form, as one 
of a group of symptoms pointing to digestive de- 
rangement, I have always found an indication for 
Lycopodium. If, however, the symptoms be rather 
neuralgic, the presence of abundant lithates leads 
me to Quinine. I cannot explain why it is so : 
but I give it you as a bit of experience.—Alkaline 
urine, when secreted so by the kidney, must de- 
pend upon a depressed state of the general, especi- 
ally the nervous, system. Phosphoric Acid is here 
again likely to help as a medicine; and if you like 
to give it in material doses so as to obtain its che- 
mical as well as its dynamic effects I at least shall 
not quarrel with you. But I apprehend that alka- 
line urine is most frequently the result of inflam- 
mation of some part of the urinary mucous tract, 
and requires the treatment proper thereto. 
3. I suppose that the use of nitro-muriatic acid 
in oxaluria is one of the most satisfactory bits of 
the ordinary practice. What is the rationale of 
its action ? There is no alkaline condition here to 
be chemically neutralized; indeed, the alliances of 
the oxalic are rather with the lithic than the plios- 
pliatie diathesis, as Dr. Bence Jones has demon- 
strated. I suspect that the nitro-muriatic acid is a 
tertium quid different either from the nitric or the 
muriatic : and that its action in oxaluria is specific 
and dynamic. I must add, however, that—upon 
the analogy of the usefulness of Phosphoric Acid 
in the phosphatic diathesis— I gave Oxalic Acid AZOTURIA. 
377 
itself, in the 12th dilution, to a case of this kind, 
and with very satisfactory results. 
4. When, in connexion with any of the causes 
and varieties of gravel, renal calculi are formed, the 
case is passing into the region of chemistry or sur- 
gery. Your general and medicinal means may 
indeed still check their multiplication or increase. 
If pain accompanies their passage down the ureter, 
Dr. Beakley tells us that five-drop doses of Cha- 
momilla 1 frequently repeated will relieve : hut I 
should be prepared with the inhalation of chloro- 
form in the very probable event of its failure. 
Azoturia 
—i. e. excess of urea in the urine—you are hardly 
likely often to encounter. If you should do so, 
you will read with interest Dr. Drysdale’s case in 
vol. xxv of the Brit. Journal, in which, after the 
failure of remedies symptomatically selected, Senna 
(j>, four drops twice a day, was given with marked 
benefit. Dr. Drysdale was led to this medicine by 
the statement in Cl. Muller’s paper that Senna 
invariably causes in healthy persons an increase in 
the amount of urea, chloride of sodium, earthy 
phosphates, and urates in the urine, the specific gra- 
vity of which is consequently increased. You may 
also consider what has been said of Causticum 
(Pharmacodynamics, p. 205), though I do not 
know that urea formed part of the undue tissue 
waste it has been found to rectify. LETTER XLI. 
diseases of the urinary organs (continued). 
I have hitherto been speaking of disorders in 
which renal mischief is but one, however import- 
ant, element. But I must now tell you what we 
can do when the kidney itself is primarily and 
solely affected. 
Renal Congestion, 
though not mentioned in our systematic treatises, 
I take to be no uncommon malady. I do not 
mean their chronic and mechanical engorgement, as 
from valvular disease or pregnancy; but an acute 
hypersemia of the glands, short of inflammation, 
caused by cold. Here, as you might expect, Tere- 
binthina is an almost infallible remedy. I have 
always given the 3rd dec. dilution. 
The condition just mentioned probably lies at 
the bottom of 
Suppression of Urine, 
and we accordingly have a case cured by Dr. Yeld- 
ham with Terebinthina 1, in which no urine had 
been passed for four days (Annals, I, p. 386). Sup- 
pression of urine has also been observed in cases of HSEMATURIA, 
379 
poisoning by Mercurius corrosivus, Arsenic, and 
Kali bichromicum; so we have some medicines to 
fall back upon, should Turpentine disappoint us. 
The last named is said to have been beneficial in 
the ischuria which follows Asiatic cholera, whose 
association with absence of the biliary secretion 
suggests its dependence upon drain of fluid from 
the blood rather than direct action of the poison 
upon the glands. 
Hsematuria 
is often another manifestation of renal congestion, 
and Terebinthina is nearly always serviceable in its 
treatment. If it be a part of general purpura, you 
will of course treat it on the principles laid down 
when speaking of that disease. I cannot say 
whether Arnica is of service when bloody urine 
depends, as it frequently does, upon mechanical 
disturbance of renal calculi. In the so-called “in- 
termittent haematuria” no blood whatever is pre- 
sent, according to Dr. Lionel Beale.* Dr. Trinks 
has recorded a case (Annals, vol. iii, p. 228) in 
which hsematuria was the prominent symptom of 
post-scarlatinal nephritis. As anaemia was already 
resulting, he gave China 1st dec., three drops every 
four hours, with the result of rapid disappearance 
of both local and general symptoms. 
Haematuria from disease of the bladder requires 
the treatment of the disease it complicates. Its 
presence, however, is in chronic cases an indication 
for Ferrurn Muriaticum : and, when acute, it calls 
* See the ‘ Practitioner * for Aug., 1868. 380 
PYELITIS. 
for Hamamelis or Millefolium, besides the local 
measures in which I need not instruct you. 
Under the heading 
Pyelitis 
I will now speak of the forms of suppurative ne- 
phritis, which nearly always begin in the medullary 
portion and the pelvis of the kidney. A large 
number of them are either secondary to bladder 
disease, or they manifest their existence largely by 
symptoms of distress of that organ. Sir B. Brodie 
has given a capital account of these cases. He be- 
lieves that they often arise from “an injudicious 
use of large doses of copaiva and cubebs, especially 
the latter ■ ” and that it is here, and not in simple 
catarrh of the bladder, that uva ursi and buchu exert 
the influence which has given them repute in urinary 
disorders. He also recommends the Tinct. Ferri Mu- 
riatis. These hints may be of service to us. The Uva 
ursi and the Ferrum Muriaticum promise most: and 
the former has cured a case of the kind. 
Nor can I suggest anything better when pyelitis 
arises from mechanical violence or from the irrita- 
tion of calculi. If there is drain of pus from the 
kidney, you will of course keep your patient up by 
China. 
Of cancer and tubercle of the kidney, in their 
therapeutical aspects, I have nothing to say : and 
so we will pass on to the urinary passages, which 
we have already approached when speaking of pye- 
litis. Let us take first the diseases of the bladder. IRRITABLE BLADDER. 
381 
Cystitis, 
in its acute form, is rarely met with. When oc- 
curring as a metastasis of gonorrhoea, it must be 
treated with Cantharis; and the constitutional ir- 
ritation will generally require the alternation there- 
with of Aconite. When resulting, as it sometimes 
does, from local damp, Dulcamara is even better 
than Cantharis. Chronic cystitis—catarrh of the 
bladder—is common enough, though generally se- 
condary to stricture, stone, diseased prostate, &c. 
You are not the less to apply to it your specific 
remedies, while of course you will not neglect the 
treatment appropriate to the primary affection. 
Here again Cantharis takes the first place, but 
Cannabis saliva closely treads upon its heels. The 
clogging of the catheter with mucus described by 
Morgagni in poisoning by the latter drug is just 
what is often observed in this malady. The Chi- 
maphila umbellata is another medicine specifically 
applicable to this condition, especially wdien occur- 
ring in women. 
The remedies used in old-school practice for 
chronic cystitis—notably pareira brava, turpentine, 
and cubebs—are almost confessedly homoeopathic 
thereto ; and you may bear them in mind in the 
event of your having to go beyond the medicines 
commonly used by Homoeopathic physicians. 
Irritable Bladder, 
without inflammation, is often a symptom of gout, 
when Nux vomica may relieve it. If it be a 382 
IRRITABLE BLADDER. 
simple hypersesthesia, you will generally get good 
results from a persevering use of Belladonna. But 
if the irritability be diurnal only—indicating a 
localization in the inferior portion of the bladder,— 
and without spasm, Ferrum is specific. The pre- 
cisionising involved in this last bit of practice we 
owe to Dr: Robert Cooper of Southampton (Annals, 
vol. v, p. 399).* You must remember that irrita- 
bility of the bladder sometimes arises from disease 
remotely seated,—as in the kidney, the uterus, or 
the rectum : or from an irritating quality of the 
urine. 
* His cases are peculiarly instructive. The first was “ a light- 
haired, pale complexioned, delicate little girl,” who had been 
suffering for two weeks from “incontinence of urine, coming on 
nearly every half-hour, sometimes Softener, but only in the day- 
time, and invariably ceasing on her retiring to bed at night, and 
when lying down during the day.” She had been taking much 
alloeopathic medicine, chiefly Iron. After Podophyllum had been 
taken for three days without avail, Dr. Cooper, suspecting that the 
Iron had caused the trouble, gave Arsenicum as an antidote, and in 
less than a week no trace remained of her distressing malady. 
Then the brother of the little girl, two or three months afterwards, 
was afflicted in a precisely similar manner: and as there was with 
him no antecedent history of pernicious medication, he got Ferrum 
Phosphoricum 1 with speedy and complete success. The next 
case was of a woman, set. 65, a teetotaller: her symptoms were 
aggravated after drinking tea. The same medicine and dose cured 
in a few days: the trouble had lasted six months. The fourth case 
was after parturition, and the vesical disorder was accompanied 
with metrorrhagia and a sense of hearing down and weakness in 
the hypogastrium. All the symptoms disappeared in a few days 
under the Iron. In these cases the phosphate was given; but in a 
fifth the acetate acted equally well, and in the 6th dilution. In 
the sixth case—a man—the phosphate was again successfully 
prescribed: it seemed to him as if any fluid he took went right 
through him ten minutes after. RETENTION OF URINE. 
383 
Strangury. 
By this term (of which dysuria is a practical 
equivalent) I mean frequent, difficult, and painful 
micturition,—a small quantity only being passed at 
a time. It is, I suppose, an affection of the neck 
of the bladder, and may be either nervous or inflam- 
matory. When it occurs in an acute form—and I 
know few seizures more painful—do not care to in- 
quire to which of these categories it belongs, but 
give your patient repeated doses of Camphor, and I 
promise you that you will earn his grateful thanks. 
The same treatment is applicable when absorption 
of cantharides from blister is the cause of the 
symptoms. In cases of less urgency, you will with 
advantage discriminate between the inflammatory 
and the nervous variety. In the former, you can 
hardly do better than give Cantharis itself, if your 
patient be of the male sex. But if the dysuria 
occur, as it very often does, in a woman, I commend 
to you Copaiba and the Eupatorium purpureum. 
The cases in which I have seen the former act so 
well have all been women advanced in life : but I 
do not know that it has any special suitability to 
these. In nervous dysuria you will find Belladonna, 
in the 1st dilution, a rarely-failing remedy. If you 
should want another, you may try Apis. 
Retention of Urine 
may be either spasmodic or paralytic. The former 
variety will come under our notice in connexion 384 
CANCER OF THE BLADDER. 
with stricture of the urethra. The latter is a true 
paralysis of the bladder. When occurring idiopathi- 
cally, as in a case described by Sir B. Brodie 
(Lectures on the Urinary Organs, 4th Ed. p. 101) 
Opium ought to be its remedy ; and the same medi- 
cine might help the catheter to prevent accumulation 
of urine in typhus. When paralysis of the bladder 
occurs in connexion with disease or injury of the 
spine it might be thought that little could be done 
for it. But I have seen power return, and ammo- 
niacal urine become healthy, in a case of this kind 
under drop doses of the Tincture of the Muriate of 
Iron. 
Hysterical retention is of this character: and 
while I concur in the desire not to use the catheter 
for it if possible, I cannot suggest any medicine 
capable of supplying the instrument’s place. 
Stone in the Bladder 
calls for our medicines only to diminish the inflam- 
mation it sets up : and of these I have spoken under 
Cystitis. 
Cancer of the Bladder 
is hardly likely to be touched by anything you can 
do for it: but the haemorrhage to which it gives 
rise may be checked by Ferrum Muriaticum. 
Passing now from the bladder to the urethra, and 
reserving gonorrhoea and gleet for the diseases of 
the male sexual organs,, I shall have to speak of STRICTURE. 
385 
Stricture. 
You may think that I am here presuming upon 
the province of Surgery: but it is not so. Let me 
cite Sir B. Brodie’s sketch of the usual history of 
these cases. “ The patient voids his urine in a 
diminished stream. The diminution gradually in- 
creases, being sometimes attended with a slight 
mucous or muco-purulent discharge. By-and-bye 
there is a complete retention of urine. This sub- 
sides spontaneously, or is relieved by art. After an 
interval, which may vary from weeks to months, or 
even to years, he is overtaken by another attack of 
retention. During the whole of this time the stream 
of urine continues to become smaller; it is flattened, 
or otherwise altered in shape, or divided into two. 
At last the urine never flows in a stream larger than 
a thread, nor without great effort and striving.” 
Now there are three stages in this melancholy pro- 
gress in which our medicines will render effectual 
help. 
1. The first is in the attack of retention, when 
the stricture is narrowed by spasm or inflammation, 
or both. When pure spasm is present, it will gene- 
rally yield with great rapidity to repeated doses of 
Camphor. When inflammation predominates or 
complicates, as from gonorrhoea or irritating injec- 
tions, you may depend with equal confidence upon 
Aconite. With these medicines, and the warm 
bath, you will seldom need the catheter. 
2. I think there is no doubt but that the inci- 
pient symptoms of organic stricture of the urethra 
may be in many cases abolished by the administra- 386 
STRICTURE. 
tion of Clematis. I have given you the evidence 
for this statement when speaking of the medicine 
in question in my letters on Pharmacodynamics.* 
3. When organic stricture has become confirmed, 
so that mechanical dilatation is indispensable, Dr. 
Yeldham testifies to the great advantage of having 
such medicines as Aconite and Cantharis to control 
all inflammatory and spasmodic tendencies prior to 
the introduction of instruments. Aconite, more- 
over, administered after their passage, has been 
found to prevent the sometimes perilous rigor which 
in susceptible persons follows the operation. 
The surgical diseases of the prostate, i. e. the 
mechanical consequences of its enlargement, belong 
to those of the urinary organs. But physiologically 
the gland is a part of the male sexual system: and 
its only disorder which is under medical control— 
viz. inflammation—rarely occurs save in connexion 
with gonorrhoea. So I will speak of it in my next 
letter. 
* See also * Brit. Journ. of Horn.,’ vol. xxiv, p. 689. LETTER XLII. 
DISEASES OP THE MALE SEXUAL ORGANS. 
In the present letter I shall begin, if I do not 
finish, the consideration of the maladies affecting 
the male sexual organs, including those of the tes- 
ticle, the spermatic cord, the prostate gland, and the 
penis and scrotum. 
Of the diseases of the testis I shall speak first of 
Orchitis. 
We are most familiar with this disease when oc- 
curring secondarily to gonorrhoea. In these cases it 
seems to be the epididymis on which the stress of 
the mischief falls: while in orchitis from cold, from 
sexual excess, or from mumps, the body of the gland 
is mainly affected. Whether there should he a cor- 
responding difference in the treatment,—whether the 
testis and epididymis are as distinct pathologically as 
the cortical structure and the pelvis of the kidneys, I 
cannot say.* In my own experience Pulsatilla, with 
Aconite, has given me every satisfaction alike in the 
orchitis of gonorrhoea and in that of mumps : and it 
appears to be the general favourite. Clematis is its 
only rival : and although its efficacy has been ques- 
* Parenchymatous orchitis is generally more painful than 
epididymitis, especially if the tunica albuginea is involved: and 
would hence require more Aconite. 388 
SARCOCELE. 
tioned (see HempeFs Mat. Med. vol. ii, p. 511), there 
is a case of Dr. Ransford’sin the Brit. Journ. of Horn, 
vol. xxv, p. 659, in which no medicine could have 
acted better. Spongia has some evidence in its 
favour. Its symptoms point to irritation of the 
tunica vaginalis and spermatic cord rather than of 
the body of the gland. I have never employed ice 
or compression in this disease; nor do I think either 
necessary : but there is of course nothing to forbid 
them. 
Sarcocele 
is a term including every variety of solid enlarge- 
ment of tlie testis. Where the tumour is carcino- 
matous, enchondromatous, cystic, or fibro-plastic it 
hardly comes within the range of Medicine : and 
any interference must be in the way of castration. 
Simple, strumous, and syphilitic sarcocele are the 
varieties of the disease of whose treatment I shall 
speak. 
1. Simple sarcocele means chronic orchitis, with 
induration. The medicines I have already men- 
tioned in connexion with acute orchitis—Pulsatilla, 
Clematis, and Spo?igia—have occasionally proved 
useful here. But two important additions to their 
number are Aurum and Rhododendron. I have 
myself seen the best effects from Aurum. Dr. 
Yeldham considers it specially applicable when the 
cord is palpably enlarged, and is affected with neural- 
gic pains. Rhododendron, like Spongia, seems to 
act mainly if not entirely on the tunica vaginalis: 
as you will see in its proving, and in the cases cured 
by it. NEURALGIA TESTIS. 
389 
2. Strumous sarcocele may be either chronic 
orchitis in a patient having this diathesis, or actual 
tubercular deposit,—the latter generally in the 
epididymis. In the former Spongia—and perhaps 
Iodine itself—would bid fair to be useful. In the 
latter a general anti-scrofulous treatment, medicinal 
and hygienic, would probably give the best results. 
3. To the usual remedies for syphilitic sarcocele, 
Mercury and Iodide of Potassium, we have Aurum 
to add. 
Irritable Testicle 
is so often a symptom of other mischief, as varico- 
cele, disease of the prostate or prostatic urethra ; or 
a result of improperly-regulated sexual functions,— 
that its treatment is usually “ tolle causam.” Igna- 
tia ought to be a useful medicine. 
Neuralgia Testis 
may be said to exist, when, without or besides mor- 
bid sensibility of the gland, paroxysms of sharp pain 
occur from time to time. Aurum is usually recom- 
mended for it: but I would direct your attention 
to the proving of Hamamelis by Dr. Burt in vol. 
xxiv of the Brit. Journ. of Horn., p. 610. Pull 
doses of the fluid extract of this drug gave him such 
excruciating pain in the testicles that he was com- 
pelled to discontinue the proving. He has only 
hitherto made use of this pathogenetic fact in the 
treatment of ovarian neuralgia : but I have myself 
given Hamamelis in a case of neuralgia, with heat 390 
IMPOTENCY. 
and morbid sensibility, of the testicles with very 
satisfactory results. Colocynth, also, deserves con- 
sideration (see Mr. Pope’s remarks in the Monthly 
Horn. Review, Dec. 1868, p. 733). 
Impotency. 
In undertaking the treatment of a case of this 
kind, you will of course begin by ascertaining 
whether your patient has any discoverable disease 
of the testis or cord, or of the kidney; whether he 
is dyspeptic, or has oxaluria; and whether it is 
moral treatment rather than medical which is re- 
quired. When these causes of impotencv have 
been eliminated, there remain three others to which 
his trouble may be traced, and which require treat- 
ment accordingly. 
1. The fault in many instances is in the nervous 
centres. Sometimes the sexual weakness is one 
element in general paralysis, especially locomotor 
ataxy. Sometimes there is a history of a blow or 
fall, when you will think of Arnica or Hypericum. 
You will observe cases of this variety, moreover, in 
which the loss of power is not in the testicles, but 
in the ejaculatory, erectile, and intromittent func- 
tions. This, which is a true paralysis, has been 
caused and may be cured by Arsenic. In some 
cases of conjoined sexual atony and cerebral de- 
pression Kali bromidum might prove useful. 
2. Impotency may be the result of over-indul- 
gence of the sexual functions, in which event it is 
usually complicated with spermatorrhoea (q. v.). 
Rest to the exhausted organs, and the administration SPERMATORRHOEA. 
391 
of Phosphorus and Phosphoric Acid, are the 
remedies. 
3. A premature senility, or a sort of general 
eunuchism with or without atrophy of the testicles, 
may be the condition of the patient who consults 
you for impotency. Baryta carbonica is good here : 
and Coniurn is so homoeopathic that it ought to be 
of service. The same may be said of Agnus castus, 
which Stapf states that he has several times used 
with success in impotence. Perhaps Camphor should 
be added to the list. 
Sterility 
in the male subject—i.e. capacity for sexual inter- 
course but inability to procreate—so generally 
depends upon organic causes that it rarely comes 
within the reach of medicine. If it be associated 
with atrophy of the testicles, the medicines capable 
of causing this atrophy, viz. Iodine and Conium, 
might be tried. 
Spermatorrhoea. 
We owe to Lallemand the demonstration of the 
frequent dependence of this trouble upon chronic 
inflammation of the prostatic portion of the urethra, 
with the seminal ducts and vesicles, and the pros- 
tate. But we are not, I think, to follow him in 
the treatment of such cases by the local application 
of nitrate of silver,—roughly homoeopathic though 
it be.* We shall accomplish the same end by our 
* A milder local treatment is advocated by Dr. Yaughan-Hughes 392 
SPERM ATORItHCEA. 
internal medicines, which by elective affinity seek 
out and influence the affected part. The chief of 
these are Cantharis and Staphysagria. Dr. Kidd 
speaks highly of the former: * and I have myself 
seen great benefit result from the latter. 
Excluding the comparatively rare instances in 
which spermatorrhoea results from rectal irritation, 
which must be treated with reference to the latter 
region; and from suppressed cutaneous eruptions, 
where Sulphur is required, the only other form of 
spermatorrhoea we have to combat is the atonic, 
from masturbation or sexual excess. Hahnemann 
and his immediate followers, as Hartmann, consider 
China specific in this condition. It would suit the 
condition of morbid irritability in which it com- 
mences admirably. “ The frequent and morbid 
excitement of the sexual organs, resulting in an 
involuntary emission of semen, and caused even by 
slight abdominal irritations, is permanently relieved 
by Cinchona : ” so writes Hahnemann. Later on 
Phosphorus and Phosphoric Acid become our most 
suitable medicines : and, in alternate use and 
varying dilutions, will be found very serviceable. I 
must confess, however, that the after-effects of 
long-continued masturbation are not easy to re- 
move. Perhaps the habit is seldom entirely broken 
off. 
in a paper on this disease, under the title of “ The Irritable Pros- 
tate,” in vol. v of the ‘ Annals.’ You will weigh his recommenda- 
tions in unusually obstinate cases. 
* ‘ Annals/ vol. v, p. 131. VARICOCELE. 
393 
Hydrocele, 
in its common vaginal form, has not unfrequently 
been cured by Homoeopathic remedies. “Acute 
hydrocele,” i.e. inflammation of the tunica vaginalis 
independently of the other contents of the scrotum, 
would probably find its best remedy in Sponyia. 
But chronic hydrocele is rather a serous dropsy. 
Pulsatilla, Rhododendron, and Aururn are again the 
medicines which have done the good service to the 
testicle: but Graphites is to be added. Cases 
illustrative of the action of Pulsatilla and Graphites 
by Dr. Black may be read in the ‘ Brit. Journ. of 
Horn./ vol. vii, p. 525, and there is a case cured 
by Rhododendron by Dr. Hastings in the same 
Journal, vol. xviii. p. 351. I have myself seen a 
hydrocele disappear under Aurum. 
In cases which refuse to yield to this treatment 
you will consider the arguments of M. Jousset, to 
which I have already directed your attention (Phar- 
macodynamics, p. 329), and which go to prove that 
the Iodine injections so successful in hydrocele cure, 
not by setting up inflammation, but by a specific 
alterative influence exerted upon the serous walls of 
the sac. 
The disorders of the spermatic cord which come 
before us for treatment are varicocele and retraction 
of the testicles. 
Varicocele 
is as open to specific treatment as is varix occurring 
elsewhere in the body, and by the same medicines, 394 
RETRACTION OF THE TESTICLES. 
viz. Hamamelis and Pulsatilla, whose affinity for 
the testicle gives them especial power over this 
local variety of the complaint. You may use a 
suspender or apply the pressure of a truss as you 
please : but I think you will find that the “ radical 
cure” of varicocele is better obtained by the use, 
internal and external, of these specifics than by any 
of the operative procedures now in vogue. 
Ttetraction of the Testicles 
must imply a spasm of the cremaster muscle. We 
are familiar with it as a symptom of the passage of 
a renal calculus : and even in apparently idiopathic 
cases it would be well to see if there is any obscure 
urinary irritation at the bottom of it. But if none 
such is discoverable you will do well to consider the 
frequent appearance of this symptom among the 
subjects of lead-poisoning: and Teste’s statement, 
that he has employed Plumbum with particular 
success in “ an excessively painful retraction of the 
testicles and penis, which seemed to re-enter the 
hypogastrium (in consequence of prolonged venereal 
excesses and repelled tetters).” 
When now we come to the prostate gland, you 
will naturally think of that chronic enlargement of 
its substance which is one of the troubles of old 
age. I cannot tell you that medicine has any 
control over this : nor indeed is it likely. I can 
only speak of the treatment of acute and chronic 
inflammation of the gland. 395 
GONORRHOEA. 
Prostatitis 
is rarely seen save as a complication of gonorrhoea 
or gleet. In its acute form Pulsatilla appears to 
be its specific remedy, with or without Aconite as 
may be required. If the inflammation tend to 
linger in a subacute form, Dr. Yeldham recommends 
the administration of grain doses of Kali hydriodicum. 
Chronic prostatitis may be helped by Pulsatilla, but 
finds a still more efficient remedy in Thuja. A 
good case of it, treated mainly by this medicine, is 
recorded in the * Brit. Journ. of Horn./ vol. xxiv, 
p. 499. 
We have lastly to consider the diseases affecting 
the penis and scrotum, and will begin with the most 
common and central of all the maladies of the male 
sexual organs, 
Gonorrhoea. 
I have no opinion to offer as to the abortive 
treatment of this disease, whether by the Sepia 30 
recommended by Jahr, or by the injections of the 
old school. But I can confidently recommend the 
following treatment for the fully established disorder. 
If your patient has it for the first time, and the 
inflammatory symptoms run high, put him on a low 
dilution of Aconite, and trust to this medicine alone. 
A case by Mr. Pope in vol. xxv of the ‘ British 
Journal/ p. 508, will show you what it can do. 
When the inflammatory symptoms have subsided, 
or if they have been moderate from the first, give 
Cannabis saliva steadily. It seems generally agreed 396 
BALANITIS. 
that the proper dose for this medicine is from one 
to five drops of the mother-tincture. The only 
additional remedy likely to be required in acute 
gonorrhoea is Cantharis, which should be given 
intercurrently with the other medicines when the 
urinary symptoms indicate that the inflammation is 
extending towards the bladder. 
Chronic gonorrhoea—“ gleet”—is not always 
amenable to internal remedies, though to the Far- 
rum Muriaticum of the old school we have to add 
Cannabis, Petroselinum, Sepia, and Thuja. The 
last is especially serviceable when the prostate is 
involved, or when condylomata are present. Zin- 
cum Muriaticum has been found useful by Tessier. 
If you have to use injections, those recommended 
by Dr. Yeldham are effectual and uninjurious, viz. 
Liq. Plurnbi Diacet. 53s, Aquae Destill. $j, and an 
infusion of an ounce of powdered Hydrastis root to 
a pint of water. 
Dor further information upon the treatment of 
gonorrhoea and gleet I refer you to the last-named 
author’s capital book on “ Homoeopathy in Venereal 
Diseases,” and to some observations by Dr. V. 
Meyer in the Brit. Journ. of Horn., vol. xv. 
I have said nothing about the Copaiba and 
Cubebs of the ordinary treatment. There is little 
doubt of their action being of a specific nature: 
and perhaps some day they may find their place in 
the Homoeopathic treatment of the disease. 
Balanitis 
is not a very serious matter: but any one will SOFT CHANCRE. 
397 
thank you for telling them how rapidly it may be 
subdued by Mercurius. In neglected cases Dr. 
Yeldham recommends the local use of Calendula. 
Soft Chancre, 
with its suppurating bubo, is now generally recog- 
nised as a local affection. Mercurius is its great 
remedy, not on account of its relation to the syphi- 
litic poison, but because of its action on the part, 
and its power over ulcerations generally. For the 
same reasons Nitr’ic Acid is an excellent medicine 
wherewith to re-inforce the action of Mercurius 
when that is flagging. 
If the chancre should become phagedaenic, it 
seems generally agreed that Mercurius corrosivus is 
the best medicine to arrest the mischief; but I 
have known it cause disappointment. All these 
medicines are recommended in the lowest potencies. 
The treatment of the chancrous bubo I will 
borrow from the large experience of Dr. Yeldham. 
He recommends the early evacuation of the matter. 
But if this has been delayed, or the patient is un- 
healthy, and the bubo becomes phagedaenic, “ it 
demands the most careful management, both local 
and constitutional. The former consists, first, in 
the use of warm linseed poultices; and, secondly, 
of Calendula lotion, in the proportion of one part 
of the tincture to eight of water. Cotton-wool 
should be soaked in this, and laid in, and over, the 
wounds. The constitutional treatment consists in 
the administration of the Biniodide of Mercury, in 
two or three grain doses of the 2nd dec. trituration, 398 
INFLAMMATION OF THE SCROTUM. 
if Mercury has not already been given ; or, if it 
have, of Acidum Nitricum, in ten drop doses of the 
2nd dec. dilution; or of Kali hydriodicum, in one 
or two grain doses, three times a day. The 
patient’s powers should, at the same time, be sus- 
tained by a generous diet, to which a table-spoon- 
ful of cod-liver oil every night is an excellent addi- 
tion. He should, also, keep himself quiet, and as 
much as possible in the recumbent posture. Move- 
ment, from the peculiar situation of the disease, 
tends to retard the healing process ” (Homoeopathy 
in Venereal Diseases, p. 73). 
I must add, however, that Carlo animalis has 
considerable reputation in dispersing these buboes, 
even after fluctuation can be detected. 
Elephantiasis of the penis and scrotum (and pru- 
rigo of the latter) belongs to Cutaneous diseases; 
but I must speak of the form of cancer Avhich 
affects them, and which is nearly always 
Epithelioma. 
If this could be seen and treated early, I should 
expect very good results from Thuja. Later, 
Arsenic would probably do all that could be ex- 
pected from medicine. 
Inflammation of the Scrotum 
is either of the “ diffuse ” form, affecting the abun- 
dant cellular tissue : or one threatening mortifica- 
tion, analogous to the noma pudendi of the other 
sex. Apis for the former, Arsenicum for the latter, 
would be the suitable medicines. LETTER XLIII. 
DISEASES OE THE EE MALE SEXUAL SYSTEM. 
The disorders peculiar to the female sex will 
next engage our attention : aud from the frequency 
with which they come under our notice will de- 
mand a careful consideration. I have abundant 
material on which to draw,—England, .France, 
Spain, and America having each produced a treatise 
on the Homoeopathic treatment of these maladies, 
from the pen of Leadam, Jahr, Croserio, and 
Guernsey respectively. Besides these there are 
Dr. Peters’ Treatises on the “ Disorders of Menstru- 
ation ” and on the “ Diseases of Married Females.” 
I begin with the diseases of the ovaries. Yery 
little is known of the action of medicines upon 
these organs : but their homology with the testes 
leads us to apply to their morbid conditions the 
remedies suitable in the corresponding diseases of 
the latter; and we have every reason to trust the 
soundness of our inference. 
Ovaritis 
is very uncommon in an acute form : but when oc- 
curring, as from sudden suppression of the menses, 
Aconite and Pulsatilla are its medicines, as in the 
corresponding acute orchitis. When occurring in 400 
OVARIAN NEURALGIA. 
connection with gonorrhoea, Dr. Ludlam recom- 
mends the internal and external use of Hamamelis. 
If the peritoneum be involved, Belladonna is his 
remedy : but I have seen this element in ovaritis 
rapidly dispelled by Mercurius corrosivus, while 
Pulsatilla was required to complete the cure. 
Colocynth, also, must be remembered here. Pul- 
satilla is often serviceable also in the more frequent 
chronic form of the disease : but it has a rival in 
Conium, which is strongly recommended by Dr. 
Drury. Platina is recommended by Dr. Hering in 
induration,* Lachesis in abscess of the ovary. 
Chronic ovarian trouble often comes before us as 
Ovarian Neuralgia. 
It seems probable that a large proportion of these 
cases depend on chronic subacute inflammation of 
the surface of the organ and of the adjacent peri- 
toneum (ovarian folliculitis and pelvi-peritonitis). 
We should have here, besides the occasional pa- 
roxysms, permanent tenderness and enlargement, 
and perhaps continuous pain. But there may un- 
questionably be a pure neurosis of the ovary, 
answering to the irritable and neuralgic testicle. 
Of the three cases cured by Dr. Burt with Hama- 
melis (Brit. Journ. vol. xxiii, p. 614) the first seems 
to belong to the former, the second and third to 
the latter category. This medicine is also highly 
praised in the inflammatory form by Dr. Ludlam, 
of Chicago, in his very interesting Clinical Lecture on 
* See a case by Mr. Harmar Smith in the ‘ Brit. Journ.’ vol. 
xxv, p. 157. OVARIAN DROPSY. 
401 
Ovaritis in the United States Medical and Surgical 
Journal, from which I have already quoted. Colo- 
cynth is also in considerable repute in ovarian neu- 
ralgia. Its virtues are probably owing to its 
specific influence upon the peritoneum,—chronic 
inflammation of the ovarian portion of this mem- 
brane so often lying at the bottom of the symp- 
toms. In pure ovarian neuralgia Dr. Ludlam 
recommends Atropine or Valerianate of Zinc. 
Ovarian Dropsy. 
In thinking over the possible curability of this 
disease, it must be remembered that it corresponds, 
not with hydrocele, but with cystic disease of the 
testicle. As the only help for the latter is castra- 
tion, so it would appear that ovariotomy is quite in 
place for the former. But as there is no hurry 
about these cases, it is worth while testing the 
reputed virtues of some of our medicines. Of 
these Apis and Iodiiim stand first: some cases illus- 
trating the action of the former have come from 
America, and there is one cured by Iodine in 
the Brit. Journ., vol. xx, p. 588. In Dr. Lea- 
dam’s book there are two cases, one of apparently 
complete cure, the other of great diminution of 
size. In the former many medicines were given, 
according to the general symptoms : the latter had 
Sepia and Sulphur. The only case I have had an 
opportunity of treating was a tolerably favourable 
one, the tumour being unilocular, and the patient’s 
general health excellent. I gave Apis persistently, 
and in various dilutions, for thj*ee months: and 402 
MENORRHAGIA. 
then again after having tapped her, but without 
any result. Bromide of Potassium seems coming 
into use in the old school in the treatment of 
ovarian dropsy, and Dr. Black has just published 
(Brit. Journ. of Horn., Jan. 1869) a case cured by 
this medicine in grain doses three times a day. 
If ovariotomy is decided upon, our remedies for 
peritonitis and vomiting would probably go far to 
diminish the possible fatality of the operation. 
I will take next the disorders of menstruation, 
which occupy a common ground with the diseases of 
the ovaries and those of the uterus. I will speak 
first of 
Menorrhagia. 
I tliink the best division of the cases in which 
this trouble occurs to be that of Dr. Guernsey, who 
classifies Menorrhagia as Organic, Sympathetic, or 
Functional. Organic menorrhagia implies that some 
local disease of the womb is present, of which the 
haemorrhage—generally inter-menstrual as well as 
menstrual—is but a symptom. Sympathetic menor- 
rhagia is that which appears in Bright’s disease 
and in tuberculosis, in the inhabitants of malarious 
districts, and in the subjects of lead-poisoning. 
The persistent treatment of these cases must of 
course be that of the primary disease. But you 
must not therefore suppose that you cannot diminish 
the profuseness of the menstrual flow at the time. 
What Dr. Kidd has told us may be done with 
Sabina, Secale, and Ferrum in the menorrhagia of .MENORRHAGIA. 
403 
fibrous tumours (see Brit. Journ. of Horn., vol. xx, 
p. 52) is true also of other instances of the organic 
and sympathetic forms of the disease. 
The remedies for menorrhagia are,in the first rank, 
Crocus, Ipecacuanha, and Sabina; in the second, 
Aloes, Arsenicum, Belladonna, Chamomilla, China, 
Calcarea, Ferrum, Hamamelis, Platina, and Secale. 
I place the three first named in the front rank, 
because they are most frequently used. Crocus is 
invaluable in functional menorrhagia, when the dis- 
charge is blackish and lumpy. It should be given 
during the flow only, and China or some other 
medicine suited to the cause substituted in the inter- 
vals. I have often used it with success : but have 
never met with the “ sensation as if something were 
alive in the abdomen in the form of a ball ” which 
is said to be so characteristic of it. Sabina is suit- 
able in the frequently occurring cases which depend 
npon active hypersemia of the uterus: the blood is 
bright red. If urinary or rectal irritation co-exist, 
the indications for it are still clearer. It may often 
be continued during the intervals, as the sole remedy 
required. Ipecacuanha may be given where neither 
Crocus nor Sabina is specially indicated, and where 
much nausea is present. 
The other anti-menorrhagic medicines are called 
for under the following conditions. Aloes is good 
where the menorrhagia depends upon general pelvic 
congestion, and is accompanied by piles. Arsenicum, 
in material doses, has proved curative in some ob- 
stinate cases, perhaps of chronic endo-metritis. Bel- 
ladonna may be given when the indications are 
present of which I shall speak under the head of 404 
MENORRHAGIA. 
Uterine Congestion. Chamomilla lias undoubted 
control over uterine haemorrhage : and may be given 
in preference to other medicines when it has been 
brought on by disturbing emotions, and where sensi- 
bility and mobility, local and general, are abnormally 
exalted. China is of course the best medicine for 
relieving the debility incident to menorrhagia. But 
it is also homoeopathic to the disorder itself, pro- 
ducing a flow like that of Crocus. It is accordingly 
specially useful to re-inforce that medicine in the 
menstrual intervals. It helps, moreover, to restore 
the periodicity in cases of irregularity. Calcarea 
is suitable, during the intervals, in cases where the 
menorrhagia is but one element of general mal-nu- 
trition, as in that sympathetic with tubercle. A 
Dr. Patzack has reported some striking cures with a 
medicinal course comprising Calcarea, Sulphur, 
China, and Nux vomica. You will find his observa- 
tions in Peters’ Treatise. It is doubtful to which of 
the medicines, or whether to all, the benefit is to be 
ascribed. Ferrum is good in some cases of passive 
menorrhagia, chiefly from organic disease of the 
womb. Platina is a favourite remedy for this dis- 
order : and would probably be most in place when it 
depended upon undue ovarian excitement. The 
same may be said of Hamamelis. With Platina the 
menses are too early and too long-continued, as well 
as profuse. Secale is given by our therapeutists as 
by those of the old school in atonic conditions of 
the uterus, as in those who have resided in tropical 
climates; and, strange to say, often produces its 
effects in infinitesimal doses. 
This is all I have to say about menorrhagia; and AMENORRHOEA. 
405 
now I have to direct your attention to the opposite 
condition, 
Amenorrhoea. 
I include under this heading all marked defi- 
ciencies of the catamenial flow, whether in quantity 
or quality, down to its complete absence. I will 
not now speak of the form of this disorder which 
comes before us in those entering upon puberty, a3 
I shall have to speak of their troubles under the 
head of “ Critical Age.” But I am thinking of 
those in whom the menses are suddenly suppressed, 
or gradually diminished until they finally disappear. 
The treatment of these cases will vary according as 
the cause is local or constitutional. 
The menses which a chill has suddenly suppressed 
may often be restored then and there by the timely 
administration of Aconite. If too late for this, a 
course of Pulsatilla continued until the next period 
comes round rarely fails to put matters straight. 
But if after such suppression anjemia has set in, 
you will materially aid the restoration of the func- 
tion by a previous chalybeate course. The case I 
have already cited when writing upon Anaemia 
illustrates the advantage of this method. 
Cases in which the catamenia are simply sus- 
pended—i.e. fail to occur at the expected time— 
are generally due to change of climate or mode of 
life, and rarely cause any derangement of health or 
require treatment. But the most important variety 
of amenorrhcea is that in which the discharge, 
having diminished in amount for two, three, or 406 
CHLOKOSIS. 
more periods, or the interval having become longer 
and longer, has finally ceased. This is generally 
dependent upon constitutional causes, and the men- 
strual suppression is but a symptom of the deranged 
health of the whole system. It is rare that the 
error is on the side of plethora. Where it is so, 
Belladonna should be given during the intervals, and 
Aconite at the periods; and the obvious hygienic 
regulations observed. Far more commonly the 
general condition is one of mal-nutrition and debility. 
If its character be that of ansemia simply, the 
chalybeate treatment already recommended is usually 
sufficient to set everything right. When hvdrsemia 
is present, and there is some pale discharge at each 
period, Argentum nitricum deserves attention (see 
the observations of Dr. Yon Grauvogl, in the Brit. 
Journ. vol. xxvi). The constitutional condition, 
however, most commonly associated with amenorrhoea 
is that which is styled 
Chlorosis. 
Chlorosis is, I take it, something more than 
anaemia : it is a cachexia. It is rare that iron alone 
will cure it, though with the aid of specific remedies 
it powerfully contributes to restore the impoverished 
blood. You will consider the whole group of symp- 
toms present; and then select a remedy corresponding 
bothwith these and with the depressed catamenialfunc- 
tion. You will generally find it amongst the following 
—Pulsatilla, Cyclamen, Graphites, Sepia, Sulphur, 
Conium, Plumbum, and Natrum Muriaticum. Pulsa- 
tilla is suitable for the simplest form of chlorosis, INFREQUENT MENSTRUATION. 
407 
where the patient is just pale, chilly, and languid, with 
nausea, loss of taste and appetite; the bowels regu- 
lar, or tending towards diarrhoea. It is much aided 
by Sulphur when the patient is habitually unhealthy. 
Cyclamen acts very like Pulsatilla : headache with 
dizziness and obscuration of sight are symptoms 
specially calling for it. Graphites stands next to 
Pulsatilla in the frequency of its usefulness: con- 
stipation and tendency to cutaneous eruptions are 
its special indications, and it is perhaps better when 
the menses are delayed, scanty, and painful, than 
when they are altogether absent. Sepia is most 
suitable when there is much leucorrhoea, and where 
the general dyscrasia is considerable: the rectum 
also gives evidence of the existence of portal or pel- 
vic congestion. Natrum Muriaticum also has con- 
stipation for one of its indications : and, like Sepia, 
is most useful in chronic cases with greatly impaired 
nutrition, as evidenced especially by the appearance 
of the skin. The same is to be said of Plumbum, 
which was introduced as a remedy for chlorosis by 
Dr. Winter of Lunenburg. You will find his 
paper translated, with some additional observations 
by Dr. Drysdale, in vol. i of the ‘ British Journal/ 
p. 160. Conium is homoeopathic where the amenor- 
rhcea is part of a general depression of sexual 
activity : in which cases the salts of Baryta also 
might be useful. 
Infrequent Menstruation 
requires special mention, because it may co-exist 
either with a scanty or with a copious discharge. 408 
DYSMENORIIIICEA. 
In the former case the medicines—especially Gra- 
phites—mentioned under amenorrlioea and chlorosis 
have to be considered, and to these Kali carboni- 
cum and Dulcamara maybe added. When the flow 
is copious, although late, Belladonna, Calcarea, 
Chelidonium, China, Nux vomica, and Phosphorus 
are all homoeopathic, and the choice between them 
must be based upon the characters already assigned 
to these medicines. 
Vicarious Menstruation 
is rather an annoyance than a disease of moment. 
Dr. Leadam recommends Ferrum, and Dr. Carroll 
Dunham Bryonia as ordinarily the most suitable 
remedies for re-diverting the menstrual nisus to its 
proper seat. Hamamelis, also, has occasionally 
effected this purpose. 
I have last to speak of painful menstruation, 
Dysmenorrhoea. 
In undertaking tlie treatment of a case of this 
kind, you will of course begin by eliminating the 
purely mechanical variety of “ obstructive dysmenor- 
rhoea.'* Whether arising from congenital nar- 
rowness of the cervix, or from subsequent flexion of 
the womb, in either case it seems to require me- 
chanical treatment, though the latter is somewhat 
(as we shall see) under the influence of medicine. 
Functional dysmenorrhoea implies that the ova- 
ries and uterus (chiefly the latter) cannot perform 
their periodical duties without pain. Either their DYSMENORRHOEA. 
409 
natural livpersemia oversteps the boundary of health, 
or their nerves are abnormally sensitive ; or the 
uterine muscular fibres are prone to spasm or stiff- 
ened by rheumatism. The leading medicines for 
dysmenorrhcea will find their place under one or 
other of these forms. 
Obstructive dysmenorrhcea, i. e. when the pain 
is felt chiefly if not entirely before the flow begins, 
when not mechanical, is due to narrowing of the 
cervical canal by congestion or by spasm. If from 
congestion limited to the uterus itself, Sabina 
should be given during the flow and the intervals, 
and Aconite administered while the pain lasts. If 
the congestion be more general—as shown by con- 
stipation, liseinorrhoids, hepatic disturbance, and so 
on— Collinsonia is a good medicine, both at the 
periods and between them. Tor the spasmodic 
form I find Gelseminum, not higher than the 1st 
dec, dilution, a most excellent remedy. It is 
scarcely more than palliative at the time, however ; 
and Caulophyllum is the best medicine to be given 
as curative during the intervals. Its action upon 
the uterus is like that of Secale, but with the 
difference (so important here) that it influences the 
cervix as well as the fundus. 
Non-obstructive dysmenorrhcea, where the pain 
continues throughout the flow, means either ovarian 
irritation, or uterine rheumatism or neuralgia. It is 
probably in ovarian dysmenorrhcea that the virtues of 
Hamarnelis, which is attaining much reputation in 
this disorder, find their scope. A curious variety of 
this form is the “ membranous dysmenorrhcea,” in 
which, under the morbid ovarian stimulus, the 410 
DYSMENOIUUKEA. 
normal catamenial exfoliation of the uterine mucous 
membrane becomes an inflammatory process. If 
the Hamamelis given for the ovaries is insufficient 
to cure this complication, you may with advantage 
remember the striking results once obtained by Dr. 
H. Bennet in a case of this kind from Borax (see 
Peters, p. 146). When the uterus is rheumatic, 
Actcea Racemosa is to us what Guaiacum seems to 
be in the old school. And when it is liable to 
suffer neuralgic pain in the performance of its 
monthly function, Chamomilla and Coffea are re- 
commended,—but I have seen the most speedy 
effects from Xanthoxylum. Dr. Hale’s experience 
with this drug quite coincides with this allotment 
of its place. “ I think Xanthoxylum,” he writes, 
“ more especially indicated in females of spare 
habit, nervous temperament, and delicate organiza- 
tion. In some cases of plethoric habit it has failed 
me.” 
You will observe what large use I have made of 
the American remedies in my recommendations for 
dysmenorrhoea. Indeed I should have had little to say 
with confidence about its treatment did I not pos- 
sess these valuable agents. The subject is touched 
with a very uncertain hand by Leadam and Peters, 
to whom they were unknown. LETTER XLIY. 
DISEASES OF THE FEMALE SEXUAL SYSTEM 
(icontinued). 
I now come to the morbid states of the uterus 
itself. And first of 
Uterine Congestion. 
By this name, and not by that of chronic metritis, 
I must describe that permanently hyperaemic con- 
dition of the womb which obtains when its tem- 
porary physiological engorgements have become 
pathological. There need not be any ulceration 
of the cervix here : and of this I shall speak sepa- 
rately. The medicines of chief service in this 
malady are Belladonna, Conium, Murex purpurea, 
Pulsatilla, Sabina, and Sepia. In discriminating 
between these, you may first divide them into two 
groups, according as the congestion to which they 
correspond is arterial or venous. In the first 
group we shall have Belladonna, Murex, and Sa- 
bina : in the second Conium, Pulsatilla, and Sepia. 
Then, subdividing still farther, you will think of 
Sabina in preference where haemorrhage is free, 
and there is consentaneous urinary irritation : of 
Belladonna where there is the characteristic sensa- 
tion of pressure downwards, as if the contents of 412 
HYSTERALGIA. 
the pelvis would be forced out (Qy. tenesmus of 
the cervix ?) : of Murex where the patient com- 
plains of great faintness and sinking at the epigas- 
trium. In the venous cases, Pulsatilla will be 
most suitable when the affection is recent, and 
where the patient’s temperament is that belonging 
to this medicine ; Sepia where the rectum is in- 
volved in the congestion : Conium where there is 
evidence of diminished sexual life. You will con- 
sider also the character of the leucorrhoea always 
present in these latter cases as helping to deter- 
mine the choice. 
When long-standing congestion has brought the 
uterus into a state of induration, these remedies 
cease to be applicable, and Mercurius corrosivus 
and Platina take their place. 
There is also a form of uterine congestion not 
contemplated in the above remarks, viz. that se- 
condary to general abdominal or pelvic engorge- 
ment. Sulphur and Nux vomica in the former, 
Aloes or Collinsonia in the latter, will be the suit- 
able remedies. 
Hysteralgia. 
The “ irritable uterus ” is sometimes a congested 
one, still oftener a flexed one : and requires treat- 
ment accordingly. But when all such cases have 
been eliminated, there remain behind some to 
which the description of Gooch and Ferguson ap- 
plies,—in which the uterus, without recognisable 
lesion, is a constant source of trouble in itself and 
to the whole system. None of the old remedies CEItVICO-METllITIS. 
413 
are so good for this complaint as the Actcea Race- 
mosa. The frequent presence of a rheumatic ten- 
tency in the patients strengthens the indications 
for it. I recommend you to continue its use, in 
varying dilutions, for a considerable length of time. 
Endo-metritis. 
By this name I mean an inflammation (only met 
with as chronic) of the mucous membrane lining 
the body of the uterus. The membranous dysmenor- 
rhoea of which I have already spoken is probably of 
this nature: and the Borax found so useful there 
must not be forgotten here. But the chief remedy 
for endo-metritis is Arsenicum. It is especially 
useful when menorrhagia is a prominent symptom 
of the disease. 
I come now to the very difficult subject of the 
treatment of the inflammations, indurations, and 
ulcers of the os and cervix uteri. I will discuss 
the subject under the head of 
Cervico-metritis. 
There seems no reason, a priori, why ulcerations 
of this part should not be as curable by internal 
means as those which occur elsewhere. But the 
prejudice in favour of local caustics is so strong, 
and the temporary relief they afford is so obvious, 
that their relinquishment is one of the most diffi- 
cult tasks the convert to Homoeopathy has to per- 
form. But 1 am persuaded that he must perform 
it, if he wishes to be thorough in his new system, 414 
CERVICO-METRITIS. 
and not a mere eclectic. Dr. Madden's published 
experience is instructive upon this point. Having 
devoted a good deal of attention to uterine diseases, 
and feeling far from satisfied with the results of 
internal medication in ulceration of the cervix, he 
proposed and for some time practised the local ap- 
plication of caustics (see his elaborate paper in 
the Brit. Journ. of Horn., voh ix, p. 11). But 
before many years had passed over, we find him 
candidly avowing that he had found the practice 
ultimately injurious, leading to the development of 
disease in other parts (see vol. xi of the same 
Journal, p. 638). Now he tells us (Annals, vol, v, 
p. 129) that he never uses any stronger application 
to the uterus than weak Calendula lotion. Leadam 
and Guernsey on the other side tell us that in- 
ternal medicines are sufficient without any cauteri- 
zation. And the current of opinion in the old 
school itself seems to me to be setting against the 
barbarous local treatment which not long ago was 
thought indispensable. 
If, however, we are to dispense with these potent 
measures, we must all the more carefully select our 
specific remedies. The main distinction I appre- 
hend to be between ulceration within or without the 
cervix. In the former case the surface affected is 
that of a freely-secreting glandular organ, covered 
with columnar epithelium : in the latter it is an 
ordinary mucous membrane with squamous epi- 
thelium, covering a fibro-muscular structure. In 
the former the history generally begins with leu- 
corrhoea, this being itself often a symptom of venous 
congestion j and the abnormal activity of the cervical LEUCORRHOEA. 
415 
muco-glands has gone on to irritation, inflammation, 
and ulceration. In such a case the medicines will 
be those for chronic leucorrhoea, of which I shall be 
speaking directly. The latter form of ulceration is 
more primarily inflammatory. If it be superficial, 
Mercurius solubilis or Arsenicum (the latter if the 
pain is burning and the patient weak) should be 
given internally, and injections of Calendula (one 
part to eight, or weaker) employed. If it be more 
deeply excavated, and the visible portion of the os 
and cervix be swollen and indurated, Mercurius 
corrosivus is my favourite medicine : but Dr. 
Leadam speaks highly of Lycopodium and Hepar 
sulphuris. You will of course look carefully after 
syphilis, and also sycosis, in your patient: and 
treat their local manifestations as you would do if 
they appeared on the penis. 
Leucorrhoea 
is indeed a symptom rather than a disease, and may 
be associated with many of the uterine maladies we 
have already considered or shall yet have to con- 
sider. But there are several varieties of leucorrhoea 
which come before us for treatment as such : and 
the remedies for these I shall now consider. 
First, we have leucorrhoea occurring in connexion 
with general debility—as from residence in tropical 
climates, over-lactation &c.—implying an atonic 
state of the uterus, but nothing farther. In ad- 
dition to the general measures you will here adopt 
for strengthening the system, you will remember 416 
LEUCORRHCEA. 
the special virtues of Helonias as a uterine roborant. 
If, nevertheless, the leucorrhoea persists, you will 
find Pulsatilla the specific remedy for the morbid 
activity of the glands of the cervix. 
A still more common form of leucorrhoea is that 
which comes before us in those who have had severe 
abortions, or who have borne children too frequently. 
Here, I apprehend, besides debility, there is passive 
uterine congestion. Accordingly, Sepia is our chief 
remedy: and with the aid of general and local 
bracing will do great things for our patients. 
When leucorrhoea from either cause, hut especially 
from the latter, has lasted some time, irritation, 
going on to inflammation and ulceration of the 
glands of the cervix is set up, as has been shown 
by Dr. Tyler Smith. Accordingly, when Pulsatilla 
and Sepia have been fairly tried, but without 
success, or when from the symptoms or an ex- 
amination you diagnose disease of the cervix, you 
must resort to more deeply acting medicines. Of 
these I have most confidence in Iodine, which is 
especially useful in strumous or tuberculous subjects. 
The forms of leucorrhoea hitherto mentioned are 
uterine, mainly from the mucous crypts of the 
cervical canal. But there is a vaginal leucorrhoea, 
usually associated with a chronic inflammatory 
condition of the passage. For this Dr. Leadam 
strongly recommends Mercurius solubilis : hut the 
value of Sepia in gonorrhoea in the female—which 
s mainly a vaginitis—should make it serviceable 
also here. Thuja, moreover, has some evidence in 
its favour. 
I have only to add that in leucorrhoea from rectal P12III-UTERINE HEMATOCELE. 
417 
ion, besides the ever-recurring Sepia, Collin- 
and Aloes are indicated. 
ave thus endeavoured to indicate the principal 
ies for the principal forms of leucorrhoea. 
iyou meet with a case which falls under none of 
headings, or refuses to yield to these remedies, 
aust just treat it symptomatically, according 
3 colour, quality, and consistence of the dis- 
3, the concomitant symptoms, and so on. The 
ines supposed to be suitable for these will be 
in the Repertories. 
to vaginal injections in leucorrhoea, my own 
ence is decidedly in their favour. Free irri- 
i of the os and cervix daily with cold water is 
questionable service: and something is to be 
**;■ the injection of a solution of the medicine 
is being given internally, or of Hydrastis. 
se of medicinal astringents, however, I do not 
imend. 
Peri-uterine Hsematocele 
I its surgical rather than medical questions as 
s treatment. There are two occasions, how- 
I m which our medicines may interpose with 
:age. The first is when the primary hsemor- 
is still going on. Here Hamamelis would 
3th the nature of the trouble and the source 
e it proceeded. The second is when the 
m is intra-peritoneal, and has set up inflam- 
i. The medicines already recommended for 
| aitis would now come to our aid. 418 
DISPLACEMENTS OE THE UTERUS. 
Displacements of the Uterus, 
—including ante- and retroversion, and prolapsus— 
will next engage our attention. It may be thought 
that medicines can have little to say to these 
mechanical disorders. But remember how often 
the flexions of the womb depend upon congestion of 
the organ or the presence of fibrous tumours in its 
walls, and bow prolapsus generally implies weakness 
of the uterine supports; and the place of medicines 
as remedial agents is evident. What they can some- 
times do may be illustrated by the following case 
(‘ Brit. Journ. of Horn./ vol. xxiii, p. 669). 
“ In 1858 I was called to see an unmarried 
woman of thirty who had been ill for three years, 
and had never got much relief from any medical 
advice she had received. I found her general heaJth 
much impaired, with constant pain in the back and 
pelvic region, with extremely painful menstruation, 
her spirits depressed, and herself convinced that no 
one had understood her case, and feeling that there 
could be no cure for her. In my examination of 
the case I learned from her that, three years pre- 
viously, while assisting her father to lift some heavy 
article, she had felt something give way, and had 
become sick immediately; had kept her bed for 
some time after; had got little help from any 
medicine, and had slowly recovered so as partially 
to resume her labours, but had never been well since, 
nor ceased to suffer in the back and lower part of 
the abdomen. 
“ On making the necessary examination, I found DISPLACEMENTS OF THE UTERUS. 
419 
the uterus retroverted, the os pressed high up 
against the pubes, the fundus low down in the 
hollow of the sacrum. The slightest attempt to 
replace the organ gave such severe pain as to make 
me desist immediately; and, after two futile at- 
tempts, I decided to try Sepia 30, and see her again 
in a few days. I then found her feeling better, but 
she said that each repetition of the medicine gave 
pain from the inguinal region to the pubes, ‘ a kind 
of drawing pain/ I ordered a continuance of the 
Sepia, and saw her again about a week after my 
first examination. To my great joy I found the 
cervix uteri had descended an inch or more, and the 
fundus correspondingly ascended. I can hardly ex- 
press the delight felt at this discovery, believing from 
that moment that the idea so long cherished would 
be fully realized, and that my patient would be 
really cured when the uterus had regained its normal 
position, and I did not doubt that the means which 
had so well begun the work w'ould complete it. 
“ I need only add that the first menstruation 
after the treatment commenced was accomplished 
with comparatively little suffering, and that as the 
cure progressed the suffering ceased. The cure 
went steadily on, and at the third examination the 
position was normal : and, although the patient was 
obliged to rise several times each night to wrait on 
an aged grandmother, and did not relax from her 
usual duties about the house, she had no relapse. 
Some two years after T went to ascertain if she still 
remained well, and found that she had steadily 
gained in health, and had no return of the disease.” 
This case is reported by a “ lady practitioner ” 420 
DISPLACEMENTS OF THE UTERUS. 
in America. I may also refer you to a paper by 
Dr. Liedbeck, of Stockholm, in vol. xx of the 
‘ British Journal/ in which he relates some ex- 
periences with Belladonna as a uterine remedy. 
Two of the cases cured by it were of retroversion. 
He prefers using it in the form of an ointment, 
which is to be rubbed in to the hypogastrium and 
thighs. In prolapsus Stannum is a most useful 
medicine. It relieves speedily the sensation of 
bearing down, and seems to strengthen the uterine 
ligaments. There are also (I have mislaid the 
reference) some cases on record cured by Secale: 
and one mentioned by Biickert, of prolapsus from 
lifting a heavy load, in which Nux vomica and 
Aurum proved curative. Then Dr. Preston com- 
municates (c Brit. Journ./ vol. xxv, p. 497) his 
experience with Ferri Iodidum in uterine displace- 
ments in general, which seems to have been very 
satisfactory. Dr. Guernsey mentions a case of ten 
years’ standing, in which the uterus, after being 
once replaced, and Conium administered, came down 
no more. But it is no uncommon thing for such a 
proceeding to be followed by a cure without Conium 
or any other medicine,—adhesions forming between 
the (generally) ulcerated cervix and the vagina, 
which prevent the return of prolapse. 
You will now be able to estimate the relative 
place in the treatment of uterine displacements of 
medicines and pessaries. As a rule, you will be 
doing most justice to your patients if you begin with 
medicines alone. If, after a fair trial, mechanical 
support seems indispensable, do not therefoi e discon- 
tinue your medicines, as they may hasten the time POLYPUS UTERI. 
421 
when a radical cure shall have been accomplished, 
and pessaries be no longer needed. These remarks 
do not apply to the restoration of the uterus in the 
first instance to its normal position, as by manipula- 
tion or the sound. 
Polypus Uteri 
is another of those diseases in which Homoeopathy 
can occasionally accomplish by internal medicines 
that for which the knife or the ligature were thought 
the only remedies. Dr. Petroz considers these 
growths to be a manifestation of the svcotic diathesis, 
and gives a case in which Thvja 18 effected in eleven 
days the detachment of a large one, which had 
caused distress for a long time (Memoire sur la Sycose, 
in Cretin’s Edition of his collected writings). In 
vol. xxvi of the ‘ British Journal/ p. 364, are re- 
corded two cases, in one of which five fibrous polypi 
were expelled from the interior of the uterus under 
the use of Conium, and in the other one from the 
vagina under Thuja 1 and Calcarea 3. This action 
may of course have been spontaneous (see Dr. 
Helmuth’s paper on Fibrous Tumour in the ‘ Brit. 
Journ./ vol. xxiii, p. 548). The analogy of nasal 
polypi, in which our medicines are so often helpful, 
is very encouraging here. 
Fibrous Tumour 
of the Uterus you have more reason for expecting 
to be under the control of medicine, as Mercury, 
Iodine, and Bromine have already some repute in its 422 
UTERINE CANCER. 
treatment. There is a paper on the subject by Dr. 
Kidd in vol. xx of the Brit. Journal. He bears 
testimony to the value of Mercury in discussing 
these tumours, recommending the bichloride (gtts.j 
•—iij of the 2nd dec. dilution) where profuse muco- 
purulent excoriating leucorrhoea exists, and the 
biniodide in cases characterised by a stony hardness 
of the tumour without much excoriation. The 
cases he gives, however, hardly bear out his sug- 
gestions, as in one of the four only was any im- 
pression made upon the tumour. Here, moreover, 
Mercurius corrosivus was the curative agent, although 
no leucorrhoea wras present. Dr. Helmuth, of 
America, who has contributed a paper on the sub- 
ject to vol. xxiii of the same Journal (p. 538), is 
less sanguine as to the results of Homoeopathic 
medication. 
The menorrhagia accompanying fibrous growths 
is ordinarily under the control of the usual remedies 
for this trouble : but you must not hesitate to give 
full and repeated doses of Ergot in the flooding 
which accompanies the expulsion of polypi. 
Uterine Cancer. 
In addition to the general remarks I have made 
upon the treatment of cancer, I shall now give you 
some reference to records of cases in which it occurred 
in the uterus. In vol. xvii of the ‘British Journal/ 
Dr. von Viettinghoff gives two cases of uterine can- 
cer. In one <f all signs of uterine suffering ” passed 
away after six months5 treatment. Several medicines 
were used, but Sepia seemed to do most good. In IIVDROMETRA, 
423 
the other, great palliation was effected by this and 
other medicines prescribed according to the symp- 
toms. In vol. xix of the same Journal Dr. Brad- 
shaw mentions a case in which Hydrastis was used 
for six months, externally and internally :—“ the 
disease ” he writes “ is apparently arrested.” In 
vol. xx Dr. Bayes gives a case of commencing 
scirrhus of the os. Hydrastis was of no service : 
but the os became soft under the Iodide of Arsenic, 
3rd trit. Then there is Dr. Quin’s case of fungus 
haematodes in the Annals, vol. i, to which I have 
already referred. Belladonna and Thuja were most 
useful here. 
When these cases are weighed, I think we may 
come to the conclusion that in most, if not all cases 
of uterine cancer, we can effect palliation by the 
medicines which act upon that organ—as Sepia and 
Secale—conjoined with those appropriate to the 
diathesis—Arsenicum, Hydrastis, Thuja, Kreasote— 
given according to the symptoms. But I do not 
think we can hold out any fair hope of cure: and 
should removal be practicable—as in the cauliflower 
excrescence of the os—I should not have a w'ord to 
say in bar of the proceeding. 
I have nothing to say about Physometra, as I 
doubt its idiopathic occurrence. But 
Hydrometra 
must be mentioned, as there is a case on record 
(; North Araer. Journ. of Horn.,’ vol. iii, p. 89) in 
which Sepia proved curative of it. It was of course 
the non-pregnant variety. LETTER XLV. 
DISEASES OF THE FEMALE SEXUAL SYSTEM 
(continued). 
We have now finished the disorders of the ovaries 
and uterus. The less important morbid states of 
the vagina and the pudenda must next come under 
our notice. 
Vaginitis 
comes before us in two leading forms, first, as the 
basis of a peculiar form of leucorrhoea; secondly, 
as the main element of gonorrhoea in the female. 
Of the former I have already spoken. The latter 
disorder requires Aconite and Cantharis in the first 
instance : but later, when inflammation has con- 
siderably subsided, instead of the Cannabis we should 
give to the other sex, I recommend Sepia. 
Vaginismus 
I mention to indicate that we want remedies for it. 
If no local alteration can be discovered, and the 
affection seems as true a hypersesthesia as the irri- 
table uterus or testicle, we ought to get good results 
from such medicines as Ignatia and Belladonna. 
If Scauzoni be right, however, our treatment of the CANCEll. 
425 
woman is but one element in the cure of vaginismus 
(see the ‘ Practitioner’ for Dec. 1868, p. 381). 
Vulvitis, 
as occurring in children, will be considered here- 
after. In adults, acute vulvitis occurs idiopathically, 
or from diphtheria, erysipelas, or gonorrhoea. Bella- 
donna, Apis, and Sepia might be useful here: but 
I know no drug which has so intense an action 
upon the external genitals as Arsenicum, and should 
be disposed to rely upon it in preference to any 
other. Chronic vulvitis is either eczematous or 
follicular. In both Mercurius is useful: but for 
the former Arsenicum must again be suggested, and 
for the latter Dr. Leadam recommends in addition 
Thuja, locally as well as internally, and Sepia. 
Acute Labial Abscess 
(I speak of the circumscribed variety, generally, if 
not always, an inflammation of the vulvo-vaginal 
gland) requires different remedies from those of 
vulvitis, in which the surface is mainly affected. 
There is a case in the fBrit. Journ. of Horn/ vol.xxiv, 
p. 311, in which Apis seems to have arrested the 
progress of the inflammation. 
Cancer 
of the external generative organs in the female is, 
like that of the other sex, usually of the epithelial 
variety, and so somewhat amenable to treatment. 426 
XV MPHOMANIA. 
Conium, Arsenicum, and Thuja are the medicines 
likely to help. In a case which I had the oppor- 
tunity of treating for a short tijne I saw marked 
relief from the lancinating pains afforded by the 
higher dilutions of the two former medicines. 
Pruritus Pudendi 
I shall speak of when upon the diseases of the 
skin. 
N y mphomania 
is generally associated with some irritation of the 
external parts, and I accordingly mention it here. 
It is happily rare in the present day : but our older 
Homoeopaths seem to have had some experience in 
its treatment. Hahnemann himself has recorded a 
case (‘ Brit. Journ. of Horn./ vol. vii, p. 494) in 
which Hyoscyamus was the principal remedy. Platina 
also is generally recommended : it -would be es- 
pecially serviceable when ovarian irritation lay at 
the root of the symptoms. Of late Origanum is 
said to have caused and cured this form of mania 
(see ‘North Amer. Journ. of Horn./ vol. xv, p. 62). 
The treatment of the affections of the urinary 
organs in the female does not differ from that of the 
similar disorders occurring in the male subject. But 
one of these is peculiar to the former sex, and 
deserves special mention. I mean STKJULITY. 
427 
Vascular Tumour of the Urethra. 
Before resorting to surgical measures for this 
trouble, it might be well to try the administration 
of Thuja, to which medicine its nature and origin 
strongly point. 
Before leaving the female organs of generation T 
must say something about 
Sterility. 
Many of the ovarian, uterine, and vaginal diseases 
already enumerated are associated with sterility, and 
the treatment of the latter will accordingly be that 
appropriate to the former. But if none of these 
exist, and no mechanical impediment to the ingress 
of the spermatozoa be present, and there be no fault 
on the husband’s side, then a course of Homoeopathic 
medication may be tried with fair hope of success. 
The constitution of the patient, and any symptoms 
of ill-health she may have, must be taken into 
account in your prescription. Apart from these 
Borax and Conium are the medicines most in repute : 
the former is said to be indicated by the co-existence 
of an acrid leucorrhoea, the latter is suitable to de- 
pressed ovarian activity. 
The diseases of the mamma of most frequent oc- 
currence and practical importance are those which 
occur during lactation. These will be considered 
among the disorders incident to the puerperal state. 
But I must speak here of certain tumours of the 
breast, viz., the simple glandular, the irritable, and 
the scirrhous. 428 
IRRITABLE TUMOUR 
Chronic Mammary Tumour, 
simple and painless, may be fatty in nature, when 
a course of Calcarea, in various dilutions, might be 
given with advantage. More commonly it is a 
circumscribed hypertrophy of the glandular and 
connective tissue, with more or less cystic forma- 
tion. I do not know if any case of this kind has 
been cured by Homoeopathic medicines, though I 
should feel encouragement in trying a course of one 
or all of those—Hydrastis, Phytolacca, and Conium 
—which I shall presently mention as possessing 
an elective affinity for the breasts. 
Irritable Tumour 
of the mamma is somewhat analogous to ovarian 
neuralgia and irritable testicle. Sir Astley Cooper, 
as you probably know, had a high opinion of Co- 
mum in its treatment : and in our school we rank 
this medicine very high among those which act 
upon the breast. I have found it especially useful 
where painful glandular enlargements have followed 
blows upon the breast. More recently, two of the 
American indigenous remedies have acquired high 
repute in the treatment of mammary tumours. 
These are Phytolacca and Hydrastis. The action 
of Phytolacca upon the breasts is well illustrated 
by Dr. E. M. Hale is an article upon it in the 
‘ Brit. Journ. of Horn.’ vol. xxi, p. 201. He states 
that he has treated several cases of irritable mam- 
mary tumour successfully with Phytolacca in the MAMMARY SCIRRHUS. 
429 
lowest dilutions. Hydrastis has a still more gene- 
ral reputation. I shall have to speak directly of 
its claims as a remedy for mammary scirrhus. 
But if you will read Dr. Bayes’ paper on the sub- 
ject in the Annals (vol. iii, p. 489), and the discus- 
sion following, you will find that even those who 
doubted its efficacy in the malignant, spoke highly 
of its power over the simple tumours of the breast. 
It may be used externally as well as internally with 
advantage. 
Mammary Scirriais. 
I speak only of this form of cancer of the 
breast : as there is no doubt that the encephaloicl 
variety ought to be removed by operation as soon 
as detected. But as we have some prospect of 
being able to cure, or at any rate to retard the 
progress of scirrhus in this situation, the question 
between submission to immediate surgical measures 
and a trial of Homoeopathic medication may fairly 
be raised. 
In speaking of the power we have over mam- 
mary scirrhus, I am not referring to anything 
which our ordinary medicines can do,—not even 
including Conium. Dr. von Viettinghoff speaks of 
this medicine as “ specific in cancerous induration 
of the mammm attended with lancinating pains. 
But his cases do not bear out his assertion. That 
it will to some extent relieve the pains themselves 
I do not doubt: but I think it has yet to be 
proved that it has any power of checking the pro- 
gress of the disease. The remedy whose introduc- 430 
MAMMARY SCIRRHUS. 
tion lias given us new hope is the Hydrastis Cana- 
densis. You will remember the facts and cases I 
brought under your notice when writing about this 
drug. Should a patient come before you affected 
with this disease, you will do well to look over the 
observations to which I have there referred. If 
the case be one of those in which benefit may, 
upon those data, reasonably be expected from Hy- 
drastis, viz., “ scirrhus in an early stage occurring 
in well-developed breasts,” you will do well to give 
it a fair trial. Administer it internally in varying 
dilutions, and apply it externally in not too strong 
a lotion (20 drops of the tincture or strong infusion 
to a pint of water for continuous use, to 5'j 
to relieve pain). When the medicine acts the im- 
provement is speedy : so that if after a month or 
two there is no change for the better there is no 
longer hope from this source to stand in the way of 
an operation, if that be otherwise admissible. If, 
moreover, after temporary improvement from Hy- 
drastis a relapse occur, there is little use persisting 
in it. 
Should operation be inevitable, you will consider 
the evidence adduced by Hrs. Marston and Mac* 
Limont in favour of enucleation by Chloride of Zinc 
in preference to excision by the knife. Their 
papers on the subject are in the ‘ Brit. Journ. of 
Horn./ vol. xxi, p. 611, and vol. xxiii, p. 196. LETTER XLYI. 
DISEASES OF THE FEMALE SEXUAL SYSTEM 
(icontinued). 
I have now to consider the maladies—hitherto 
purposely omitted — from wliich the woman is 
liable to suffer in discharging her great function of 
maternity. We will take first the disorders of 
Pregnancy. The treatment of these is very fully 
discussed in the treatises of Leadam and Peters : 
and I shall not have much to add to their recom- 
mendations. 
There are two primary facts about every pregnant 
woman,—that her blood is super-flbrinated, and her 
nervous system hypersesthetic. The former lies at 
the bottom of the sub-febrile condition which is 
sometimes met with in the early, but more fre- 
quently in the later months of pregnancy. This is 
greatly under the control of Aconite. The excess 
of fibrin is a physiological, not a pathological 
change; and it has overstepped the boundary of 
health when fever is induced by it. The hyperses- 
thesia, also, need not be morbid. It does not take 
much, however, to fret it into irritability of temper, 
sleeplessness, and other mental disturbances. It is 
probably also the cause of the readiness with which 
other organs sympathise with the uterus,—reflex 
excitability being increased. Hence also the cramps, 432 
DISOKDlillS or PREGNANCY. 
and spasms, and “fidgets/’ and the “false pains/’ 
which are observed in these subjects. The remedies 
for each of these will be given as we go on. I 
mention the general condition chiefly to suggest 
that it indicates the higher dilutions of our medi- 
cines as most suitable for the disorders of preg- 
nancy—an indication which experience has gene- 
rally confirmed. 
I will take the ailments of the pregnant woman 
in the same order as that in which I have been con- 
sidering the maladies of the human species in 
general. Accordingly, having already spoken of 
the fever which is her special blood-disease, I 
will pass on to the disorders of her brain, spine, and 
nervous system in general. 
Mental disorder,—in fully developed mania or 
melancholia,—attacks not so much the pregnant as 
the puerperal woman. But there is a condition of 
mind met with in the former, which is unquestion- 
ably morbid. It is characterised by irritability of 
temper, readiness to shed tears on slight provoca- 
tion, undue fear of the approaching confinement, 
and so on. A good many medicines are mentioned 
by Peters as suitable to special shades of this state 
of mind. I myself have found Aetata Racemosa so 
beneficial for it, that I have rarely had to resort to 
any other remedy. If I needed such, I should 
expect to find it in Pulsatilla. 
The headache of pregnant women is not, to my 
knowledge, different from that which they have at 
other times, and whose treatment we have already 
discussed. In the early months it is usually ner- 
vous, in the later months congestive. DISORDERS OF PREGNANCY. 
433 
Sleeplessness in these subjects often arises from 
a febrile state of system, and will be removed by 
Aconite. When this cause is not operative, you 
will find Coffea useful when the patient cannot get to 
sleep for a long time after retiring, Nux vomica 
when she sleeps at first, but wakes early in the 
morning and cannot get off again. In the later 
months sleep is often hindered by cramps in the 
calves, or a sense of painful restlessness in the 
lower extremities which they call “ fidgets.” Here 
I have found Chamomilla very beneficial. Dr. 
Leadam speaks highly of Veratrum for cramps. 
The digestive organs sympathise with the gravid 
uterus more, perhaps, than any other part of the 
body. Tooth-ache, salivation, vomiting, heart-burn, 
constipation—are well-known troubles of pregnancy. 
Let me give you some hints as to their treatment. 
The tooth-ache of pregnancy may either be a 
sympathetic neuralgia, or may arise from caries of 
the teeth produced or furthered by the patient’s 
condition. In the latter case Kreasote (and, as 
some say, Staphysagria) will act as well as in other 
circumstances. But in the former the ordinary 
medicines—Aconite, Belladonna, Coffea, and Cha- 
momilla—will rarely give more than temporary 
relief: while uterine medicines like Sepia and Mag- 
nesia carbonica are curative. Calcarea, also, is 
recommended. 
Salivation is one of the most obstinate of this 
class of affections. Mercury and Iodine are homoeo- 
pathic enough: I wish I could say they were 
curative. Dr. Leadam recommends Sulphur, fol- 434 
DISORDERS OF PREGNANCY. 
lowed by Nairum muriaticum or Arsenicum, in 
obstinate cases. 
The vomiting of pregnancy must generally be 
treated otherwise than as an affection of the sto- 
mach. Nux vomica, which is perhaps its most 
important remedy, probably acts by diminishing 
the reflex excitability which enables the uterus to 
disturb the stomach. Kreasote, whose sphere is 
“ sympathetic vomiting/’ is a remedy of the same 
kind. Again, Sepia is one of our best medicines 
for this trouble: and here we must suppose that 
the action is upon the uterus itself, the starting- 
point of the morbid circuit. It is only when the 
stomach has become irritable, and most of the food 
is rejected as soon as taken, that Ipecacuanha is 
suitable: and even here it is best alternated with 
Nux vomica. 
Heartburn is often a great trouble with these 
patients. It is not necessarily associated with 
acidity : if the latter be present to any extent, you 
may give Calcarea, and let your patient take freely 
of the sub-acid fruits, which are always grateful to 
her. If the heart-burn stand alone, Pulsatilla and 
Capsicum are the most useful medicines. 
Respecting the strange tastes and longings which 
pregnant women not uncommonly display, I think 
it well to gratify them unless the substance 
desired be injurious, as chalk or cinders, or the 
digestive organs be obviously disordered. In the 
latter case treat these upon the the usual principles. 
The longing for chalk often implies acidity, and 
that for cinders flatulence, so that Calcarea and 
Carho vegetabilis may remove the symptoms. Other DISORDERS OP PREGNANCY. 
435 
medicines are recommended for the various morbid 
cravings by Leadam and Peters : but I know not on 
wbat grounds. 
Constipation is no uncommon accompaniment of 
pregnancy, especially in the early months, when I 
suppose it to depend upon a sort of congestive 
inertia of the lower bowel. Better than all the old 
remedies for this trouble I find the Collinsonia 
Canadensis, which I recommend to be given in the 
1st, 2nd, or 3rd dilution. It is no less useful for 
hsemorrhoids, when these occur in connexion with 
constipation. 
Diarrhoea is far less common than constipation. 
Pulsatilla is generally its remedy, the characteristic 
indication being often present that the stools occur 
mainly at night. Secale, and Phosphorus or Phos- 
phoric Acid, are sometimes preferable,—the latter 
especially when there is prostration and loss of 
flesh. 
The only symptoms of the respiratory organs with 
which I am acquainted in connexion with pregnancy 
are cough and dyspnoea. The cough is a spas- 
modic one, from reflex excitation. Belladonna, in 
the 1st dec. dilution, has been my favourite medi- 
cine for it. But should any of the indications, now 
familiar to you, for Ipecacuanha, Hyoscyamus, or 
Conium, be prominent, you will do well to give 
these medicines as though no pregnancy were pre- 
sent. The dyspnoea and oppression often com- 
plained of in the later months is gastric rather than 
pulmonary : and I can quite believe Dr. Leadam 
that Nux vomica is its best remedy. 436 
DISORDERS OF PREGNANCY. 
The bladder, from its proximity to the uterus, is 
even more liable to be affected than the rectum in 
pregnancy. In the early months it is usually a 
sympathetic tenesmus of the neck which is present, 
and Belladonna is here again very useful, in the 1st 
dec. dilution. Nux Vomica and Cantharis are possible 
alternatives, and smelling at Camphor will often give 
temporary relief. Towards the end of the time, the 
frequent calls to pass water are, I think, of 
mechanical origin,—the capacity of the viscus 
being diminished by the pressure of the womb. 
A much more important affection of the urinary 
organs induced by pregnancy is albuminuria, with 
its accompanying anasarca. The tendency here is 
to granular degeneration of the kidneys. Colchicum 
has most theoretic, Arsenicum and Apis most prac- 
tical evidence in their favour here : but we want 
careful observations on the point. We certainly 
ought not to allow a patient to reach the time 
of parturition with albumen still passing in her 
urine. 
And now of the troubles which the gravid uterus 
causes to itself, and to other parts of the female 
sexual system. 
Sometimes the commencing enlargement of the 
womb is attended with much distress. Here Dr. 
Leadam recommends Nux vomica, Pulsatilla, or 
Belladonna,—according to the symptoms, or the 
patient’s constitution. 
In others the natural enlargement of the breasts 
at this period causes undue pain and tension. 
Conium and Pulsatilla are suitable here when neu- MISCARRIAGE. 
437 
ralgia predominates, Bryonia and Belladonna when 
the symptoms are rather inflammatory. 
Pruritus pudendi is a very troublesome accom- 
paniment of early pregnancy. Collinsonia is its 
best internal remedy : but local palliatives are re- 
quired. You must not forget that follicular vulvitis 
(q. v.) is sometimes present as the cause of this 
trouble. 
As the uterus increases in weight, it often causes a 
very distressing dragging pain in the lumbar region. 
I mention this pain because it has often been re- 
lieved by a curious medicine for it, Kali carbonicum. 
Sometimes the uterus itself is the seat of pain, 
and resents pressure and the movements of the 
child. This is described by Cazeaux as rheumatism 
of the womb. Actcea Racemosa, with or without 
Aconite, ought to benefit it. 
The “false pains” of later pregnancy have gene- 
rally been checked by Charnornilla in my hands ; 
but Drs. Drury and Leadam both recommend the 
higher potencies (12th or 30th) of Pulsatilla. Some- 
times, when they seem truly uterine, and recur 
regularly as if parturition were beginning, I have 
seen them rapidly banished by giving after each a 
drop of the mother-tincture of Secale. 
I have last to speak of the important subject of 
Miscarriage. 
The treatment of this accident is prophylactic as 
well as curative. The fault which causes the ten- 
dency to its occurrence may lie with the ovum, 
with the placenta, or with the uterus itself. If the 438 
MISCARRIAGE. 
ovum be the cause, it is usually that it is syphilitic. 
If the mother also manifest symptoms of this taint, 
by treating her accordingly you may remedy the 
infant’s condition. But if she be free, I think it 
well to try whether the administration of occasional 
doses of a high dilution of Mercurius may favour- 
ably modify the nutrition of the foetus. This plan 
has proved very successful in the case of scrofulous 
offspring,—Sulphur and Calcarea being the medi- 
cines given. 
The error of the placenta which leads to abor- 
tion is usually fatty degeneration. It would be 
worth trying the administration of Phosphorus in 
cases where this change was deemed likely to super- 
vene. When the womb itself, without extraneous 
reason, is given to casting untimely fruit, medicine 
can do much in the way of prevention. Ascertain 
first whether its irritation is secondary to that of 
the ovaries : and if so, treat the latter organs. If 
not, remember that the muscularity of the uterus is 
small during the earlier, great during the later 
months of pregnancy. In abortion occurring 
during the earlier months, accordingly, Sabina 
would be more suitable than Secale, and vice versa 
if the contrary obtained. These are the medicines 
most in repute for the prevention of the habit of 
abortion. 
When haemorrhage and pains indicate that mis- 
carriage is imminent, we have some remedies which 
will materially aid perfect rest in averting the acci- 
dent. First, you will ascertain the cause: and if 
this be mechanical, will give Arnica, if emotional, 
—as from fright or other nervous agitation,—Cha- MISCARRIAGE. 
439 
momilla. If neither of these causes is in opera- 
tion, ancl the symptoms have occurred spontaneously, 
the Sabina or Secale already recommended as pre- 
ventives will be no less useful as curatives. If 
pains are present, it is best to give a dose after 
each: but if there is hsemorrhage the doses must 
be frequently repeated. LETTER XLVII. 
DISEASES OF THE FEMALE SEXUAL SYSTEM 
(continued). 
Parturition, 
like pregnancy, ought to be a physiological process: 
but too often in our day and society it presents 
pathological features. These we are often enabled 
by Homoeopathic medication so to modify that they 
give place to the normal phenomena of the process. 
Many of them, of course, are beyond the reach of 
such means : and you will understand that in those 
dystocic conditions I have left unmentioned you 
must do your best upon the common principles of the 
obstetrical art. Perhaps we have fields here yet to 
conquer : for indeed this is a department which has 
not been assiduously cultivated by Homoeopathic 
practitioners. The position in which most of us are 
placed, in this country at least, makes it impossible 
for us to attend confinements. The result is that 
we have little practical experience of the application 
of our remedies to the accidents of labour. I shall 
therefore rely mainly upon the recommendations of 
those few who have devoted themselves to this 
branch of practice. Dr. Leadam has just published, 
as supplementary to his book already cited, a paper 
on “ The Medicinal Treatment of some disorders 
occasionally met with during Parturition,” (‘Monthly PARTURITION. 
441 
Horn. Review,’ Nov. 1868). On this, as embodying 
his latest experience, I shall especially draw. 
The earliest object for which you may have to 
administer medicines to a parturient woman is to 
rectify a mal-presentation. It seems at first un- 
likely that such an effect can be looked for from 
drugs. But we have a sure basis on which to act, 
viz. the occasional occurrence, and therefore the 
possibility, of spontaneous version. If the uterus 
can effect this change to the norm, there is no 
reason why it should not be aided towards it by 
specific remedies. Pulsatilla, in high dilutions, is 
the medicine credited with the power of furthering 
natural version. In a paper on “ Homoeopathic 
Tocology ” by Dr. Fincke, in vol. vi of the 
‘ American Homoeopathic Review,’ you will find a 
collection of the cases in which under Homoeopathic 
treatment a mal-presentation has been rectified. 
They may of course have been coincidences : but 
you cannot do wrong, should you encounter a case 
of this kind, to give a dose of Pulsatilla 30, and 
wait a while for a chance of a favourable change. 
The next contretemps which may need help is a 
rigid and undilatable condition of the os uteri, 
hindering progress. Dr. Leadam tells us that 
results of magical rapidity may almost always be 
obtained here from the 30th dilution of Belladonna. 
Eocperto crede is all I can say. Dr. E. M. Hale 
reports a case of this kind in which, after the failure 
of Belladonna, Pulsatilla, and Aconite, Caulophyllin, 
in half-grain doses every fifteen minutes, effected 
dilatation in an hour. 
We will suppose that now the 03 is properly 442 
PARTURITION'. 
dilated, but tlie pains too feeble to bring the child 
into the world without assistance. Dr. Leadam tells 
us that we have two excellent medicines for this con- 
dition, Pulsatilla and Secale, both in the 30th dilu- 
tion. As far as I can make out the distinctive 
spheres of the two, according to his experience and 
that of Croserio, it is that Pulsatilla is most suitable 
when the pains are from the first irregular and un- 
satisfactory, Secale where they are weak from gene- 
ral or uterine exhaustion. I confess that this action 
of Secale in infinitesimal doses is at present a mys- 
tery to me. But it is well vouched for, and the 
following case from Croserio seems to show what it 
can do. 
“ In the case of a Avoman, 26 years of age, in 
her first labour, in whom the sacro-pubic diameter 
of the superior strait did not offer more than tAvo 
inches and a half, I had the patience to Avait for 
seventy-two hours the natural efforts of labour. 
The head being in the first position, at the end of 
the second day it began to engage in the superior 
strait. At the end of the third day, the pains 
slackened very much; the woman became very 
feeble, was pale, exhausted, and had lost all hope. 
I put Secal. cor. 30 into a glass of Avater, and gave 
her a teaspoonful at 11 o’clock in the evening. 
Some minutes after she fell asleep, and slept very 
quietly for three quarters of an hour, Avhen, awakened 
by a violent pain, she made a courageous effort, and 
two hours after gave birth to a child, pale and in 
a state of asphyxia, but which was recalled to life 
by proper care. The recovery of the mother pro- 
ceeded in a regular manner.” POST-PARTUM HAEMORRHAGE. 
443 
Should the uterine inertia arise from the foetus 
being already dead, Dr. Leadam states that a dose 
of China 18 before Pulsatilla or Secale is very 
serviceable. 
If the pains are excessive, or excessively felt by 
the patient, we are recommended to give Coffea or 
Ckamomilla. 
And now, with or without these aids, the infant 
is born: but the placenta has not been extruded 
into the vagina. Can we aid its detachment by 
medicines ? It seems that we can. A dose of 
Arnica 6 may in all cases be given as soon as the 
child is separated. If this is insufficient, Pulsatilla 
or Secale may be given as for deficiency of uterine 
contractions during the previous stage. “But in 
some nervous subjects” writes Dr. Leadam “where 
tremors supervene during this stage, an equally, or 
in cases more especially where there is a tendency 
to haemorrhage, even a more singularly effective 
remedy is Ignatia 3.” 
Once again a dose of Arnica may be given before 
the patient is left, as a prophylactic against after- 
pains. Of these more anon : but I must not leave 
the subject of Parturition without noticing its two 
most formidable accidents, Haemorrhage and Con- 
vulsions. 
Of 
Post-partum Haemorrhage 
Dr. Leadam writes—“Its treatment by Homoeo- 
pathic remedies offers to the patient an immunity 
from danger—not unfrequently the difference be- 444 
POST-PARTUM HAEMORRHAGE. 
tween life and death—compared with which allo- 
pathic practice in the most experienced hands is a 
perfect nullity.” This is from his recently pub- 
lished paper. He defers the consideration of the 
subject to another opportunity ; but he assures us 
thus from his experience that we may have confi- 
dence in the' medicinal treatment of the accident 
which he has sketched in his former work. 
You will say “ Surely the one thing we have to 
do in post-partum haemorrhage is to obtain contrac- 
tion of the uterus. We can accomplish this most 
effectually by cold and pressure. We hardly care 
even to give Ergot, so little time have we.for wait- 
ing for medicinal action. The administration of 
infinitesimals seems too supererogatory here to be 
thought of.” 
I must confess that I sympathise with you in 
this objection, so far as the primary importance of 
such measures as the application of cold and pres- 
sure is concerned. I think that our attention 
should not be diverted from these potent means of 
inducing uterine contraction by any question of 
medicines. Nevertheless, our old teachers have 
been wont to tell us that Ergot has its place in the 
prevention, at any rate, of post-partum haemorrhage. 
To give, when this is apprehended, one or two 
doses of the drug during the last pains, or before 
the extraction of the placenta, is always reckoned 
good practice. Here, then, our medicines have 
their sphere in lieu of Ergot, as before in undue 
protraction of labour. “The circumstances,” writes 
Hr. Tyler Smith, “ which interfere with efficient 
uterine contraction after delivery, or produce inertia, POST-PARTUM HEMORRHAGE. 
445 
are many of them the same as those which lead to 
powerless labour. Amongst these circumstances are, a 
general relaxed habit of body, weakness of the abdo- 
minal muscles, and umbilical hernia. Such conditions 
are frequently found in the greatest degree in women 
wrho have resided in tropical climates. They occur 
also in women wdio have borne large families.” 
Here Secale is indicated ; and if the efficacy of the 
30th dilution be substantiated, it will be better than 
the crude drug. “ The uterus often flags when 
labour has been long delayed from any cause, 
whether the womb be simply inert, or worn out by 
prolonged action.” Pulsatilla would be called for 
by inertia, Arnica by fatigue of the organ. “ The 
same result may sometimes, but far less frequently, 
spring from exactly opposite causes. After a very 
rapid labour, or after the extraction of the body 
immediately after the birth of the head, the uterus 
may suddenly fail.” Here Ignatia would be 
suitable. 
For administration during hsemorrhage itself, 
Dr. Leadam recommends Ipecacuanha, Sabina, 
Crocus, Chamomilla, Belladonna, Nux Vomica, 
Hyoscvamus, Ferrum, or China according to the 
well-known indications for each, such as I have 
mentioned when speaking of menorrhagia. I say 
again, we have rarely time or thought to spare for 
such measures. I hope Dr. Leadam will tell us ere 
long what place he finds for them, and how far he 
relies upon them. The power of China, however, 
to relieve exhaustion, and of Ferrum to remove the 
quasi-congestive head symptoms resulting from this 
cause, is beyond dispute. 446 
PUERPERAL CONVULSIONS. 
Puerperal Convulsions 
must be discussed here : as they more frequently 
complicate labour, present or imminent, tlmn the 
puerperal state proper. In treating a case of this 
kind, you must first ascertain if albuminuria is 
present, and the convulsions are uraemic. Should 
it be so, you may give the remedies whose indica- 
tions I shall mention presently: but your main 
duty is to relieve the pressure on the kidneys by 
emptying the uterus as speedily as possible. 
Abnormal reflex excitability is at the bottom of 
non-albuminuric puerperal convulsion. For this 
Ignatia and Hyoscyamus—the latter especially— 
are most valuable remedies: and one or other should 
be administered whenever you see reason to dread 
convulsion. Chamomilla and Coffea are less fre- 
quently indicated :—if the pains, or the sense of 
the pains, be excessive, they might be suitable. If 
the patient is actually in a convulsion, or the fits 
are recurring rapidly, Belladonna is the classical 
remedy. But I would suggest Hydrocyanic Acid 
as a possible alternative, especially in ursemic cases. 
While you are giving frequent doses of the proper 
medicine, you will see that no eccentric irritation— 
gastric, rectal, vesical—which you can remedy exists 
or remains. But I would not advise you to inter- 
fere with the uterus. 
I think that by these means you will be able to 
dispense with the once universal bloodletting in 
puerperal convulsions. Aconite may sometimes be 
given with advantage, when of old the lancet would PUERPERAL CONVULSIONS 
447 
have seemed demanded by the symptoms. The 
chloroform inhalations of modern practice are not 
open to the same objection : and in the uraemic 
form at least I should have no hesitation in using 
them as a temporary expedient till I could effect 
delivery, should Homoeopathic medicines seem in- 
sufficient for the purpose. 
A dose or two of Opium is often very useful for 
relieving the condition of brain left behind after 
puerperal convulsions: and should uraemia in par- 
turient women take rather the form of coma I 
should prescribe it in preference to any other 
medicine. 
Some cases by Dr. Wielobycki illustrating the 
action of several of these medicines may be read in 
the ‘ Brit. Journ. of Horn./ vol. v, p. 197. LETTER XLVIII. 
DISEASES OF THE FEMALE SEXUAL SYSTEM 
(continued). 
The disorders of the puerperal state will next 
engage our attention. 
When the patient is a multipara, your first 
thought must be to diminish the severity of her 
after-pains. For this purpose the dose of Arnica 
I have recommended you to give before you leave 
your patient will do much. But if at your next 
visit you find that the pains are distressing, you 
must prescribe specially for them. Gelseminum, in 
the 1st dec. dilution, is the medicine on which I am 
accustomed to rely : and Dr. Leadam confirms my 
recommendation. Cliamomilla or Coffea, and some- 
times Ignatia or Pulsatilla, may be required,—the 
two former by the excessive sensibility of the 
patient. When the pains are intestinal rather than 
uterine, Cocculus is the most suitable medicine. 
If the perinseum is torn, you will find the 
local application of Calendula of the utmost service 
to promote healing and union. 
The bladder may at this time require assistance. 
If no urine has been passed within twelve hours of 
the labour, you will do well to give a dose of 
Aconite—say the 3rd dec.—every fifteen minutes, 
and ivait to see the effect. If this should not sue- DISORDERS OF THE PUERPERAL STATE. 
449 
ceed in an hour, give Belladonna (in a higher dilu- 
tion) after the same manner. You -will rarely need 
the catheter. I know nothing of “ incontinence of 
urine” after labour (the dribbling from an over- 
distended bladder must not receive that name): Dr. 
Leadam recommends Arnica and Belladonna for it. 
Yery painful hsemorrhoids are sometimes deve- 
loped after labour. Dr. Leadam recommends Pul- 
satilla 30 for this trouble. In a case I once saw, 
very rapid relief was given by Aconite and Bella- 
donna. 
Morbid conditions of the lochia occasionally 
require attention. If the sanguineous character 
continue too long, Sabina should be given. If the 
discharge becomes offensive, without uterine mis- 
chief or neglect of cleanliness to account for it, 
Sepia, Secale, Carbo animalis and vegetabilis have 
been recommended ; but the most general consent 
is in favour of Kreasote, which I have myself seen 
act very satisfactorily. Suppression of the lochia 
nearly always indicates supervening fever or 
inflammation; and is the signal for Aconite. If 
the lochia continue too long, but of natural quantity 
and quality, Dr. Leadam speaks highly of Calcarea 
30. Caulophyllum 3 has also been given with 
success. 
A few words upon the management of the bowels 
after labour. I need hardly say that Homoeopathy, 
always repugnant to purgatives, repudiates them 
here with especial abhorrence. We regard them as 
unnecessary, and often injurious. Dr. Tyler Smith 
says that “ left to themselves, the bowels would 
probably pass a week or ten days in a state of 450 
PUERPERAL FEVER. 
inactivity.” The real fact is that spontaneous 
evacuation generally takes place about the fourth or 
fifth day. If it be delayed beyond the sixth, you 
may with advantage treat the patient as for consti- 
pation, premising a simple enema to remove accumu- 
lations. The rectum is generally at fault, and Col- 
linsonia the most applicable remedy: but Dr. 
Leadam speaks highly of Zincum 3. If the torpor 
be in the colon, Bryonia, Opium, Plumbum, Vera- 
trum are more suitable. 
Diarrhoea is not common : when it occurs, Hyos- 
cyamus or Pulsatilla will be the remedy,—the latter 
when the evacuations are most frequent at night. 
The disorders of Lactation play an important 
part among puerperal maladies : but of these I will 
speak separately farther on. 
I have now to discuss the treatment of the great 
phlogoses and neuroses which attack the lying-in 
woman. This I shall do under the heading re- 
spectively of Puerperal Fever and Puerperal 
Insanity. 
Puerperal Fever. 
The pathological questions raised by this disease 
are of the utmost interest. Are the various inflam- 
mations—metritis, peritonitis, uterine phlebitis—of 
the puerperal state only local manifestations of a 
febrile blood-poison ? is this latter anything per se, 
or is it only an altered form of the erysipelas with 
which—if not with other toxsemise—it is inter- 
changeable? what are its laws as to spontaneous 
origination, epidemic influence, and spread by con- FUERPERAL FEVER. 
451 
tagion ?—these are some of the points which 
obstetricians are actively discussing. I think that 
for our therapeutical purposes we need not go 
beyond the conclusions arrived at by Gooch.* 
There are two leading forms of the disease. In 
one, the inflammation—metritis, peritonitis, or both 
—is to all appearance primary, and the fever 
is sthenic. In the other the symptoms of an ady- 
namic fever are present from the commencement, 
and local affections may or may not be developed. 
1. When a chill, followed by the development of 
pain and tenderness, indicates the supervention of 
inflammation, you will lose no time in bringing 
your patient under the influence of Aconite. Very 
often this is all that is required. But should the 
symptoms gain ground, you must substitute or 
alternate a more locally acting medicine. When 
the uterus itself is inflamed (puerperal metritis) I 
can confirm Hartmann’s recommendation of Nux 
vomica, in the higher dilutions. I have been 
astonished at the rapidity of its action. When the 
inflammation attacks the peritoneum (puerperal 
peritonitis) you will best continue your Aconite, but 
give in alternation with it Belladonna, Bryonia, or 
Mercurius corrosivus. Belladonna is most frequently 
used : and the relation between puerperal fever and 
erysipelas makes it especially suitable. Colocynth, 
which is indeed homoeopathic to peritonitis, is 
recommended where tympanitis is excessive. 
2. In the most virulent form of puerperal fever 
proper, which kills in a day or two, the only hint I 
* See Ms Essay on Puerperal Fever in the New Sydenham So- 
ciety’s Edition of his Works. 452 
PUERPERAL INSANITY. 
can give for treatment is Dr. Tyler Smith's state- 
ment that “the blood in these cases resembles that 
of persons killed by lightning or Hydrocyanic Acid” 
In less foudroyant cases you will give, besides free 
support and stimulus, either Arsenicum or Lachesis, 
and to these general consent gives Hyoscyamus as a 
valuable auxiliary. 
Besides these chief forms of puerperal fever, 
uterine phlebitis, whether primary or secondary, 
requires special treatment. Pulsatilla for the pri- 
mary inflammation, when you can diagnose it: 
Lachesis or China for the resulting pyaemia—are 
the medicines. 
Puerperal Insanity 
may take the form either of mania or of melan- 
cholia. Stramonium, Hyoscyamus, or Cannabis 
Indica ought to help puerperal mania. The dis- 
tinctive indications for the two former I have 
already given when speaking of simple mania. The 
Indian hemp would be specially called for when the 
mental delusions were of an exalted character. For 
puerperal melancholia Platina, Pulsatilla, Aurum, and 
Arsenicum would seem suitable : but I should have 
most confidence in Actcea Racemosa. 
The disorders of lactation are greatly under the 
control of our medicines. 
At the first coming in of the milk, Aconite will 
hasten the resolution of the fever, and Bryonia 
will relieve undue engorgement of the breasts 
threatening inflammation. 
If the milk is late in appearing, or becomes after- DISORDERS OF LACTATION. 
453 
wards diminished in quantity, Agnus castus and 
Asafcetida are the medicines recommended. Dr. 
Kallenbach’s cases illustrating the action of the 
latter are in the 1 Brit. Journ. of Homoeopathy,’ 
vol. ii, p. 417. 
Sulphur, Calcarea, Silicea, or Mercurius may be 
given according to the symptoms when the quality 
of the milk seems to be at fault, and the child 
rejects it. 
Sore nipples require local applications, among 
which Calendula is important. Phellandrium is 
said to remove pain felt in these after each applica- 
tion of the child. Where this pain is of a neural- 
gic character, and shoots from the point of the 
nipple through to the scapula, Dr. Guernsey speaks 
in high terms of the value of Croton. 
In weaning, Bryonia will prevent engorgement 
of the breasts, and Pulsatilla or Calcarea is recom- 
mended to diminish the flow of milk. 
China is, as might be supposed, of the utmost 
value against the effects of over-lactation. 
And now of the treatment of acute mastitis,— 
the much-dreaded “ milk-abscess.” I can nearly 
always promise you an arrest of this inflammation 
if taken sufficiently early. Bryonia is the great 
medicine for this purpose, in the 6th or 12th dilu- 
tion. Belladonna is said to be preferable “ when 
the tumid breast exhibits a surface with erysipe- 
latous redness, and is glossy but I have never had 
occasion to use it internally, though before I be- 
came acquainted with Homoeopathy the external 
application of the ointment was a favourite practice 
of mine. Phosphorus is recommended when it is 454 
PHLEGMASIA ALBA DOLENS. 
too late to prevent suppuration, to relieve pain, 
hasten the termination of the disease, and promote 
the healing of the abscess. It has several times 
cured a fistulous condition of the breast left behind 
after milk-abscess. When the “ caking ” of the 
breast, whether acute or chronic, is very great, 
Phytolacca is recommended to us by Dr. E. M. 
Hale : and from what I saw of its action in a case 
I recently treated I am disposed to confirm his 
good opinion of it.* 
The last puerperal disorder of which I shall speak 
is the “ white leg ” or 
Phlegmasia alba dolens. 
When the symptoms of this disease depend upon 
a phlebitis extending from the uterine into the 
crural veins, Pulsatilla will pretty speedily effect 
their removal. But I imagine that the lymphatic 
vessels are often as much to blame as the veins: 
and that the latter are as frequently obstructed by 
coagula from a distance as primarily inflamed. I 
have certainly found it an obstinate affection : and 
Dr. Leadam’s indications for remedies read rather 
hypothetical than as the result of successful ex- 
perience. 
And now, before leaving the disorders of the 
female sexual system, let me say a few words upon 
the phenomena of the 
* There is a paper on this subject by a lady M.D. (American, of 
course) in the ‘ Brit. Journ. of Horn.,’ vol. xxiv, p. 406. CRITICAL AGE. 
455 
Critical Age. 
What I have to say is in the main a reproduc- 
tion of a short paper “ On some Remedies for Cli- 
macteric Sufferings ” which I published in the 
24th vol. of the ‘ Brit. Journ. of Homoeopathy/ 
p. 619. 
There are few women to whom the menopausia 
is not a time of considerable distress. They can- 
not call themselves, or be treated as, invalids; yet 
they rarely feel at ease. One of the most 
common of their troubles they call “ flushes.” 
They “ come over/’ as they express it, in sud- 
den heats, sometimes dry, more commonly ac- 
companied with perspiration, but rarely if ever 
preceded by chill. The attacks last but for a few 
minutes, but recur frequently, and cause indescrib- 
able discomfort. The pathological condition ap- 
pears to be a hypersesthesia of the vaso-motor 
nerves, analogous to that of the cerebro-spinal 
system which obtains in hysteria. There is no 
arterial tension, and Aconite does not help. But 
we have a valuable remedy for it in Lacliesis. 
Administered in the 6tli or 12th dilution, it will 
rarely fail to reduce the trouble to a minimum, and 
to gain us the grateful thanks of our patient. I 
owe the original suggestion of this medicine to Dr. 
Madden. Dr. Gray, of New York, has recom- 
mended Sanguinaria, and Dr. Trinks Sulphuric 
Acid, for these flushes: so that you have something 
to fall back upon, should Lachesis fail you. 
2. There are two forms of distress in the head 456 
CRITICAL AGE. 
complained of by menopausic patients. The one 
appears to be a special local manifestation of that 
general hypersesthesia of the vascular nerves which 
I have already described. There is little or no 
pain ; but the patients complain of great giddiness, 
with rush of blood, throbbing, beating, and roaring, 
sometimes with noises in the ears. Lachesis helps 
this, but not very decidedly. On the other hand, 
it finds in Glonoine a most efficient remedy. I 
believe that Dr. Kidd was the first to suggest this 
medicine for the malady in question (f Annals/ 
September, 1864) ; although the pathogenetic indi- 
cations for it are so strong as to make it wonderful 
that no one had pointed out its applicability before. 
I have always used it, as recommended by Dr. 
Kidd, in the 3rd dec. dilution. 
The other head affection of this period of life is 
a true ache, a burning pressure upon the vertex. 
Sometimes it is here, as elsewhere, a symptom of 
debility from loss of fluids ; as when the shifting 
menses occasionally stream forth profusely. In 
these cases the patient often complains of a feeling 
as if the head was opening and shutting. The 
medicines are obviously China and Ferrum. Quite 
as often, however, there is no such cause present to 
account for it, and the distress is purely sympathetic. 
In this case I have rarely failed to relieve with 
Lachesis. 
3. The third climacteric affection I have to men- 
tion is “ sinking at the stomach,” and is very com- 
mon. I have reason to suppose that the solar 
plexus with its ganglia is the seat of this dis- 
tressing sensation, which is by no means confined CRITICAL AGE. 
457 
to menopausic subjects. In idiopathic cases un- 
connected with this change in the system, I find 
Hydrocyanic Acid an invaluable medicine. But in 
the sufferers under consideration its place seems 
taken by the Actcea Racemosa. “ Faintness at the 
epigastrium ” is a symptom of frequent recurrence 
in its pathogenesis; and its relation to the uterus 
makes it specially suitable. I give it in the 2nd and 
3rd dec. dilutions, and rarely find it fail to relieve. 
At the other extremity of the sexual life we are 
not unfrequently called upon for assistance. Some- 
times it is simply a disturbance of the circulation, 
and Aconite is sufficient. If the catamenia are too 
scanty to begin with, a course of Pulsatilla is use- 
ful : if they are profuse and too frequent, China is 
generally the most applicable of the remedies for 
menorrhagia. LETTER XLIX. 
DISEASES OE THE SKIN. 
The Homoeopathic treatment of cutaneous diseases 
may be pronounced to be in a very satisfactory state, 
especially as we claim for our method the results 
gained in chronic cases from Arsenic. In a review 
of Mr. Hunt’s book in vol. xxi of the ‘ British 
Journal’ (p. 660) I have argued out the homoeopa- 
thicity of this drug to the skin affections treated by it. 
You will not find me recommending it indiscrimi- 
nately for all forms of cutaneous disease : but there 
are not many of these upon which it has not some 
specific action. Of special Homoeopathic literature 
on the subject we have a paper, mainly theoretical, 
by Dr. Bussell, on “ The Skin and its Diseases,” in 
vol. x. of the fBritish Journal of Homoeopathy:’ 
and some results of Dispensary practice in this 
sphere by Dr. Marston in the f Monthly Homoeo- 
pathic Beview ’ for 1867. 
My classification of skin diseases is based on 
those of Prof. Hughes Bennett and Mr. Erasmus 
Wilson. I think you will find it intelligible. 
In the order Exanthemata we have to consider 
Erythema, Erysipelas, Urticaria, and Boseola. 
Erythema. 
This superficial inflammation of the skin is often ERYSIPELAS. 
459 
symptomatic only. When idiopathic, it is described 
as occurring under four forms, e. lseve, e. solare, 
e. intertrigo, and e. nodosum. The simple form, 
and that from insolation, must be treated like ery- 
sipelas with Belladonna, and Rhus if vesicles form. 
Intertrigo is one of the special diseases of childhood. 
Tor erythema nodosum I can recommend Apis and 
Arnica : Dr. Madden also speaks well of Rhus. 
Erysipelas. 
The treatment of this malady is one of the triumphs 
of Homoeopathy, and its remedies have been quietly 
adopted in the old school,—few following Liston’s 
example, and recognising the source whence they 
were obtained. I am speaking especially of Bella- 
donna. The pathogenetic power of this medicine 
to determine the blood to the skin is unquestioned : 
and its control over the cutaneous inflammation 
which obtains in erysipelas is one of the certainties 
of Medicine. I say especially “the cutaneous in- 
flammation/’ for it is where inflammatory symptoms 
predominate, as in erysipelas simplex and phlegmo- 
nodes, that Belladonna is the great medicine. Where 
vesicles form (e. miliare and phlyctenodes) Rhus is 
better : and where there is less redness but more 
swelling (e. oedematodes) Apis should be given. 
When gangrene occurs, Lachesis is reputed the 
specific remedy : but Arsenicum may be needed. 
Wrhen erysipelas invades the brain, Belladonna is 
doubly indicated: and for the erysipelatous angina 
Apis is an efficient remedy. In every form of the 
disease you will of course watch for symptoms indi- 460 
ROSEOLA. 
eating Aconite: just as on the other hand you have 
learnt to give stimulants when these seem needed. 
Urticaria. 
In this disorder I have always given Apis, and with 
the best results,—the symptoms disappearing within 
three days, while Erasmus Wilson states their 
natural duration to be seven. I know, however, 
that Urtica urens is a favourite with some practi- 
tioners : and its recent proving has disclosed its 
power to cause a nettle-rash even when taken inter- 
nally. In children, Teste states that it may be 
banished by a single dose of Croton. 
In chronic urticaria—i. e. when any unusual 
article of diet will bring out the rash—the digestive 
organs must be seen to. But when there is nothing 
wrong with these, I have obtained most satisfactory 
results from the administration of Arsenicum and 
Apis on alternate days. 
Roseola 
requires no treatment but a few doses of Aconite. 
In the first order you will observe that Bella- 
donna is the typical remedy, Apis only leading a 
step farther. When now, in the order Vesiculcp, 
we pass from simple inflammation of the skin to 
that of a more effusive type, Belladonna is left 
behind, and Rhus takes its place. In this order we 
shall speak of Eczema, Herpes, Scabies, Pemphigus, 
and Rupia. HEltPES. 
461 
Eczema. 
In simple acute eczema, I think you will rarely have 
occasion to use any medicine but Rhus. Teste recom- 
mends its alternation with Ledum; hut I cannot 
see any warrant for this practice. On the other 
hand, I rank Croton only below Rhus: and think 
that it sometimes relieves the itching even sooner. 
In eczema rubrum Mercurius ought to be the 
specific remedy, as this is pathologically identical 
with the eczema mercuriale: but I am not ac- 
quainted with any record of its use. The same 
medicine would be suitable for e. impetiginodes. 
In chronic eczema Rhus and Croton will still do 
much : but they will often need the re-inforcement 
of Arsenicum. 
Herpes, 
if occurring in its simple form, would doubtless be 
met by Rhus. But it is hardly known save in the 
forms of herpes zoster (shingles) and herpes circin- 
natus. The former has been treated by many 
remedies, as you may see by an extract from 
Riickert’s later collection given in the f Brit. Journ. 
of Horn./ vol. xx, p. 492. I have myself never 
given any medicine for it but Rhus, and have been 
fully satisfied with the results. I must mention, 
however, Dr. Garth Wilkinson’s testimony to the 
relief given to the itching by the local applica- 
tion of a Cantharides lotion. The neuralgic pains 
which sometimes linger, especially in old people, 462 
SCABIES. 
after shingles are very troublesome. Ranunculus 
and Cistus may be suggested in addition to Rhus 
and Arsenicum for their removal. 
Herpes circinnatus (ringworm of the surface) is 
usually treated, and with fair success, by Sepia. 
But when the proving of Tellurium produced so 
similar an eruption, I followed Dr. Metcalf in pre- 
scribing it instead of Sepia for this disorder, and 
have never failed to cure it speedily thereby. 
Scabies. 
This name calls up one of the main controversies of 
Homoeopathy, in the connexion of itch with Hahne- 
mann’s celebrated psora-theory. I have already, 
when writing to you of Sulphur, expounded and 
discussed this theory: and you will see that my 
conclusion is that as far as scabies itself is con- 
cerned its very existence may be forgotten. No 
reasonable doubt can now exist but that the recep- 
tion of the acarus is the proximate cause of the 
whole phenomena of the disease. You must of 
course destroy this insect as you would destroy lice : 
and if Sulphur ointment will do it more effectively 
than other more cleanly applications, we must have 
resort to it. The extensive experience of such men 
as Hebra and Erasmus Wilson may be taken as con- 
clusive when they say that they have never seen any 
ill-effects from the practice. 
Whether anything is gained by giving internal 
medicine in scabies I cannot say : though I gene- 
rally do so. Sulphur itself is thoroughly homoeo- 
pathic to the eruption, as you may see in Wurmb’s IMPETIGO. 
463 
proving of the drug. Croton also, and Hepar Sul- 
phuris, are recommended. 
Pemphigus, 
when recent, may he cured by Rhus, as I can testify. 
When chronic there is such a body of evidence in 
favour of Arsenic being specific that it would seem 
loss of time to give any other medicine. 
Rupia. 
Of the treatment of this malady I have had no 
experience, nor do I know of any in Homoeopathic 
records. If it he true that it rarely appears in 
syphilitic subjects unless Mercury has been largely 
given, Mercurius would be a suitable remedy for the 
simple form, and Iodine and Iodide of Potassium, 
and Aurum, for the syphilitic. I imagine that 
rupia generally implies a broken-down constitution : 
and that cod-liver oil, with nutrients and stimu- 
lants, will do more for it than medicine. 
I now come to the order Pus tula, which includes 
Impetigo and Ecthyma. 
Impetigo. 
Some forms of this malady, under the names of 
porrigo capitis and crusta lactea and serpiginosa, 
are peculiar to children. In adults, I find Viola 
tricolor very effectual in recent cases of the simple 
kind. The impetigo ervsipelatodes finds its remedy 
in Tartar Emetic; which is also sometimes curative 464 
JLICHEN. 
in the simple form, as in a case of Dr. Dudgeon's 
recorded in the 26th vol. of the ‘ Brit. Journ.' 
p. 311. For chronic impetigo you may try what 
Antimonium crudum and Kali bichromicum can do, 
and the latter especially is often curative; but you 
are still within the limits of Homoeopathy if you fall 
back upon Arsenic, which Mr. Hunt finds as valuable 
here as in chronic eczema and psoriasis.—There is 
a case in the f Brit. Journ. of Horn.' vol. xxii, p. 569, 
of impetigo figurata cured by Conium. 
Ecthyma. 
“ The pustules,” says Erasmus Wilson, “ following: 
the irritation of Tartar Emetic are ecthymatous.” 
This fact would lead us to give it as a remedy in 
this disease, in one case of wrhich, indeed, it has 
already proved curative. 
I am doubtful where to class rhagades: but, as 
they often begin with pustules, I will mention them 
here. A very useful remedy for them is Graphites, 
given internally, and applied externally as an oint- 
ment. 
One species of the order Papula—Strophulus— 
is a child's malady. The other two are Lichen and 
Prurigo. 
Lichen. 
Of this disorder I can only speak theoretically. 
But pathogenesy would suggest Sulphur as suitable 
for the simple form, and Apis for the lichen tropicus 
(prickly heat). In lichen agrius and chronicus Ave 
cannot do better than again fall back upon Arsenic. LEPRA. 
465 
Prurigo 
also, when recent, is often removed by Sulphur, and 
when chronic by Arsenic. I believe that you will 
do better by persevering with these medicines than 
by trying all that cause itching of the skin. You 
can, and ought to, aid their action by all means for 
improving the cutaneous functions, especially Turkish 
baths : and in local prurigo external applications are 
generally unavoidable. 
And now of the Squama, which are Pityriasis, 
Psoriasis, and Lepra. 
Pityriasis. 
Of this complaint I can only say that Teste 
recommends Cantharis for it, and that Arsenicum 
causes it more readily than any other eruptions, and 
so ought to cure it. 
Psoriasis, 
in its recent form, especially when affecting the 
hands, I have seen yield very rapidly to Mercurius 
solubilis. Even when chronic, much good is obtain- 
able from this medicine : but you will generally have 
to give Arsenic to complete the cure, when this is 
attainable. • 
Lepra, 
also, is usually met by Arsenic or its Iodide. But 
in one case, after Mercurius, the constitutional 
symptoms led me to Iodine, and a speedy and per- 
manent cure rewarded my choice. 466 
ELEPHANTIASIS. 
The Tuberculce are Lupus, Cheloid, and Ele- 
phantiasis. 
Lupus, 
in the form called “ exedens,” is probably under 
the control of no other medicine but Arsenic; and 
this, as Mr. Hunt tells us, often has to be given for 
years to do its work. Of lupus non-exedens, I 
only know that Dr. V. Meyer mentions having 
cured a case with Apis, in the 4tli dilution. The 
Hydrocotyle, of which I shall speak under the head 
of elephantiasis, might be useful here. 
Of the treatment of cheloid I know nothing: 
but I must say a few words about that of 
Elephantiasis. 
The Hydrocotyle Asiatica is an esteemed native 
remedy for this disease. Its proving has displayed 
its elective affinity for the skin: and “ lepra tuber- 
culosa,” which is an European approach to elephan- 
tiasis, has more than once yielded to it. I refer 
you for all information regarding it to a paper in 
the ‘ Brit. Journ. of Horn.,’ vol. xvi, pp. 461 and 
580. I once obtained great benefit from it in a case 
simulating the “ Barbadoes legand am now 
trying it in one of hereditary Indian elephantiasis. LETTER L. 
diseases of the skin (continued). 
"We have discussed the orders of general cutaneous 
disease. Taking now the remaining constituents of 
the skin, we have as affections of the,papillae Icthyosis 
and Warts, Of the former I can say nothing : 
hut you will thank me for reminding you how to 
cure 
Warts. 
I am referring to what I said when writing upon 
Thvja. Uncertain in its local action when only one 
or two are present, I have never known its internal 
administration fail in dispersing them when they 
come in crops. Calcarea too is recommended for 
this purpose. 
'll The affections of the sebaceous glands are Mollus- 
cum, Acne, and Sycosis. 
Molluscum. 
The only notice of this malady in Homoeopathic 
literature with which I am acquainted is one by 
Dr. Dudgeon in the ‘ Hahnemann Materia Medica/ 
vol. i, p. 50. He there states that in a case then 
under his care the tumours of this curious disease 468 
ALOPECIA 
were disappearing under the action of Silicea and 
Lycopodium. 
Acne. 
The simple form of this disease, as it often occurs 
in young people, may generally be cured by Bella- 
donna if the patients are full-blooded, by Pulsatilla 
if they are pale and slender. In more chronic 
cases Sulphur is required: and it is often useful to 
touch each prominence daily with a camel’s hair 
brush dipped in the mother tincture. Acne rosacea 
is a very obstinate affection: and probably more 
good is got by constitutional treatment, especially 
directed against alcoholic toxication, than by cuta- 
neous remedies. Carbo animalis, Antimonium cru- 
dum, Ruta, and Ledum,—as well as the never- 
failing Arsenic, have been recommended. 
Sycosis menti. 
TLere is a case of tLis disease in one of tLe 
earlier volumes of tLe fBrit. Journ. of Horn./ in 
wliicL Tartar Emetic, externally and internally, was 
curative: and I Lave myself Lad a similar one. I 
Lave seen no benefit from TLuja or Antimonium 
crudum, both of wliicL I have tried. 
Under the Lead of affections of the hair-follicles 
I Lave to speak of Alopecia, Plica Polonica, and 
Favus,—reserving Ping-worm for tlie diseases of 
cLildren. FAVUS. 
469 
Alopecia 
includes as its simplest form the “ falling of the 
hair ’’ which results from general or local debility. 
Phosphoric Acid is often very serviceable in these 
cases. If the baldness be complete, whether general 
or in patches, you will of course first enquire after a 
syphilitic history : and if the taint be detected, you 
will, I think, find Fluoric Acid the specific medicine 
for this local manifestation of it. In non-syphilitic 
cases Mr. Hunt leads us to expect gi’eat things from 
Arsenic, but you must not forget Teste’s singular 
experiences with Aloes (‘ Pharmacodynamics/ p. 64). 
Plica Polonica 
is said to have been cured by Vinca minor : but 
you are not likely to have an opportunity of treating 
it in this country. 
Favus. 
Is this disease primarily parasitic and local ? If 
so, there is no need for me to discuss internal 
remedies for it. But you know that the question 
is a moot one: and that dissentients from the 
doctrine are to he found in the old school as 
well as in ours. Teste recommends; with appa- 
rent belief in their efficacy; Sulphur; Dulcamara; 
Oleander, and Hepar sulphuris in its treatment. 
When the scrofulous diathesis is plainly marked, 
you will remember what I mentioned about the 
improvement in the beauty of the hair and the 470 
FUltUNCLE. 
cleanness of the scalp which has been observed to 
follow the use of Iodine in these subjects. 
I have in conclusion to discuss the treatment of 
some miscellaneous affections of the skin and its 
appendages not included in the above categories. 
These are Boils, Carbuncles, Whitlows, Disease of 
the Nail-matrix, and Ulcers. Last I must say a 
few words upon the disorder of the cutaneous 
sensory nerves which we call Pruritus. 
Furuncle 
is a trouble about which you will probably be glad 
to know if we have any means of dealing with it. 
I can recommend the following bits of treatment to 
you with much confidence. If you can catch a boil 
in the stage of inflammatory engorgement, before 
matter has formed, it may almost always be blighted 
by repeated doses of the 1st dilution of Belladonna * 
And if the boils, like sorrows, 
“ come not single spies, 
But in battalions/’ 
if they recur again and again, the constitutional 
tendency may with equal frequency be checked by a 
course of Sulphur. 
The local management of boils, should they not 
have been blighted in their incipience, is of course 
a surgical matter: but possibly suppuration is 
favoured and expedited byHepar sulphuris or Silicea. 
It is only right to mention that Arnica is supposed 
* Dr. Madden tells me that even later still its progress may be 
arrested by Silicea, in the 3rd trituration; but of this I have no 
experience. DISEASE OF THE NAIL MATRIX. 
471 
to have some specific influence over boils and the 
furuncular diathesis. 
Carbuncle 
is often nothing more than a large boil, and requires 
treatment accordingly. But when the inflamma- 
tion is of a malignant type, and accompanied with 
prostration and other symptoms of blood-poisoning, 
then Lachesis or Arsenicum, preferably the former, 
will be required, as in malignant erysipelas. 
Whitlow 
may certainly often be arrested by the timely 
administration of Silicea, or of its analogue Fluoric 
acid. When the disease is fully established, you 
can conduct it through its course with considerable 
mitigation of suffering by persistence with Silicea, 
or (as Dr. Bayes recommends) with Hepar sulphuris. 
But that the homoeopathic treatment of whitlow 
requires local aids is indicated by the recommenda- 
tion of one of our leading German colleagues that 
Nitric Acid should be applied to the finger (see 
‘Brit. Journ. of Horn./ vol. xxi, p. 218). 
Disease of the Nail-matrix, 
leading to impaired growth and mal-nutrition of the 
nails, has been caused by Mercury, and in a case 
under my own observation was cured by this drug. 472 
ULCEKS. 
Ulcers. 
These, of course, are not diseases of the skin : 
but I cannot well range them under any other 
category. All, except sometimes the “weak” and 
“ indolent,’* require and repay constitutional treat- 
ment : but all, save the “ scrofulous/* need local 
applications also. These last will often heal spon- 
taneously as the general health improves under 
such medicines as Sulphur and Calcarea. When 
they are slow to fill up, the Phosphate may be 
advantageously substituted for the Carbonate of 
Lime, according to Dr. Beneke*s suggestions (c Brit. 
Journ. of Horn.’ vol. xvii). “ Weak ” and “indo- 
lent ** ulcers should be treated by the local applica- 
tion of Calendula, in the proportion of a drachm of 
the tincture to an ounce of water. You should see 
that the lint soaked in the solution fits accurately 
to the ulcerated surface, and does not overlap the 
surrounding skin. If Calendula fails, apply Kali 
bichromicum, gr. j to Aq. the same manner. 
These applications are tolerably efficacious even by 
themselves: but they are much aided by the well- 
understood management which includes rest and 
support. 
The remaining forms of ulcer require both con- 
stitutional and local treatment. For the “inflamed** 
ulcer, if it is the raw surface itself that is red 
and hot, Arsenicum, will be most suitable, with 
water dressing: if the surrounding skin is the seat 
of chronic inflammation, give Belladonna and apply 
Calendula or Hydrastis in the manner practised at PRURITUS. 
473 
the London Homoeopathic Hospital (see 1 Annals/ 
vol. v, p. 356, and f Monthly Horn. Review/ Sept., 
1867). The “ irritable” ulcer is rather intractable: 
I think Lachesis a good medicine for it, but find 
it usually necessary to seal it up, so as entirely 
to exclude the contact of air. Lachesis is 
also useful for “ phagedsenic ” and “ sloughing ” 
ulcers, as also is Arsenicum: the best local applica- 
tion for these is a weak solution of Kreasote. The 
treatment of the “varicose'” ulcer is that of "Vari- 
cosis itself: but you may with advantage apply to 
the sore the medicine you are giving internally. 
Pruritus, 
in its general form, is happily not common. If 
you have a case to treat, try first what can be done 
by attending to the general health, and improving 
the condition of the skin by baths, frictions, &c. 
If it does not thus yield, consider the exact nature 
of the itching, and the circumstances under which 
it is aggravated or relieved, and look out these 
symptoms in a good repertory. In this way, you 
will possibly find in Opium, Nux vomica, Mercurius, 
Sulphur, or some less-known medicine the remedy 
of which you are in search. 
The local varieties of pruritus—all haunting the 
intracrural region—are generally symptomatic, and 
demand a careful enquiry into their causes. Sul- 
phur is sometimes useful for pruritus ani, and 
Collinsonia for pruritus pudendi: Thuja also must 
be borne in mind when there is much perspiration 
at this spot. But local pruritus is very rebellious 474 
PRURITUS. 
against internal remedies; and you will generallyhave 
to resort to the external applications in best repute, 
of which Mercury in some form—as the unguentum 
hydrargyri nitratis and Trousseau’s hot solution of 
the bichloride—is the chief constituent. 
Anent these diseases of the skin I will make a 
remark which is applicable to all diseases. I have 
often had to say of this or that morbid condition— 
“ I know of no medicine homoeopathic to it, or 
which has cured it.” And T have perhaps hardly 
sufficiently explained what the Homoeopathic practi- 
tioner is to do under such circumstances. He must 
treat the case symptomatically. Abandoning his 
special regard to the lesion he diagnoses or the 
trouble for which his patient consults him, he must 
consider the latter for the nonce as a bundle of 
symptoms, and with repertory and materia medica 
hunt for the medicinal analogue thereto. It is not 
a satisfactory method, either in its nature or in its 
results. Now and then, indeed, it enables you to 
make a brilliant hit: but you would find the misses 
many times more frequent if you often employed 
it. Still, it is better than nothing. It not un- 
commonly effects the extinguishment of special 
symptoms, which you may have thought irremove- 
able save with the disease as a whole, and which 
have caused much distress. And sometimes the 
disappearance of the disease itself establishes the 
homoeopathicity of the medicine to it, although its 
proving has not been carried sufficiently far or wide 
to effect the change in question. LETTER LI. 
DISEASES OF THE LOCOMOTIVE ORGANS. 
As the organs of locomotion I shall class the 
Muscles, Bones, and Joints; and in the present 
letter will put down what I have to say upon the 
treatment of their morbid conditions. 
And first, of the muscles. As there is no reason 
why these organs should not be attacked by inflam- 
mation, I will speak of 
Myositis, 
though I confess I know nothing practically about 
it. Should you encounter it, you will remember 
what I said when writing to you upon Bryonia, 
that both the symptoms of the provers and the post- 
mortem appearances make it probable that this 
medicine is a specific irritant to muscular fibre. 
A far more frequent affection of the muscles is 
that now known as 
Myalgia. 
I need not tell you how much we are indebted to 
Dr. Inman of Liverpool for the identification of 
myalgia as a pathological entity. But we owe to 
Dr. Madden its naturalization—so to speak—in 476 
SPASMS. 
Homoeopathic regions, and the establishment upon 
a firm basis of its chief remedy. You will find the 
paper of his to which I refer in vol. xxv. of the 
‘ Brit. Journ. of Horn.,’ p. 76 : and I feel sure that 
you will derive many a valuable hint from its perusal. 
Arnica is the grand remedy for myalgia in all its 
forms, especially when it results from fatigue or 
injury of the muscle. Even the heart, when its 
muscular walls have been strained by over-exertion, 
as from rowing, may have its integrity restored by 
this medicine, of which Dr. Bayes has furnished 
some valuable cases in point (c Monthly Horn. 
Beview,’ Dec. 1866). Another useful medicine for 
myalgia is Actcea Racemosa, which has the credit of 
having to all intents cured one of the severest and 
most obstinate cases of the kind on record. The 
seat of the affection was the diaphragm, and Dr. 
Madden himself was both the sufferer and the 
healer. You will find the narrative of the case, 
which extends over nine years, in p. 493 of the same 
volume of the Journal. Gelseminum, also, is of 
decided service, as recommended by Dr. E. M. Hale, 
for acute general myalgia, with feverishness, as from 
unwonted or undue bodily fatigue. 
Spasms 
of the voluntary muscles have several times come 
under our notice, as tetanus and tetany, torticollis, 
writer’s cramp, and so on. In all these the ner- 
vous system is primarily at fault, and the muscular 
trouble is secondary. But what are called “ cramps’’ 
may result from simple debility or over-fatigue, MUSCULAR RHEUMATISM. 
477 
when Arnica will help. The next most common 
cause is intestinal irritation, of which the choleraic 
cramps are a crucial instance. For these you will 
always think of Cuprum. 
Before leaving the subject of muscular pain and 
spasm, the debility they imply may have its remedy 
allotted to it. This is Digitalis, whose power over 
muscular life we have already ascertained. You will 
find it a valuable adjunct to the rest and nourish- 
ment you will naturally prescribe for the radical 
cure of these patients. 
The last affection of the muscles of which I have 
to speak is 
Muscular Rheumatism. 
I cannot at present follow Dr. Garrod in regard- 
ing this affection as a distinct disease: but it 
■unquestionably requires different treatment from 
that of rheumatism involving the joints or fascia. 
Bryonia and Tartar Emetic are its reputed remedies 
when occurring in an acute and general form : but 
we know it best in the forms of pleurodynia (of 
which I have already spoken), of lumbago, and of 
stiffneck. 
Lumbago, when quite recent, and especially when 
involving the lumbar muscles, will yield with pleasing 
rapidity to Aconite 1st decimal. There is a less 
acute variety, in which the lumbar fascia seem to 
me most affected, and where Rhus is preferable. 
You will notice how much the treatment of rheu- 
matic lumbago corresponds with that of rheumatic 
sciatica. Like sciatica, also, lumbago has a non- 478 
TEKIOSTITIS. 
rheumatic variety, where Acteea Racemosa or Nux 
vomica will prove more suitable, or perhaps Arnica 
may be required. 
Stiff-neck may always, I think, be rapidly cured 
by one of two remedies,—Aconite if it results from a 
draught of cold air, Dulcamara if it arises from damp. 
The first disease of the bones of wdiich I shall 
speak is 
Periostitis. 
Of the syphilitic and mercurial forms of this 
disease, which are usually circumscribed, I will 
speak immediately under the head of “nodes.” 
The diffuse form is either acute, from cold or 
injury : or chronic, from rheumatism or scro- 
fula. The specific tissue-irritants of the periosteum 
which we possess are Mezereum, Phytolacca, Mercu- 
rius, Silicea, Kali bichrornicum, and perhaps Guaia- 
cum. In acute periostitis I should recommend the 
first of these,with Aconite: but when suppuration has 
taken place, Silicea is indicated, and should be per- 
severed with until all symptoms have subsided. The 
propriety of incision, whether subcutaneous or 
direct, is a surgical question which I must leave to 
your discretion. “ Periosteal rheumatism ” is 
hardly an inflammation ; I have already spoken of 
its treatment. Chronic periostitis in strumous 
subjects will commonly yield to the general diathetic 
measures you will adopt: but one or other of the 
medicines above mentioned may help in its re- 
moval.* 
* Ituta and Asafaetida are spoken of as periosteal remedies: I 
have no knowledge of them in this capacity. OSTITIS. 
479 
Nodes 
are either “soft” or “hard.” Silicea, which is 
good for either, is especially suitable to the former. 
When soft nodes form on the scalp, Kali bichro- 
micum is perhaps superior in efficacy to Silicea. 
But for the genuine hard syphilitic node, with its 
nocturnal pain, we have no medicine like the Iodide 
of Potassium, with whose application Homoeopathy 
seems to have little to do. You will see the rationale 
of the action of this remedy discussed by Dr. 
Madden in his paper upon it in the ‘ Brit. Journ. 
of Horn./ vol. xxvi, p. 415. You will see also that 
we have no reason for expecting that its virtues will 
be displayed in infinitesimal doses. 
Ostitis, 
in the acute form, is practically identical with acute 
necrosis, as which I shall consider it. Chronic inflam- 
mation of bone, whether primary, or extending from 
the periosteum, is syphilitic, mercurial, or scrofu- 
lous. If syphilitic, the first question is whether 
the patient has been mercurialized. If not, Mercu- 
rius suggests itself as in every way a most homoeo- 
pathic and suitable remedy. Aurum is its most 
important ally: and the two medicines may re- 
inforce and replace one another until the cure is 
complete. Too often, however, the osseous disease 
owes its origin to the improper use of Mercury : and 
here our primary aim must be to antidote the 
poison. Nitric Acid is the most important agent 
we Homoeopaths have for this purpose: and then 480 
CARIES. 
comes Hepar sulphuris. These medicines are likely 
to suffice when the mercurialization has not been 
extreme. But if the patient is in the latter unlucky 
case, or if the syphilitic diathesis is very pronounced, 
I cannot but think the ordinary prescription of 
Iodide of Potassium still more satisfactory. 
Chronic scrofulous ostitis is nearly, if not always, 
caries : of which I shall now speak. 
Caries 
is reputed incurable under ordinary treatment, and 
is relegated to the knife. We have better auguries. 
Let me cite the following case :—it is given by Dr. 
Laurie in his “ Elements.-” 
“ A boy became affected, after scarlet fever, with 
caries of the temporal bone, which, during a period 
of five or six years, periodically broke out afresh, 
discharged an offensive pus, and then healed again. 
The entire left side of the cranium was arrested in 
its growth, and consequently rendered much smaller 
than the other side; the left eye also appeared 
strikingly smaller than the right one. The intellect 
of the boy was, nevertheless, not in any way affected. 
Several remedies improved, but failed in curing the 
caries. After the employment of Fluoric Acid the 
attack came on earlier, and in a more aggravated 
form than usual, but never returned. From that 
time onward the less half of the cranium commenced 
to growr, and the previous inequality of size between 
the twro sides of the head became gradually less, and 
finally imperceptible.” 
Besides Fluoric Acid, its chemical congener, NECROSIS. 
481 
Silicea, is a valuable medicine for caries, as also are 
Phosphorus and Acidum Phosphoricum. The last 
should especially be chosen when there is free 
suppuration, and hectic is present. If the caries be 
syphilitic or mercurial, the treatment I have indi- 
cated for ostitis arising from these causes is 
required. 
Necrosis 
is, I imagine, not uncommon as an acute disease. 
I have seen three well-marked examples of it : and 
one of the patients all but succumbed to the inten- 
sity of the sympathetic disturbance. I can say 
nothing as to the effect of medicines upon the pro- 
gress of the inflammation. Aconite in semi-material 
doses, internally and locally, would seem best calcu- 
lated to be of service. Whether subsequently to an 
acute attack, or primarily chronic, we have often to 
treat a necrosis already accomplished, and the dead 
bone awaiting detachment. Here, as in caries, the 
question of surgical interference will arise: and 
here, as in caries, I would recommend you to 
refrain. Give Silicea as your basis remedy : bring- 
ing to its aid occasionally any other medicine 
which the general condition mayseem to demand. 
You will see exfoliation gradually taking place, and 
your patient’s health not suffering under the pro- 
cess. Symphytum, I should add, is a medicine 
recommended in aid of the detachment of the 
sequestrum. 482 
SYNOVITIS. 
Neuralgia of Bone 
is, happily, rare ; should you encounter it, I would 
suggest the trial of Zincum as a remedy. 
Mollities Ossium. 
There is a paper on this disease by Dr. Arnold of 
Heidelberg in vol. vi of the ' Brit. Journ. of Homoeo- 
pathy/ He recommends, apparently from expe- 
rience, Calcarea and Iodine in its treatment. Theo- 
retically, I should have thought Phosphorus the 
specific remedy, if there be any: since mollities is 
unquestionably a fatty degeneration. 
I have now to speak of the diseases of the joints, 
and shall begin with 
Synovitis. 
This inflammation, in its acute form, is readily 
manageable by Homoeopathic remedies, without 
the need of the leeches, the blisters, or even the 
continuous cold to which you have been accustomed. 
If it has been excited by injury, you will do well to 
keep the joint covered by a weak Arnica lotion. 
Otherwise, simple water-dressing is the only local 
application necessary. You will of course keep the 
joint at rest, and, if practicable, elevated. Then, 
for internal medicine,—Aconite, if there is fever or 
intensity of local action, but alternated with the 
more specific remedies, Bryonia or Pulsatilla; the 
former when, as often happens, the patient is rheu- 483 
WHITE SWELLING OF TIIE JOINTS. 
matic, although the synovitis be simple ; the latter 
in children, delicate women, and indeed in the 
majority of the cases in which synovitis occurs. 
The support of strapping or a bandage is all that is 
afterwards required to cause absorption of the effu- 
sion,—the medicines being continued. If suppura- 
tion has taken place, you should give Hepar sulphuris, 
and apply a solution of it externally : but I cannot 
promise you that the matter will be absorbed with- 
out evacuation. Should this latter have taken place, 
and matter be discharging, Silicea, also locally as 
well as internally, seems preferable to Hepar. 
Tor the simple form of chronic synovitis I recom- 
mend,—if it be syphilitic or mercurial, Kali 
hydriodicum; if it be rheumatic, Mercurius. But in 
either or any case the predominance of serous effu- 
sion over inflammatory thickening (“ hydrops arti- 
culi ”) leads to Iodine or its compound with potash 
as the most suitable remedy. Here again Homoeo- 
pathy occupies common ground with the old school. 
I can say nothing about the “ brown fibro-gela- 
tinous degeneration of the synovial membrane,” 
described by authors as occurring chiefly in the 
adult female. Chronic scrofulous synovitis forms 
one variety of the disease which I shall call by the 
old but useful name of 
White Swelling of the Joints. 
This disease may begin, as you know, either in 
the synovial membrane, in the cartilage, or in the 
cancellous structure of the ends of the bones. The 
diagnosis of the different origins is important, as in 484 
ARTHRALGIA. 
addition to tlie general anti-scrofulous medicines 
you will prescribe, those influencing the tissue 
primarily affected will be specially serviceable. 
There are few cases in which Sulphur and Calcarea 
and cod-liver oil will not be useful, given as an 
occasional course. But when synovitis has been 
the primary mischief, Pulsatilla or Hepar Sulphuris 
will help. The painful ulceration of the cartilages 
calls for Mercurius corrosivus. And when the 
disease has begun in the bones, Silicea, Calcarea 
phosphorica, and perhaps some of the other medi- 
cines I have mentioned as applicable to caries, are 
required. Aconite is often serviceable for constitu- 
tional irritation: but when this has assumed a 
distinctively hectic type, Phosphoric Acid is more 
suitable. 
These remarks are of course applicable to disease 
of the hip—“ morbus coxae ”—as of other joints. 
But here you will also find Colocynth a very useful 
medicine, relieving as it does much of the pain 
accompanying the disease, from irritation of the 
neighbouring nerves. 
Arthralgia 
is a convenient terra, including as it does both the 
“hysterical joint” and neuralgia, often sympathetic, 
haunting the articulations. Hysterical joints, like 
hysterical sufferings generally, are obstinate things 
to deal with, and I have no special suggestions to 
offer beyond what I have said regarding hysteria 
generally. Nor do I think that neuralgia of joints 
is ever primary, so as to require a special medicine. 485 
GANGLION. 
Should it be so, however, Plumbum should be 
thought of. 
As closely connected with the joints, I must 
speak of bursitis and of ganglion. 
Bursitis. 
In acute inflammation of these sacs, Aconite and 
Belladonna are efficacious. In the chronic form, of 
which the house-maid’s knee is a well-known 
instance, Rhus, internally and externally, has proved 
curative : but you may have to fall back upon the 
similar use of Iodide of Potassium. Ruta is some- 
times good for bunion. 
Ganglion, 
also, lias disappeared in ray hands under Ruta : but 
I cannot tell you that it will always succeed. LETTER LII. 
DISEASES OF CHILDREN. 
You will call this a very arbitrary division : and 
may perhaps be disposed to criticise it as unfitting 
to a scientific classification. Perhaps it is: yet 1 
cannot doubt that it is practically useful to present 
under one view both the diseases peculiar to infancy 
and childhood, and the modifications of ordinary 
disease which these subjects present. The “jucunde” 
element in Homoeopathic treatment naturally makes 
it sought to for children, so that we have large 
experience in the treatment of their maladies. The 
results of this experience I think it well to present 
in a connected form : and I do not think you will 
find the arrangement otherwise than convenient. 
I will begin by passing down the classes of 
diseases already identified, and noting the treatment 
of such of them as are peculiar to children, or 
offer special characters when occurring in early life. 
In addition to what I shall myself bring forward, 
you may consult the special treatises on c Diseases 
of Children’ by Hartmann, Hartlaub, and Teste, 
—all of which have been translated into English : 
and the remarks on the treatment of infantile dis- 
orders appended by Drs. Leadam and Guernsey to 
their gynaecological manuals already cited. RACHITIS. 
487 
Among the Blood Diseases I have purposely left 
for the present occasion one of the cachexise, rickets, 
Rachitis. 
We are learning more and more not to regard 
this malady as one seated in the bones only, but as 
a true constitutional diathesis ranking with scrofula 
and tuberculosis. “ If a child cuts its teeth late, 
if it does not walk so early as other children, if the 
fontanelles are late in closing, the probability is 
that it is the subject of rickets,” so writes Dr. 
Hillier.* He further defines it “ A general disease 
of nutrition chiefly affecting infants, characterised 
at first by unhealthy alvine secretions, pains in the 
limbs, perspirations about the head, and subse- 
quently by great muscular weakness and retarded 
ossification and dentition, softness of hones, with 
abnormal growth of cartilage, causing various de- 
formities in the head, trunk, and limbs. In the 
spleen, lymphatic glands, and liver there is degene- 
ration with enlargement, sometimes also in the 
cerebrum.” 
If, knowing these facts about Rachitis, we re- 
cognise the malady in its early stage, and trace its 
causation to improper diet, it is probable that regu- 
lation of the latter, and the administration of cod- 
liver oil and suitable medicines for the digestive 
derangement present, may be all that is required 
for use. But when the diathesis is well marked, 
and especially when unsuitable food has not origi- 
nated it, you will have to seek to more specific 
# Clinical Treatise on Diseases of Children. 1868. 488 
INFANTILE KEM IT TEXT FEVER. 
medicines. I can expect little from the Buta, 
Staphysagria, Mezereum, Lycopodium, and Pinus 
svlvestris, suggested by Hartmann; still less from 
the Mercurius solubilis, Colchicum, and Sulphur 
which are Teste’s eccentric recommendations. Nor 
can Calcarea, I think, he regarded as a specific 
remedy for the rachitic diathesis. There is some- 
thing more here, even in the bones, than deficiency 
of lime-salts. To Phosphoric Acid, on the other 
hand, I can follow Hartmann in ascribing great 
powers for good; and to it I will add Silicea. The 
former corresponds with the diarrhoea and the pains 
in the limbs, and perhaps to the bone disease and 
the albuminoid degeneration. The latter covers the 
perspirations about the head, the sensitiveness of 
the surface, and the tendency to increased growth 
of cartilage. With these two medicines, but especi- 
ally with the latter, I can encourage you to expect 
great things in the treatment of rickets. 
None of the fevers already mentioned present in 
children any aspects demanding special modifications 
of treatment. But there is one child’s fever which 
is quite peculiar to early life, and well called 
Infantile Remittent Fever. 
I know that it is a question at the present day 
whether such a fever is a distinct pathological 
entity. But I cannot doubt its existence, and its 
independence of local inflammation. We have, 
moreover, a most excellent medicine for it in Gelse- 
minum, which fact itself goes far to establish its 
essential nature. I recommend you to give this HEREDITARY SYPHILIS 
489 
medicine instead of Aconite when tlie remittent 
character of the fever is well marked. But it will 
generally need an ally to remove the gastric 
symptoms ; and this I have always found in Pulsa- 
tilla : though you must not forget Antimonium cru- 
dum. Should the head symptoms be prominent, 
the most suitable medicine is Hyoscyamus. 
And now I have to speak of syphilis as occurring 
in infants, i. e. 
Hereditary Syphilis. 
I have nothing better to propose for the treat- 
ment of this malady, in its full constitutional mani- 
festation, than the small doses of Mercurius to 
which you have been hitherto accustomed. The 
Kreasote recommended bv Teste does not, I appre- 
hend, reach deep enough for the developed disease, 
but only touches its cutaneous manifestations. If 
condvlomata appear, Nitric Acid must be given: 
and if the cachexia is considerable, you may with 
advantage fall back upon Aurum. Hartmann, how- 
ever, recommends China to support the little 
patient’s strength in his struggle -with the poison. 
I pass now to the disorders of the Brain and 
Nervous System as they occur in childhood. I 
need not tell you how excitable these little brains 
are : and how readily they can be fretted into mor- 
bidity. Besides the judicious general management 
so important in these cases, you will find the ut- 
most benefit from some of our medicines. On the 
one side stand those suitable for nervous erethism 
simply, which are Coffea, Chamomilla, Iyncitia, 490 
ACUTE HYDROCEPHALUS. 
Hyoscyamus, and Stramonium ; on the other those 
which reach to inflammatory mischief, of which 
Belladonna is facile princeps. The place and uses 
of these remedies are already familiar to you : and 
I shall have occasion to speak again of some of 
them under the head of Acute Hydrocephalus and 
of Morbid Dentition. I will come at once to the 
former of these. 
Acute Hydrocephalus. 
I fear we cannot but echo the melancholy ex- 
perience of the old school of treatment, and say 
that fully developed tubercular meningitis is incur- 
able. I have never seen a case recover wheu 
effusion had set in. But I must tell you what 
medicines appear to do most for the symptoms, or 
give us the most hopeful outlook. Let me first 
refer you to such information on the subject as our 
literature gives us. 
Hartmann groups together the tubercular and 
the non-tubercular forms of meningitis, and hence 
his estimate of our power over the disease seems 
too flattering. lie recommends Bryonia, Pulsa- 
tilla, or Zincum, according to the symptoms, for 
the stage of incubation : Belladonna and sometimes 
Bryonia in that of inflammatory excitement: and 
Helleborus and Sulphur when exudation has set in. 
Teste admits that tuberculous meningitis is incur- 
able ; but speaks warmly of Belladonna and Bryonia 
in the simple variety. His editor, Hr. fulte, con- 
firms the value of Bryonia when effusion is im- 
pending : but recommends its alternation with ACUTE HYDROCEPHALUS. 
491 
Helleborus. Leadam and Laurie appear to speak 
theoretically only : and Guernsey says nothing as 
to the prognosis under the remedies whose indica- 
tions he gives. Dr. Bayes (‘Brit. Journ. of Horn.,’ 
vol. xxi, p. 22) relates a fatal case, and mentions 
another: but states that he has generally been suc- 
cessful with Pulsatilla in insidious cases, and with 
Belladonna and Aconite in those of an acuter 
type. Dr. Wahle, in an article on the disease in 
vol. ii of the same Journal, p. 285, commends 
Bryonia, Helleborus, and Sulphur: Dr. Elb con- 
siders Zincum effectual against paralysis of the 
brain in the last stage (qy. ?) : and Dr. Hummel 
considers Sulphur the fundamental remedy through- 
out. Dr. Bussell relates a case apparently of the 
tubercular form recovering after effusion had set 
in under Aconite and Arsenicum : and Dr. Watzke 
had a similar result from the persevering use of 
Digitalis and Yeratrum. More recently, America 
has given us Yeratrum viride for the inflammation, 
and Apocynumfor the effusion. And, in a German 
prize essay on the subject (‘ United States Medical 
and Surgical Journal/ vol. i, p. 237), Glonoine 
and Apis are regarded as specific in the two stages 
respectively. 
I think that the general agreement as to the 
value of certain remedies — notably Belladonna, 
Bryonia, Helleborus, and Sulphur—points to a true 
power exerted by our remedies over meningitis as 
such, though there is no proof that they have cured 
a case where tubercle was the exciting cause. The 
possibility of the presence of the latter, however, in 
a given instance, affects the prognosis rather than 492 
ACUTE HYDROCEPHALUS. 
the treatment: and in the chance of its absence 
“ nil desperandum” must be our motto. The fol- 
lowing may be sketched as the most hopeful system of 
therapeutics for the disease. 
In the premonitory stage, where digestive de- 
rangement is the prominent feature, you must re- 
member the commendations given to Pulsatilla, in 
the medium dilutions, which indeed corresponds well 
with the symptoms present and the usual tempera- 
ment of the patients. But do not continue it too 
long, especially after vomiting has set in. Then go 
at once to Belladonna, which is now your sheet- 
anchor. Some say the higher dilutions are best; 
but I have more confidence in the lowest: I have often 
seen the premonitory symptoms of cerebral mischief 
in children clear away under the 1st dec. dilution, 
alternated or not with Aconite according to the 
presence or absence of fever. Dr. E. M. Hale con- 
siders Veratrum viride to unite the virtues of both 
drugs :—I have no experience with it. Belladonna 
continues to be the proper medicine as long as 
effusion keeps off, unless you see good to substitute 
or interpose Sulphur, which you may wisely do if 
the symptoms do not abate: or you may go on to 
Bryonia. In the brain, as elsewhere, impending 
effusion is the indication for this medicine, as com- 
pleted effusion is for Helleborus. In doubtful cases, 
Belladonna and Bryonia, or Bryonia and Helle- 
borus, may be alternated, as recommended by Teste 
and Pulte. Here, again, Sulphur may be resorted 
to if the usual medicines fail. Beyond these I feel 
leaving firm ground : and can say nothing definite 
about the remaining medicines. There are, how- CONVULSIONS. 
493 
ever, some curious recoveries mentioned in Peters’ 
* Treatise on Diseases of the Brain ’ as occurring 
from semi-material doses of Belladonna, which I 
think worthy of attention. 
Chronic Hydrocephalus 
is, as Watson says, a dropsy, while acute hydroce- 
phalus is an inflammation. It' is also rather a 
symptom of some general cachexia—as scrofulosis 
or rachitis—than an independent local disorder. Its 
treatment is accordingly best conducted with such 
medicines as Sulphur, Calcarea, and Silicea, though 
Hellebore may be a useful adjunct. 
Convulsions. 
I need hardly point out to you the importance 
of ascertaining whether there is any eccentric cause 
which may account for these phenomena in children. 
If such be detected, you will of course apply your- 
self to its removal as speedily as possible. But 
there will remain two classes of cases in which 
special treatment will be required. The first is 
where a morbid condition has been set up in the 
brain by some eccentric irritation, but does not 
disappear upon the removal of the exciting cause. 
Belladonna, Hydrocyanic Acid, and Ignatia are here 
the most important medicines: the first when the 
patient is full-blooded, the second when he is of the 
opposite constitution, and the third when the con- 
vulsions seem spinal rather than cerebral. Then 
again we frequently encounter convulsions as a 494 
INFANTILE PARALYSIS. 
symptom of idiopathic brain disorder, or of the dis- 
turbance of that organ incident to other diseases, as 
the exanthemata. The main indication for treat- 
ment, as well expounded by Dr. Hitchman,* is the 
presence of excitement or depression of the brain, as 
indicated by the elevated or depressed fontanelle. 
The former requires Belladonna, and sometimes 
Aconite : if it comes on suddenly, Glonoine may be 
preferable. The latter is best helped by Zincum,— 
the lowest triturations of the oxide or the sulphate 
being most in favour. 
Whatever medicine you select, you will best give 
it in the intervals between the attacks, — as, for 
instance, a dose after each fit. During the paroxysm 
itself, you may let the child smell at Camphor, which, 
Dr. Leadam says, will often calm a powerful con- 
vulsion instantly. 
I should add that Teste, after recommending 
Kreasote 24 for the convulsions of dentition, and 
Stannum 30 for those arising from worms, states 
that “ when convulsions in nursing children seem 
to be idiopathic, the only medicine to oppose to them 
is Helleborus.” 
There is a form of Paralysis so peculiar to child- 
hood that it is known as 
Infantile Paralysis. 
I do not mean by this the hemiplegia which is 
not uncommon in children, which is of cere- 
bral origin, and dates nearly always from a con- 
* “A Stray Leaf on Infantile Convulsions,” Brit. Journ. of 
Horn. vol. xxii, p. 109. INFANTILE PARALYSIS. 
495 
vulsion if it be not a symptom of organic disease. 
The “ essential paralysisof infancy is spinal; 
usually ushered in by a feverish attack; more or 
less general at first, but afterwards, if it do not 
altogether disappear, limited to a limb or two, or 
even to a group of muscles ; and accompanied with 
atrophy of the latter organs. I think that all evi- 
dence is in favour of spinal congestion being the 
starting-point: and of hypersemic softening and 
atrophy of the antero-lateral columns lying at the 
bottom of the confirmed cases. I should accord- 
ingly recommend Gelseminum in the early period, 
by which medicine the natural tendency to recovery 
might be furthered. Later, Belladonna and Secale 
become the most suitable medicines : and there is 
no reason why you should not give the paralysed 
muscles the benefit of localized galvanism. LETTER LIU. 
diseases of children (continued). 
I have nothing to add relative to the treatment 
of diseases of the eyes and ears in children, except 
to say that Dr. Leadam has just published (f Monthly 
Horn. Review,’ Jan. 1869) a note on Ophthalmia 
Neonatorum, in which he states that Aconite 30, 
two globules every three hours, is sufficient to cure 
the disease without any other help save sponging 
with warm water and exclusion of light. When 
granular lids have supervened upon neglected cases, 
Zincum 5 is his remedy. Any hints from one so 
experienced in this branch of practice are valuable ; 
so I cannot resist enriching my pages with these 
observations. 
I come now to the disorders of the Digestive 
Organs occurring in children, and take first the 
various forms of 
Stomatitis. 
This disease may be simple, aphthous, or ma- 
lignant. I will speak of the two latter under the 
titles of aphthae and cancrum oris respectively. 
Simple stomatitis (muguet), which is an exudative 
inflammation of the buccal mucous membrane, has 
no better medicine than Kali chloricum, w'hich is CANCRUM ORIS. 
497 
confessedly homoeopathic to the morbid condition. 
I have treated a good many cases in children with 
the 1st dec. trituration with very satisfactory success. 
Aphthae. 
In the treatment of thrush, also, we occupy 
common ground with the old school, and maintain 
the homoeopathic specificity of the Borax which we 
give as well as they. It will cure when internally 
administered only, and in almost any dilution: but 
there seems no reason why its local application 
should not be conjoined. Mercurius is also homoeo- 
pathic, and is well spoken of: Hartmann also com- 
mends Sulphuric Acid, and Teste Muriatic Acid,— 
both advising the local as well as the internal use 
of the medicines. 
Cancrum Oris. 
The well-known tendency of Mercury to cause this 
serious disease would justify us in opposing one of 
its salts to at least its primary manifestations. The 
only case I have seen w'as subsequent to measles, 
and yielded fairly to Mercurius solubilis and Muri- 
atic Acid. But you should always hold Arsenicum 
in reserve, as the medicine of all others best fitted 
to cope with the disorganizing process we are now 
considering. In an epidemic of cancrum oris oc- 
curring in Germany, Arnold found this medicine, 
in the 3rd and 4th dec. triturations, the only cura- 
tive. 498 
MORBID DENTITION. 
As a child’s affection of the tongue—though it 
is more than that—I will speak of 
Stammering. 
Great good may often be obtained in this affec- 
tion by the persevering use of Stramonium. This is 
Teste’s recommendation : and it is sustained by 
some cases which you will find in the ‘ Brit. Journ. 
of Horn./ vol. xviii, p. 240. The medium dilutions 
seem most suitable. 
The mention of the teeth in connexion with 
children at once introduces us to the large subject 
of 
Morbid Dentition. 
I am quite unable to agree with those wTho set 
down to teething almost all the troubles to which 
the yearling is subject. The cutting of the teeth 
is as truly a physiological process as is the growth of 
the bones : and in healthy children should and does 
pass off with scarcely more disturbance. Without 
doubt, however, when there is a predisposition to 
blood disease or to nervous disorder, the increased 
activity of the whole system during the process of 
dentition will tend to throw out these morbid procli- 
vities, as in the shape of cutaneous eruptions or of 
convulsions. Again, if a child be or become ca- 
chectic, especially if he acquire rickety tendencies, 
dentition, like every other nutritive process, will be 
badly and so painfully performed. And then, if 
once the teeth come to be cut pathologically instead MORBID DENTITION. 
499 
of physiologically, the mouth becomes indeed the 
starting point of many other evils. 
If you coincide with these views, you will follow 
me in a much more sparing use of the gum lancet 
than is fashionable around us: and will eagerly 
inquire into the medicinal resources at our command 
for restoring dentition to its normal quietude. 
There is a general agreement that Calcarea, in 
the higher dilutions, is a most valuable medicine 
when the teeth are cut slowly and painfully, and 
the bowels are much disordered in sympathy with 
the mouth. But we are indebted to Teste for 
pointing out that there is a not unfrequent form of 
morbid dentition in which Kreasole is a superior 
remedy. This latter shows itself in thin, irritable, 
or cachectic children : it is characterised by extreme 
agitation and wakefulness while the teeth are being 
cut, and they often seem to decay as soon as they 
appear : the neighbouring parts are much inflamed, 
and the bowels tend to constipation. I can add my 
testimony to the great value of Kreasote, 12 to 24, 
in such a condition. It may be continued both in 
the intervals, and while the teeth are coming 
through. But if you are giving Calcarea as the 
constitutional remedy, you will require Aconite or 
Chumomilla at the time of cutting. The former is 
preferable when much fever is present, the latter 
when nervous symptoms predominate: and either 
in its place will give most grateful, relief. 
Of the convulsions of teething I have already 
spoken—they are best averted by the persevering 
use of the remedies for morbid dentition. The 500 
DIAIUUKEA. 
diarrhoea Avhich often occurs at this time will come 
under notice immediately. 
Diarrhoea 
in young children is always a serious disorder, and 
you will find it a great comfort both to yourself and 
to the anxious mothers of your patients if you can 
treat it successfully. Let me try to indicate the 
most suitable remedies for its many varieties. 
1. The earliest diarrhoea of human life is that 
which affects children who are brought up by hand, 
and whose intestines reject the unnatural diet. No 
amount of approximation to mother’s milk will 
render artificial feeding tolerable by these children : 
and if medicine will not help them they will die. 
I have found two medicines of great service in this 
condition, Nux vomica and Lycopodium. Nux, in 
the 1st dilution, I give in non-inflammatory cases ; 
Lycopodium, in the 30th, where muco-enteritis has 
evidently been set up. 
2. An acute inflammatory diarrhoea is much more 
common in infants and young children than in 
adults. It would run on, I suppose, if not checked, 
to dysentery; as its seat seems to be the colon. 
Mercurius corrosivus, generally alternated Avith 
Aconite, is the medicine on which I have depended, 
and with every reason to he satisfied. 
Sometimes, especially when the inflammation is 
in the rectum, Podophyllin is a capital medicine. 
The following is a case in point. 
“ Sept. 5th, 1866.—At about 3 o’clock this after- 
noon I saw a little boy between tAvo and three years DIARRHCEA. 
501 
old, who had been taken ill at noon. From that 
time till now he had been seized every quarter of 
an hour with severe pain in the abdomen, followed 
by passing of a small quantity of mucus and blood. 
There was no vomiting or fever. I have nearly 
always given Podophyllin in such cases, but have 
looked upon the occurrence of prolapse of the rectum 
at each stool as pathognomonic of the remedy. 
The absence of this symptom in the present in- 
stance, and the prominence of the colic, led me in 
preference to Colocynth, of which I gave a drop of 
the 2nd dilution every two hours. 
“ Sept. 6th, 11.30 a.m.—No improvement what- 
ever; the pain and purging have continued every 
quarter of an hour or so during the night, and the 
poor child looks much exhausted. I now fell back 
on the tried remedy, and gave half a grain of the 
third trituration of Podophyllin every two hours. 
“ Sept. 7th.—The little boy came walking into 
the room to see me to-day, looking quite himself 
again. The mother informed me that after the 
third dose of the new medicine (i. e. in four hours 
after beginning its administration) the pain and 
purging had both ceased, and had never returned 
since/’ 
3. Children are as liable as others to the diar- 
rhoea set up by the heat of the weather : and the 
same medicines are applicable to them as to adults. 
But they have a form of summer-complaint quite 
peculiar to themselves, which is known in America 
as “ cholera infantum.” Profuse vomiting and 
purging, with collapse, characterise it; and it is a 
very dangerous disease. I cannot feel that we have 502 
DIARRIIffiA. 
the specific for it. Veratrum, which seems indi- 
cated, lias always failed in my hands : Arsenicum 
has only been one degree better. Iris, of which I 
had great hopes at onetime, will check the vomiting 
speedily, but leaves the bowels untouched. I gave 
Tartar Emetic a fair trial one summer, but it was 
very uncertain : and from Elaterium I got no results 
whatever. Dr. Madden’s Australian experience 
(see f Annals/ vol. v, p. 37), combined with Dr. 
Hempel’s reiterated recommendations, makes it 
probable that Aconite should be the first medicine 
given in these cases. Croton deserves a trial: it is 
said to be especially indicated when the stools are 
ejected with great force. 
Sometimes cholera infantum, after beginning 
more or less acutely, subsides into a chronic form, 
and threatens to carry off the child by marasmus. 
The mucous membrane of the intestines is then 
profoundly altered, and the condition called gastro- 
and entero-malacia is present. Calcarea acetica 
and Arsenicum, in low potencies, have done best in 
my hands here ; but it is a not uncommonly fatal 
disease. 
4. One of the most frequent causes of diarrhoea 
in children is dentition. If moderate, it is hardly 
well to interfere with it; not improbably it acts as a 
safety valve. But if you do treat it, remember its 
origin; and whatever medicine you give for the 
bowels, alternate with it one that acts on the ner- 
vous circuit along which the irritation has travelled. 
Such are pre-eminently Chamomilla and Belladonna. 
They will, especially the former, sometimes cure 
alone : but it is generally well to alternate with COLIC. 
503 
them a medicine acting more specifically on the 
intestinal mucous membrane. Mercurius is most 
frequently required : it is especially indicated when 
the natural colour of the motions is most widely 
departed from. Rheum and Magnesia carbonica are 
not unfrequently useful (you will remember the 
Rhubarb and Magnesia of old) : the former when 
the motions have an acid smell, and there is a good 
deal of colic. 
5. There is, lastly, the diarrhoea which sooner or 
later accompanies all the “wasting diseases” of 
children. Phosphorus and Phosphoric Acid, and 
Arsenicum, are its medicines when it requires special 
treatment. With the latter, in the 3rd dec. tritu- 
ration, I have many times arrested it in cases seem- 
ingly desperate. 
Colic. 
This name is often applied to all the abdominal 
pains of sucking infants : but I think unadvisedly. 
There are many cases in which there is no disorder 
of the bowels, and the gripings are evidently caused 
by the child having sucked in atmospheric air with 
its food, and distension or irregular contraction of 
the intestines being produced thereby. There is no 
disease present, and Chamomilla and Colocynth will 
make no impression. But give the baby a few 
drops of chloric ether in a teaspoonful cf some aro- 
matic water,and the “ carminative5’ will indeed charm 
the pain away with the flatulence. Another so- 
called colic in infants consists in the gripings which 
accompany diarrhoea or disordered motions. Their 504 
TUBERCULAR PERITONITIS. 
presence will rather help you to the right medicine 
for the primary malady than induce you to select a 
special remedy for themselves ; but if they are very 
severe, a dose of Bryonia or Colocynth will be helpful. 
Moreover, if the child is being brought up by hand, 
you will always do well to let him, under these cir- 
cumstances, take lime-water instead of aqua pura 
with his milk. 
True colic occurring in children is amenable to 
the same treatment as that for adults. But an 
additional remedy is recommended by Teste, in the 
shape of Cina 9—12, a dose every quarter of an 
hour. “ The child tries,” he says, “ but in vain, to 
go to stool. At the most, he succeeds in the ex- 
pulsion of gas, and incomplete stools, which give him 
no relief. The principal seat of the pain is a fixed 
point above the umbilicus. The pulse is normal, 
sometimes a little frequent; but the face is pale and 
pinched.” 
Prolapsus Ani 
is a not uncommon complaint in infants and young 
children. I mention it more especially, because I 
have, following Dr. Madden, obtained such satisfac- 
tory results from Podophyllum, 12th dilution, in 
its treatment. 
Tubercular Peritonitis. 
In one case in which I had every reason to sup- 
pose this condition to be present, recovery took 
place under the steady use of Arsenicum and Cal- 
carea. China is recommended by both Hartmann 
and Teste : and Sulphur must not be forgotten. LETTER LIV. 
diseases or children {continued). 
. The disorders of the Respiratory Organs con- 
stitute a most important group of the maladies of 
childhood. They include Laryngismus Stridulus, 
Hooping Cough, Croup, and Broncho-pneumonia. 
Besides these, I shall say something about the treat- 
ment of some other respiratory affections when 
occurring in childhood. 
I notice Coryza in these subjects only to say that 
if Nux vomica fails to relieve the “ stuffy’’ condition 
of the nostrils which so seriously interferes witli 
sucking, Sambucus will often succeed. I come at 
once to 
Laryngismus Stridulus. 
That this disorder, the “Asthma Millari ” of the 
old nosologists, has often been confounded with croup, 
I need not tell you. It is itself a pure spasm : but 
long ago it was pointed out how frequently it de- 
pended upon strumous disease of the bronchial 
glands, and now we are learning to regard it as 
very commonly a symptom of rachitis. The Corallia 
Rubra so lauded by Teste in its treatment may, from 
its calcareous nature, be suitable to these diathetic 
conditions as wrell as to the laryngeal spasm. I 506 
PEETUSSIS. 
believe smelling at Mosclius to be the best means of 
relief during the paroxysms : but if they recur fre- 
quently, and are accompanied by carpo-pedal con- 
tractions, Belladonna must be given where there is 
arterial excitement and cerebral congestion, Cuprum 
where these symptoms are absent. Any obvious 
local excitant of the spasm must be removed by 
suitable means: but I think that such is rarely 
present. 
Pertussis. 
I shall begin by sketching to you the treatment 
of hooping-cough which in the great majority of 
cases has seemed to me amply satisfactory : and 
shall then give you the suggestions and results of 
others, and the most suitable remedies for its com- 
plications. 
I regard hooping-cough (with Trousseau) as a 
specific pulmonary catarrh, the spasm being its dif- 
ferentia, but the catarrh being no less of its essence. 
I accordingly begin the treatment with Aconite and 
Ipecacuanha in alternation. Sometimes no other 
medicines are required. But if the spasmodic stage 
be well marked, Drosera had better be substituted. 
Whether given according to Hahnemann’s plan,—a 
single dose being allowed to act for several days : 
or as recommended by Dr. Bayes, who administers 
a fractional dose of the mother-tincture after each 
fit of coughing: or in the ordinary way—this 
medicine is of undoubted efficacy. When the spasm 
has quite disappeared, it may be discontinued : and 
should the patient take cold during convalescence, FEKTUSSIS. 
507 
and the cough return, Aconite and Ipecacuanha 
should be resumed as at first. Under this plan of 
treatment I have seldom known uncomplicated 
hooping-cough to last, in its pronounced manifesta- 
tions, longer than a month. 
And now for other writers. Hartmann gives in- 
dications, in the catarrhal stage, for (besides Aconite 
and Ipecacuanha) Dulcamara, Pulsatilla, Chamomilla, 
Nux vomica, Scilla, Belladonna, and Carbo vege- 
tabilis; in the spasmodic stage for (besides Drosera) 
Cina, Cuprum, Conium, and Yeratrum; and in the 
stage of convalescence Hepar sulphuris and Sulphur. 
Teste’s treatment is altogether a singular one. He 
begins with Corallia Rubra 30, which is taken for 
four or five days : then followed up by Chelidonium 
6 until the cough has become merely catarrhal, 
when Pulsatilla is to finish off the case. I once 
treated a family of children on this plan, and they 
certainly all had the disease very mildly. Corallia 
has won commendations in hooping-cough from 
several physicians. Indications for these and several 
other medicines are given in an article on Hooping- 
cough in No. 3 of the £ United States Medical and 
Surgical Journal and there is also an article upon 
its treatment by Dr. Black in vol. xiv of the £ Brit. 
Journ. of Homoeopathy.’ 
The complications of hooping-cough occur either 
on the side of the lungs or on that of the brain. 
The attack often sets in with acute symptoms of 
pulmonary congestion : and these yield rapidly to 
Aconite and Phosphorus. I should trust to the 
same medicines in the event of bronchitis or broncho- 
pneumonia supervening in the course of the malady. 508 
CROUP. 
Primary pneumonia is rare ; but here, if ever, Teste’s 
Chelidonium should be of service. Convulsions are 
a serious matter. When they are attended with 
symptoms of cerebral congestion,—the brain never 
properlyrecovering itself during the intervals between 
the paroxysms, Opium should be given in alternation 
with the medicine for the spasm : or, in full-blooded 
active children, Belladonna may be given alone. 
But if the convulsions seem just an extension of 
the essential spasm, and the symptoms approximate 
to those of laryngismus stridulus, Hydrocyanic Acid 
or Cuprum is the best medicine. But convulsions 
are more easily prevented than cured : and their 
best prophylactic is the medicine which is most 
effective in diminishing the violence and frequency 
of the spasmodic cough. 
Croup 
is one of the most important of children's diseases, 
from its acute accession, its violent symptoms, and 
its strong tendency to end in death. You will be 
pleased to know, therefore, that Homoeopathy has 
remedies capable of coping with it in all its forms; 
and indeed counts its treatment one of its chief the- 
rapeutic triumphs. Besides the full and satisfactory 
account given of its treatment by Hartmann, you 
will find a study of the several croup medicines in 
vol. v of the c Brit. Journ. of Horn./ an elaborate 
article on the disease by Dr. Elb of Dresden in vol. 
x, and cases by Prof. Henderson in vol. viii. 
You will perceive from all these sources of in- 
formation that the two leading remedies for croup CROUP. 
509 
are Aconite and Spovgia. In so-called “ catarrhal 
croup ” you may leave these medicines to be taken 
in alternation every hour or two, and be tolerably 
certain of finding your patient improved at your 
next visit. It is probable that many a case of true 
croup has been arrested in its incipience by this 
treatment. But however suddenly the symptoms 
may have set in, however evident may be the exist- 
ence of membranous exudation, however late the 
commencement of Homoeopathic treatment, do not 
omit your Aconite. Stay with your patient if pos- 
sible, and give him a dose every quarter or half 
hour until the symptoms begin to abate. Then leave 
it to act for a while : and at your next visit you will 
judge if it is going to cure single-handed, or if it 
will require some more locally-acting remedy to 
supplement it. 
In true membranous croup, the medicines between 
which our choice lies are Iodine, Bromine, and Kali 
Bichromicum. I am not disparaging the great service 
to therapeutics rendered by Hahnemann in indi- 
cating Spongia as the leading remedy for croup, 
when I give my preference to the Iodine itself 
which is its most important constituent. To Hrs. 
Koch and Elb we owe the establishment of the value 
of Iodine in croup. Its volatility, moreover, enables 
its inhalation to be added to its internal administra- 
tion,—a practice which has many times been 
followed with the utmost advantage. The very 
similarly acting Bromine has often been used with 
success, as you will see by the references I have 
given when writing to you upon that drug. It is 
probably best suited to the asthenic forms of the 510 
CIIOUP. 
disease,, such as occur in unhealthy neighbourhoods. 
Kali bichromicum—of all medicines most homoeo- 
pathic to membranous croup—has frequently cured 
it. A perusal of the cases given in the appendix to 
Dr. Drysdale’s schema of the drug in the Hahne- 
mann Materia Medica, and of those furnished by 
Dr. Paul Belcher to the 5th vol. of the e North 
Amer. Journ. of Homoeopathy/ and by Dr. Wright 
to the 14th vol. of the same Journal, will satisfy 
you on this head. I have never used it: but 
it is a medicine in which I have the utmost 
confidence in all the morbid states to which its 
proving points, and in which I have tested its 
powers. 
Whatever medicine you choose, I recommend you 
to alternate it with Aconite. Croup is a neuro- 
phlogosis, and the spasmodic paroxysms need as 
much help as the continuous inflammation. When 
active disease has subsided, you will find Spongia 
or Hepar sulphuris useful in restoring the laryngeal 
membrane to its normal condition, the former when 
the cough is hard and dry, the latter when it is 
hoarsely mucous. 
I must not leave the subject of croup without 
referring to the exceptional plan of treatment ad- 
vised and warmly commended to us by M. Teste. 
“ Ipecacuanha and Bryonia,” he writes “ (but given 
concurrently, for both would be inert alone), are in 
all cases, whatever be the form of the attack or in- 
tensity of the disease, the great modifiers of croupal 
angina.” He recommends the dilutions from 6 to 
12 : and frequent repetition of the dose. This was 
long before M. Curie had demonstrated by experi- 511 
BllONCIIO-rNEUMONlA. 
ment the power Bryonia has of producing false 
membranes in the air-passages. As Ipecacuanha 
unquestionably corresponds with the neurotic element 
in croup, the prescription is soundly based: and 
there are not wanting testimonies to its efficacy. 
Its comparative merits further experience must 
decide. 
I have last to speak of bronchitis and pneumonia 
as they occur in children. They are more com- 
monly met with conjointly than separately, and the 
mixed disease may fairly be called 
Broncho-pneumonia. 
This is practically equivalent to the “ capillary 
bronchitis” and “ lobular pneumonia” of authors, 
as the one rarely occurs without the other pre- 
ceding or following. Let me repeat what I have 
said upon the bronchitis of children, in the paper 
before referred to upon that disease. 
“ The characteristic of bronchitis, as I have 
observed it in children, is the extreme rapidity with 
which the inflammation runs down the mucous 
membrane, and, involving the ultimate air-cells of 
the lung, becomes true pneumonia. Broncho- 
pneumonia, except in these subjects, I take to be very 
rare—rarer than pleuro-pneumonia, and still rarer 
than pneumonia simplex ; and it comes fraught with 
double danger, the narrowing of the air-passages 
being super-added to the spoiling of the lung itself. 
'When death results, it is from apnoea, with its blue 
lips, livid complexion, and cold extremities. I have 
very rarely seen a case go thus far under homoeopathic 512 
BRONCHO-PNEUMONIA. 
treatment; and I have only known one that did so 
recover. 
“Aconite is as valuable in the bronchitis of children 
as it is in that of adults, if it is given soon enough. 
It will break up the catarrh, and leave nothing but a 
loose cough, which will be helped by Ipecacuanha if 
it is spasmodic—by Pulsatilla if otherwise. But very 
often we are summoned too late for the success of this 
abortive treatment. The dyspnoea, the crepitation, 
and the dulness on percussion, tell us that we have 
broncho-pneumonia to deal with. Now I do not 
affirm that Aconite does no good here. I only say 
that it cannot be depended on to cure, however 
much it may relieve the general distress. For 
myself, I generally abandon it altogether in favour 
of the great remedy for this form of the disease— 
Phosphorus 
I am disposed from later experience to modify 
the recommendation involved in the last paragraph, 
viz. the discontinuance of Aconite on commencing 
the administration of Phosphorus. I am disposed 
to think that the action of the former on the vaso- 
motor nerves aids the latter in modifying the 
tissue-irritation, and that without it the Phosphorus 
is even liable to cause aggravation. 
What are we to do when, in these cases, asphyxia 
threatens ? Chiefly, I think, to ascertain whether 
it is caused by the intensity of the inflammation, or 
by the profuseness of the mucus of resolution, or by 
impending “ paralysis of the lungs.” In the first 
alternative, we should push on with our Aconite 
and Phosphorus. In the second and third, our 
most potent allies should be Tartar Emetic and BRONCHO-PNEUMONIA. 
513 
Solania, as recommended for capillary bronchitis 
in the aged. 
Belladonna is mentioned by several writers as of 
value in the pneumonia of children: and in the 
class of cases described by Dr. Hillier “ in which 
cerebral symptoms prevail to such an extent as to 
mask the pulmonary symptoms, and often to mis- 
lead the practitioner,” it ought to be quite in place. 
But it is primary “ lobar pneumonia” in which this 
complication occurs. In its absence, Phosphorus is 
the medicine to be given : I am not sure whether 
Aconite helps it here or not. But for both “ lobular” 
and “ lobar” pneumonia in children we must weigh 
the claims of Chelidonium. This again is a medicine 
recommended, in an apparently arbitrary manner, 
by Teste: but which subsequent experimentation 
has proved to bear a true pathological relationship 
to the disease. I refer you to Dr. Buchmann’s 
proving of Chelidonium (‘Brit. Journ. of Horn./ 
vols. xxiii—xxv); and especially to his remarks and 
observations regarding its use in pneumonia at p. 
64 of vol. xxv. The cases given confirm Teste’s 
recommendation of the remedy, even to its especial 
value when the right side is affected. His mode of 
administration, however, was not followed, which is 
to give a dose of the 6th or 12th dilution every 
quarter of an hour for four or six doses. “ This 
done,” he says, “we shall in an immense majority of 
cases, observe a marked, sometimes an astonishing, 
remission of all the local as well as the general 
symptoms.” After this, other medicines may be 
given. Dr. Pulte appends a note to the American 
edition stating that this treatment has been found 514 
BRONCHO-PNEUMONIA. 
very efficacious, in considerably shortening the 
attach : and that the administration of the Cheli- 
donium in this way is generally followed by the 
peculiar greenish discharges characteristic of liver 
affection. LETTER LV. 
diseases of children (continued). 
As I have discussed the lymphatic and lacteal 
system as part of the Circulatory Organs, this 
will be the place for considering the affections 
of the lymphatic and lacteal glands so common in 
scrofulous children. I shall do this under the two 
heads of Strumous Adenitis and Tabes Mesenterica. 
Strumous Adenitis. 
The medicines which meet with most general 
commendation in the treatment of enlarged lymph- 
atic glands are Sulphur, Calcarea, and Silicea in 
one class : Rhus, Dulcamara, Mercurius, and 
Conium in another. The first three are considered 
most suitable when the scrofulous diathesis is well- 
marked : the latter when a local affinity for the 
glands is chiefly desired in the remedy. Rhus is 
highly commended by Hartmann when an inflamed 
gland is of a stony hardness. He would give one 
dose of a high dilution, and allow it to act for 
some time. Teste exalts Rhus into the primary 
medicine for all cases of scrofulous glands, giving 
repeated doses of the 2nd potency. He follows it 
up by Mercurius and Sulphur, stating that the 
latter medicine, if given first instead of last, will 516 
TABES MESENTERICA. 
only start but not complete a cure. Dulcamara is 
Hartmann’s remedy when damp, Conium when con- 
tusion is the exciting cause,—conditions, I may 
add, to which the disease is very rarely traceable. 
He also suggests, on theoretical grounds, Cistus 
Canadensis.* 
I have made pretty full trial of most of these 
medicines, but have found little satisfaction from 
any of them. I follow my brethren of the old 
school in accounting Iodine and its compounds the 
most important medicines for diseases of the ab- 
sorbent glands. Its specific action upon them I 
have already argued at some length. Iodine itself, 
the Iodide and especially the Biniodide of Mercury, 
the Iodide of Potassium (with which I have seen 
my friend Dr. Belcher obtain very good results at 
our Dispensary), and the Iodide of Calcium—all 
are valuable in the treatment of strumous adenitis. 
As to external applications here, I apprehend that we 
should use them only to obtain with greater rapidity 
the specific effects of the medicines. With the 
external use of Iodine as a vesicant we can have no 
sympathy. 
Tabes Mesenterica 
is nothing more than strumous disease of the 
glands of the mesentery, and its general symptoms are 
due to the disturbance of the important part they play 
* In the Leopoldstadt Hospital at Vienna, Clematis seems the 
favourite remedy for enlarged lymphatic glands : and Dr. Madden 
tells me that he has frequently obtained striking results from the 
1st trit. of the arseniate of soda. ENURESIS NOCTURNA. 
517 
in nutrition. There is no reason, therefore, why we 
should depart from our Iodine in the treatment of 
this malady: and with it indeed I have made some 
of the most beautiful cures I ever saw in medical 
practice. The ensemble of symptoms unmistake- 
ably calls for it,—wasting, hectic especially marked 
by night-sweats, appetite alternately ravenous and 
deficient, dry laryngeal cough, and diarrhoea. When 
the last is severe, Arsenicum (not higher, I think, 
than the 3rd. dec.) is of great temporary service 
but it has no curative power over the entire disease. 
It is only right, however, that I should say that 
Iodine holds by no means this foremost place in 
the recommendations of others for mesenteric 
disease. Calcarea is with most the favourite medi- 
cine : there is a case on record cured by it in the 
* Monthly Horn. Review/ vol. vii, p. 24. Dr. Kidd 
recommends Mercurius corrosivus where there is 
evident inflammation of the glands, previous to the 
development of tabes, and I have followed his sug- 
gestion with decided benefit. Teste’s prescription 
is among his most curious singularities, viz. Sarsa- 
parilla 18, Aloes 6, and Colchicum 12 in succession, 
each for a week or more, three or four times a day. 
From this medication he states that he has “'ob- 
tained for several years past the most surprising 
results.” 
The chief urinary difficulty with children is 
Enuresis Nocturna, 
which is often a very obstinate affection. Wherever 518 
ENURESIS NOCTURNA. 
you can trace it to worms, you may give Cina with good 
liope of success. Again, when it is accompanied by 
a high-coloured and strong-smelling urine, Benzoic 
Acid will generally both render the urine normal 
and prevent its escape. But in the numerous cases 
which present neither of these indications you will 
have to decide between a large number of medi- 
cines : and here as elsewhere a multitude of 
remedies means small success with any. Belladonna 
and Atropine have in my experience met with the 
fewest failures: and next to these I would place 
Causticum. If you have to search farther for a 
remedy, I may refer you to a collection of cases of 
the malady from various sources in the c North 
Amer. Journ. of Horn./ vol. iii; and to cases 
illustrating the virtues of the Plantago major in 
the f Brit. Journ. of Horn./ vol. xxv, p. 319, and 
of Thuja in the same Journal, vol. xxvi, p. 491. 
Gelseminum is also to be remembered : and the 
frequent connexion of the trouble with a too heavy 
sleep suggests the possible usefulness of Opium. 
In Strangury, which in a slight form is not un- 
common in children, as from cold or damp, Aconite 
or Dulcamara is serviceable. But unless one or 
other of these causes be distinctly traceable, you 
will be safer in prescribing Belladonna. When 
urinary troubles in children arise from their passing 
much red sand with their water. Lycopodium is 
specific. 
The genital organs of male children are rarely 
the seat of disease: and when such occurs it is 
surgical rather than medical. The female child, CRUSTA LACTEA. 
519 
however, is sometimes troubled with a kind of 
leucorrhcea, which not unnaturally causes much 
trouble in the mind of her mother. It is readily 
curable by Calcarea and cleanliness. A more im- 
portant disease of these subjects is 
Noma Pudendi. 
This affection appears to be precisely analogous 
to cancrum oris; and here there can be no question 
between Mercurius and Arsenicum, the local affinity 
of the latter being so much the greater. 
And now of the cutaneous diseases of childhood, 
several of which are very characteristic of this 
period of life. 
Intertrigo, 
besides the obvious local management, is often 
greatly helped by Homoeopathic remedies. Chamo- 
milla is good in simple cases; Lycopodium where 
the chafing obstinately recurs, and seems constitu- 
tional ; Mercurius where the parts affected are raw 
and very painful. 
Impetigo has two local varieties very common in 
children, crusta lactea and porrigo capitis. 
Crusta lactea 
(tinea mucosa) is an impetigo of the face. I have 
every reason to be satisfied with the Viola tricolor 
recommended by Hartmann for this disease: but in 520 
RINGWORM. 
obstinate cases you may with advantage remember 
Teste’s commendation of Sepia. 
Porrigo capitis 
(scalled head) is more difficult to cure. Calcarea 
muriatica, in the 1st dilution, is my favourite medi- 
cine : but Sulphur must often be interposed. Silicea 
is good where there is abundant suppuration, and 
Viola tricolor where itching is distressing. I 
believe it also to be important not to remove the 
crusts until there is reason to believe that the 
tendency to return of disease is checked. 
A papular eruption peculiar to children is “ red 
gum,” 
Strophulus. 
Cliamomilla is generally its specific remedy : but 
where the digestive organs are at fault, Pulsatilla 
or Antimonium crudurn may be required. 
Ringworm. 
That this disease is, when recent, amenable to 
internal remedies alone, seems to disprove the 
theory of its parasitic origin. The medicine for it 
is Sepia, at about the 6th dilution. But if this 
fails, you must resort to some local parasiticides, of 
which I suppose a solution of Sulphurous acid would 
be about the best. 
There are a few miscellaneous affections of SCLERODERMA NEONATORUM. 
521 
children on whose treatment I shall remark before 
leaving the subject of their diseases. 
Cephalhematoma 
may disappear under the occasional application of a 
weak Arnica lotion: but should it linger, Dr. 
Guernsey states that a single dose of a high dilu- 
tion of Calcarea will always disperse it. 
Nevus 
I have seen disappear under Thuja 12. Calcarea 
must here also be remembered. 
Hernia 
in infants is said to be sometimes curable by 
internal medicine, especially by Nux vomica. There 
can be no harm in trying. 
Mastitis neonatorum 
is generally produced by foolish endeavours on the 
part of nurses to squeeze out milk from the breasts. 
Bryonia is its specific remedy. 
Icterus neonatorum 
should be treated by Chamomilla, followed, if it 
should be required, by Mercurius. 
Scleroderma neonatorum 
you are hardly likely to see, unless you should be- 
come attached to a Foundling Hospital. Should 522 
TRISMUS NEONATORUM. 
you ever meet with it, I recommend you to try 
Bryonia, which has caused and cured a similar 
affection (Haningkrankheit) in oxen (see * Brit. 
Journ. of Horn/ vol. xxv, p. 25). 
Trismus neonatorum, 
when arising (as it usually does) from inflammation 
of the umbilicus, seems best treated by Belladonna, 
though I know of no experience regarding it. 
When from the influence of the mother’s emotions 
through the milk Ignatia is most suitable. 
A word from Hartmann in conclusion. “ Small 
or highly attenuated doses at long intervals are 
best for a sick child, provided the remedy has been 
correctly chosen, which we may easily know from 
the fact that the child will fall into a sweet slumber 
after the first dose, and will awake refreshed and 
in better spirits.” He is speaking, of course, of 
acute diseases. LETTER LYI. 
CASUALTIES MISCELLANEOUS. 
This will be my last letter to you. I shall 
devote it to the subject of Casualties,—mentioning 
under that heading what part our medicines play in 
the - treatment of Wounds, Contusions, Strains, 
Burns, Chilblains, Stings, Fractures, Sunstroke, 
and Emotional Disturbances. For fuller informa- 
tion on the subject I refer you to Dr. Yeldham’s 
papers on surgical subjects in the f Brit. Journ. of 
Horn/ and the ‘ Annals,’ and to Dr. Franklin’s 
recently published work on the f Science and Art of 
Surgery.’ 
Wounds 
The division of wounds into incised, punctured, 
contused, and lacerated is familiar as regards their 
surgical management: but it bears no less upon 
their medicinal treatment. 
In “ incised ” wounds your one object is to 
secure union by the first intentiou. Besides the 
mechanical measures you will adopt for this pur- 
pose, Calendula comes in as the most potent “ vul- 
nerary ” that has ever been discovered. Its in- 
fluence is entirely inimical to suppuration : and, 
having itself no irritating properties, it may be 524 
WOUNDS. 
freely applied to the cut surfaces and edges. The 
strength may be from the pure tincture (as recom- 
mended by Dr. Leadam for ruptured perinseum) to 
a mixture of one part to eight of water or glycerine. 
An “ Aqua Calendula,” which is a strong infusion, 
was used in the earliest experiments made with the 
plant. 
“ Punctured ” wounds may he aided in their 
healing by Calendula. They often give, however, 
an amount of general and local trouble out of all 
proportion to their size : and Teste appears borne 
out in his assertion that their specific remedy is 
Ledum, which may be used both externally and 
internally. If he is right, too, a potency not of the 
lowest should be selected for both purposes. 
In “ contused ” wounds, it is generally admitted 
that the element “ contusion ” is of more moment 
than the element “ wound.” Hence Arnica should 
be given, and used in preference to Calendula. The 
latter may come in afterwards to promote healing, 
if required. 
It was in “ lacerated ” wounds that Calendula 
first gained its reputation: and if the promotion of 
healing by the first intention were all that was 
needful, we should not have to look farther. But 
lacerated are like punctured wounds in the distress 
they cause,—both at the part and in the system at 
large : and this is especially of a “ nervous ” cha- 
racter. Accordingly, Dr. Franklin has been led to 
treat them with Hypericum, and reports the best 
possible results from its use. He makes the lotion 
with one part of the tincture to twenty of water. 
Another order of wounds is the u poisoned.” CONTUSIONS. 
525 
Some of these will come under notice when we are 
upon bites and stings. But the dissecting wound 
is a familiar instance of the kind I now refer to. 
Inflammation of the absorbents leading from it may 
often be controlled by Aconite and Belladonna, and 
further extension of the mischief prevented. But 
if constitutional irritation is set up, Lachesis and 
afterwards China may be required, as advised for 
pysemia. We have no special local treatment for 
these injuries. 
For “ surgical ” or “ traumatic fever ” Aconite is 
always the medicine when its character is synochal, 
Arsenicum when it is typhoid, Lachesis when it is 
pysemic, China when it is hectic. The last-named 
medicine, moreover, has acquired a high reputation 
in “ traumatic gangrene,” Dr. Franklin confirm- 
ing herein from his experience the original report 
of its efficacy by Dr. Dake. 
Contusions. 
You know already the reputation of Arnica for 
bruises : and certainly the manner in which it re- 
moves the pain and discolouration is very gratifying, 
and quite of a specific character. It is generally 
used—as a lotion—in the strength of one part of 
the tincture to from twenty to forty parts of water. 
But Teste says that the potencies are quite as use- 
ful for external application: and if it be so, we 
shall be able to avoid the risk of setting up erysi- 
pelas, to which some people are liable from contact 
with this drug. 
The only contusions to which Arnica is less 526 
BUUNS AND SCALDS. 
applicable are those which involve glandular parts,— 
as the female breast, and the periosteum,—as the 
tibia in kicks on the skin. Conium in the former, 
Ruta in the latter, are then its substitutes. 
Strains 
are supposed to be more benefited by Rhus than by 
Arnica; and some cases which you will find in vol. 
xxv of the ‘Brit. Journ. of Horn./ p. 662, bear out 
the opinion of its efficacy. It is said to be espe- 
cially suitable in strains of ligamentous parts, as 
tendons and fasciae, occurring in robust persons, and 
having the especial Rhus characteristic, that the 
pain is felt most when the parts are first moved, 
and becomes easier as the motion continues. But 
Arnica is a capital medicine for strains as well as 
bruises, and when the muscular fibre itself is the 
seat of the mischief is superior to Rhus or anything 
else. 
Burns and Scalds 
require different medicinal treatment according to 
their intensity and to the constitutional symptoms 
which accompany them. 
Burns of the first degree—i. e. where erythema 
only, or but slight general raising of the cuticle 
obtains—are best treated locally by Urtica urens, in 
the proportion of one part of the tincture to 
twenty of water. Bo not remove the rags when once 
applied, but keep them wet with the lotion. 
For burns of the second degree—i. e. where BURNS AND SCALDS. 
527 
there is considerable vesication—Cantharides takes 
the place of Urtica as the external application. 
About the same proportions of tincture to men- 
struum, or a little more of the former, may be 
used. 
Of the efficacy of these two remedies there is no 
question, and they are in general acceptance among 
us. But we have no such accredited medicine for 
burns of the third degree, where the cutis vera is 
involved, and the tissues are carbonized. Kreasote 
and Causticum have been thought useful, and I 
should myself try the former with some hope of 
benefit. But the constitutional treatment is here 
of more importance than the local, as the eschar 
must separate, and if it needs aid may receive it 
from the ordinary means of Surgery. 
The constitutional treatment in cases of burn 
or scald depends upon the symptoms present. In 
burns of the fust and second degree the uneasiness 
of the part affected is chiefly felt, and Rhus inter- 
nally will aid the external applications in giving 
relief. But when these are extensive, and in burns 
of the third degree, the general symptoms are con- 
siderable. Bor the primary “ shock ” repeated 
doses of Camphor are helpful. If fever set in, the 
medicines recommended for surgical fever in its 
various forms come to our aid. We must also be 
on the look out for the duodenal mischief which 
Mr. Curling has shown to be so frequent after 
severe burns:—I have already mentioned the value 
here of Kali bichromicum. 
The full effeet of cold—frost-bite—is out of the 528 
FKACTUllES, 
range of medicine. But I may give you some sug- 
gestions in aid of the treatment of a minor form of 
this evil, 
Chilblain. 
Agaricus, internally and externally, is of much 
repute in the treatment of this trouble. Should it 
not succeed, Pulsatilla is very good, especially when 
the itching is worse towards evening: and Rhus 
when the chilblains are inflamed. 
Stings. 
Teste speaks in the strongest terms of the rapid 
relief given in mosquito bites by the application or 
even internal administration of Ledum, so high as 
the 15th dilution. I suppose that the same treat- 
ment would be applicable to the stings of bees, 
wasps, and other venomous creatures. For serpent- 
bites the use of Arsenic in the form of the Tanjore 
pills is sufficiently specific and even Homoeopathic 
for us: but I know of nothing which should super- 
sede the usual ammonia and stimulants in these 
cases. 
Fractures. 
Besides the more obvious uses of medicines for 
this accident and its complications, they come into 
especial play when the bones seem disinclined to 
unite. If the patient be of a scrofulous constitu- 
tion, I have verified Dr. Cogswell's recommenda- EMOTIONAL DISTURBANCES. 
529 
tion of Iodine as promoting union. Should no 
such cause be traceable, you may test the claims 
which Symphytum makes by its very name to 
efficacy here : or you may, perhaps with more 
reason, follow Dr. Henriques in bringing into play 
the action of Ruta on the periosteum. 
Sunstroke 
finds a most homoeopathic and effective remedy in 
Glonoine. Many cases are on record of its speedy 
efficacy in removing the acute symptoms: and I 
have found it no less useful in some of the after- 
effects which linger about the patient. It is only 
when these are of a continuously hypersemic type 
that they call preferably for Belladonna. 
Emotional Disturbances 
have received especial study from Homoeopathic 
therapeutists : and the following are the main con- 
clusions at which they have arrived. 
The immediate effects of fright are best con- 
trolled by a dose—some say, of Opium, some, of 
Aconite. I should prefer the latter. But when 
fright has given rise to a genuine neurosis, as chorea 
or epilepsy, Ignatia is more suitable than any other 
medicine. 
Bor the effects of grief, also, Ignatia bears away 
the palm, especially when the emotion is suppressed. 
When anger has been the disturbing emotion, 
Chainomilla removes its effects, even when these 
reach as far as jaundice. 530 
SENILIS. 
Beyond these well-tested recommendations, a 
good deal that is very hypothetical has been written 
about the remedies for the effects of emotion. You 
have probably enjoyed the fun made out of this 
material in c My Novel/ But the subject is not 
less worthy of farther and more experimental study. 
I must, last of all, introduce a new heading, 
“Miscellaneous,” to include two diseases for which 
I can find no place in my nosology. These are 
Atrophy and Senile Gangrene. 
By 
Atrophy 
I do not mean any form of phthisis or tabes induced 
by recognizable local disease. I refer to the inex- 
plicable wasting away (“ tabes sicca ” of the old 
writers) sometimes seen in adults, and rarely cured. 
An interesting case of the kind is described by Dr. 
Scriven of Dublin in vol. ii of the ‘ Annals/ 
p. 208. A cure took place under the use mainly of 
Natrum murialicum and Arsenicum. You will also 
remember how Zincum has caused a condition of 
this kind, to which the very name of “ tabes sicca” 
was felt most applicable by the observer. 
Gangrsena Senilis 
has so precise an analogue in the phenomena of 
ergotism that, if anything can arrest it, Secale 
ought to do so. There is a case in the * Brit. 
Journ./ vol. x, p. 335, in which the application of CONCLUSION. 
531 
this fact seems to have been successfully made. In 
the case of Archbishop Whately, who died of this 
disease, Secale was not given. An account of the 
last illness of this prelate is given by the same Dr. 
Scriven, who was his attendant, in vol. iii of the 
‘ Annals/ p. 318. 
And so I end my task. We have now surveyed 
together the whole field of disease, with a view to 
determining what Homoeopathy has yet done or 
may yet do towards its conquest. 1 think you will 
feel with me that the result of our survey is emi- 
nently satisfactory. During the sixty years since 
the establishment of “ similia similibus curantur ” 
as the guide to specific medication, at least eight- 
tenths of the ills to which flesh is heir have been 
brought within its range of action. Of the two- 
tenths which remain, one consists of mechanical 
disorders requiring mechanical assistance ; and the 
other is only awaiting fresh knowledge of diseases 
and drugs on our part for its annexation. 
It is true that in the territory already won many 
patches remain whose cultivation is far from perfect, 
many diseases and varieties of disease for which we 
crave more perfectly fitting remedies. But the 
number of these is yearly decreasing. Even while 
these pages have been passing through the press, 
there is reason to hope that we have obtained a 
remedy for the graver forms of scarlatina as specific 
as Baptisia is for typhoid. This is the Ailanthus 
glandulosa. First suggested, on the strength of a 
case of poisoning observed by him, by Dr. P. P. 
Wells of Brooklyn in the ‘ American Homoeopathic 532 
CONCLUSION. 
Review/—then commended to British readers by 
Mr. A. C. Pope in the ‘ Monthly Homoeopathic 
Review/ its efficacy has now received practical con- 
firmation in the hands of Dr. Andrew Chalmers. 
His cases, in the number of the latter Journal for 
Dec. 1868, are amply satisfactory : and Dr. Madden 
tells me that from what he has seen of the action of 
the medicine in some recent cases in London he has 
no doubt of its direct specificity and eminent value. 
I hope that this volume may do for Homoeopathic 
Therapeutics something of what Bacon’s ‘ DS 
Augmentis ’ did for knowledge in general, and by 
noting deficiencies encourage the work which shall 
make them disappear. 
And now I have only to bid you God speed and 
farewell. In becoming a practitioner of Homoeo- 
pathy you have accepted a position which is as 
onerous as it is advantageous. Use your vantage 
ground for the promotion of the advance of medi- 
cine as well as for your own success in practice, 
that there may be a bearing of its onera, and not 
merely a receiving of its munera. I shall not 
regret then that I have for the last four years spent 
most of my leisure in putting together the materials 
for your work. 
Yours ever affectionately, 
Richard Hughes. INDEX. 
PAGE 
Abortion 437 
Acidity 250 
Acne 468 
Addison’s Disease 352 
Adenitis, Strumous 515 
After-pains 448 
Ague 79 
Albugo 193 
Albuminuria 368 
,, of Pregnancy 436 
Alopecia 469 
Alternation 36 
Amaurosis 199 
Amenorrhcea 405 
Anemia 44 
Aneurism 346 
Anger, effects of 529 
Angina, catarrhal 223 
„ chronic 226 
„ pectoris 341 
Angioleucitis 350 
Anus, Fissure of 284 
,, Prolapse of 285 
„ „ in children 504 
Ano, Fistula in 286 
Aphonia 304 
Aphthe 497 
Apoplexy 121 
„ Pulmonary 321 
Arteries, Diseases of. 346 
Arteritis 346 
Arthralgia 484 
Ascarides 287 
Ascites 288 
Asthenopia 201 
Asthma 312 
Ataxy, Locomotor 148 
Atheroma 367 
Atrophy 530 
Auxiliaries 38 
Azoturia 377 
PAGE 
Balanitis 396 
Biliousness 290 
Bilious Remittent Fever ... 85 
Bladder, Diseases of 381 
„ Irritable 381 
„ Catarrh of 381 
,, Stone in 384 
„ Cancer of 384 
Blepharitis 175 
Blepharospasm 177 
Boils 470 
Bones, Diseases of 478 
„ Neuralgia of 482 
Brain, Diseases of 114 
„ Softening of 119 
„ Fever 117 
Breast, Diseases of 427 
Bronchitis 306 
Bronchiectasis 311 
Bronchocele 353 
Broncho-pneumonia 511 
Brow-ague 169 
Bubo 397 
Burns 526 
Bursitis 485 
Cecum, Inflammation of... 257 
Calculi, biliary 295 
„ renal 377 
Cancer 53 
Cancrum oris 497 
Carbuncle 471 
Cardialgia 242 
Caries 480 
Casualties 523 
Catalepsy 164 
Cataract 195 
Catarrh 298 
Cephalalgia 133 
Cephalhematoma 521 534 
PAGE 
Cerebro-spinal Meningitis, 
Epidemic 78 
Chancre. Hard 107 
„ 'Soft 397 
„ Phagedsenic 397 
Change of Medicine, The... 33 
Chest, Injuries of 334 
Chicken pox 92 
Chilblain 528 
Children, Diseases of 486 
Chlorosis 406 
Cholera, English 262 
,, Asiatic 266 
„ infantum 501 
Chorea 161 
Choroiditis 194 
Chromatopsia 202 
Chylous Urine 369 
Circulatory System,Diseases 
of 338 
Cirrhosis of Liver 292 
Classification of Diseases... 4 
Clavus Hystericus 134 
Colic in adults 259 
„ in children 503 
„ Lead 260 
Condylomata 113 
Conjunctiva, Diseases of 176,192 
Conjunctivitis Simplex ... 176 
„ Palpebrarum 176 
,, Diphtheritic 182 
Constipation 272, 277 
Contusions 525 
Convulsions, Puerperal ... 446 
„ in children ... 493 
Cornea, Diseases of 192 
„ Opacities of 193 
Corneitis 192 
Coryza 298 
Cough 3§5 
Cramps of the calves, 172, 433, 
476 
Critical Age 455 
Croup 508 
Crustalactea 519 
Cystitis 381 
Deafness, Throat 209 
„ Nervous 214 
INDEX 
PAGE 
Delirium tremens 129 
Dementia 127 
Dengue 101 
Dentition, Morbid 498 
Diabetes mellitus 368 
„ insipidus .... .... 374 
Diarrhoea, in adults 261 
,, in children 500 
„ adiposa . 289 
Digestive Organs, Diseases of 216 
Diphtheria 227 
Diplopia 201 
Dose, The : 27 
Dropsy, Acute Renal 357 
„ Post-scarlatinal 99, 357 
Duodenitis 257 
Duties of the Homoeopathic 
Practitioner, The 40 
Dysentery 264 
Dysmenorrhcea 409 
Dyspepsia, Acute 245 
„ Chronic 246 
„ Duodenal 257 
Dysuria 383 
Ear,Diseases of... 204 
Ear-wax, Deficiency of ... 205 
Ecstasy 164 
Ecthyma 464 
Ectropium 177 
Eczema 461 
„ aurium 204 
Elephantiasis. 466 
Embolism 347 
Emotional Disturbances ... 529 
Emphysema 311 
Empyema 333 
Endocarditis 343 
Enteritis 255 
Enterodynia 259 
Entropium 177 
Enuresis nocturna 517 
Epilepsy 151 
Epistaxis 302 
Erysipelas 459 
„ aurium 204 
Erythema 458 
Eustachian Tube, Affections 
of 209 INDEX 
535 
PAGE 
Exophthalmos 354 
Exostoses of the Ear 209 
Eye, Diseases of 175 
Eyelids, Inflammation of... 175 
„ Spasmodic and Pa- 
ralytic Affections of 177 
„ Quivering of 178 
Facial Palsy 147 
False Pains 437 
Farcy 106 
Favus 469 
Febricula 68 
Fever, in pregnancy 432 
„ Intermittent 79 
„ Malignant Purpuric 78 
„ Puerperal 450 
,, Relapsing 75 
„ Remittent 85 
„ „ , Infantile 488 
„ Scarlet 95 
„ Surgical 525 
„ Typhoid 71 
„ Typhus 69 
„ Yellow 76 
Fissure of Anus 284 
Fistula in ano 286 
„ lachrymalis 178 
Flatulence 252 
Flushes 455 
Fractures 528 
Fright, Effects of 529 
Furuncle 470 
Gall-stones 295 
Ganglion 485 
Gangrene, Traumatic 525 
„ Senile 530 
Gastric Fever 71 
Gastritis 237 
Gastrodynia 243 
Gastro-malacia 502 
General Paralysis, Spinal... 147 
„ „ of the Insane 128 
Giddiness 139 
Glanders 106 
Glaucoma 198 
Glossitis 217 
Glosso-laryngeal Paralysis 147 
PAGE 
Goitre 353 
• „ Exophthalmic 354 
Gonorrhoea 395 
Gonorrhoeal Rheumatism 67 
Gout 58 
„ Rheumatic 66 
Gravel 375 
Grief, Effects of 529 
Gum-boil 221 
Haematemesis 253 
Haematuria 379 
Haemoptysis 320 
Haemorrhage, Post-partum 443 
Haemorrhoids 279 
Hay-fever 300 
Hay-asthma 300 
Head, Injuries of 141 
Headache 133 
Heart-burn 251 
„ of Pregnancy... 434 
Heart, Diseases of 338 
„ Palpitation of 338 
„ Hypertrophy of. 339 
,, Dilatation of. 340 
„ Fatty Degeneration 
of 341 
„ Valvular Disease of 344 
Helminthiasis 286 
Hemeralopia 201 
Hemicrania 134 
Hemiplegia 146 
Hepatic Congestion 290 
Hepatitis 291 
Hernia 276 
„ in infants 521 
Herpes 461 
„ zoster 461 
,, circinnatus 462 
Hip-joint, Disease of 484 
Histrionic spasm of face ... 173 
Homoeopathic Practitioner, 
Duties of the 40 
Hooping-Cough 506 
Hordeolum 176 
Hydrocele 393 
Hydrocephalus, acute 490 
„ chronic ... 493 
Hydrometra 423 536 
INDEX 
PAGE 
Hydrophobia 104 
Hydro-thorax 332 
Hyperesthesia 166 
Hypochondriasis 129 
Hysteralgia 412 
Hysteria 166 
Icterus 294 
,, neonatorum 521 
Idiocy 128 
Ileus 274 
Impetigo 463 
Impotency 390 
Indigestion, acute 245 
„ chronic 246 
Influenza 299 
Infra-mammary Pain 334 
Insane, General Paralysis 
of the 128 
Insomnia 140 
Internal Ear, Diseases of... 215 
Intertrigo 519 
Intestines, Diseases of 255 
„ Ulceration of/... 258 
„ Cancer of 259 
„ Hemorrhage from 259 
„ Obstruction of 274 
Intussusception 275 
Iritis, Rheumatic 186 
„ Arthritic 188 
,, Syphilitic 188 
„ Traumatic 190 
Ischuria 379 
Itch 462 
Jaundice 294 
„ Malignant — 292 
Joints, Diseases of 482 
,, White Swelling of 483 
„ Hysterical 484 
„ Neuralgia in 484 
Keratitis 192 
Kidneys, Diseases of 355 
,, Granular Degene- 
ration of 363 
„ Amyloid Degene- 
ration of. 365 
Fatty „ 366 
PAGE 
Kidneys, Congestion of ... 378 
Labia, Acute Abscess of ... 425 
Lachrymal Apparatus, Dis- 
eases of 178 
Lachrymal Sac, Inflam- 
mation of 178 
Lactation, Disorders of ... 452 
Lacteals, Diseases of. 350 
Lagophthalmos 177 
Laryngismus stridulus 505 
Laryngitis 303 
Leucocythaemia 351 
Leucoma 193 
Leucorrhcea 416 
„ in children 519 
Lichen 464 
Lientero 264 
Lippitudo 176 
Lips, Cancer of 216 
Lithic Diathesis 375 
Liver, Diseases of. 290 
,, Abscess of 291 
„ Acute Atrophy of... 292 
„ Cirrhosis of 292 
„ Fatty Degeneration 
of 293 
„ Amyloid _ „ 293 
„ Pigmentary „ 294 
„ Cancer of 294 
Lochia, Morbid Conditions 
of 449 
Lock-jaw ., 173 
Locomotive Organs, Dis- 
eases of 475 
Locomotor Ataxy 148 
Lumbago 477 
Lumbrici 287 
Lungs, Abscess of 320 
„ Congestion of 320 
Lupus 466 
Lymphatics, Diseases of ... 350 
Lymphatic glands, Stru- 
mous enlargement of 515 
Male Sexual Organs, Dis- 
eases of 387 
Malignant Purpuric Fever 78 
„ 106 INDEX. 
537 
PAGE 
Mal-presentation 441 
Mammae,Chronic Tumourof 428 
Irritable Tumour 
of 428 
„ Scirrhus of ...... 429 
Mania 126 
„ Puerperal 452 
Mastitis 453 
• „ neonatorum 521 
Mastoid cells, Diseases of... 213 
,, process, Caries of 213 
Measles 93 
Melancholia 127 
„ puerperal 452 
Membrana Tympani, Affec- 
tions of 209 
Meningitis, Cerebral 114 
,, Tubercular ... 490 
„ Spinal 142 
„ Epidemic Cere- 
bro-Spinal... 78 
Menopausia, Sufferings of 455 
Menorrhagia 402 
Menstruation, Disorders of 402 
„ Infrequent 407 
„ Vicarious ... 408 
Mental Disorder 125 
„ „ in pregnancy 432 
Mesenteric Disease 516 
Metritis, Endo- 413 
„ Cervico- 413 
Migraine 134 
Miliaria 102 
Milk-abscess 453 
Miscarriage 437 
Mollities ossium 482 
Molluscum 467 
Morbus coxae 484 
Mouth, Diseases of 216, 496 
,, Ulcers of 216 
Muco-enteritis 256 
Magnet 496 
Mumps 222 
Muscles, Diseases of 475 
Muscles of the Eye-ball, 
Affections of 202 
Muscular Rheumatism 477 
Myalgia 475 
Mydriasis 194 
PAGE 
Myelitis 143 
Myopia 202 
Myositis 475 
Naevus 521 
Nail-matrix, Disease of ... 471 
Nasitis 297 
Nebula 193 
Necrosis 481 
Nephritis 357 
Nervousness 166 
Neuralgia 167 
,, intercostal ..;... 334 
Neuroses, The 151 
Nipples, Sore 453 
Nodes 479 
Noma pudendi 519 
Nymphomania 426 
Odontalgia 220 
(Edema Pulmonum 321 
(Esophagus, Diseases of ... 255 
Opacities of Cornea 193 
Ophthalmia, Arthritic 188 
„ Catarrhal 178 
„ Gonorrhoeal... 180 
„ neonatoruml80,496 
„ Purulent 181 
„ Rheumatic ... 185 
„ Strumous 183 
„ Syphilitic 188 
„ Tarsi 176 
Orchitis 387 
Ostitis 479 
Os Uteri, Diseases of 413 
Otalgia 211 
Otitis externa 205 
Otorrhoea 207 
Ovaries, Diseases of 398 
Ovaritis 398 
Ovarian Neuralgia 399 
„ Dropsy 401 
Oxaluria 376 
Ozsena 300 
Pain after food 249 
Pancreas, Diseases of 289 
Paralysis 145 
,, Agitans 150 538 
INDEX 
PAGE 
Paralysis, Facial 147 
„ General Spinal... 147 
„ Glosso-laryngeal 147 
„ Infantile 494 
„ Rheumatic 148 
,, Wasting 149 
Paraplegia , 147 
Parotitis 222 
Parturition, Disorders of... 440 
Parulis 221 
Pemphigus 463 
Penis, Diseases of 395 
„ Epithelioma of 398 
Pericarditis 312 
Periosteal Rheumatism ... 65 
Periostitis 478 
Peritonitis 287 
„ puerperal 451 
„ tubercular 504 
Peri-uterine Haematocele... 417 
Pertussis 506 
Pharyngitis 226 
Phlebitis 347 
„ Uterine 452 
Phlegmasia alba dolens ... 454 
Phosphatic Diathesis 376 
Photophobia 202 
Photopsia 202 
Phrenitis 116 
Phthisis Pulmonalis 323 
„ Laryngea 304, 327 
Piles 279 
Pityriasis 465 
Plague 77 
Plethora 43 
Pleurisy 330 
„ spurious 334 
Pleurodynia 333 
Plica Polonica 469 
Pneumonia 316 
Pneumo-thorax 333 
Polycholia 290 
Polypus aurium 208 
„ narium 302 
„ uteri 421 
Polyuria 374 
Porrigo capitis 520 
Post-partum Haemorrhage 443 
Pregnancy, Disorders of ... 431 
PAGE 
Presbyopia 202 
Proctitis 257 
Progressive Muscular Atro- 
phy 149 
Prosopalgia 170 
Prostatitis 395 
Prurigo 465 
Pruritus , 473 
Psoriasis 465 
Pterygium 192 
Ptosis 177 
Ptyalism 222 
„ in pregnancy 433 
Pudenda, Cancer of 425 
„ Noma of 519 
„ Pruritus of, 426, 437, 
473 
Puerperal State, Diseases of 448 
„ Convulsions 446 
„ Fever 450 
„ Mania 452 
„ Melancholia 452 
„ Peritonitis 451 
Pulmonary Apoplexy 321 
,, Cancer 329 
„ Syphilis 328 
Purpura 47 
Pustule, Malignant 106 
Pyaemia 348 
Pyelitis 380 
Quinsy 225 
Rachitis 487 
Relapsing Fever 75 
Remittent Fever 85 
,, ,, Bilious ... 86 
„ „ Infantile 488 
Repetition of Dose, The ... 32 
Respiratory Organs, Dis- 
eases of 297 
Retina, Affections of 198 
Retinitis 199 
Rheumatism 62 
,, Gonorrhoeal... 67 
Rheumatic Gout 66 
Rickets 487 
Ringworm of the scalp ... 520 
„ „ surface 462 
Roseola 460 INDEX. 
PAGE 
I Stomach, Cancer of 241 
„ Catarrh of 238 
„ Ulcer of 238 
I Stomatitis 496 
Strabismus 203 
Strains 526 
Strangury 383 
„ in children 518 
, Stricture of Urethra 384 
Strophulus 520 
Struma 51 
Stye 176 
Sunstroke 529 
Supra-renal capsules, Dis- 
ease of 352 
Sycosis H3 
„ menti 468 
Synovitis 483 
Syphilis 107 
„ hereditary 489 
Tabes mesenterica 516 
„ sicca 530 
Tape-worm 287 
Tarsal Tumours 177 
Teeth, Diseases of 220 
Testis, Diseases of 387 
„ Irritable 389 
„ Neuralgia of 389 
„ Retraction of. 394 
Tetanus 157 
Tetany 172 
Text-books, Homoeopathic 3 
Throat, Diseases of 223 
Throat-deafness 209 
Thyroid gland, Diseases of 352 
Tic-douloureux 170 
Tic-non-douloureux 170 
Tinnitus aurium 215 
Tongue, Diseases of 217 
„ Cancer of. 219 
,, Syphilis of 218 
„ Ulcer of 218 
Tonsils, enlarged 225 
Tonsillitis 225 
Toothache 220 
„ in pregnancy ... 433 
Torticollis 173 
Trismus 173 
539 
PAGE 
Rotheln 101 
Rubeola 93 
Rupia 433 
Salivary glands, Diseases of 222 
Salivation 222 
„ in pregnancy ... 433 
Sarcocele 388 
Scabies 462 
Scalds 526 
Scarlatina 95 
„ rheumatica 101 
Sciatica 171 
Scleroderma neonatorum... 521 
Scorbutus 47 
Scrofulosis 51 
Scrotum, Diseases of 395 
„ Epithelioma of ... 398 
„ Inflammation of 398 
Scurvy 47 
Sea-sickness 253 
Sexual Organs, Male, Dis- 
eases of 387 
„ ,, Female „ ... 399 
Shingles ‘ 461 
“ Similia Similibus” 13 
Sinking at the Stomach ... 456 
Skin, Diseases of 458 
Sleeplessness 140 
Small-pox 87 
Softening of the Brain 119 
Somnambulism 165 
Spasms 477 
Spermatic cord, Diseases of 393 
Spermatorrhoea 391 
Spinal Congestion 144 
„ Concussion 145 
„ Haemorrhage 145 
,, Irritation 144 
,, Meningitis 142 
Spleen, Diseases of 351 
„ Hypertrophy of ... 351 
Splenitis 351 
Stammering 498 
Sterility in the Female 427 
„ „ Male 391 
Stiff-neck 478 
Stings 528 
Stomach, Diseases of 236 540 
INDEX 
PAGE 
Trismus neonatorum 522 
Tuberculosis 52 
Tympanum, Affections of... 211 
Tympanic Mucous Mem- 
brane, Inflammation of 211 
Hypertrophy and Rigi- 
dity of. 212 
Tympanic Ossicles, Anchy- 
losis of 212 
Typhlitis 257 
Typhoid Fever 71 
Typhus 69 
„ icterodes 76 
Ulcers 472 
Urethra, Stricture of 385 
,, Vascular Tumour of 427 
Urinary Organs, Diseases of 355 
Urine, Retention of 383 
„ Suppression of 378 
Urticaria 460 
Uterus, Diseases of 411 
„ Cancer of 422 
„ Congestion of 411 
„ Displacements of 418 
„ Fibrous Tumour of 421 
„ Polypus of 421 
PAGE 
Vagina, Diseases of 424 
Vaginismus 424 
Vaginitis 424 
Varicella 92 
Varicocele 393 
Varicosis 348 
Variola 87 
Veins, Diseases of 347 
Vertigo 139 
Vision, Derangements of... 198 
Vomiting 252 
„ of Pregnancy ... 434 
Vulvitis 425 
Warts 467 
Wasting Palsy 149 
Water-brash 251 
White Leg 454 
Whitlow 471 
Worms 286 
Wounds 523 
Writer’s cramp 173 
Wry-neck 173 
Yellow fever 76 
Zona 461 
LONDON : PRINTED BY ,T. E. ADLARD, BARTHOLOMEW CLOSE.